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Results for “OKLAHOMA”

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At least 451 records · Page 25Linked to original sources
PubMed1989

Outbreaks of hepatitis A among illicit drug users, Oklahoma, 1984-87.

Transmission of hepatitis A has been described in many settings, although few outbreaks have been reported among illicit drug users. We report six unrelated outbreaks of hepatitis A among users of marijuana and intravenously administered methamphetamine. Although the exact mode of transmission could not be determined, practices associated with illicit drug use may have facilitated transmission of hepatitis A. These outbreaks and other recent information indicate that illicit drug users may be at increased risk of acquiring hepatitis A infection.

Adolescent↗
PubMedDate not supplied

Management of prescription refills in primary care: an Oklahoma Physicians Resource/Research Network (OKPRN) study.

BACKGROUND: Management of prescription refills is a significant challenge for primary care practices, but little information exists on the best way to do it. METHODS: Using the "best practices research" method within a primary care practice-based research network, we delineated steps involved in the process and the most important requirements for each step. We identified potential exemplary practices for each step and conducted practice audits and patient surveys to document actual performance. Methods with the highest performance ratings for the predetermined requirements for the steps were combined into a "best" unified approach. RESULTS: Half of the surveyed practices were satisfied with at least one step in their current refill management process, but only 9% (3 practices) were satisfied with all 5 steps. Practice audits identified acceptable methods for each step. The best combined method involves teaching patients to call the pharmacy first for prescription refills, accepting only fax requests from the pharmacy, allowing a nurse or medical assistant to make most refill decisions, documenting them in the chart immediately, responding back to the pharmacy by fax, and relying on the pharmacy to notify the patient when the refill is ready. Patient satisfaction with this method was reasonably good. The cost per refill was approximately $0.25 excluding overhead associated with office equipment and utilities. CONCLUSIONS: A satisfactory method for managing prescription refills in primary care practices was identified using the best practices research method.

Benchmarking↗
PubMedDate not supplied

Clinical decision-making in blood pressure management of patients with diabetes mellitus: an Oklahoma Physicians Resource/Research Network (OKPRN) Study.

BACKGROUND: Outcomes can be improved when the blood pressure (BP) is kept below 130/80 in patients with diabetes mellitus. However, physicians and patients achieve this target less than 50% of the time. The purpose of this study was to determine the reasons for this apparent quality deficit from the perspective of a small random sample of family physicians. METHODS: Nine family physicians completed interviews about encounters with diabetic patients with BP >or=130/80 for whom no change in management was recorded. Four investigators analyzed the transcribed interviews to identify and categorize reasons for failure to intervene. RESULTS: Ninety-eight (62%) of 159 patients had BP >or=130/80 at the index visit. No change in management was recorded in 73 (74%). Physicians gave 175 reasons for nonintervention in 3 broad categories, physician-related, patient-related, and information/measurement-related reasons, and 10 subcategories. In most cases they gave more than one reason (mean 2.4) per case. The most frequent subcategories were limited treatment options (47/73; 64%), inadequate information on which to intervene (43/73; 59%), and patient nonadherence (27/73; 37%). Competing demands were mentioned in 10 cases (13.7%). Physicians differed with regard to the kinds of reasons given. CONCLUSIONS: Physicians have a variety of clinical reasons for not responding to elevated BP in diabetic patients. Some might be addressed with better technology (eg, more reliable BP measurements) or health care system reforms (eg, less expensive medications). Others (eg, patient nonadherence) are more challenging. Methods for measuring quality must be robust enough to account for legitimate clinical reasons for not achieving BP targets. Physician-based interventions will need to take into account different physician personalities and practice styles.

Adult↗
PubMed2006

A comparison of the military entrance processing station screening audiogram with the Defense Occupational and Environmental Health Readiness System reference audiogram at Fort Sill, Oklahoma, in 2000.

BACKGROUND: The Department of Defense Hearing Conservation Program requires that a reference audiogram be performed at initial entry training (IET), before noise exposure. In the Army, only Fort Sill, home of the field artillery, and Fort Benning, home of the infantry, are in compliance. All military applicants receive a screening audiogram at a military entrance processing station (MEPS) to qualify for service. This audiogram does not meet the Defense Occupational and Environmental Health Readiness System-Hearing Conservation (DOEHRS-HC) standard. Nevertheless, it has been proposed that the MEPS screen be used as the reference because of limited resources and time during IET medical in-processing. METHODS: A total of 11,816 individual reference audiograms performed at Fort Sill 95th Adjutant General Recruit Reception Center in 2000 were identified in the DOEHRS-HC database. Results of the MEPS screening audiograms were found for 11,311 (96%) of these individuals. The two audiograms were compared by frequency and ear and by using the two Department of Defense criteria for threshold shift. RESULTS: A total of 14.49% (95% confidence interval, 14.48-14.50%) of audiograms using the three-frequency average difference and 23.19% (95% confidence interval, 23.18-23.20%) using the four-frequency difference in either ear demonstrated a threshold shift. The mean difference in intensity between the two audiograms ranged from 5 to 12 dB and varied by frequency and ear, with the greatest differences being seen at 500 and 6,000 kHz and in the left ear, compared with the right ear. The mean threshold level was higher for each frequency in the DOEHRS-HC audiogram, compared with the MEPS audiogram. CONCLUSIONS: Approximately 15% of soldiers at Fort Sill in 2000 showed a clinically significant threshold difference between their MEPS screening and the DOEHRS-HC baseline audiogram. Methodological variations in testing and interval noise-induced hearing loss could account for these differences. The results do not support the use of the MEPS screening audiogram as the reference audiogram. Compliance with the Hearing Conservation Program in the Army would require either improving MEPS testing to DOEHRS-HC standards or performing baseline audiograms at all five IET sites.

Adolescent↗
PubMed2001

Aflatoxin production in supplemental feeders provided for northern bobwhite in Texas and Oklahoma.

Mycotoxins are toxic metabolites produced by varous species of fungi. Aflatoxin (AF), a particular type of mycotoxin, can negatively impact many wildlife species in the laboratory; however, the magnitude of the problem in the field environment is unclear. Wild birds generally consume a combination of native foods and agricultural grains. A common practice in which birds, such as northern bobwhite (Colinus virginianus), contact stored agricultural grain is through supplemental feeding. This feeding practice may promote the production of AF. The objectives of this study were to (1) examine AF production in supplemental feeders and (2) examine the relationship between weather and AF production in supplemental feeders. Samples were collected from supplemental feeders from November through February of 1996-97 and 1997-98. Mean monthly AF concentration of samples from feeders ranged from 0.57+/-2.86 to 15.47+/-14.69 ppb. Aflatoxin concentration in supplemental feeders increased from pre-sample to one month after filling the feeders each year. AF production in supplemental feeders was highly variable among months with no real temporal pattern between years. Instead, AF production was related to the highly variable relative humidity of the study area which influences moisture content of grain. Average relative humidity can be used to predict AF production.

Aflatoxins↗