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PubMed1995

Polymerization of recombinant Hb S-Kempsey (deoxy-R state) and Hb S-Kansas (oxy-T state).

In order to investigate the role of the R (relaxed) to T (tense) structural transition in facilitating polymerization of deoxy-Hb S, we have engineered and expressed two Hb S variants which destabilize either T state (Hb S-Kempsey, alpha 2 beta 2 Val-6,Asn-99) or R state structures (Hb S-Kansas, alpha 2 beta 2 Val-6, Thr-102). Polymerization of deoxy-Hb S-Kempsey, which shows high oxygen affinity and increased dimer dissociation, required about 2- and 6-fold higher hemoglobin concentrations than deoxy-Hb S for polymerization in low and high phosphate concentrations, and its kinetic pattern of polymerization was biphasic. In contrast, oxy- or CO Hb S-Kansas, which shows low oxygen affinity and increased dimer dissociation, polymerized at a slightly higher critical concentration than that required for polymerization of deoxy-Hb S in both low and high phosphate buffers. Polymerization of oxy- and CO Hb S-Kansas was linear and showed no delay time, which is similar to oversaturated oxy- or CO Hb S. These results suggest that nuclei formation, which occurs during the delay time prior to deoxy-Hb S polymerization, does not occur in T state oxy-Hb S-Kansas, even though the critical concentration for polymerization of T state oxy-Hb S-Kansas is similar to that of T state deoxy-Hb S.

Carboxyhemoglobin↗
PubMed2002

Nutrient composition of Kansas swine lagoons and hoop barn manure.

A total of 312 samples in two experiments were analyzed to determine mean nutrient concentrations of swine lagoons and hoop barns in Kansas. First, in a retrospective study (Exp. 1), we obtained 41 sample analyses from the Kansas Department of Agriculture of sow, nursery, wean-to-finish, finish, and farrow-to-finish operations in 1999. The average total N concentration was 899 ppm (SD = 584 ppm), while the total P concentration was 163 ppm (SD = 241 ppm). In an attempt to reduce the variation, we conducted a prospective experiment standardizing collection procedure, laboratory techniques, phase of production, and season of year to more accurately determine the nutrient concentrations of swine lagoons in Kansas. In Exp. 2, we used 236 lagoon and 35 hoop barn manure samples taken in 2000 from Kansas swine operations to determine the impacts of production phase and season of the year on nutrient concentration. The different operations with swine lagoons were: 1) sow; 2) nursery; 3) wean-to-finish; 4) finish; and 5) farrow-to-finish, with a total of 9, 8, 7, 10, and 8 lagoons sampled from each phase of production, respectively. The total N and P concentrations from lagoons were 1,402 and 204 ppm, respectively, averaged over all samples. Concentrations of total N were higher in wean-to-finish and finishing lagoons (P < 0.05) compared with sow and farrow-to-finish lagoons. Lagoon analyses also revealed that N concentrations decreased (linear, P < 0.05) during the summer and fall compared with winter and early spring. The concentration of P was greater (P < 0.05) for wean-to-finish compared with farrow-to-finish lagoons. Phosphorus concentrations for all lagoons increased (quadratic, P < 0.05) from February until June, but then declined steady throughout the remainder of the year. Average total N and P in hoop barns were 8,678 and 4,364 ppm, respectively. No seasonal changes in N and P concentrations were observed in manure from hoop barns. Season and type of production phase affect the nutrient content of Kansas swine lagoons, and producers will benefit from obtaining individual analyses from their lagoons when developing nutrient management plans rather than utilizing published reference values.

Animal Husbandry↗
PubMed2006

Low back pain and musculoskeletal symptoms among Kansas farmers.

BACKGROUND: Farming continues to rank as one of the most dangerous occupations in the United States. The purpose of this study was to determine the prevalence of low back pain and other musculoskeletal disorders (MSDs) among the farmers and to examine the factors associated with occupational back pain. Farmers in a predominately corn and soybean growing region of Kansas served as the study sample. METHODS: Questionnaires were mailed out to 499 active farmers of a Farmers' Cooperative in Southeast Kansas. The self-administered questionnaire was used to determine the prevalence of self-reported symptoms of back pain and other MSDs and to determine the strength of associations between back pain and work factors. RESULTS: The participation rate was 57.2%. The low back was the anatomical area with the highest prevalence of self-reported work-related pain (37.5%), followed by the shoulders (25.9%), knees (23.6%), and neck (22.4%). Close to 60% of the farmers reported that they experienced farm work-related MSD symptoms in at least one of the nine body areas in the previous year. Nearly one quarter of the farmers reported seeing a physician for their low back symptoms, and one in five farmers had to modify their work habits due to low back symptoms during the previous year. CONCLUSIONS: Low back pain and other musculoskeletal conditions are a significant problem for Kansas farmers. This group of Kansas farmers experienced low back pain at a much higher rate than the general working population and higher than other groups of farmers previously studied.

Aged↗
PubMed2003

The Kansas Living Initiatives for End-of-Life Care.

The Kansas Living Initiatives for End-of-Life Care (LIFE) project was formed in 1999 by over 70 Kansas organizations, agencies and associations to further the cause of dignified, comfortable and peaceful end of life in terminally ill patients. LIFE developed a module on end-of-life care that was added to the Kansas year 2000 Behavioral Risk Factor Surveillance system, convened meetings of partners including health professional licensing boards, reviewed state laws and regulations, and published a joint policy statement of the Kansas Boards of Healing Arts, Nursing and Pharmacy on the use of controlled substances for pain management. Activities of Project LIFE and outcomes are described.

Health Policy↗
PubMed1991

Medicolegal aspects of tornadic storms in Kansas, U.S.A.

Kansas is known for its fierce whether, including tornados in the spring and fall and blizzards in the winter. A recent series of tornados cut a path of destruction a mile wide for greater than 40 miles (64 km), killed 20 people, and caused several hundred casualities on the evening of April 26, 1991, in Tornado Alley, which runs from the northern border of Oklahoma through southern Kansas past Wichita toward Emporium, Kansas. The wind velocity was greater than 200 mph. Twenty people were killed, 17 of these in Andover, Kansas, a small town east of Wichita. Injuries caused by the tornados and the excellent emergency response and care provided by medical, law-enforcement, and volunteer personnel in the wake of the storms are described here.

Cause of Death↗
PubMed1984

Physical measurements of 9- to 12-year-old children in Kansas.

Measurements of height, weight, triceps, skinfold, and arm circumference were obtained from 3,231 Kansas children 9 to 12 years old as part of the Nutrition Education and Training Needs Assessment Project. Data were collected in 97 schools randomly selected throughout the state. Participating fifth grade students were divided equally between boys and girls; approximately 95% were Caucasian, 3.4% were black, and the remainder were from other ethnic groups, a profile similar to that of the Kansas population. Girls and boys in the study sample tended to be taller and to weigh more than girls and boys of similar age in national studies. Because of adolescent growth spurts, which differ among individuals, the data would need to be interpreted with caution if individual students' growth patterns were being assessed. Kansas girls and boys also tended to have larger triceps skinfold and arm fat area measurements than their counterparts in the NHANES I study. Those data, coupled with the tendency toward greater weight, suggested a greater incidence of overweight among Kansas children than among elementary school children nationally.

Body Height↗
PubMed1996

"Empyricism" in Kansas: Chiropractic's legal struggle, 1906-1915.

Empiricism plagued the Kansas Territory even as it entered into statehood and was caused by numerous dabblers into the health care field. They were 'wannabe' doctors of all kinds: pure charlatans, fakers of all type, faith healers and even osteopaths and chiropractors, all practicing in violation of Kansas law from 1854-1914. This was not an unusual finding in any of the western territories, before or since. This article describes the chiropractic struggle for licensure from 1906-1915. Numerous chiropractors suffered the indignity of arrest, trial, fines or even jail while pursuing the ultimate goal of an independent chiropractic act. The enacted Kansas chiropractic act of 1913 became the focal point of the battle for a board of examiners to issue licenses. The specific language therein set forth a requirement for the first appointed board members; it mandated practice of a stipulated number of years before licensure. Only in Kansas, and later California, would this language cause dire consequences.

Chiropractic↗
PubMed2005

Perinatal periods of risk: analysis of fetal-infant mortality rates in Kansas City, Missouri.

OBJECTIVES: The Perinatal Periods of Risk (PPOR) technique was used to analyze resident fetal and infant death data from Kansas City, Missouri, for the period 1998-2002. Results offer important information that can be used to develop community-based prevention strategies related to racial/ethnic disparities in infant mortality rates (IMR). METHODS: The PPOR approach for fetal and infant mortality can be mapped by birthweight at delivery and time of death into four strategic prevention areas: 1) Maternal Health/Prematurity (MHP), 2) Maternal Care (MC), 3) Newborn Care (NC), and 4) Infant Health (IH). For this analysis, all fetal and infant death certificates from the metropolitan Kansas City area were linked to their birth certificates and those associated with residents of Kansas City, Missouri, proper were used to create the dataset used in this analysis. Due to the small number of fetal and infant deaths among other ethnic groups, the analysis was restricted to a comparison of the disparity of IMR between Blacks, Whites, and a national non-Hispanic white reference group. The Kitagawa formula was used to determine contribution to excess deaths from birthweight-specific mortality and birthweight distribution rates. Logistic regression techniques were used to identify risk factors for death among Black fetuses and infants with very low birthweights and also deaths due to sudden infant death syndrome (SIDS). RESULTS: The PPOR analysis showed that of the excess deaths among black infants, when compared to a national reference group, 47% was attributable to MHP and another 29% was attributable to IH. Differences in MC and NC only accounted for 27 and 8% of the total excess deaths. During the study period, rates of sudden infant death syndrome (SIDS) were found to be significantly higher among Blacks as compared to Whites (2.12 vs. 0.81 per 1,000). An analysis of maternal characteristics for SIDS deaths among blacks using a step-wise logistic regression model, found that maternal age less than 20 years old, previous births, inadequate prenatal care, and being a Medicaid recipient were significant-adjusted odds ratios of 23.7 (95% Cl 10.48, 53.67), 8.4 (95% Cl 3.64, 19.21), 2.9 (95% Cl 1.38, 6.05) and 2.5 (95% Cl 1.04, 5.84), respectively. CONCLUSIONS: PPOR is an easy to use approach that helps focus community initiatives for improving maternal and infant health. In Kansas City, Missouri, efforts to further lower IMR in blacks can be achieved through the reduction of risk factors affecting maternal health and through maternal education to improve infant health.

Adolescent↗
PubMed1988

Autoimmune antibody (IgG Kansas) against the fibrin stabilizing factor (factor XIII) system.

Serum from a patient who died from massive hemorrhage within 4 months after onset of an acquired bleeding disorder at age 85 contained a potent inhibitor of fibrin stabilization. Other parameters of coagulation and fibrinolysis and his bleeding time were within normal limits. The inhibitor was shown to be an IgG with kappa light chains (IgG Kansas); its specific target was the factor XIII system itself. Although IgG Kansas combined with the virgin [ab] form of the zymogen, it did not block the thrombin-catalyzed conversion to [a'b]. However, IgG Kansas prevented the subsequent Ca2+-mediated activation of [a'b] to a + b, where a denotes the catalytically competent factor XIIIa species. IgG Kansas, in contrast to a previously studied autoimmune antibody from a similar bleeding disorder (IgG Warsaw), could also inhibit the transamidating activity of the preactivated a enzyme.

Aged↗
PubMed2001

Itinerant surgical and medical specialist care in Kansas: report of a survey of rural hospital administrators.

In most rural areas, specialist nonprimary care, when available, is provided by "itinerant" physicians and surgeons who periodically visit from a distant home base. Little is known about current usage and acceptability of itinerant specialists in rural communities. Administrators of hospitals in rural and frontier Kansas counties were asked to report the frequency of itinerant care in their facilities, the home base of each specialist and a listing of procedures performed during specialist visits. Administrators were also asked to respond on a Likert scale to six questions inviting their assessment of itinerant care. Responses were received from 53 of 56 hospitals. All offered at least one monthly session of itinerant medical or surgical care. The most common specialties represented were cardiology (in 87 percent of hospitals), urology (68 percent), orthopedics (68 percent) and radiology (60 percent). General surgeons consulted in over 80 percent of responding hospitals. Psychiatrists, dermatologists and neurologists were rarely available in the hospitals surveyed. Administrators generally rated itinerant care highly, though some expressed concern about revenue lost when specialists performed procedures in their home-base office or hospital. No associations were found between amount of care offered and potential explanatory variables such as hospital size, distance from subregional centers, or percentage of patients hospitalized locally. Further study is needed to better understand differences in itinerant specialist utilization and acceptance among rural Kansas hospitals. Because Kansas demographics are similar to those of many other American rural areas, such study may offer insights applicable to other regions.

Hospitals, Rural↗
PubMed2002

Distribution and prevalence of Echinococcus multilocularis in wild predators in Nebraska, Kansas, and Wyoming.

To further determine the distribution and prevalence of Echinococcus multilocularis in the central United States, 245 wild canids (125 red foxes, 120 coyotes) and 33 bobcats were collected from Nebraska, Kansas, and Wyoming and examined for this parasite. Animals examined included 11 red foxes from the western panhandle of Nebraska; 5 red foxes and 30 coyotes from southern Nebraska; 56 red foxes and 1 coyote from northeastern Nebraska; 20 red foxes, 63 coyotes, and 13 bobcats from northern Kansas; 2 red foxes, 26 coyotes, and 20 bobcats from southern Kansas; and 31 red foxes from east-central Wyoming. Of these, 27 of 72 (37.5%) red foxes from Nebraska were positive, including 2 of 11 (18.2%) from the western panhandle and 25 of 56 (44.6%) from the northeastern part of the state. Mean intensity of infection was 282 worms (range, 1-5,150). New distribution records were established for E. multilocularis in western Nebraska as well as for several northeastern counties. These findings support previous estimates that the southernmost front of the parasite's range extends along the southern border of Wyoming, eastward through central Nebraska and central Illinois into Indiana and Ohio.

Animals↗
PubMed2004

Hemorrhagic disease in Kansas: enzootic stability meets epizootic disease.

Kansas (USA) could represent a transition area between contrasting epidemiologic patterns of hemorrhagic disease (HD) in the midwestern United States. In this study, we compare the distribution of reported clinical HD with serologic data to determine whether the risk of HD in white-tailed deer (Odocoileus virginianus) is associated with geographic location corresponding to the reported distribution of two white-tailed deer subspecies. On the basis of a high prevalence of antibodies (91-100%) to multiple serotypes of epizootic hemorrhagic disease virus (EHDV) and bluetongue virus (BTV), with correspondingly few reports of clinical HD, it appears that a state of enzootic stability exists in central and western Kansas. This area corresponds to the reported range of O. virginianus texanus. In contrast, in the eastern third of the state, which corresponds to the reported range of O. virginianus macronurus, antibody prevalence is significantly lower (45%), EHDV serotypes appear to predominate, and HD, as confirmed by virus isolation, has been consistently reported. These results suggest an abrupt demarcation between enzootic stability in central and western Kansas to a pattern of epizootic HD within the eastern part of this state. Understanding host, vector, and environmental variables responsible for these contrasting patterns could have application to understanding the risk of HD in the midwestern United States.

Animals↗
PubMed2002

Getting to no: how Kansas advocates derailed the Anthem steamroller.

A battle royale has taken shape in Kansas about the future of its Blue Cross and Blue Shield plan. This past February, Kansas Insurance Commissioner Kathleen Sebelius rocked the corporate health care establishment by refusing to allow Anthem Insurance Company to buy the state's independent Blue Cross and Blue Shield plan. Then in June, a state judge overturned her decision. Now the case is headed to appeals court, where Sebelius will seek to have her decision reinstated. At the heart of the legal wrangling is the unprecedented manner in which advocates have asserted consumer interests, raising issues that will persist long after the courts hand down a final ruling. States of Health looks at how consumer advocates have responded to the proposed Blues transaction, a process that has strengthened the health consumer voice in Kansas--and offers important lessons for advocates in other states as well.

Blue Cross Blue Shield Insurance Plans↗
PubMed1992

Tornado disaster--Kansas, 1991.

On April 26, 1991, 54 tornadoes swept across six midwestern states, causing 24 deaths and more than 200 injuries, requiring disaster-relief services for more than 8000 persons, and causing property damage of more than $250 million. In Kansas, one tornado, with wind speeds exceeding 260 mph, caused 17 deaths. The 46-mile path of the tornado led through Andover, Kansas (Butler County) (population: 4300), where the town's only outdoor warning siren failed. A mobile-home park (MHP) in Andover with 244 homes and one community storm shelter was struck by the tornado, resulting in the destruction of 205 (84%) of these homes. This report summarizes a poststorm survey, conducted by local health departments, the Kansas Department of Health and Environment, the American Red Cross, and CDC, to identify risk factors for injury and death among persons in the MHP.

Adult↗
PubMedDate not supplied

Oral health progress in Kansas.

In 2003, Kansas received a grade of "D+" from Oral Health America in an annual rating of the state's oral health status (Oral Health America, 2003). This low grade confirmed what advocates had been saying for some time: Kansas---at several levels--is not taking seriously the oral health needs of many of its citizens. The purpose of this article is to discuss the Kansas dental health system and the role of the nurse in oral health.

Delivery of Health Care↗
PubMed2005

Improvement in local public health preparedness and response capacity--Kansas, 2002-2003.

After the terrorist attacks of September 11, 2001, increased funding was provided to federal, state, and local health departments to improve their capacities for terrorism preparedness and emergency response. To evaluate the effect of this funding and to identify priority program areas in Kansas, the Kansas Association of Local Health Departments (KALHD) contracted with the Kansas Health Institute (KHI) to perform an independent assessment of local health department (LHD) preparedness capacity using a CDC assessment tool. This report summarizes the results of two surveys of LHDs and changes in preparedness capacity from 2002 to 2003. The findings indicated a substantial increase in local preparedness capacity, although increases among counties varied widely. Repeated assessments of preparedness using standardized tools can provide useful information to help guide federal, state, and local public health policies and investments.

Disaster Planning↗
PubMed2002

Processing complaints and disciplining nurses. An overview of the investigative process by the Kansas State Board of Nursing.

This is a brief review of the process the Kansas State Board of Nursing would utilize when investigating a complaint and determining discipline against a licensee, and does not include all points of law that could apply. Although the Kansas Administrative Procedures Act was discussed, there are many sections of the statute that were not addressed. The Board of Nursing has published two pamphlets "Your Rights Before the Kansas State Board of Nursing" and "The Investigative Process" which are valuable to the nurse in understanding the process. These are available on the KSBN's website www.ksbn.org or by mail.

Data Collection↗
PubMed2006

Outbreaks of multidrug-resistant Shigella sonnei gastroenteritis associated with day care centers--Kansas, Kentucky, and Missouri, 2005.

Infection with Shigella sonnei that is resistant to antibiotics commonly used in pediatric practice has become more common during the past decade. In 2005, Kansas, Kentucky, and Missouri reported increases in shigellosis cases associated with day care centers caused predominantly by multidrug-resistant (MDR) (i.e., resistant to ampicillin and trimethoprim-sulfamethoxazole [TMP/SMX]) strains of S. sonnei. Pulsed-field gel electrophoresis (PFGE) patterns for isolates from Kansas and Missouri were similar, suggesting a common outbreak in the Kansas City area, whereas isolates from Kentucky had a different pattern. This report describes the investigation of two outbreaks of MDR shigellosis associated with day care centers and reviews measures for prevention and control of S. sonnei infection in these settings. Given the current rates of resistance to antibiotics available to treat children with shigellosis safely, public health measures initiated during shigellosis outbreaks should focus on promoting appropriate handwashing and diapering practices in day care centers.

Adolescent↗