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PubMedDate not supplied

The course of posttraumatic stress disorder in a follow-up study of survivors of the Oklahoma City bombing.

BACKGROUND: The course of posttraumatic stress disorder (PTSD) in populations directly exposed to terrorist attacks is of major importance in the post-9/11 era. Because no systematic diagnostic studies of the most highly exposed individuals of the 9/11 terrorist attacks have yet been done, the Oklahoma City bombing remains a unique opportunity to examine PTSD over time in high-exposure terrorist victims. METHODS: This study assessed 137 survivors in the direct path of the explosion at approximately 6 and 17 months postdisaster, using the Diagnostic Interview Schedule. RESULTS: Combined index and follow-up data yielded a higher (41%) incidence of PTSD than detected at index (32%) or follow-up (31%). All PTSD was chronic (89% unremitted at 17 months) with no delayed-onset cases. The avoidance and numbing symptom group C, unlike groups B and D alone, was pivotal to current PTSD status and was associated with indicators of functioning at index and follow-up. The findings at index were sustainable. CONCLUSIONS: This follow-up study confirmed the immediacy of onset of PTSD and its persistence over time, pointing to the need for early interventions that continue over the long term. Group C avoidance and numbing symptoms may aid in early recognition of PTSD and in predicting long-term functioning.

Adult↗
PubMed2003

Diabetes Patient Tracker, a personal digital assistant-based diabetes management system for primary care practices in Oklahoma.

It has been demonstrated that electronic patient registries combined with a clinical decision support system have a significant positive impact on the documentation and delivery of services provided by health care professionals. While implementation of available commercial systems has not always been proven effective in a number of primary care practices, development and implementation of such a system in a practice-based research network might enhance successful implementation. Physicians in our practice-based research network (Oklahoma Physicians Resource/Research Network) initiated a project that aimed at designing, testing, and implementing a personal digital assistant-based diabetes management system. We utilized the "best practice" approach to determine the principles on which the application must operate. System development and beta testing were also accomplished based on the direct feedback of user clinicians. Practice Enhancement Assistants (PEAs) were available in the practices for assistance with implementation. Implementation of the Diabetes Patient Tracker (DPT) resulted in a significant improvement (p<0.05) in nine of 10 diabetic quality of care measures compared with pre-intervention levels in 20 primary care practices. Regular PEA visits similarly increased the number of foot exams and retinal exams performed in the last year (p=0.03 and 0.02, respectively). DPT is a low-cost, feasible, easily implementable, and very effective paper-less tool that significantly improves patient care and documentation in primary care practices.

Computer-Assisted Instruction↗
PubMed2005

Risk of tornado-related death and injury in Oklahoma, May 3, 1999.

On May 3, 1999, powerful tornadoes, including a category F5 tornado, swept through Oklahoma. The authors examined all tornado-related deaths, hospital admissions, and emergency department visits to identify important risk factors. Data on deaths and injuries directly related to the tornadoes and information obtained from a survey of residents in the damage path of the F5 tornado were used in a case-control analysis. The direct force of the tornadoes caused 40 deaths, 133 hospital admissions, and 265 emergency department outpatient visits. The risk of death from the F5 tornado was greater for persons who were in mobile homes (odds ratio (OR) = 35.3, 95% confidence interval (CI): 7.8, 175.6) or outdoors (OR = 141.2, 95% CI: 15.9, 6,379.8) when the tornado struck than for those in permanently anchored houses. Risk of severe injury was also greater for persons in mobile homes (OR = 11.8, 95% CI: 3.4, 51.7) or outdoors (OR = 34.3, 95% CI: 4.4, 1,526.2). However, the risk of death (OR = 0.0, 95% CI: 0.0, 9.9), severe injury (OR = 0.0, 95% CI: 0.0, 2.0), or minor injury (OR = 0.8, 95% CI: 0.1, 3.1) was not greater among persons in motor vehicles than among those in houses. The risk of death (OR = 0.6, 95% CI: 0.1, 1.7), severe injury (OR = 0.2, 95% CI: 0.1, 0.6), or minor injury (OR = 0.3, 95% CI: 0.2, 0.7) was lower among those fleeing their homes in motor vehicles than among those remaining. Recommendations involving the relative safety of motor vehicles during a tornado should be evaluated using experience from recent tornado events.

Adolescent↗
PubMed1998

History, race, and attachment to place among elders in the rural all-black towns of Oklahoma.

This research examines place attachment among older residents of the all-Black towns of Oklahoma. Social-historical occurrences, personal experiences associated with race, and expressed differences between social-historical groupings of older African Americans influence the level of social and autobiographical insideness among the elderly residents. The findings extend current conceptualizations of place attachment by showing that (a) place attachment is not a constant, even among long-term residents; (b) social-historical factors can play an important role in the level of place attachment; (c) race can be a salient element of place attachment; (d) experiences outside the community, such as racial discrimination, can influence the level of social and autobiographical bonding to the community; and (e) subgroup identity within minority groups can be associated with variations in community place attachment. The findings point to the value of carefully examining the issues of history and race in research focusing on older minority group members.

Black or African American↗
PubMed2001

Preparing future aging advocates: the Oklahoma Aging Advocacy Leadership Academy.

PURPOSE: This article describes the organization, operation, and evaluation of the Oklahoma Aging Advocacy Leadership Academy (OAALA). DESIGN AND METHODS: The Academy was designed to assure the continuation of future cohorts of advocates and volunteers for aging programs and services. It is a statewide training program consisting of 10 weekend sessions. The curriculum incorporates age-related content and advocacy/leadership/voluntary skills training. Evaluation consisted of: (a) a pre-post assessment of perceived familiarity with advocacy and volunteer leadership issues; (b) post-Academy participant assessments of the quality of various aspects of the Academy; (c) post-Academy written statements about areas that were valuable and in need of change; and (d) a compilation of student volunteer and advocacy activities. RESULTS: Evaluation results indicate that the OAALA led to significant increases in perceived familiarity with issues and very positive participant assessments of quality. In addition, many participants spontaneously initiated advocacy and volunteer activities while enrolled in the Academy. IMPLICATIONS: Our experience with the Academy suggests that it is a feasible means of preparing individuals to become successful old-age advocates and volunteer leaders.

Adult↗
PubMed1989

Population estimation of the horse fly, Tabanus abactor (Diptera: Tabanidae), in northcentral Oklahoma.

A mark-recapture technique was used to estimate daily populations of host-seeking Tabanus abactor Philip. Daily population estimates were calculated for 31 and 37 d for areas of 2.1 km2 and 4.6 km2 for 1982 and 1983, respectively. In 1982, population estimates ranged from 22,767 to 2,125,322 flies/2.1 km2 per d with a mean of 467,277 flies/d. In 1983, population estimates ranged from 48,962 to 2,794,389 flies/4.6 km2 per d with a mean of 759,616 flies/d. The estimated average number of host-seeking females per hectare was 2,225 (0.22 flies/m2) and 1,651 (0.17 flies/m2) for 1982 and 1983, respectively. Although daily population estimates fluctuated greatly, primarily because of fluctuation in recapture rates, seasonal trends during both years were similar. The estimates calculated in this study appear to be representative of the population of T. abactor in northcentral Oklahoma based on previous studies determining seasonal abundance.

Animals↗
PubMed1992

Cotton rats and other small mammals as hosts for immature Dermacentor variabilis (Acari: Ixodidae) in central Oklahoma.

Eight species of small mammals were evaluated as potential hosts for American dog ticks, Dermacentor variabilis (Say), in an upland, tallgrass prairie study site in central Oklahoma. Only hispid cotton rats, Sigmodon hispidus, and deer mice, Peromyscus maniculatus, were found to be important hosts for immature D. variabilis. Although D. varibilis larvae and nymphs frequently infested both cotton rats and deer mice, cotton rats were the most important host species for both immature stages in the study area. Cotton rats constituted 63.2% of the total 530 small mammals captured and were hosts to 85.2% of all larvae and 88.7% of all nymphs. Deer mice accounted for 19.8% of all small mammals captured and were hosts for 14.5% of the larvae and 10.8% of the nymphs recovered. The remaining small mammal species were hosts for less than 1% of the immature ticks collected. Larval infestations peaked during summer, whereas summer and spring peaks were noted for the nymphal infestations. The relative importance of cotton rats and deer mice as hosts for immature ticks could be largely, but not completely, explained by cotton rats being more than three times as abundant as deer mice. Attachment site data indicated that differences in grooming behavior also might be partially responsible for the larger infestations observed on cotton rats. Other possible ecological and behavioral explanations of the heavy infestations observed on cotton rats are discussed.

Animals↗
PubMed1993

Relationship of cliff swallows, ectoparasites, and an Alphavirus in west-central Oklahoma.

Approximately 250 isolates of a newly recognized virus, related to western equine encephalitis virus (family Togaviridae, genus Alphavirus), were obtained from cimicid bugs, Oeciacus vicarius; Cliff Swallows, Hirundo pyrrhonata; and House Sparrows, Passer domesticus in a study area in west-central Oklahoma at Buggy Creek and Caddo Canyons. Antigenicity of the virus strains varied slightly from isolate to isolate. This paper summarizes the ecology of the area by describing in general the flora and fauna there.

Alphavirus↗
PubMed1994

Epidemiology of traumatic spinal cord injury and acute hospitalization and rehabilitation charges for spinal cord injuries in Oklahoma, 1988-1990.

Few injuries result in more profound and long-term disability than traumatic spinal cord injury. This study describes the demographic and epidemiologic characteristics of traumatic spinal cord injury among Oklahoma residents reported to the statewide, population-based surveillance system in 1988-1990; initial acute hospital and rehabilitation charges for 1989 are also included. There was a reported incidence rate of 40 per million population. Based on a reporting sensitivity of 77%, the "true" incidence of spinal cord injury was estimated to be 51 per million population. Motor vehicle crashes accounted for 48% of injuries. Males aged 15-29 years and blacks were at highest risk of injury. Among blacks, the injury rate due to violence was seven times that for whites or Native Americans. Alcohol/drug use was a contributing factor in 39% of injuries and was highest among males aged 20-29 years (58%), Native Americans (57%), and victims of motor vehicle crashes (48%) or violence (51%). The combined initial charges for persons receiving both acute and rehabilitative care ranged from $9,790 to $666,510, with a median of $53,410 per patient; for complete quadriplegia, the combined median charge was $88,585. Despite its low incidence, hospitalization and rehabilitation charges for spinal cord injury in 1989 caused an economic burden of an estimated $8.4 million. While the charges presented were only a small portion of the total costs of spinal cord injury, they further substantiate the need for prevention efforts targeting these debilitating, often permanent injuries. These efforts should target young males and blacks, and should focus on preventing injuries associated with motor vehicle crashes, violence, and alcohol/drug use.

Accidents, Traffic↗
PubMed2000

Persian leopard (Panthera pardus) attack in Oklahoma: case report.

The authors report a fatal case of a Persian leopard (Panthera pardus) attack in an animal sanctuary in Oklahoma. The victim was a 53-year-old Costa Rican woman who was attempting to feed the animal when she was attacked and killed. Autopsy, radiography, fingerprint analysis, microbiologic cultures, and dental impressions were used to evaluate the case. These simple techniques can be applied to similar cases involving wild and domestic animal attacks.

Animals↗
PubMed1999

Posttraumatic stress responses in bereaved children after the Oklahoma City bombing.

OBJECTIVE: To investigate the responses of middle and high school students exposed to the 1995 Oklahoma City bombing across a spectrum of loss. METHOD: A questionnaire measuring exposure, personal consequences, initial response, and current posttraumatic stress and other symptoms was administered to 3,218 students 7 weeks after the explosion. RESULTS: More than one third of the sample knew someone killed in the explosion. Bereaved youths were more likely than nonbereaved peers to report immediate symptoms of arousal and fear, changes in their home and school environment, and posttraumatic stress symptoms. Retrospective measures of initial arousal and fear predicted posttraumatic stress symptoms at 7 weeks. CONCLUSIONS: The results support the literature addressing the role of initial response in posttraumatic stress symptom development. The study raises concern about the impact of television, and traumatized youths' reactivity to it, in the aftermath of disaster.

Adolescent↗
PubMed1989

Meridional analysis of with-the-rule astigmatism in Oklahoma Indians.

Refraction and keratometry records were obtained for 142 consecutive with-the-rule astigmats and for 100 consecutive nonastigmats from W. W. Hastings Indian Health Service Hospital in Tahlequah, Oklahoma. Patients were 5 to 40 years of age. Patients with higher degrees of Indian ancestry were more common in the astigmatic group than in the spherical refraction group. An analysis of refractive error and keratometry by principal meridian was performed. The horizontal meridian refractive error in astigmats was most often near emmetropia. Compound myopic astigmatism and mixed astigmatism accounted for over 3/4 of the cases. The astigmats as a group had flatter corneas in the horizontal and steeper corneas in the vertical than the nonastigmats. Horizontal refractive errors and horizontal keratometry readings showed a weak but significant correlation in astigmats but not in nonastigmats.

Adolescent↗
PubMed1976

Laryngeal neoplasm mortality in Oklahoma: 1950-1970.

A survey of death certificates of victims with laryngeal cancer in Oklahoma for the period 1950 to 1970 attempts to corroborate findings of the current literature. Sex-race specific death rates per 100,000 for white, nonwhite, and American Indian populaces displayed a distinct sex and racial pattern: respectively, 38.52, 28.11, and 12.52 for males; 5.25, 1.23, and 0 for females. Age-adjusted death rates per 100,000 for white males for the four consecutive five-year periods were 19.00, 21.64, 20.91, and 26.81; these rates show constant mortality for laryngeal cancer for the period between 1950 and 1965, followed by an increase of approximately 30% in the 1966 to 1970 interval. Similar analysis of the white females, nonwhite males, and nonwhite females did not reveal such a clear secular pattern, although the adjustment for age did preserve the sex and racial pattern indicated above. Age-adjusted laryngeal cancer death rates of 42.34, 46.14, and 48.51 for the rural, nonmetropolitan, and metropolitan counties, respectively, indicated a direct association between mortality and degree of urbanization. All findings appeared to be in concordance with those given in the recent literature.

Adult↗
PubMed1983

Nontuberculous mycobacterial trends at the Veterans Administration Medical Center in Oklahoma City.

Laboratory culture results, dating back to 1960, were reviewed at the Veterans Administration Medical Center in Oklahoma City. Nontuberculous mycobacterial incidence increased substantially during the 21-year period as tuberculosis incidence decreased. Nontuberculous mycobacteria were found to represent 13.7% of all mycobacterial isolates, with Mycobacterium kansasii and M intracellulare-avium complex the predominant species. When the dates of first positive cultures were evaluated, a significant month-to-month variation was found in M tuberculosis but not nontuberculous mycobacteria, suggesting a different mode of transmission for the two. There was no significant difference in the racial distribution or age of individuals with nontuberculous mycobacteria.

Age Factors↗
PubMed1992

Community-wide outbreak of hepatitis A among an Indian population in Oklahoma.

Between September 1983 and September 1984, 118 cases of hepatitis A were reported from Caddo County, Oklahoma. No common source was identified, and the epidemic curve suggested person-to-person transmission. In July 1984, enhanced control measures were implemented; these consisted of improvements in surveillance, standardization of case investigation, an expanded, although targeted, use of immune globulin, and a public awareness campaign. Control measures resulted in a decrease in the delay between onset of symptoms and case report (from 12 days to 4 days), an increase in the percentage of patients with confirmed cases interviewed (from 77% to 100%), an increase in the percentage of patients reporting contact with a previous case (from 39% to 72%), and an increase in the average number of household-like contacts per case (from seven to 27). Within two incubation periods of the implementation of enhanced controls, the outbreak ended. These data indicate that community-wide outbreaks of hepatitis A can be stopped with an intensive epidemiologic approach, coupled with the expanded and targeted use of immune globulin.

Adolescent↗
PubMed1992

Adolescent blood pressure survey: Tulsa, Oklahoma, 1987 to 1989.

The study goals were to document the incidence of elevated blood pressure (BP) values in public high school students in Tulsa, Oklahoma; to determine whether age and sex are risk factors; and to encourage adolescents with abnormal screening BP values to seek medical care. Over a 2-year period, 5537 adolescents aged 14 to 19 years were evaluated by a mass screening method. Blood pressure was measured once between 8:30 and 9:30 AM, with the students seated. Korotkoff phases 1 and 5 were recorded as systolic and diastolic BP. According to the criteria of the Second Task Force on Hypertension in Children and Adolescents, 334 students had elevated BP values (either systolic, diastolic, or both) (an incidence of 6%). Boys had an incidence of elevated systolic BP of 5.8%, while girls had a 2.8% incidence, a difference that might have been expected because of the generally higher incidence among men in the adult population. The incidence of elevated diastolic BP was 2.8% in boys and 2.1% in girls. Statistically significant differences between boys and girls mean systolic and diastolic elevations were found, but were not considered clinically significant. An instructional mailing was done in an effort to stimulate follow-up medical care for those with abnormal findings, but its effect was not measured.

Adolescent↗
PubMed1995

Acute myocardial infarction in Oklahoma: are we different?

Data regarding 787 patients admitted to Saint Francis Hospital in Tulsa, Oklahoma, with acute myocardial infarction (MI) were analyzed to determine circadian variation and to assess demographic and anatomic characteristics. The study population consisted of 634 men (81%) and 153 women (19%). This cohort displayed a circadian rhythm that nearly duplicated a previously published national data base. As was seen nationally, our patients had a peak incidence between 6 AM and noon. Of the total population, 448 patients had acute cardiac catheterization allowing definition of the infarct vessel. The majority of myocardial infarctions were from right coronary artery occlusions. Men were more likely than women to have an anterior MI. Both men and women were more likely to have an inferior MI if they were less than 65 years of age, though this was more pronounced for women. As the population aged, they were more likely to have an anterior myocardial infarction.

Adult↗