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At least 73 records · Page 4Linked to original sources
PubMed1995

Certified nurse-midwifery in Kansas: survey of physicians.

Following U.S. trends, the number of practicing certified nurse-midwives in Kansas is growing. Since collaboration with physicians is vital to the successful practice of nurse-midwifery, Kansas obstetrician-gynecologists and family practice physicians were surveyed regarding certified nurse-midwifery. Seventy-two randomly-selected physicians received an 11-item questionnaire. The majority of responding physicians (n = 40) expressed an interest in certified nurse-midwifery. Most obstetricians indicated they would consider bringing a certified nurse midwife into their practices. Obstetricians were more knowledgeable about certified nurse midwifery and were more open to collaboration with nurse-midwives than were family practice physicians. Results indicate that the environment is ripe for certified nurse-midwife/physician collaboration in Kansas.

Certification↗
PubMed1995

Vaccination coverage surveys in county health departments--Kansas, 1993-1994.

The objective of the Childhood Immunization Initiative (CII) is to protect all children in the United States by their second birthday against nine vaccine-preventable diseases. Specific objectives for 1994 were to increase coverage levels to at least 85% for the third dose of diphtheria and tetanus toxoids and pertussis vaccine (DTP3) and the first dose of measles, mumps, and rubella vaccine (MMR1); 75% for the third doses of oral poliovirus vaccine (OPV3) and Haemophilus influenzae type b vaccine (Hib3); and 30% for the third dose of hepatitis B vaccine (HepB3) (1). To determine whether county health departments in Kansas had achieved the national vaccination objectives, in 1993 staff from the Kansas Department of Health and Environment (KDHE) began assessing vaccination coverage rates for children aged 2 years served by county health departments in that state. This report presents the results of the first vaccination coverage assessments of all 105 county health departments in Kansas during November 1993-November 1994.

Child↗
PubMed1996

Monthly incidence of stroke in rural Kansas.

The relationship between the principal clinical diagnosis of cerebrovascular accident (CVA) and the month of admission to a regional medical center in Northwestern Kansas was investigated. The retrospective study identified 472 charts of subjects that had been admitted to a rural regional medical center in Northwestern Kansas over a six year period with the principal clinical diagnosis of stroke. Spearman's correlation coefficients indicated there was no significant relationship between the total number of admissions per month or by number of admissions in each classification of disease coding group. The study demonstrated a peak occurrence in July (n = 55) and the lowest occurrence in September (n = 25). These findings indicate that environmental factors characteristic of Northwestern Kansas may have no effect on the occurrence of stroke.

Cerebrovascular Disorders↗
PubMed1997

Kansas v. Hendricks.

The U.S. Supreme Court considered an appeal by the State of Kansas that arose from the Kansas Supreme Court's invalidation of the Kansas Sexually Violent Predator Act. The Act establishes procedures for the civil commitment of persons who, due to a "mental abnormality" or "personality disorder," are likely to engage in "predatory acts of sexual violence." The Supreme Court held that the Act's definition of "mental abnormality" satisfies substantive due process requirements. The Court further held that since the Act does not establish criminal proceedings, it does not violate the Constitution's double jeopardy prohibitions or its ban on ex post facto lawmaking. The Court's holding and its implications are discussed.

Adult↗
PubMed2000

[Contribution of the Kansas technique for reducing complications of mature cataract surgery].

PURPOSE: We report our experience with the Kansas technique of phakosection which eliminates or limits most complications of classic manual extracapsular extraction. PATIENTS AND METHODS: This retrospective study included our first 80 patients undergoing surgery for mature cataract between May 1996 and May 1998 where we used the Kansas technique. We compared outcome with a group of 30 patients who underwent classic manual extracapsular extraction in a study performed in 1995 by the same surgeon in the same hospital. RESULTS: Per- and post-operative complications were significantly lower with phakosection. Functional rehabilitation was quicker, better and provided better patient comfort. DISCUSSION: Despite some difficulties encountered in a public hospital (viscoelastic excessively fluid and in small quantity, lack of suitable knives or reuse of sterilized disposable knives), we found that the Kansas technique is very well adapted to mature cataracts and our working conditions. CONCLUSION: Phakosection allowed us to give our patients with mature or very mature cataracts the benefit of small incisions. With a moderate increase in cost, this technique significantly reduced our per- and post-operative complication rates and gave quicker and better visual recovery. In our countries, this technique provides better care than phakoemulsification.

Adult↗
PubMed1995

Kansas coconuts: legalizing chiropractic in the first state, 1910-1915.

When the Kansas Supreme Court averred that, under existing law, chiropractic was the practice of medicine, the matter was settled. The beleaguered chiropractic profession of that state had two choices: it could risk continued harassment by the medical establishment or seek legislation. In a small frontier town in western Kansas, a benchmark trial would clearly demonstrate the public's feeling about chiropractic's right to exist on its own merits, separate and distinct from medicine. That coveted goal seemed to have been achieved by passage of the Chiropractic Act of 1913, the world's first such law. However, a board of examiners could not be legally seated. It would be a combination of brilliant legal strategy on the part of the chiropractors and the medical board's own negligence that would end the dilemma, allowing licensure in Kansas by 1915.

Chiropractic↗
PubMed1982

Morbidity and mortality associated with the July 1980 heat wave in St Louis and Kansas City, Mo.

The morbidity and mortality associated with the 1980 heat wave in St Louis and Kansas City, Mo, were assessed retrospectively. Heat-related illness and deaths were identified by review of death certificates and hospital, emergency room, and medical examiners' records in the two cities. Data from the July 1980 heat wave were compared with data from July 1978 and 1979, when there were no heat waves. Deaths from all causes in July 1980 increased by 57% and 64% in St Louis and Kansas City, respectively, but only 10% in the predominantly rural areas of Missouri. About one of every 1,000 residents of the two cities was hospitalized for or died of heat-related illness. Incidence rates (per 100,000) of heatstroke, defined as severe heat illness with documented hyperthermia, were 26.5 and 17.6 for St Louis and Kansas City, respectively. No heatstroke cases occurred in July 1979. Heatstroke rates were ten to 12 times higher for persons aged 65 years or older than for those younger than 65 years. The ratios of age-adjusted heatstroke rates were approximately 3:1 for nonwhite v white persons and about 6:1 for low v high socioeconomic status. Public health preventive measures in future heat waves should be directed toward the urban poor, the elderly, and persons of other-than-white races.

Adult↗
PubMed2002

Impact and cost-effectiveness of respiratory syncytial virus prophylaxis for Kansas medicaid's high-risk children.

OBJECTIVES: To determine the impact of prophylactic therapy for respiratory syncytial virus (RSV) infections on subsequent hospitalizations and related lengths of stay and costs and to estimate whether prophylactic treatment was cost-effective. DESIGN: Retrospective cohort study of the 1999-2000 RSV season. Propensity scores were used to identify an untreated comparison group to adjust for treatment selection bias. SETTING: State of Kansas Medicaid program. PARTICIPANTS: The study population included children 10 months or younger at the start of the RSV season or born during the season who either were premature or had chronic lung disease. All children were continuously enrolled in Medicaid throughout the season. MAIN OUTCOME MEASURES: Inpatient admission for RSV infections and associated lengths of stay and costs; cost-benefit analysis of drug costs per reduction in hospitalization costs. RESULTS: The RSV-preventive treatments reduced the odds of hospitalizations to 0.47, lengths of stay by 74%, and hospitalization costs by $703. Given an average drug cost of $4687, the cost-benefit ratio was 6.67. CONCLUSIONS: Despite the demonstrated efficacy of intravenous RSV immune globulin and palivizumab in clinical trials, use of these agents in actual practice has not generated expected outcomes in the Kansas Medicaid program. Although their use generated reductions in all 3 hospital-related outcomes, their costs overwhelmed these benefits.

Cost-Benefit Analysis↗
PubMedDate not supplied

Biological aging and Cox hazard analysis of mortality trends in a Mennonite community from south-central Kansas.

This study investigated mortality in 568 individuals from the Goessel Mennonite community in rural central Kansas. There were three main objectives to this research: 1) characterize mortality trends within a biologically well-defined Mennonite community; 2) determine what biochemical, morphological, and physiological risk factors could be related to all-cause mortality, stratified by age and sex; and 3) compare these results to previously described variables that were associated with both biological age and mortality in this population. Mortality data were obtained from three sources: Kansas Vital Records, the Social Security death index, and church records. In total, 221 (39%) individuals were found to have died in this population between January 1980-June 2002. Analogous to the larger US population, the three leading causes of death in this community were heart disease, cancer, and stroke, accounting for 60% of all deaths. Besides advancing age, the greatest biological risk factor in this population was decreased amounts of albumin in men (relative risk, 2.47), potentially indicating underreported cases of either chronic kidney disease or frailty syndrome for males. Cox proportional hazard models demonstrated that increased amounts of total cholesterol may provide a protective effect for elderly individuals. We conclude, based on the previously described heritability of both albumin (h(2) = 0.40) and total cholesterol (h(2) = 0.50) in this population, that underlying genetic factors associated with both chronic degenerative diseases and biological aging may have important implications for understanding mortality patterns in this community.

Aged↗
PubMed1987

Rhodococcus equi in fecal and environmental samples from Kansas horse farms.

Horse farms in Kansas were surveyed for the incidence of Rhodococcus equi. Fecal specimens and soil or cobweb samples were collected from each farm and cultured on selective media. One control farm (with no history of R. equi infection), one farm which had an outbreak 3 and 4 years previously and 2 farms which had R. equi-infected foals that season were surveyed. In addition, fecal samples from 21 horses hospitalized in the Kansas State University Veterinary Hospital were cultured. There was no significant difference in the incidence of R. equi in fecal samples from the 2 farms with recent disease problems. The farm with a history of disease had a significantly higher percentage of positive fecal cultures than the 2 farms with a more recent history of disease. Neither ration composition nor sex of the horses appeared to affect the fecal culture results. Fecal samples from 2 birds on 1 farm were positive for R. equi.

Animals↗
PubMed2000

The impact of a state hospital closure on local jails: the Kansas experience.

In 1990, Kansas's Mental Health Reform legislation began transferring fiscal support for the delivery of mental health services away from state institutions and into the local community, culminating in the closure of one state hospital facility in 1997. Kansas jails were studied to determine the resulting impact of that hospital closure on the State's jail systems, including whether an increase in incarceration rates of persons with severe and persistent mental illnesses followed the closure of the hospital. Though a relationship between the hospital closure and incarceration rates cannot be substantiated, the results do provide a rare birds-eye view of the extent of and problems associated with the incarceration of persons with mental illness in a predominantly rural state.

Community Mental Health Services↗
PubMed2001

Metals, boron, and selenium in Neosho Madtom habitats in the Neosho River in Kansas, U.S.A.

In 1991 and 1992 we determined the levels of metals, arsenic, boron, and selenium in the Neosho River drainage in southeastern Kansas, the primary habitat for the threatened Neosho madtom (Noturus placidus). We evaluated concentrations in sediments, mussels (Quadrula pustulosa and Q. metanevra), and fish (Percina phoxocephala, Cyprinus carpio, and Ictiobus bubalus) from three sites on the Neosho River and one site on the Cottonwood River. We also evaluated contaminant concentrations in C. carpio composite samples collected by the Kansas Department of Health and Environment (KDHE) at two additional locations on the Neosho River in 1990-92. Sediments were contaminated by lead. Concentrations of selenium, boron, and most metals in mussels were low to normal for biota. Arsenic levels in mussels and fish suggest low-level contamination of biota. Aluminum, barium, manganese and strontium concentrations were much higher in mussels than in fish. Five fish composite samples had cadmium concentrations that indicate chronic deleterious effects on biota. Lead concentrations in six fish samples were elevated. Mercury concentrations in most large fish composites exceeded concentration for protection of animals that might consume them. We believe that reductions in cadmium, lead, and mercury contamination, in particular, would benefit aquatic life in the river.

Animals↗
PubMed1999

Issues in balancing teenage clients' confidentiality and reporting statutory rape among Kansas Title X clinic staff.

Through Federal welfare reform, Congress directed states to aggressively enforce statutory rape laws. Family planning professionals deal with many adolescent clients, and their support for such enforcement or willingness to report is unclear. The authors of this study examined current attitudes and practices of family planning program managers (FPPMs) about statutory rape law enforcement, including current reporting practices. In 1997, all 77 local Kansas Title X FPPMs were surveyed. Structured telephone interviews were conducted with 10 FPPMs to add detail to quantitative responses. Sixty-eight FPPMs responded to the written survey (88%). Of these, 79% supported aggressive enforcement, and 43% thought enforcement would reduce adolescent pregnancy rates. With increased enforcement, 38% believed teenagers would be discouraged from seeking reproductive health care, compared to 41% who believed they would not. Among key informants, all of whom were FPPMs, willingness to report cases was mixed, with those who would report wanting the flexibility to judge on a case-by-case basis. For those not reporting cases, confidentiality concerns overrode beliefs in any positive outcome of enforcement. Kansas Title X FPPMs strongly supported aggressive enforcement, but had mixed beliefs about negative consequences. Among those interviewed, there were also mixed beliefs and practices about reporting. Reporting from FPPMs will be sporadic and arbitrary unless protocols are developed and laws are clarified.

Adolescent↗
PubMed1991

Ixodes scapularis (Acari: Ixodidae) in Kansas: a new distribution record.

The blacklegged tick, Ixodes scapularis Say, previously known to occur only in the extreme southeastern corner of Kansas, has been collected in Douglas and Jefferson counties in the northeast. The new collections extend the northern range of this species in Kansas by approximately 240 km. The role of I. scapularis as a vector of the Lyme borreliosis spirochete, Borrelia burgdorferi, makes this a noteworthy extension of its known range. The proximity of these new collection sites to large centers of human population is of special significance to health-care providers in that region.

Animals↗
PubMed2000

Medicare competitive pricing: lessons learned in Phoenix and Kansas City.

Many lawmakers have embraced the idea of bringing more competition to the Medicare program as a way to achieve greater cost efficiency and provide more choice for beneficiaries. Advocates of this strategy believe Medicare should move away from its historical administrative pricing approach toward a competitive bidding process similar to those used by many private purchasers. Yet, despite support for the concept, every effort to test it in the marketplace has been met with strong opposition. Most recently, competitive bidding demonstration projects set to take place in Phoenix and Kansas City have been delayed by congressional action. Nevertheless, it is clear that those participating in the demonstration projects-notably private purchasers, consumers, health plans, and the Health Care Financing Administration-have already learned a great deal about the types of issues that must be considered if Medicare is truly to pay health plans in a competitive manner. This article explores the lessons learned so far in Phoenix and Kansas City, including design considerations such as plan participation, the standard benefit package, the bidding process, and the government contribution to premiums. It also examines the reasons for opposition to the project and their implications for broader Medicare reform efforts.

Arizona↗
PubMed2002

Kansas City VAMC Optometry Residency Program: a survey of residents since 1975.

BACKGROUND: The nation's first one-year, Council on Optometric Education accredited hospital-based optometry residency program began at the Kansas City Veterans Affairs Medical Center in 1975. As part of the 25th anniversary review, past residents were surveyed to determine whether the residency had met their goals and influenced their postresidency activities. This is the first in-depth study of a single residency program. METHODS: A 34-question survey was developed based on one previously used in a 1987 national study of Veterans Affairs residents. The survey was designed to provide data comparable to that found in other residency surveys. RESULTS: Forty-eight of 50 former residents responded, and at least one survey was returned for every year from 1975 through 2000. One hundred percent of residents noted that the program met or exceeded expectations in patient diversity, workload, and level of responsibility. Additionally, almost 30% of residents currently or previously held Veterans Affairs staff positions, and they have collectively published 316 papers, 33 textbook chapters, and five textbooks. CONCLUSIONS Judged by these responses, the Kansas City Veterans Affairs Medical Center Optometry Residency Program offers an exceptional clinical training program that surpasses resident expectations. Finally, former graduates of the program have made a significant contribution to patient care and to the optometric profession as demonstrated by their clinical, academic, and research accomplishments.

Adult↗
PubMed2002

Evaluation of community health assessment in Kansas.

This article evaluates the status of community health assessment in Kansas. It describes community characteristics associated with community health assessment completion, factors contributing to success, as well as barriers and limitations that prevented Kansas communities from initiating a community health assessment or completing the process. Survey findings show that certain community characteristics such as interagency cooperation, history of success at problem solving, and shared decision-making power are strongly associated with completion of a community health assessment. Results also indicate that factors such as lack of leadership, money, and time as well as poor functioning coalitions may hinder the completion of community health assessment.

Chi-Square Distribution↗
PubMed2001

Distribution and sources of nitrate-nitrogen in Kansas groundwater.

Kansas is primarily an agricultural state. Irrigation water and fertilizer use data show long- term increasing trends. Similarly, nitrate-N concentrations in groundwater show long-term increases and exceed the drinking-water standard of 10 mg/l in many areas. A statistical analysis of nitrate-N data collected for local and regional studies in Kansas from 1990 to 1998 (747 samples) found significant relationships between nitrate-N concentration with depth, age, and geographic location of wells. Sources of nitrate-N have been identified for 297 water samples by using nitrogen stable isotopes. Of these samples, 48% showed fertilizer sources (+2 to +8) and 34% showed either animal waste sources (+10 to +15 with nitrate-N greater than 10 mg/l) or indication that enrichment processes had occurred (+10 or above with variable nitrate-N) or both. Ultimate sources for nitrate include nonpoint sources associated with past farming and fertilization practices, and point sources such as animal feed lots, septic systems, and commercial fertilizer storage units. Detection of nitrate from various sources in aquifers of different depths in geographically varied areas of the state indicates that nonpoint and point sources currently impact and will continue to impact groundwater under current land uses.

Agriculture↗