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At least 217 records · Page 12Linked to original sources
PubMed2006

Association of ventricular arrhythmias detected by implantable cardioverter defibrillator and ambient air pollutants in the St Louis, Missouri metropolitan area.

BACKGROUND: It has previously been reported that the risk of ventricular arrhythmias is positively associated with ambient air pollution among patients with implantable cardioverter defibrillators (ICD) in Boston. AIMS: To assess the association of community exposures to air pollution with ventricular arrhythmias in a cohort of ICD patients in metropolitan St Louis, Missouri. METHODS: ICD detected episodes reported during clinical follow up were abstracted and reviewed by an electrophysiologist to identify ventricular arrhythmias. A total of 139 ventricular arrhythmias were identified among 56 patients. A case-crossover design was used with control periods matched on weekday and hour of the day within the same calendar month. Conditional logistic regression models were adjusted for temperature, barometric pressure, and relative humidity in the 24 hours preceding the event. RESULTS: There was a significant (24%, 95% CI 7% to 44%) increase in risk of ventricular arrhythmias associated with each 5 ppb increase in mean sulphur dioxide and non-significantly increased risk (22%, 95% CI -6% to 60%; and 18%, 95% CI -7% to 50%) associated with increases in nitrogen dioxide (6 ppb) and elemental carbon (0.5 microg/m3), respectively in the 24 hours before the arrhythmia. CONCLUSIONS: These results provide evidence of an association between ventricular arrhythmias and ambient air pollutants in St Louis. This is consistent with previous results from Boston, although the pollutants responsible for the increased risk are different.

Adult↗
PubMed2003

Mortality in workers in poultry slaughtering/processing plants: the Missouri poultry cohort study.

BACKGROUND: Subjects who work in poultry slaughtering and processing plants have one of the highest human exposures to viruses that cause cancer in chickens and turkeys. It is not known whether these viruses cause cancer in humans also. Epidemiological studies investigating this issue are scarce. AIMS AND METHODS: Mortality was studied during the period 1969-90 in a cohort of 7700 subjects who worked in poultry slaughtering and processing plants and were members of a local poultry union in the State of Missouri. RESULTS AND CONCLUSIONS: Statistically significant excess risks of non-malignant respiratory diseases, accidents, and symptoms, senility, and ill-defined conditions, and increased but not statistically significant excesses for some cancers were observed in particular race/sex groups. Most of these results were based on small numbers of deaths, and in many cases were evident only in particular subgroups of the cohort. Because of this and the multiple comparisons made, chance could not be ruled out in explaining the findings. Furthermore, the cohort is young, with only 6% deceased at the end of follow up. Further follow up of this cohort is required before a reliable assessment of the potential risk associated with these viruses can be made.

Abattoirs↗
PubMed1987

Is nursing a profession? Results of a Missouri study.

This article examines the question of whether or not nursing is or should be a profession. The conclusion is based primarily on an analysis of what constitutes a profession and an empirical study of some nursing practices and attitudes. The analysis of professions recognizes three prominent models in sociology: trait, functional, and power or control. It bypasses these in favor of a "cluster concept," which asserts that the public has a number of expectations of an occupation before it will bestow the status of profession upon it. We then give an analysis of some of the results of the survey of a sample of Missouri registered nurses. The gist of the data is said to reflect the facts that these nurses think nursing is or should be a profession, but that other factors tend to show that nursing lacks the requisite cluster to substantiate the claim to be a profession. We conclude that nursing should perhaps not be a profession since it has been a bastion of the "ethics of compassion" in a world that is increasingly beset by an "ethics of competence."

Attitude of Health Personnel↗
PubMed2005

Characterization of solid waste disposed at Columbia Sanitary Landfill in Missouri.

Waste sorts were conducted during each of the four quarters (or seasons) of 1996 at the City of Columbia Sanitary Landfill. A detailed physical sampling protocol was outlined. Weight fractions of 32 waste components were quantified from all geographic areas that contribute to the Columbia Sanitary Landfill using a two-way stratification method, which accounted for variations in geographical regions and seasons. Comparisons of solid waste generated between locations and seasons were conducted at the 80% confidence level. The composition of the entire waste stream was 41% paper, 21% organic, 16% plastic, 6% metal, 3% glass and 13% other waste. Paper was the largest composition and glass was the smallest composition for all geographical regions. The result of this study was also compared with a 1987 Columbia, Missouri study conducted by EIERA (1987), with studies conducted in other states such as Minnesota, Wisconsin, Oregon and with national study conducted by the USEPA (USEPA 530-R-96-001, PB96-152 160. US Environmental Protection Agency, Office of Solid Waste, Washington, DC). The results of studies from other states are different from this study due to different local conditions, different methodologies and a different scope. There was a small (5%) increase in per capita weight from 1987 to 1996. The total per capita weight in the present study was 60% greater than the national per capita weight reported by the USEPA (1996) due to that the USEPA report excluded industrial, construction and certain commercial waste. The total per capita weight agrees with the national per capita weight for municipal waste reported by Tchobanoglous (1993), which included industrial, construction and commercial sources. The geographical and seasonal effects on the waste composition are evaluated and discussed. Statistical analysis indicates that waste characteristics are different among geographical regions and seasons. The potential for waste recovery and reduction is also discussed.

Conservation of Natural Resources↗
PubMed1997

A descriptive study of breastfeeding practices and policies in Missouri hospitals.

All Missouri hospitals that offer maternity services were assessed to measure their compliance with WHO/UNICEF Baby Friendly Hospital Initiative (BFHI). Representatives from seventy six hospitals responded to a telephone survey relating to hospital breastfeeding practices and policies as defined by BFHI's Ten Steps to Successful Breastfeeding. No hospital fully supported the Ten Steps. Compliance with the WHO/UNICEF criteria varied greatly. The least support was for Step I, only 28% of hospitals had a written breastfeeding policy that was communicated to all staff. The greatest support was for Step 3, 93% of hospitals had staff who informed all pregnant women of breastfeeding benefits. In order to increase breastfeeding rates and duration, administrators of hospitals that offer maternity services must increase their efforts to consistently implement the Ten Steps, to become more baby friendly, and to more fully establish a breastfeeding culture within their institutions.

Breast Feeding↗
PubMed1989

Antimicrobial susceptibility and serotypes of Actinobacillus (Haemophilus) pleuropneumoniae recovered from Missouri swine.

The antimicrobial susceptibility of 73 Actinobacillus (Haemophilus) pleuropneumoniae isolates from swine in Missouri was determined with a microdilution minimal inhibitory concentration test system. Serotyping was accomplished by means of co-agglutination. Serotype 1 (39/73) and serotype 5 (30/73) were commonly found, whereas serotype 7 (4/73) was infrequently encountered. Most isolates (MIC90) were found susceptible to ampicillin (amoxicillin), cephalothin, penicillin, erythromycin, gentamicin, and kanamycin. Marked resistance was found with oxytetracycline, tylosin, and sulfadimethoxine. The data indicate that use of ampicillin (amoxicillin) or penicillin may correlate well with the favorable outcome of treatment.

Animals↗
PubMed2006

If you build it, they will come: lessons from developing walking trails in rural Missouri.

Given the high rates of sedentary behaviors, attempts to increase physical activity have incorporated individual and, more recently, policy and environmental approaches for promotion of activity. This article presents a summary of the approaches being used by the Ozark Heart Health Coalitions in developing walking trails in rural Missouri. In summarizing these approaches the authors describe 10 lessons with the aim of articulating the process and, thereby, increasing interest and capacity in development of walking trails. Qualitative and quantitative data were used to show burden and priorities and build support with numerous stakeholders. Stakeholders were engaged to identify common objectives, obtain land and funding, and determine trail size, materials, and time needed for construction. Implementation activities focused on trail maintenance and addition of amenities (e.g., playgrounds, benches). In the area of evaluation, they collect data via interviews with walkers on trails and community telephone surveys.

Community-Based Participatory Research↗
PubMed1979

Cadmium in forest ecosystems around lead smelters in Missouri.

The development of Missouri's new lead belt within the past decase has provided an excellent opportunity to study the dissemination and effects of heavy metals in a deciduous forest ecosystem. Primary lead smelters within the new lead belt have been identified as potential sources of cadmium as well as lead, zinc, and copper. Sintering and blast furnace operations tend to produce significant quantities of small particulates highly enriched in cadmium and other heavy metals. At one smelter, samples of stack particulate emissions indicate that as ms accompanied by 0.44 lb zinc, 4.66 lb lead, and 0.01 lb copper/hr. These point-source emissions, as well as a number of other sources of fugitive (wind blown) and waterborne emissions contribute to a significant deposition of cadmium in the surrounding forest and stream beds. Mobilization of vagrant heavy metals may be significantly increased by contact of baghouse dusts or scrubber slurries with acidic effluents emanating from acid plants designed to produce H2SO4 as a smelter by-product. Two separate drainage forks within the Crooked Creek watershed permit some comparisons of the relative contributions of cadmium by air-borne versus water-borne contaminants. Cadmium and other heavy metals have been found to accumulate in the forest litter and partially decomposed litter along stream beds. Greater solubility, lower levels of complexation with organic ligands in the litter, and greater overall mobility of cadmium compared with lead, zinc, and copper result in appreciable contributions of dissolved cadmium to the watershed runoff. The present paper attempts to define the principle sources and current levels of heavy metal contamination and summarizes the efforts undertaken by the industry to curtail the problem.

Air Pollutants↗
PubMed2006

Evaluating the effectiveness of a Senior Mentor Program: the University of Missouri-Columbia School of Medicine.

At the University of Missouri-Columbia School of Medicine, we developed a voluntary senior-mentor program, the Senior Teacher Educator Partnership (STEP), for first- and second-year medical students. Using qualitative research methods, we examined the impact of STEP on medical students' attitudes and then assessed the congruence of what is learned through STEP with the knowledge, skills, and attitudes needed to provide care to the elderly patient. STEP was found to be a successful strategy for teaching themes of recognizing the elderly within an ecological context, enhancing sympathy and empathy, emphasizing respect for elderly persons, and gaining an appreciation that aging is an individualized process. New areas identified for student learning experiences included understanding the complexity of the health care system and its impact on elderly patients, understanding the payment system, and developing skills in assessment and care coordination. A model is described for continuous enhancement of educational programs to be used to improve educational experience in geriatrics.

Adult↗
PubMed2005

The impaired and disruptive physician: the Missouri Physicians' Health Program--an update (1995-2002).

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 recovery rate in this study of 197 participants was 90%. New concepts of the "Behaviorally Disruptive Physician" and the Joint Commission on the Accreditation of Health Care Organization requirements regulating physician impairment are also discussed.

Humans↗
PubMed2005

The ethical challenges in farming: a report on conversations with Missouri corn and soybean producers.

Interviews with Missouri corn and soybean farmers reveal what farmers consider are important ethical challenges in agriculture. In contrast to the literature, which characterizes ethical challenges in term of philosophical debates about soil conservation, the use of pesticides and genetically modified seeds, and the treatment of animals, for instance, this research finds that farmers perceive ethical challenges in behavioral terms. The reason is rooted in the industrialization of agricultural production, which creates tensions for farmers between doing what they believe is right and doing what they feel they must in order to survive.

Agriculture↗
PubMed2004

Epidemiology of a tuberculosis outbreak in a rural Missouri high school.

OBJECTIVES: 1) Demonstrate the importance of maintaining a tuberculosis (TB) control program even in low-incidence areas by studying a TB-contact investigation of a highly infectious high school student in rural Missouri, and 2) discuss factors that perpetuated or contained this school-based outbreak. METHODS: A case review of the index patient, a 15-year-old high school student, established estimates of his level and duration of infectiousness. Contact investigations of his household (n = 5), high school (n = 781), and school bus (n = 67) were administered according to guidelines established by the Centers for Disease Control and Prevention. High school students were stratified further based on classroom exposure, and relative risks were calculated for each risk group. RESULTS: The case review revealed that the index patient had evidence of a pulmonary cavity on chest radiograph 6 months before his TB diagnosis. Of the 5 household contacts, all were infected and 3 (60%) had developed active TB disease. Of the 781 high school students sought for TB screening, 559 (72%) completed testing, and 58 (10%) were PPD-positive. Sixty-seven bus riders were sought for testing and 7 (19%) were purified protein derivative (PPD)-positive, with 1 bus rider subsequently diagnosed with active disease. Risks were calculated based on classroom and bus exposure to the patient. The relative risks for a positive PPD were 3.2 for attending any class with the patient (n = 25), 4.2 for classes with less ventilation (n = 21), and 5.7 for > or =3 classes (n = 7) with the patient. A total of 62 students started treatment for latent TB infection, and 49 have completed it. Forty-two of these students received directly observed therapy through the local public health agency and the high school. CONCLUSION: This investigation demonstrated widespread adult-type transmission from a pediatric TB case with a 6-month delay in diagnosis. Several actions contributed to the success of this investigation, including rapidly mobilizing the public health system, centralizing follow-up, and on-site testing and treatment with directly observed therapy. Pediatricians need to maintain awareness of TB and risk factors in children, even in low-incidence areas. Prompt diagnosis would have reduced the severity of illness in the patient and potentially prevented widespread school-based transmission. Public health authorities must maintain an infrastructure to respond to large TB outbreaks.

Adolescent↗
PubMed2003

Post-establishment movement of western corn rootworm larvae (Coleoptera: Chrysomelidae) in Central Missouri corn.

If registered, transgenic corn, Zea mays L., with corn rootworm resistance will offer a viable alternative to insecticides for managing Diabrotica spp. corn rootworms. Resistance management to maintain susceptibility is in the interest of growers, the Environmental Protection Agency, and industry, but little is known about many aspects of corn rootworm biology required for an effective resistance management program. The extent of larval movement by the western corn rootworm, Diabrotica virgifera virgifera LeConte, that occurs from plant-to-plant or row-to-row after initial establishment was evaluated in 1998 and 1999 in a Central Missouri cornfield. Post-establishment movement by western corn rootworm larvae was clearly documented in two of four treatment combinations in 1999 where larvae moved up to three plants down the row and across a 0.46-m row. Larvae did not significantly cross a 0.91-m row after initial host establishment in 1998 or 1999, whether or not the soil had been compacted by a tractor and planter. In the current experiment, western corn rootworm larvae moved from highly damaged, infested plants to nearby plants with little to no previous root damage. Our data do not provide significant insight into how larvae might disperse after initial establishment when all plants in an area are heavily damaged or when only moderate damage occurs on an infested plant. A similar situation might also occur if a seed mixture of transgenic and isoline plants were used and if transgenic plants with rootworm resistance are not repellent to corn rootworm larvae.

Analysis of Variance↗
PubMed2003

Host associations and seasonal occurrence of Haemaphysalis leporispalustris, Ixodes brunneus, I. cookei, I. dentatus, and I. texanus (Acari: Ixodidae) in Southeastern Missouri.

Hemaphysalis leporispalustris (Packard), Ixodes brunneus Koch, Ixodes cookei Packard, Ixodes dentatus Marx, and Ixodes texanus Banks were collected during a 3-yr study of pathogen-tick-host interactions in southeastern Missouri. H. leporispalustris was collected from the eastern cottontail rabbit, Northern bobwhite, and Carolina wren, and it was active all year. I. brunneus was collected by drag and from passerine birds during December, March, and April. I. cookei was collected from raccoons and mink during April, June, September, October, and November. I. dentatus was collected from the cottontail rabbit and Carolina wren throughout the year. I. texanus was collected from the eastern gray squirrel, Virginia opossum, and raccoon throughout the year.

Animals↗
PubMed2000

Host association and seasonal activity of Amblyomma americanum (Acari: Ixodidae) in Missouri.

From June 1993 through June 1996, 2,260 adult, 4,426 nymphal, and 2,178 larval lone star ticks Amblyomma americanum (L.) were collected in Missouri from vertebrate hosts and by dragging a cloth over vegetation. Prevalence, mean intensity, and relative abundance of each stage varied among hosts. The relative abundance of adult lone star ticks was highest on white-tailed deer, but this stage was also collected from raccoons, opossum, red fox, coyotes, and wild turkey. Nymphs were collected from gray squirrels, eastern cottontail rabbits, opossums, red fox, Carolina wren, and bobwhite quail, but the highest relative abundance occurred on wild turkey, white-tailed deer, and raccoons. Eastern cottontail rabbits, white-tailed deer, raccoons, and squirrels had the highest relative abundance of larval lone star ticks, but they were also found on opossums and wild turkey. The activity of adult lone star ticks was greatest from May through July. The activity for nymphs was highest from May through August, and for larvae, July through September.

Animals↗
PubMed1985

WIC prenatal participation and its relationship to newborn Medicaid costs in Missouri: a cost/benefit analysis.

The primary purpose of this study was to determine if WIC prenatal participation is associated with a reduction in Medicaid costs within 30 days after birth, and, if so, whether the reduction in Medicaid costs is greater than the WIC costs for these women. This evaluation of WIC was performed using 7,628 Missouri Medicaid records matched with their corresponding 1980 birth records. This file was then divided into a WIC group containing 1,883 records and a non-WIC comparison group of 5,745 records. WIC participation was found to be associated with the reduction in Medicaid newborn costs of about $100 per participant (95 per cent confidence interval $43,153); mother's Medicaid costs were not affected. For every dollar spent on WIC, about 83 in Medicaid costs within 30 days of birth were apparently saved according to the results of this study (95 per cent confidence interval $.40, $1.30). Reductions in low birthweight rates and NICU admission rates among WIC infants provided two possible reasons for the reduced Medicaid costs associated with WIC food supplementation. As WIC food costs increased, both mean birthweight and newborn Medicaid savings also increased. Because of possible inconsistencies in the data, similar studies are needed in other states.

Adolescent↗
PubMed1989

Maternal smoking during pregnancy: no association with congenital malformations in Missouri 1980-83.

Using a multisource birth defects registry developed by the Missouri Center for Health Statistics for the years 1980-83, we examined the relation between maternal smoking during pregnancy and the occurrence of congenital malformations. There were 288,067 live singleton births in this data set of which 10,223 had one or more congenital malformations. When adjusted for potential confounders the odds ratio for congenital malformations in the infants of women who smoked during pregnancy was not increased (odds ratio = 0.98, 95% confidence interval = 0.94 - 1.03). We examined the relation between smoking and groups of malformations using the International Classification of Diseases, 9th Revision, as well as analyzing for certain specific malformations within each group and found no increased risk for infants of smokers.

Birth Certificates↗
PubMed1991

Physical activity on the job and cancer in Missouri.

We conducted a series of case-control studies to investigate the risks of 16 cancer types in relation to occupational physical activity. These studies were based on Missouri Cancer Registry data for 17,147 White male cancer patients registered between 1984 and 1989. Colon cancer risk was increased for both the moderate (odds ratio (OR) = 1.1; 95% confidence interval (CI) = 1.0, 1.3) and low (OR = 1.2; 95% CI = 1.0, 1.5) activity levels. Similar elevations were observed for prostate cancer at the moderate (OR = 1.1; 95% CI = 1.0, 1.3) and low (OR = 1.5; 95% CI = 1.2, 1.8) levels of activity, and for cancer of the testis at the low activity level (OR = 2.2; 95% CI = 1.3, 3.7). An opposite trend (p less than 0.01) was noted for lung cancer, which showed decreased risk at the moderate (OR = 0.9; 95% CI = 0.8, 1.0) and low (OR = 0.8; 95% CI = 0.6, 0.9) activity levels. These associations suggest that further study of the relationship between physical activity and site-specific cancer risk is warranted.

Case-Control Studies↗