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At least 235 records · Page 13Linked to original sources
PubMed1997

Mandatory parental involvement in minors' abortions: effects of the laws in Minnesota, Missouri, and Indiana.

OBJECTIVES: This study examined the effects of parental involvement laws on the birth rate, in-state abortion rate, odds of interstate travel, and odds of late abortion for minors. METHODS: Poisson and logistic regression models fitted to vital records compared the periods before and after the laws were enforced. RESULTS: In each state, the in-state abortion rate for minors fell (relative to the rate for older women) when parental involvement laws took effect. Data offered no empirical support for the proposition that the laws drive up birth rates for minors. Although data were incomplete, the laws appeared to increase the odds of a minor's traveling out of state for her abortion. If one judges from the available data, minors who traveled out of state may have accounted for the entire observed decline in the in-state abortion rate, at least in Missouri. The laws appeared to delay minors' abortions past the eighth week, but probably not into the second trimester. CONCLUSIONS: Several empirical arguments used against and in support of parental involvement laws do not appear to be substantiated.

Abortion Applicants↗
PubMed1999

Residential radon exposure and risk of lung cancer in Missouri.

OBJECTIVES: This study investigated residential radon exposure and lung cancer risk, using both standard radon dosimetry and a new radon monitoring technology that, evidence suggests, is a better measure of cumulative radon exposure. METHODS: Missouri women (aged 30 to 84 years) newly diagnosed with primary lung cancer during the period January 1, 1993, to January 31, 1994, were invited to participate in this population-based case-control study. Both indoor air radon detectors and CR-39 alpha-particle detectors (surface monitors) were used. RESULTS: When surface monitors were used, a significant trend in lung cancer odds ratios was observed for 20-year time-weighted-average radon concentrations. CONCLUSIONS: When surface monitors were used, but not when standard radon dosimetry was used, a significant lung cancer risk was found for radon concentrations at and above the action level for mitigation of houses currently used in the United States (148 Bqm-3). The risk was below the action level used in Canada (750 Bqm-3) and many European countries (200-400 Bqm-3).

Adult↗
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↗
PubMed1990

Phencyclidine and violent deaths in St. Louis, Missouri: a survey of medical examiners' cases from 1977 through 1986.

A survey of 104 deaths involving phencyclidine (PCP) occurring from 1981 through 1986 in metropolitan St. Louis, Missouri, is presented. Four black males (22-33 yr) died from fatal PCP intoxication. PCP was detected in an additional 100 deaths: 81 homicides, 13 suicides, and 6 accidental deaths. Seventy-five of these deaths were homicides of Black males (mean age 27 years) typically dying from gunshot wounds, 64 cases. In 50% of deaths where PCP was detected, other drugs were co-administered: ethanol (35%) and cocaine (20%) being the most common mixtures. A dramatic continuous increase in PCP abuse from 1984 through 1986 was demonstrated by drug abuse indicator data: treatment admissions, emergency room episodes, police exhibits, and driving under the influence of PCP arrests. Increased abuse of PCP in St. Louis has been associated with increased medical emergencies and violence against persons.

Accidents↗
PubMed1988

Bioavailability and cytochrome P-450 induction from 2,3,7,8-tetrachlorodibenzo-P-dioxin contaminated soils from Times Beach, Missouri, and Newark, New Jersey.

Bioavailability of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) from contaminated soils from Times Beach, Missouri and Newark, New Jersey, was examined using liver concentrations and toxicity in guinea pigs observed up to 60 days following a single oral administration, and induction of cytochrome P-450 in rats sacrificed 24 hours after a single oral dose as endpoints. Both soils are contaminated with several chlorinated dioxins and numerous other compounds. Times Beach soil resulted in greater TCDD concentration in liver and TCDD was considerably more bioavailable from Times Beach soil than from Newark soil. However, both soils induced cytochrome P-450 activity to approximately the same extent. Moreover, similar banding patterns of microsomal proteins were seen on polyacrylamide electrophoretic gels. The many other compounds present in the soils, particularly in Newark, may account for the similar protein bands and levels of cytochrome P-450 observed.

Animals↗
PubMedDate not supplied

The public perception of head injury in Missouri.

Head injury constitutes a significant public health concern. Despite increasing recognition of the morbidity and mortality associated with head injury, there exist few statewide estimations of the prevalence and public perception of head injury. Knowledge of the public's perception can facilitate the funding and planning for the treatment and rehabilitation of persons with head injury. This study was undertaken for this purpose by the Missouri Head Injury Advisory Council and consisted of a stratified sampling of 1123 Missourians in a statewide telephone poll. The results revealed that the general public has an accurate perception of head injury and that knowledge improved as a function of direct experience with head injury.

Activities of Daily Living↗
PubMed1999

The Missouri Developmental Disability Resource Center: a Web site responding to the critical need for information of parents with a child with a disability.

One of the greatest problems for parents who have a child with a developmental disability is a lack of access to information. Parents have a critical need to learn the specifics of their child's disability, the best treatment practices, and how the broader service delivery system works (Bradley, 1992; Rinck, Calkins, Green, & Stadler, 1986). The Missouri Developmental Disabilities Resource Center Web site [http:/(/)www.moddrc.com] was created as an innovative method of meeting the information needs of this underserved population. Challenges to the adoption of this innovative model are highlighted, and some options for addressing these issues are discussed.

Child, Preschool↗
PubMedDate not supplied

A case study of the use of telemedicine by advanced practice nurses in rural Missouri.

BACKGROUND: Telemedicine aims to increase access to health care through the use of technology, but its impact on rural health care has had limited study. The purpose of this study was to evaluate the impact of newly implemented telemedicine systems on rural practice and patient care in the Missouri Telemedicine Network. METHOD: Telemedicine equipment and hook-ups were provided to satellite clinics and nonaffiliated clinics, nursing homes, hospitals, and health departments in three rural counties. Qualitative research methods were used to elicit data and develop a case study report of the experience of the rural nurse practitioner's use of telemedicine technology. Results were then compared with those of three other counties without telemedicine technology. RESULTS: Advanced practice nurses reported professional development and connectedness with telemedicine capability. Those with telemedicine access reported both current and potential applications of technology to practice. Both formal and informal learning opportunities were cited. Those without telemedicine access viewed telemedicine as potentially supportive of enhanced patient care and professional satisfaction. CONCLUSION: This preliminary study provides support for the role of telemedicine in augmenting the role of the advanced practice nurse in a variety of rural settings.

Adult↗
PubMedDate not supplied

Private sector worksite health promotion programs in Missouri: a comparison with national survey findings and Healthy People recommendations.

Questionnaries with 22 multiple-choice questions were mailed to a random sample of 450 Missouri employers with 250 or more employees to determine the prevalence and types of workplace health promotion programs; 262 (58%) responded. Only 34% of the responding companies offered any kind of program and 65% of these offered only awareness programs, but most offered programs on all 18 topics listed in the questionnaire; 48% had a full-time program manager, 79% had some form of evaluation, and 36% had some form of financial incentives.

Cross-Sectional Studies↗
PubMedDate not supplied

Correlates of overweight and weight-loss practices in Missouri.

OBJECTIVE: To examine potential correlates of overweight and weight-loss practices in Missouri. METHODS: Two probability surveys (n=3,010) were used to investigate the associations of sociodemographic and health-related factors with overweight and attempting, exercising, dieting, and desiring to lose weight. RESULTS: Race, gender, and receiving professional advice were strongly associated with being overweight. Gender, receiving professional advice, and leisure-time physical activity were positively associated with attempting and desiring to lose weight. CONCLUSIONS: Public health programs can utilize this knowledge to reduce the prevalence of overweight by encouraging professional advice and promoting regular exercise.

Adolescent↗
PubMed1991

Dirofilaria immitis in coyotes and foxes in Missouri.

Wild canid carcasses were obtained during the 1986-1987 and 1987-1988 trapping seasons in Missouri. Hearts and lungs from 293 coyotes (Canis latrans), 85 red foxes (Vulpes vulpes) and 70 gray foxes (Urocyon cinereoargenteus) were examined for Dirofilaria immitis. Age of hosts was determined by radiographic and histologic techniques. Nineteen coyotes (7%) had from 1 to 100 D. immitis and five red foxes (6%) had from 1 to 7 D. immitis, whereas gray foxes had none. This study indicates that heartworm prevalence differs by wild canid species within the same area and during the same time period.

Animals↗
PubMed1994

Hematozoa of wood ducks (Aix sponsa) in Missouri.

We examined 371 wood ducks (Aix sponsa) for hematozoa from two localities in Missouri (USA) in 1989 and 1990. Thirty-seven (10%) harbored one or more species of blood parasites. Haemoproteus nettionis was the most common parasite, occurring in 36 (10%) of the birds. Leucocytozoon simondi was found in two (0.5%) and microfilaria occurred in five (1%) of the wood ducks examined. Infections were more prevalent in adults (18%) than in immature birds (2%). There was no difference in prevalence between sex, location, or year. Based on seasonal prevalence, transmission probably did not occur at either location in the summer. Increased prevalence in the winter samples occurred after northern wood ducks migrated into the sample areas.

Age Factors↗
PubMed1995

Prevalence of antibodies to Toxoplasma gondii in wild mammals of Missouri and east central Kansas: biologic and ecologic considerations of transmission.

Sera from 273 wild mammals from Missouri and Kansas (USA), collected between December 1974 and December 1987, were tested for the presence of antibodies to Toxoplasma gondii using the Sabin-Feldman dye test. Sixty-five (24%) had antibodies at titers of > or = 1:8, including 38 (66%) of 58 carnivores, 14 (15%) of 94 omnivores, 13 (11%) of 117 herbivores, and none of four insectivores. The prevalence of antibodies in mice (Mus musculus and Peromyscus spp.) and rats (Rattus norvegicus and Sigmodon hispidus) was low (3%), while medium sized herbivores such as squirrels (Sciurus spp.), rabbits (Sylvilagus floridanus), and muskrats (Ondatra zibethicus) had prevalences of about 18%. Red foxes (Vulpes fulva) and mink (Mustela vison) had the highest prevalence of antibodies with frequencies of 90 and 66%, respectively. In 32 attempts to isolate Toxoplasma gondii from wild mammals with positive (> or = 1:4) titers, only six (19%) were successful: a gray squirrel (Sciurus carolinensis), a beaver (Castor canadensis), an opossum (Didelphis marsupialis), a red fox and two mink. These findings are consistent with the hypothesis that the probability of infection with Toxoplasma gondii, and therefore prevalence of antibodies in wildlife, is greatest in carnivores.

Animals↗
PubMed2000

Parelaphostrongyliasis in white-tailed deer in Missouri.

The heads of 137 white-tailed deer (Odocoileus virginianus) were collected on the opening day of the 1996 Missouri (USA) fire-arms deer season and surveyed for the presence of meningeal worm (Parelaphostrongylus tenuis). Eighteen percent of the deer examined were infected. Mean intensity of infection was 2.0 (range 1-7). There were no significant differences of infection or mean intensity when deer were classified and compared according to sex or age class.

Age Distribution↗
PubMed1999

Urban-rural differences in Medicare in Missouri.

Health Care Financing Administration's (HCFA) administrative data were analyzed to examine urban-rural differences in the characteristics of Medicare beneficiaries, their utilization of medical care, the providers of services, and selected outcomes in Missouri. As compared to the residents of urban areas, the residents of the rural counties were a little poorer, had equal access to health care, and utilized more health care services; but the cost of major services was lower.

Hospitalization↗
PubMedDate not supplied

Missouri and Kevorkian continue to provoke controversy.

At the opposite ends of the right-to-die spectrum, Jack Kevorkian tries to hoodwink Michigan's doctors into joining his "obitiatry" movement and a Missouri health department official tries to "relieve" the state's residents of rights under Cruzan.

Humans↗
PubMed1997

Missouri's statewide outcomes study: lessons and surprises from the public sector.

Demand is increasing for statewide outcomes initiatives and greater focus on studies of treatment effects for publicly funded patients. Such initiatives pose enormous challenges in management--to involve key stakeholders, to protect confidentiality, and to comply with methodological standards. The state of Missouri is taking a leadership role in this direction.

Humans↗
PubMed1995

The development of a consumer guide on the quality of obstetrical services: the Missouri experience.

Missouri published a consumer guide on obstetric in the spring of 1994. This article describes the events and processes that led to the publication of the guide. The guide provided obstetrical quality-of-care indicators on structure, process, and outcomes for each facility doing deliveries. The article describes the principles followed in developing the guide, how the indicators were chosen, how the guide was constructed, and what data sources were used. Several lessons were learned including: a guide opens communication within the provider community, development of a guide is a long process, an advisory committee and preliminary review of findings by providers are necessary, and strong technical expertise is essential.

Algorithms↗