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STUDY OBJECTIVE: To compare emergency physician (EP) credentialing characteristics in two metropolitan areas of Missouri: Kansas City, which has had an emergency medicine (EM) residency program since 1973, and St Louis, which is without a program approved by the Accreditation Council for Graduate Medical Education. METHODS: A cross-sectional, descriptive survey concerning EP training, certification, and practice characteristics was administered by standardized telephone interviews. Participants were all emergency department directors in Kansas City and St Louis general hospital EDs serving more than 10,000 patients annually. RESULTS: Twenty Kansas City EDs, with an annual census of 20,250 +/- 7,200; and 30 St Louis EDs, with an annual census of 27,100 +/- 13,800, were surveyed. In Kansas City, 68% of practicing EPs were EM trained, versus 10% in St. Louis (P < .0005). The percentage of board-certified EPs was also greater in Kansas City than in St Louis (82% versus 42%, P < .0005). Eighty-six percent of ED directors in St Louis, compared with 30% in Kansas City, reported that they did not attempt to recruit EM-trained staff or that recruitment was difficult (P < .0005). CONCLUSION: The presence of an EM residency training program is associated with favorable EP credentialing characteristics in the Kansas City metropolitan area. This information may prove useful to institutions attempting to establish EM training programs in areas where none currently exist.
A total of 278 veterinarians throughout Kansas were sent mail-in survey forms asking specific questions relating to their experience with fasciolosis in their practice area. Replies were received from 178 (64%) veterinarians representing six practice types; one-third reported having seen cases of fasciolosis in their practice. The results of our survey indicate that the majority of the cattle diagnosed with liver fluke disease in Kansas are imported from other areas of the USA. However, in both central and southeastern regions of Kansas, some cattle that had never been out of the state were infected with Fasciola hepatica. Thus, these areas of Kansas should be considered endemic for liver fluke disease. Methods of diagnosis, types of operations, and improvements seen after treatment were also discussed. In order to ascertain the existence of one or more possible snail intermediate hosts within Kansas, five species of lymnaeid snails were collected from central and southeastern parts of the state and tested for their susceptibility to infection by Fasciola hepatica. The snails collected included Pseudosuccinea columella, Fossaria obrussa, Fossaria bulimoides, Fossaria parva and Fossaria dalli. Of these, Pseudosuccinea columella and Fossaria bulimoides proved susceptible to experimental infection by Fasciola hepatica. Metacercariae obtained from experimentally infected snails were used to infect both a weanling calf thereby completing the life cycle of the parasite. This report is the first to identify the existence of suitable snail intermediate hosts for Fasciola hepatica in Kansas.
BACKGROUND: Numerous studies continue to demonstrate the needs for improved palliative and end-of-life care. OBJECTIVE: Kansas stakeholders joined together, under the leadership of the Kansas Hospice and Palliative Care Organization (formerly the Association of Kansas Hospices) in 1997, to improve palliative and end-of-life care for Kansans living with advanced chronic and terminal illnesses. DESIGN: The Kansas LIFE Project (Living Initiatives for End-of-Life Care) plans and implements strategic initiatives and projects that engage public policy leaders, healthcare professionals and Kansas citizens. SETTING: Grassroots community coalitions, LIFE Project Caring Communities, have been developed, supported, resourced, and maintained as a core strategic and action tool. for assuring that local and state progress is achieved and meaningful and relevant to Kansas citizens. CONCLUSION: Local community coalitions have the best understanding of citizen needs and are important to include in state-level planning and action in ways that lead to successful, meaningful and relevant outcomes for improved care for citizens living with advanced chronic and terminal illnesses. With adequate support and strong leadership, local coalitions can effectively leverage their presence and "ownership" of communities to drive change among health care professionals, policy leaders, and citizens.
The Kansas Regional Medical Program Office for Library Services was developed to link the medical library resources and to make them available to health-related personnel throughout Kansas. Library offices have been established at the Central Kansas Medical Center, Great Bend, Stormont Medical Library, Topeka, and at the Wichita State University, Wichita. The main office, located at the Clendening Medical Library, University of Kansas Medical Center, Kansas City, provides medical library services to those three offices, the other medical libraries in Kansas, and to the health professionals in the state who do not have medical library resources available. Reference requests are accepted via a twenty-four-hour telephone service from medical librarians and from individual health professionals.
The isolated beta subunit of hemoglobin Kansas has an oxygen affinity that is as low relative to the oxygen affinity of the beta(A) subunit as the affinity of hemoglobin Kansas is low relative to hemoglobin A. Thus the low affinity properties of hemoglobin Kansas are almost completely reflected in the properties of the isolated subunits. The kinetic results show that the equilibrium affinity difference results both from a much larger oxygen dissocation rate constant in beta(Kansas) (k = 37 sec(-1) and 18 sec(-1) for beta(Kansas) and beta(A), respectively) and from a lower association reaction rate, The properties of the alpha chains from hemoglobins A and Kansas appear to be identical, as expected.
OBJECTIVES: This paper describes the development, implementation, and participant satisfaction of a faculty development program for community-based clinician educators with competencies in geriatric medicine. DESIGN: One group, ongoing trial. SETTING: University of Kansas School of Medicine, Kansas City, Kansas. PARTICIPANTS: Family physicians and general internists from throughout the state of Kansas (n = 30). INTERVENTION: This is an integrated faculty development curriculum of clinical geriatrics and educational process offered in nine sessions over 3 years. MEASUREMENTS: Project retention, session attendance, and participant satisfaction are the measures of program success. MAIN RESULTS: Project retention at 18 months, the midpoint of this project, has been 87%, with 91% of the retained participants attending all of the sessions to date. More than 95% of the participants have rated each of the first five sessions as highly satisfactory or excellent in meeting their needs as a clinician educator. Satisfaction for on-site and interactive televideo participation has been equally high. CONCLUSIONS: Our preliminary results indicate the Kansas Hartford Geriatrics Project model of community-university collaboration in geriatric faculty development is successful in recruitment and satisfaction of participants. The curriculum is highly attractive and rewarding to faculty. Interactive televideo provides a successful innovation in aging-oriented faculty development.
In late August 2004, the Kansas Department of Health and Environment (KDHE) received reports from the Crawford County Health Department (CCHD) of approximately 300 residents of Pittsburg, Kansas (2000 population: 19,243), seeking care for a pruritic rash of unknown etiology. In early September, three neighboring counties in Kansas and two neighboring states (Missouri and Nebraska) also reported such cases. These events prompted KDHE to request assistance from CDC. Additional cases subsequently were reported in Oklahoma and Texas. This report describes the investigation in Crawford County, Kansas, by public health agencies and entomologists to identify the etiology of the pruritic rash and to assess the extent of the outbreak. A microscopic itch mite (Pyemotes herfsi) was identified as the likely cause of the outbreak, which affected an estimated 54% of the Crawford County population (2000 population: 38,242). Entomologists confirmed the return of P. herfsi in Kansas in August 2005 and have recommended prevention measures, such as use of DEET-containing products, to help minimize exposure for persons outdoors.