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PubMed1995

Cooperative education: an alternative level I fieldwork.

The cooperative education program offered at the University of North Dakota is based on programs offered at other universities across the nation. Rewards of cooperative education programs are many, and they benefit students, universities, and sponsors alike. In addition to easing the costs of a university education, planning cooperative education experiences as part of the curriculum allows students to develop, practice, and receive feedback on the necessary professional skills vital to their success as occupational therapists. Universities and sponsors benefit from enhanced relationships and lay the foundation for joint ventures as educators and researchers. Further research is needed to evaluate specific outcomes related to the use of cooperative education in the training of occupational therapists. This research should address issues that include evaluation tools, students' perspectives, and employers' satisfaction with the program.

Curriculum↗
PubMed1998

Disaster preparedness pays off.

Last spring, the Red River Valley of North Dakota and Minnesota was devastated by an unprecedented flood. Flooding caused foundations to collapse and houses to float away or become severely damaged by the raging, sewage-filled water. The river displaced people from their homes, and caused significant disruption of services including water, power, and medical care for 18 days. Find out how a medical contingency plan enabled staff members at the only trauma center and the largest clinic in the region to evacuate safely and effectively nearly 1,000 patients and senior residents in 36 hours, while setting up critical services across the region to care for the 50,000 displaced residents of the flood disaster.

Aged↗
PubMedDate not supplied

Four-State FAS Consortium: model for program implementation and data collection.

The Four-State Fetal Alcohol Syndrome (FAS) Consortium on the Studies of the Prevention of FAS is an effort to bring together resources, both human and material, across the states of Minnesota, Montana, North Dakota, and South Dakota to decrease the prevalence of births affected by prenatal alcohol exposure. Beginning in September 2000, the Consortium received 3 years of funding and operates through a cooperative agreement with funding from the Center for Substance Abuse Prevention (CSAP) at the Substance Abuse and Mental Health Services Administration (SAMHSA). Three primary objectives are addressed through the Consortium structure. These include: to develop and evaluate the formation of the Consortium itself; to develop an information base that systematizes data collection that helps determine populations and areas considered high risk; and to implement and test a scientific-based prevention/intervention model for women considered high risk of abusing alcohol during their childbearing years.

Adolescent↗
PubMed2006

Why is their picture on the wedding page?: A rural community responds to a union announcement.

On August 17, 2003, two women placed a union announcement in the Grand Forks Herald and became the first same-sex couple in North Dakota to do so (Lee, 2003). This announcement generated a flood of letters, both pro and con, that appeared in on the editorial page in the Herald over the next several weeks. In this exploratory study, I conduct a content analysis of those letters. Through this analysis, the three primary thematic categories emerged upon which writers based their arguments. They include those grounded in issues of tolerance, arguments based on Christian values and Scripture and those that focused on normalization. Additionally, the letters reveal something about rural versus urban sensibilities in that relatively more urban Grand Forks residents were less likely to write negative letters than their counterparts from neighboring small towns. I conclude with a discussion of the implications of these findings and suggestions for future research.

Attitude↗
PubMed1986

Influence of weather on osteoarthritics.

This exploratory study examined the effects of selected weather variables on pain and pain-related stress in osteoarthritic subjects. Urban and rural dwelling arthritics who perceived that weather made their symptoms worse and those who did not were surveyed. Some persons with osteoarthritis in urban Chicago were more weather sensitive than their rural counterparts in Grand Forks, North Dakota. Multiple regression analysis showed that precipitation affected degree of pain for urban subjects who identified weather as a pain-generating factor; barometric pressure, relative humidity and sunshine were significant factors influencing pain-related stress. Wind speed correlated with pain and pain-related stress; relative humidity and precipitation correlated with pain-related stress for urban subjects who did not perceive weather as a problem. Specific weather variables were not identified as affecting rural subjects' pain. However, temperature and barometric pressure affected degree of pain-related stress in rural subjects who perceived weather as a problem. Subtle differences between Chicago urban and Grand Forks rural climates are reflected in arthritic subjects' degree of pain and their perception of pain-related stress.

Aged↗
PubMed2002

The effects of mailed reminders and tailored messages on mammography screening.

A mail campaign to promote mammography screening was tested with 3,887 Medicare recipients in North Dakota who had not had a mammogram in 2 1/2 years. Three types of mailings were compared: (1) a simple reminder message, (2) a reminder accompanied by a persuasive communication emphasizing personal risk, and (3) a reminder accompanied by a message tailored to the participants' chief barrier to having a mammogram. Overall, subsequent mammography rates for women in these conditions did not differ from the rate observed among women who did not receive any mailing. However, post-hoc analyses suggested that women who reported a barrier to having a mammogram were more likely to have a mammogram. Population-wide mail campaigns of the kinds tested here may be generally ineffective for Medicare recipients who are obtaining screenings infrequently. Tailoring messages may be one potentially effective intervention, if investigators can develop ways to increase responses to inquiries about barriers.

Aged↗
PubMed1993

Central service in Siberia.

In 1992, eight healthcare professionals from United Hospital in Grand Forks, North Dakota spent six weeks in Ishim, in the Siberian region of Russia, on a medical information exchange to observe the methods of healthcare delivery, assess the needs of medical facilities and share technical advice where applicable. Ishim's CS workers were anxious to learn how to better utilize the resources they had--which were few. Supplies were so limited that CS workers were provided little personal protective equipment; there were not even gloves available for handling contaminated instruments in the washing and decontamination areas. Ishim's facility reprocessed virtually everything, including tongue depressors and surgeons' gloves. The CS department cleaned, assembled and sterilized instruments for Ishim City Hospital's OR and for the city's 28 clinics. When United's representatives returned to the U.S., they formed a supply committee to procure instruments and other needed materials for the Russian hospital and clinics.

Central Supply, Hospital↗
PubMed1998

Undergraduate preparation for primary health care roles in an academic nursing center.

The goal of the Nursing Center at the University of North Dakota is to prepare professional nurses to meet priority health needs of the next century through service to people currently in need. Health needs in the state, educational needs related to preparation for primary health care roles, and an explicit nursing paradigm for primary health care framed the development of the Nursing Center. As an integral part of the College of Nursing, the Nursing Center serves as a primary site for undergraduate clinical experiences. Family-centered, community-based programs were designed to simultaneously meet health needs of underserved rural populations and educational needs of undergraduates for preparation in primary health care roles. Implementation proved feasible from both service and educational perspectives. Initial evaluation data demonstrated a high level of effective clinical activity and role development for students beyond that experienced in more traditional settings.

Community Health Nursing↗
PubMed1983

The Hospital Capitation Payment Project: new incentives and tools for cost containment.

Blue Cross of North Dakota, Blue Cross of Massachusetts, and the Blue Cross and Blue Shield Association, along with 10 hospitals, developed and implemented the Hospital Capitation Payment Project as a novel approach for containing escalating hospital costs. The hospital is paid a prospective, fixed amount for each person covered; in exchange, it assumes responsibility to provide or pay for all covered services needed by that individual. This responsibility extends to payment for covered care provided by other hospitals. The new tools and incentives created by the program, notably an innovative management information system, are designed to help hospitals better manage the health care needs and related costs of a defined population.

Blue Cross Blue Shield Insurance Plans↗
PubMed1999

Prenatal and perinatal risk factors for autism.

AIM: To identify pre- and perinatal risk factors for autism. METHOD: Case control study. We matched names of patients from North Dakota who met DSM criteria for autism, a pervasive developmental disorder, and autistic disorder with their birth certificates. Five matched controls were selected for each case. RESULTS: Univariate analysis of the 78 cases and 390 controls identified seven risk factors. Logistic modeling to control for confounding produced a five variable model. The model parameters were chi 2 = 36.6 and p < 0.001. The five variables in the model were decreased birth weight, low maternal education, later start of prenatal care, and having a previous termination of pregnancy. Increasing father's age was associated with increased risk of autism. CONCLUSION: This methodology may provide an inexpensive method for clinics and public health providers to identify risk factors and to identify maternal characteristics of patients with mental illness and developmental disorders.

Age Factors↗
PubMed1977

Western equine encephalomyelitis in horses in the Northern Red River Valley, 1975.

In mid-July, 1975, western equine encephalomyelitis (WEE) virus was isolated from mosquitoes collected in flooded areas of eastern North Dakota and western Minnesota. Inasmuch as clinical manifestations of WEE are usually observed in horses before human cases of encephalitis are recognized, surveillance of equine disease was initiated. Sixty-one practicing veterinarians from the are under surveillance reported 281 cases of WEE in horses from June through September, with peak incidence in late July. The high percentage of sero-positive, clinically normal, unvaccinated horses in one region suggested that many horses had developed non-clinical infections. The efficacy of vaccines used by the practitioners appears to have been execllent, as none of the horses vaccinated before the epizootic became ill during the period of surveillance. It was concluded that data collected from routine surveillance of encephalomyelitis in horses could be used to predict epidemics of WEE.

Animals↗
PubMed1999

Mortality of captive Canadian toads from Basidiobolus ranarum mycotic dermatitis.

Twenty-six adult free-ranging Canadian toads (Bufo hemiophrys) were collected from northeastern North Dakota (USA) during the last week of August 1994 and placed in captivity. During late December and January 1995, 21 Canadian toads died. Clinical signs included increased time sitting in water bowls, darkened dorsal skin, constant arching of their backs, and hyperemia and sloughing of ventral epidermis. The condition progressively worsened until death occurred within 5 to 7 days after onset of clinical disease. Mycotic dermatitis due to Basidiobolus ranarum was diagnosed in all toads and the fungus was isolated from 11 (52%) of 21 toads. Histology of the ventral skin and digits revealed numerous fungal spherules and occasional hyphae without significant inflammatory reaction. This condition clinically resembled red leg associated with Aeromonas hydrophila and many other bacterial organisms, and the diseases could be confused without appropriate diagnostic tests. This also is the first report of B. ranarum causing clinical disease in a toad species.

Animals↗
PubMed2004

Practical moral codes in the transgenic organism debate.

In one study funded by the United States Department of Agriculture, people from North Dakota were interviewed to discover which moral principles they use in evaluating the morality of transgenic organisms and their introduction into markets. It was found that although the moral codes the human subjects employed were very similar, their views on transgenics were vastly different. In this paper, the codes that were used by the respondents are developed, compared to that of the academically composed Belmont Report, and then modified to create the more practical Common Moral Code. At the end, it is shown that the Common Moral Code has inherent inconsistency flaws that might be resolvable, but would require extensive work on the definition of terms and principles. However, the effort is worthwhile, especially if it results in a common moral code that all those involved in the debate are willing to use in negotiating a resolution to their differences.

Advisory Committees↗
PubMed1996

Risk factors for cardiovascular disease in individuals with diabetes. The Strong Heart Study.

Coronary heart disease (CHD) is the leading cause of death among individuals with diabetes. However, information on CHD and its association with known risk factors in populations with high rates of diabetes is limited. The purpose of the Strong Heart Study is to quantify CHD and its risk factors among three geographically diverse groups of American Indians who have a high prevalence of diabetes. The study group consisted of 4549 adults between 45 and 74 years of age in 13 Indian communities in Arizona, Oklahoma, and South and North Dakota. Rates of diabetes ranged from 33% to 72% in men and women in the three centers. The prevalence rates of definite myocardial infarction (MI) and definite CHD were higher in men than in women in all three centers (P < 0.0001) and higher in those with diabetes (P = 0.002 and P = 0.0003 in women and men, respectively). Diabetes was associated with a relatively greater increase in prevalence of MI (PR = 3.8 vs 1.9) and CHD (PR = 4.6 vs 1.8) in women than in men. Logistic regression analysis indicated that prevalent CHD was significantly related to age, diabetes, hypertension, albuminuria, percent body fat, smoking, high concentrations of plasma insulin, and low concentrations of high-density lipoprotein (HDL)-cholesterol. These findings from the baseline Strong Heart Study examination emphasize the relative importance of diabetes-associated variables as risk factors for CHD among populations with high rates of diabetes.

Adult↗
PubMed2002

The problem of bias when nursing facility staff administer customer satisfaction surveys.

BACKGROUND: Customer satisfaction instruments are being used with increasing frequency to assess and monitor residents' assessments of quality of care in nursing facilities. There is no standard protocol, however, for how or by whom the instruments should be administered when anonymous, written responses are not feasible. Researchers often use outside interviewers to assess satisfaction, but cost considerations may limit the extent to which facilities are able to hire outside interviewers on a regular basis. This study was designed to investigate the existence and extent of any bias caused by staff administering customer satisfaction surveys. METHODS: Customer satisfaction data were collected in 1998 from 265 residents in 21 nursing facilities in North Dakota. Half the residents in each facility were interviewed by staff members and the other half by outside consultants; scores were compared by interviewer type. In addition to a tabulation of raw scores, ordinary least-squares analysis with facility fixed effects was used to control for resident characteristics and unmeasured facility-level factors that could influence scores. RESULTS: Significant positive bias was found when staff members interviewed residents. The bias was not limited to questions directly affecting staff responsibilities but applied across all types of issues. The bias was robust under varying constructions of satisfaction and dissatisfaction. DISCUSSION: A uniform method of survey administration appears to be important if satisfaction data are to be used to compare facilities. Bias is an important factor that should be considered and weighed against the costs of obtaining outside interviewers when assessing customer satisfaction among long term care residents.

Activities of Daily Living↗
PubMed1988

A comparison of breastfeeding rates among children with pervasive developmental disorder, and controls.

The breastfeeding rates for 50 children with pervasive developmental disorder (PDD) from North Dakota's roster of PDD patients were compared with the national average and with the rates for a control group matched for age, sex, and IQ. In addition, the breastfeeding rates for the normal siblings of the PDD and control groups were compared with the national average to help determine whether the lower breastfeeding rate among PDD patients was a function of parenting practices. The breastfeeding rates for the PDD and control groups were not significantly different from each other, but both were significantly lower than the national average. The breastfeeding rate for the normal siblings of PDD children was almost identical to the national average, but the rate for the siblings of the matched control group was significantly lower than the national average. These results are discussed in terms of hypotheses regarding the early parent-child interactions and characteristics in the families of PDD children.

Autistic Disorder↗
PubMed1990

Assessing beliefs of older rural Americans about nutrition education: use of the focus group approach.

We used the focus group interview technique as a preliminary research step in developing a nutrition education intervention for rural seniors who, because of less than optimal eating habits and changing demographics, are an important target audience. Sixty-eight well, active, rural North Dakota seniors, 60 years or older, from communities of 2,500 or fewer people, participated in five focus groups conducted in late summer 1988. As a qualitative research approach, focus group interviews offer a means of obtaining in-depth information on a specific topic from representatives of a target audience in a discussion group atmosphere. Focus groups require careful preparation and structuring and should include a capable moderator, a prepared discussion guide, carefully recruited participants, and a comfortable setting. The process generated ideas that we are using to develop a health promotion nutrition intervention that will be a mailed-home approach, including use of incentives, social role models, cholesterol screening, and learning activities. The intervention relies on the interest and ability of seniors to make positive health changes. We conclude that the focus group approach is useful in developing nutrition education interventions.

Aged↗
PubMedDate not supplied

An epidemiological study evaluating the relationship of distance from a tertiary care cancer center to early detection of colorectal carcinoma.

OBJECTIVE: AJCC stage at diagnosis determines the treatment approach and indirectly predicts outcome in patients with colorectal carcinoma. The purpose of our study was to investigate whether there was a delay in diagnosis leading to a more advanced stage at diagnosis (which affects outcome) of patients with colorectal cancers because of distance from a referral center, after positive fecal occult blood testing (FOBT). DESIGN: Our retrospective observational study involved all cases of colonic and rectosigmoid cancers that were referred for an endoscopic procedure after an initial positive FOBT done as a part of routine screening in asymptomatic patients. PARTICIPANTS: Roger Maris Cancer Center and University of North Dakota School of Medicine and Health Sciences. RESULTS: Between the years 1996-2001, 178 subjects with biopsy-proven colon cancer and 80 patients with rectosigmoid cancer were included in our study. Pearson's correlation coefficients were constructed to look at the relationship between distance from a referral center (place where the diagnosis was made) and stage at diagnosis in patients with colonic and rectosigmoid malignancies. For the colon cancer group, the regression coefficient between AJCC stage at diagnosis and distance from the referral center was 0.013 and for rectosigmoid cancers it was 0.12. Even after stratifying distances into tertiles, the correlation coefficients did not show a significant relationship (0.04 for colon and 0.16 for rectosigmoid cancers). CONCLUSION: Distance (of residence) from a tertiary care center does not seem to be a barrier to early diagnosis of colorectal carcinoma and primary care providers in rural settings are referring patients appropriately leading to optimal outcomes.

Aged↗