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At least 199 records · Page 11Linked to original sources
PubMed1990

An assessment of the student partnership program at the University of Missouri-Kansas City School of Medicine.

The partnership program at the University of Missouri-Kansas City (UMKC) School of Medicine pairs less experienced students with more experienced students to work together during the last four years of a six-year curriculum. The present study has explored how the partnership program is supposed to work, whether in reality it does work, what function it actually serves, and under what circumstances it operates best. In 1986 and 1987, the authors analyzed information from formal school documents, created and used questionnaires for the students and faculty, conducted semistructured interviews with selected students, and used the results of an annual survey, begun in 1978, of supervisors of first-year students who graduated from UMKC. The students and docents were found to favor the partnership system and reported that most partnerships worked well. The system's chief outcome is seen to be teaching teamwork: learning from and working together with student partners. The characteristics of the students, docents, and setting that contributed to successful partnerships are identified. The authors conclude that the partnership system at UMKC does achieve its objectives, which are described.

Attitude↗
PubMed1982

129I in Missouri thyroids.

Concentrations of 129I and values of the 129I/127I ration are reported in one sample of indigenous vegetation and in over forty additional individual thyroids of man, wild deer and beef cattle in Missouri. The results of this and other studies in our laboratory indicate the following order for successively lower values of 129I/127I ratios in the local environment: Rain, wild deer, commercial milk, beef cattle and human. The value of the 129I/127I ratio in the single vegetation sample is intermediate to the mean values in wild deer and commercial milk, but well within the range of values observed in both. These results are consistent with a geochemical cycle in which iodine that is enriched in 129I is transported via air into the central U.S. and then diluted with other iodine--especially mineral iodine that is added to the diets of domesticated animals--as the iodine deposited from air moves through the local ecosystem. Differences in the diets of beef and dairy cattle or differences in the biological life-times of iodine in thyroids and mammae, and hence the degree of equilibration with body iodine, may explain the lower value of the 129I/127I ratio in beef thyroids than in milk.

Animals↗
PubMed1995

A comparison of results for the University of Missouri Research Reactor radiological airborne release assessments obtained from PC-based computer programs.

The United States Environmental Protection Agency has published three computer programs, COMPLY, AIRDOS-PC, and CAP88-PC, to assist the regulated community in determining compliance with the Environmental Protection Agency radionuclide air emission standards. The programs calculate radiation doses from routine airborne release to the general public residing outside a nuclear facility site. They consider doses from inhalation, ingestion of contaminated food, air immersion, and ground deposition. A PC-based computer code, XOQDOQ-82, developed for the Nuclear Regulatory Commission, was also chosen to compare and evaluate dispersion results from the Environmental Protection Agency codes for the University of Missouri Research Reactor Center. Effects of building parameters, terrain conditions, and downwind distances on dispersion factors were calculated. The results of this study indicated that dispersion factors calculated using AIRDOS-PC and CAP88-PC were several times lower than those calculated using XOQDOQ-82 at all distances, and those dispersion factors calculated using COMPLY were several times lower than the XOQDOQ-82 values at distances greater than 600 m.

Air Pollutants, Radioactive↗
PubMed1977

Technology evaluation: a case study of MARS (Missouri Automated Radiology System).

A health care technology evaluation framework is presented along with its application to the Missouri Automated Radiology System (MARS) project. The framework is made up of the following components: evaluation objectives, evaluation design, system documentation, analysis model, evaluation measures, and data collection. The results of applying the framework indicate that MARS incerases the cost of diagnostic radiology 2.3 per cent, significantly decreases report response time, and successfully performs the film management function.

Attitude of Health Personnel↗
PubMed1999

Perceived monogamy and type of clinic as barriers to seeking care for suspected STD or HIV infection: results from a brief survey of low-income women attending Women, Infants, and Children (WIC) clinics in Missouri.

BACKGROUND AND OBJECTIVES: Barriers to seeking care for sexually transmitted diseases (STDs) have not been assessed for low-income women. We sought to determine barriers to seeking care for STDs among women receiving Women, Infants, and Children (WIC) benefits in 21 Missouri counties. GOAL OF THIS STUDY: Provide information for promoting care-seeking behavior among low-income women suspecting STD infection. STUDY DESIGN: A survey of 2,256 women was conducted; 491 reported a history of at least one STD. These women indicated possible barriers to seeing a doctor about a suspected STD and preference for type of clinic providing STD services. RESULTS: More than one fifth (21.3%) of those reporting an STD also reported at least one barrier to seeing a doctor about suspected STD or human immunodeficiency virus infection. Among those reporting barriers, the most common barrier was "I only have sex with my steady" (36.2%) followed by being asymptomatic (33.3%), embarrassment (22.8%), and cost (25.7%). Most (63.8%) preferred seeing their own doctor, with others reporting preference for community health centers (14.8%), family planning clinics (16.8%), and STD clinics (4.6%). CONCLUSIONS: Low-income women experience multiple barriers to seeking care including perceptions about a protective value of monogamy. Also, STD services in locations providing other health services for women were preferred.

Adolescent↗
PubMed1996

Substance abuse and dependence in physicians: the Missouri Physicians' Health Program.

Substance abuse and dependence (alcohol and drugs) are behavioral disorders and treatable medical diseases. There is growing concern in the medical community for physicians impaired by these diseases. The Missouri Physicians' Health Program has been established to help impaired physicians return to healthy personal and professional lives. This confidential voluntary program of early referral, intervention, treatment, monitoring, and advocacy has been highly successful. The average recovery rate in this study of 146 participants was 94%.

Female↗
PubMed1997

Cardiovascular disease control efforts among local health departments in Missouri: four-year trends and policy implications.

Knowledge, attitudes, and activities in cardiovascular disease (CVD) control among local health departments in Missouri were surveyed in 1990 and in 1994, following four years of a community-based CVD risk-reduction project. Hypertension screening was rated as the most frequently performed CVD-related activity in 1990 and in 1994. Differences in mean scores between baseline and follow-up surveys showed no significant changes except for cholesterol screening. Respondents preferred individual patient education rather than community-wide approaches to risk reduction. Our findings highlight the need for more emphasis on coalition building and community-based programs for preventing and controlling CVD at the local health department level.

Cardiovascular Diseases↗
PubMed1997

Family Violence Councils: the Missouri model.

The burden for dealing with family violence and its related problems is steadily being shifted toward local communities. Together, the Office of Injury Control in the Missouri Department of Health and National Center for Violence Prevention developed a comprehensive, multidisciplinary approach to help local communities address family violence--the Family Violence Council. The council provides a coordinated structure within the community for protocol and service development and resource sharing. Some of the lessons learned include the importance of moving beyond family violence as a "women's issue," grooming local leadership, and fostering early success by setting achievable goals.

Adult↗
PubMed1998

Organizational problems faced by the Missouri DOH in providing disaster relief during the 1993 floods.

This case study examines the organizational problems of Missouri Department of Health (DOH) while providing flood relief in 1993. It reveals low awareness of DOH's emergency plan, disorganized information collection, and perceptions that federal flood relief was "resource-driven," not "need-driven." Lessons for other health departments are (1) Information collection during disasters should be centralized. (2) Health departments should train district offices to carry out their emergency plan, and include local health departments in emergency planning. (3) Federal and state agencies providing emergency aid should be sensitive to the needs of district and local health departments.

Disaster Planning↗
PubMed1999

Assessing excess deaths in St. Louis, Missouri: 1980 to 1994.

Excess deaths in the city of St. Louis from 1980 to 1994, their trends over time, and racial death patterns were assessed using the CDC's Wonder mortality database. Death rates in the city were compared with the three lowest statistically valid county death rates in the state of Missouri. The number and percent of preventable deaths in the city population also were estimated. Findings show that approximately 50 percent of city deaths from the nine leading causes may be preventable.

Adolescent↗
PubMed2006

Problem-based learning outcomes: ten years of experience at the University of Missouri-Columbia School of Medicine.

PURPOSE: To add to a previous publication from the University of Missouri-Columbia School of Medicine (UMCSOM) on students' improvement in United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores after the implementation of a problem-based learning (PBL) curriculum by studying the performance of ten PBL class cohorts at the UMCSOM. METHOD: Characteristics of graduating classes matriculating in both traditional and PBL curricula, 1993-2006, were compared for Medical College Admission Test component scores, undergraduate grade point averages, performance on the USMLE Step 1 and Step 2 exams, faculty contact hours, and residency directors' evaluations of UMCSOM graduates' performance in the first year of residency. RESULTS: Mean scores of six of the ten comparisons for USMLE Step 1 and six of nine comparisons for USMLE Step 2 are significantly higher (p < .01) for UMCSOM PBL students than for first-time examinees nationally. These differences cannot be accounted for by preselection of academically advantaged students, increased time on task, or reduced class size. Gains in performance continue into residency, as evidenced by program directors' perceptions of superior performance of UMCSOM PBL graduates. CONCLUSIONS: The PBL curricular changes implemented with the graduating class of 1997 resulted in higher performances on USMLEs and improved evaluations from residency program directors. These changes better prepare graduates with knowledge and skills needed to practice within a complex health care system. Outcomes reported here support the investment of financial and human resources in our PBL curriculum.

Academic Medical Centers↗
PubMed2004

The emergence of Neisseria gonorrhoeae with decreased susceptibility to Azithromycin in Kansas City, Missouri, 1999 to 2000.

BACKGROUND AND OBJECTIVES: We describe the first cluster of persons with Neisseria gonorrhoeae with decreased susceptibility to azithromycin (AziDS; minimum inhibitory concentration >/=1.0 microg/mL) in the United States. GOAL The goal of this study was to identify risk factors for AziDS N. gonorrhoeae and to describe isolate microbiology. STUDY DESIGN: Persons with AziDS N. gonorrhoeae (cases) were identified in Kansas City, Missouri, through the Gonococcal Isolate Surveillance Project (GISP) in 1999 and expanded surveillance, January 2000 to June 2001. A case-control study using 1999 GISP participants was conducted; control subjects had azithromycin-susceptible N. gonorrhoeae. RESULTS: Thirty-three persons with AziDS N. gonorrhoeae were identified. Case patients were older than control patients (median age, 33 years vs. 23 years; P <0.001). Fifty percent of cases and 13% of control subjects had a history of sex with a female commercial sex worker (odds ratio, 7.0; 95% confidence interval, 1.3-36.0); 50% of cases and 4% of control subjects met sex partners on street A (P <0.01). AziDS N. gonorrhoeae isolates were phenotypically and genotypically similar and contained an mtrR gene mutation. CONCLUSIONS: With few treatment options remaining, surveillance for antimicrobial-resistant N. gonorrhoeae is increasingly important, especially among persons at high risk.

Adolescent↗
PubMedDate not supplied

The Spanish influenza of 1918 in St. Louis, Missouri.

In view of current concern about a possible pandemic of virulent avian influenza, it is timely to revisit the public health response to the "Spanish" influenza of 1918. St. Louis, Missouri, was the most successful of nine largest cities in limiting the death toll from influenza and pneumonia through the use of public health measures during the first 8 weeks of the epidemic. A second wave of cases increased the final death rate, but it remained below that of other major cities. Public health officials attributed the lower death rate to the early and rigorous ban on public gatherings.

Communicable Disease Control↗
PubMed1994

Nutrition education in Missouri schools.

This survey examined the status of nutrition education in Missouri schools, profiled teacher preparation in nutrition, and identified teacher preferences for additional nutrition education resources. Questionnaires were mailed to a systematic sample of 1,664 teachers representing different grade levels K-12 and subject areas including biological science, health, home economics, and physical education. Responses from 793 teachers indicated most integrated nutrition into other subjects such as health and science. Almost all taught the concept of food groups. Teachers expressed a need for materials on a range of concepts and preferred the videotape format. About one-third of elementary teachers reported completing a college-level nutrition course: 70% of secondary teachers had completed such a course. Results indicate the need for materials to integrate nutrition into various subjects and encourage teaching on concepts beyond the food groups.

Curriculum↗
PubMed1993

Stress and coping among Missouri rural and urban children.

A cross-sectional survey using a convenience sample of 157 Missouri rural and urban children (ages 8-13 years) yielded no significant differences in perceptions of stressors or use of coping strategies for dealing with those stressors between rural and urban children. The Feel Bad Scale and the Schoolagers' Coping Strategies Inventory measured the children's perceptions of stressors and use of coping strategies. Rural children experienced stressor levels equivalent to urban children, yet they were underserved in mental and physical health needs. The children studied reported self-care through coping strategies for management of their stressors. Longitudinal research is needed to identify the impact of stress and interventions on the health and behavior of children in rural settings.

Adaptation, Psychological↗
PubMed2002

Distribution of services and supports for people with traumatic brain injury in rural and urban Missouri.

New paradigms of disability suggest that many variables interact to influence the community functioning of people with traumatic brain injury (TBI), including injury severity and social, psychological, and environmental factors. Unfortunately, the majority of TBI outcome research to date has primarily focused on injury severity variables (e.g., neuroradiologic findings, loss of consciousness, posttraumatic amnesia) to the exclusion of environmental variables. Limited environmental resources such as rehabilitation professionals, facilities, and services may be significant barriers that affect outcome for people with TBI, particularly for those in rural areas. Using data from Missouri, where 32% of the population lives in rural counties, this study researched the availability of rehabilitation resources for individuals with TBI, with an emphasis on differences between rural and urban areas. Data indicated that there is a scarcity of rehabilitation professionals (i.e., physiatrists, mental health providers, rehabilitation therapists),facilities (i.e., hospitals offering comprehensive rehabilitation therapies), and services (i.e., support groups) in rural areas of the study state. The results suggest that (1) future rehabilitation researchers need to evaluate the impact of accessibility to rehabilitation services and resources on the outcome of people with TBI and (2) TBI health policy administrators need to consider how to increase rehabilitation resources for people with TBI in rural areas, including the use of rural-based training programs, rural debt-forgiveness training programs, and telehealth systems.

Brain Injuries↗
PubMed1990

The Missouri Elks Mobile Dental Program--dental care for developmentally disabled persons.

This article describes the origins, funding, organization, operation, utilization, and outreach program of a statewide mobile dental program for the disabled in Missouri. The article includes information based on analysis of productivity reports and patient records. Comparisons are made between the utilization by mentally retarded (MR) and other disabled patients (MCCS), their county of residence, and the location where service was provided (rural vs urban). The mean number of dental procedures provided per client was 7.3. More procedures (8.35) were provided to urban clients than rural clients (5.81). The utilization rate of urban MR clients was 63.9 percent, compared to 60 percent for rural MR clients. Other findings show 10.7 percent urban MCCS clients utilized the mobile dental program, versus 13.5 percent of the rural MCCS clients. The budgeted expenditures for providing care to this underserved group were $46,000 less than the estimated value of dental care provided in a private practice setting.

Adolescent↗
PubMed2003

Detection of Ehrlichia spp. in the blood of wild white-tailed deer in Missouri by PCR assay and serologic analysis.

Blood samples collected from wild deer in Missouri in November of 2000 and 2001 were positive by PCR assays for Ehrlichia chaffeensis (50 of 217; 23%), Ehrlichia ewingii (44 of 217; 20%), and Anaplasma species (214 of 217; 99%). Nucleotide sequences of selected amplicons from the assay for anaplasma matched sequences of the white-tailed deer agent. Serologic analysis of 112 deer sampled in 2000 showed a very high prevalence of antibodies to E. chaffeensis (97 of 112; 87%) and a low prevalence of antibodies reactive with Anaplasma phagocytophila (2 of 112; 2%).

Animal Diseases↗