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PubMed2005

Reliability and validity of the Kansas City cardiomyopathy questionnaire in patients with previous myocardial infarction.

BACKGROUND: The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a recently developed disease-specific instrument for measuring health-related quality of life (HRQoL) in patients with chronic heart failure (CHF) regardless of aetiology. AIM: To assess the reliability and validity of the KCCQ in patients with previous myocardial infarction (MI). METHODS AND RESULTS: In 754 myocardial infarction patients who were discharged alive, we collected clinical data from the patients' medical records. Two and a half years after the acute myocardial infarction, we mailed a self-administered questionnaire to the 548 patients still alive. The response rate was 74%. Internal consistency reliability, assessed with Cronbach's alpha, ranged 0.66-0.95. Test-retest reliability, tested with an intraclass correlation coefficient (ICC), ranged 0.41-0.83. The pattern of association between similar and dissimilar scales of the KCCQ and Short Form 36 (SF-36) supported the convergent/divergent validity of the KCCQ. Four of the KCCQ scales and the two summary scores discriminated between patients with and without medication for heart failure, and between different levels of left ventricular ejection fraction (LVEF) supporting different groups validity. CONCLUSIONS: The Norwegian version of the KCCQ showed acceptable reliability and cross-sectional validity, which support the use of this questionnaire to measure health-related quality of life after myocardial infarction.

Activities of Daily Living↗
PubMed2001

Immigration of insects into bins storing newly harvested wheat on 12 Kansas farms.

Adult insects entering 34 bins (36-238 t capacity) storing newly harvested hard red winter wheat on 12 farms in Kansas were sampled from July through December 1998 using ventilation traps. Insects moving through the grain stored in these bins were sampled using probe traps. During the fourth week of storage, probe traps captured Cryptolestes ferrugineus in all bins, Ahasverus advena in 32 bins, Typhaea stercorea in 31 bins, and Rhyzopertha dominica in 13 bins. Means+/-SE of 5.6+/-0.7 C. ferrugineus, 0.5+/-0.2 R. dominica, 3.5+/-0.3 A. advena, and 3.5+/-0.7T. stercorea were caught per day in probe traps. Ventilation traps provided a more direct measure than probe traps of the total numbers of insects entering bins storing newly harvested wheat. Immigration of A. advena and T. stercorea increased more than that of other species during the storage period, exceeding that of C. ferrugineus and R. dominica during some weeks. Rhyzopertha dominica had the lowest immigration rate. Bin size did not influence ventilation trap catch but as many as a third more insects may immigrate into large bins at the eaves compared with small bins because of their larger circumference. The mean numbers of C. ferrugineus, R. dominica, A. advena and T. stercorea captured in ventilation traps at the bin cap were 7.8, 2.7, 15.1 and 18.3 times, respectively, those captured in ventilation traps at the bin eaves. The estimated means+/-SE for total numbers of insects entering a bin each day were 13.6+/-4.2 C. ferrugineus, 6.3+/-4.7 R. dominica, 5.8+/-1.4 A. advena, and 21.9+/-8.2T. stercorea. Estimates of immigration rates can improve the accuracy with which insect densities are predicted using insect population growth models, and allow computer models to be used more effectively in managing insect pests. Insect infestations may be reduced by screening the openings between the bin cap and the roof, or the roof and the side walls.

Journal Article↗
PubMed2000

Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: a new health status measure for heart failure.

OBJECTIVES: To create a valid, sensitive, disease-specific health status measure for patients with congestive heart failure (CHF). BACKGROUND: Quantifying health status is becoming increasingly important for CHF. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a new, self-administered, 23-item questionnaire that quantifies physical limitations, symptoms, self-efficacy, social interference and quality of life. METHODS: To establish the performance characteristics of the KCCQ, two distinct patient cohorts were recruited: 70 stable and 59 decompensated CHF patients with ejection fractions of <40. Upon entry into the study, patients were administered the KCCQ, the Minnesota Living with Heart Failure Questionnaire and the Short Form-36 (SF-36). Questionnaires were repeated three months later. RESULTS: Convergent validity of each KCCQ domain was documented by comparison with available criterion standards (r = 0.46 to 0.74; p < 0.001 for all). Among those with stable CHF who remained stable by predefined criteria (n = 39), minimal changes in KCCQ domains were detected over three months of observation (mean change = 0.8 to 4.0 points, p = NS for all). In contrast, large changes in score were observed among patients whose decompensated CHF improved three months later (n = 39; mean change = 15.4 to 40.4 points, p < 0.01 for all). The sensitivity of the KCCQwas substantially greater than that of the Minnesota Living with Heart Failure and the SF-36 questionnaires. CONCLUSIONS: The KCCQis a valid, reliable and responsive health status measure for patients with CHF and may serve as a clinically meaningful outcome in cardiovascular research, patient management and quality assessment.

Activities of Daily Living↗
PubMedDate not supplied

[The Kansas City Cardiomyopathy Questionnaire (KCCQ) -- a new disease-specific quality of life measure for patients with chronic heart failure].

Patients' health-related quality of life is increasingly being included as an additional endpoint when evaluating the treatment of chronic heart failure. Although generic self-report instruments measuring health-related quality of life are available, there is a lack of disease-specific instruments covering various dimensions of quality of life with high reliability, validity and sensitivity to chance. Thus, the aim of the present study was to evaluate the German version of a new heart failure-specific quality of life measure, the Kansas City Cardiomyopathy Questionnaire (KCCQ). The sample consisted of 233 consecutively recruited outpatients of a university department in Germany. Test-retest-reliability was high (intraclass correlation coefficient 0.93 for both the Functional State and the Clinical Summary total scores). Construct validity was demonstrated with strong correlations to respective subscales of the SF-36. Known groups validity was shown by both statistically and clinically significant differences between NYHA classes. The examination of sensitivity to change yielded promising results. The questionnaire was well accepted by the participating patients. The KCCQ proved to be a reliable and valid self-report instrument for measuring disease-specific quality of life in chronic heart failure.

Aged↗
PubMed2026

Finerenone and quality of life in heart failure: component-level analyses and clinical relevance of the Kansas City cardiomyopathy questionnaire.

AIMS: Finerenone was shown to improve overall health status, as measured by the aggregate 23-item Kansas City Cardiomyopathy Questionnaire (KCCQ) score, in heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF). This study aimed to contextualize KCCQ changes in a manner that is relevant to patients and clinicians, thereby improving understanding of this metric in HFmrEF/HFpEF. METHODS AND RESULTS: In this prespecified analysis of FINEARTS-HF, a double-blind, randomized, placebo-controlled trial of finerenone in HFmrEF/HFpEF, we performed exploratory assessments of treatment effects on mean score changes from baseline to 12 months for each of the 23 KCCQ components (scaled from 0 [worst] to 100 [best]) using multivariable linear regression. We further compared the impact of finerenone on the KCCQ-overall summary score (KCCQ-OSS) at 12 months with the expected decline per year. Of 6001 participants in FINEARTS-HF, 5006 completed the KCCQ both at baseline and 12 months (age: 72 &#xb1; 10 years, women: 45%, baseline KCCQ-OSS: 63.9 &#xb1; 22.0). Finerenone, compared with placebo, numerically improved all but one KCCQ component, with the greatest nominal improvement observed in lower limb oedema frequency (+2.5, 95% CI: 0.9-4.1), fatigue burden (+2.2, 95% CI: 0.9-3.5), fatigue frequency (+2.1, 95% CI: 0.7-3.6), and lower limb oedema burden (+1.8, 95% CI: 0.6-2.9). KCCQ-OSS at 12 months was inversely related to age, with finerenone shifting the age-KCCQ-OSS relationship by 4.7 (95% CI: 0.4-9.1) years. CONCLUSIONS: In FINEARTS-HF, finerenone was associated with modest improvements in health status-most notably lower limb oedema and fatigue-in patients with HFmrEF/HFpEF.

Humans↗
PubMed1989

Flight behavior of Musca domestica and Stomoxys calcitrans (Diptera: Muscidae) in a Kansas dairy barn.

Aerial density, flight thresholds, and periodicity were estimated for the house fly, Musca domestica L., and the stable fly, Stomoxys calcitrans (L.), from data collected by suction traps located in a dairy barn in Kansas between 1 July and 31 October 1970. M. domestica catches increased from July to August, declining to near zero by the end of October. S. calcitrans catches peaked in July and September with a major decline in August. Both species exhibited a diel periodicity in flight with maximal activity during the early afternoon. Secondary peaks were detected in the late afternoon or early evening. M. domestica activity peaked about two hours after S. calcitrans. Male and female S. calcitrans flight activity patterns were slightly different, but peaked at the same time. Both species flew at temperatures between 20 and 38 degrees C. At temperatures over 33 degrees C, stable fly activity decreased rapidly. No upper threshold for flight by M. domestica was detected. The median temperature-flight thresholds of male and female S. calcitrans were significantly different, with females flying at lower temperatures than males. The threshold for M. domestica flight was lower than for S. calcitrans. The shape of the temperature-flight relationship indicated that the flight threshold was determined by heat accumulation.

Animals↗
PubMed1985

Foodborne streptococcal pharyngitis Kansas City, Missouri.

A foodborne outbreak of streptococcal pharyngitis occurred in association with a meeting of regional blood banking personnel held at a hotel in Kansas City, Missouri, on May 31-June 1, 1984. The incriminated meal was a salad buffet luncheon served on May 31. Of 106 persons identified as eating the luncheon, 60 (56.6 per cent) became ill. The most probable source of infection was an assortment of mousse desserts (p = 0.0532).

Disease Outbreaks↗
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↗
PubMed1988

Delta hepatitis: first two cases identified in Kansas City.

Hepatitis delta virus (HDV) was identified in 1977 and has since been found to be a worldwide disease. Prevalence in North America is highest among drug abusers. We present two IV drug abusers from the city hospital in Kansas City as the first two cases identified in the city, one with apparent superinfection and the other with a chronic HDV infection. We review the various manifestations and diagnosis of HDV, and advocate prevention of spread of HDV infection by hepatitis B vaccination and use of single donor blood products in high-risk patients.

Acute Disease↗
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↗
PubMed1983

C(3) Photosynthesis and Crassulacean Acid Metabolism in a Kansas Rock Outcrop Succulent, Talinum calycinum Engelm. (Portulacaceae).

The potential for Crassulacean acid metabolism (CAM) was investigated in the sandstone outcrop succulent Talinum calycinum in central Kansas. Field studies revealed CAM-like diurnal acid fluctuations in these plants. These fluctuations persisted under all moisture and temperature regimes in the laboratory. Despite this CAM-like acid metabolism, simultaneous gravimetric determinations of day- and nighttime transpiration rates indicated the presence of a C(3) gas exchange pattern. Subsequent analyses of diurnal CO(2) and H(2)O exchange patterns under well-watered conditions and after 3, 5, and 7 days of drought confirmed these findings, though low rates of nocturnal CO(2) uptake were observed on the fifth night after continuous drought. Finally, the delta(13)C/(12)C value of this succulent, -27.8 per thousand, emphasizes the insignificance of any nocturnal CO(2) uptake in the lifelong accumulation of carbon in this species. Thus, it is proposed that T. calycinum is a C(3) plant with some CAM characteristics, including the ability to re-fix respiratory CO(2) at night under all moisture regimes, potentially resulting in a conservation of carbon, and occasionally to fix atmospheric CO(2) at night. These findings may prove to be common among rock outcrop succulents.

Journal Article↗
PubMed2006

Variations in health insurance coverage for rural and urban nonelderly adult residents of Florida, Indiana, and Kansas.

CONTEXT: Evidence exists for differences in health insurance coverage among states, but less is known about variations across different kinds of communities within states. PURPOSE: This article assesses the role of residential setting (metropolitan county, rural adjacent, and rural nonadjacent) in health insurance coverage for adult residents, under age 65, using data from large-scale surveys collected in 3 diverse states (Florida, Indiana, and Kansas). METHODS: Descriptive statistics are provided, and logistic regression models are used to examine the relationship between uninsurance status and residential settings while controlling for personal characteristics. Adjusted uninsurance rates by residential settings are presented for each state. FINDINGS: Residential settings are significantly associated with uninsurance status in 2 of the 3 states we examined. We find that adult Floridians of rural adjacent counties are more likely to be uninsured than those in urban counties, but, for Indiana residents, uninsurance status is comparable between urban and rural adjacent residents. Rural nonadjacent Indiana residents are more likely to be uninsured compared to those in urban counties. The insurance status of adult Kansans does not vary across residential settings. CONCLUSION: Residential settings are significantly associated with being uninsured, but the significance of this link between residential locations and uninsurance status varies from state to state.

Adolescent↗
PubMed1996

Acetogenic capacities and the anaerobic turnover of carbon in a kansas prairie soil.

To assess the anaerobic capacities of a temperate grassland soil, a Kansas prairie soil was incubated anaerobically as either soil-water (1:2) suspensions or as soil microcosms at 78% soil water-holding capacity. Prairie soil formed acetate and CO(inf2) as the two main initial carbonaceous products from the anaerobic turnover of endogenous organic matter. Metabolic capacities of soil suspensions and microcosms were similar. Rates of acetate formation from endogenous organic matter in soil-water suspensions incubated at 40, 30, and 15(deg)C approximated 3.3, 2.4, and 1.1 (mu)g of acetate per g (dry weight) of soil per h, respectively. Supplemental H(inf2) and CO(inf2) were subject to consumption with the apparent concomitant synthesis of acetate in both soil suspensions and soil microcosms. In soil microcosms, rates of H(inf2)-dependent acetogenesis at 30 and 55(deg)C were nearly equivalent. The uptake of supplemental H(inf2) was not coupled to methanogenesis under any condition examined. These anaerobic activities were relatively stable when soils were subjected to either aerobic drying or alternating periods of O(inf2) enrichment. On the basis of the formation of nitrogen (N(inf2)), denitrification was engaged during anaerobic incubation periods; nitrous oxide (N(inf2)O) was also formed under certain conditions. Although extended incubation of soil induced the delayed methanogenic turnover of acetate, acetate was subject to immediate turnover under either O(inf2)- or nitrate-enriched conditions. These studies support the following concepts: (i) obligately anaerobic bacteria such as acetogenic bacteria are stable to periods of aerobiosis and are active in the anaerobic microsites of oxic soils, and (ii) acetate synthesized in anaerobic microsites of oxic terrestrial soils constitutes a trophic link to both aerobic and anaerobic microbial communities.

Journal Article↗
PubMed1970

Preservation of Borrelia kansas and Plasmodium berghei.

Borrelia kansas and Plasmodium berghei have been stored after slow freezing in thioglycollate-glycerol medium for a 6-month period. During this time, 75% or more of the Borrelia remained motile, many intracellular malarial parasites exhibited amoeboid movement, and the growth pattern of both organisms in mice remained unchanged.

Animals↗
PubMed1993

Curricular integration at the University of Missouri-Kansas City School of Medicine.

In its combined Baccalaureate-M.D. degree program, the University of Missouri-Kansas City School of Medicine endeavors to foster interdisciplinary integration by intertwining the humanities, clinical medicine, and basic sciences throughout the curriculum. Analysis over 6 years (1986-1991) of 547 students' scores on comprehensive examinations and ratings of 464 to 478 graduates' clinical abilities suggest that the integrative elements of the curriculum have a counterpart in performance. Such experience would recommend possible steps to encourage interdisciplinary integration at other schools: allow students to acquire disciplinary understandings but offer early clinical exposure for context and relevance, arrange productive repetition of material, pair more with less advanced students for integrated learning, and choose faculty who model integration and expect students to do so.

Adult↗
PubMed2004

Application and revision of the Kansas marital satisfaction scale for use with Korean couples.

To apply the Kansas Marital Satisfaction Scale to Korean couples, one item about the parenting role was added to the original scale. Using survey data from 350 married couples from the urban area of Seoul, Korea, this study investigated the availability of the original and revised forms in Korea. Values of internal consistency of responding, means, standard deviations and Pearson rs for both scales were remarkably consistent in the Korean sample and were good assessments of key dimensions of the marital process of Korean couples with children.

Adult↗
PubMed1999

Salmonella outbreaks in the Kansas City metropolitan area: varying presentations.

Four outbreaks of Salmonella in the Kansas City metropolitan area between 1996 and 1998 are used to illustrate changes in the epidemiology of foodborne diseases and recognition by public health authorities. Physicians are the critical link in the recognition of foodborne outbreaks, and that linkage is tied directly to their index of suspicion and the appropriate collection and testing of specimens from their patients, as well as notification of the local health department.

Disease Outbreaks↗