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PubMed2007

Blending education, research, and service missions: the Arkansas model.

Creating school and community partnerships with academic health centers (AHC) offers one strategy for initiating and sustaining broad-based change in health systems. This article describes the development, initial evaluation, and current iteration of the Arkansas Partners in Behavioral Health Sciences Model, a collaboration between personnel from an AHC and K-12 schools to address behavioral health issues in children. The model's focus on education, research, and service provides an opportunity for AHC faculty and school personnel to collaborate to promote mental health in school-aged youth. Quantitative and qualitative methods have been used to inform development and confirm effectiveness of the program. From 2001 through 2005, more than 2,700 school personnel from 72 of the 75 counties in Arkansas participated in more than 30,000 hours of continuing education. The programs have also targeted students using interactive televideo presentations, supplemental classroom curricula, and an exhibit in a state science museum, resulting in an outreach to more than 2,500 youths. Results of longitudinal and randomized studies also show changes in knowledge, attitudes, and behaviors. In an era of extraordinary need and finite resources for school systems, AHCs are poised to provide the critical link to improve the scientific knowledge and understanding of behavioral health conditions. The current program targets behavioral health, but AHCs also can incorporate other health conditions, scientific topics, and medical interventions to provide a important service for the public and to accomplish an important mission toward health leadership in the community.

Academic Medical Centers↗
PubMed2004

Educational strategies to enhance placement and retention of nurse practitioners in rural Arkansas.

PURPOSE: To examine the factors and incentives enhancing nurse practitioners' (NPs') long-term employment in rural areas. DATA SOURCE: The participants were 121 master's prepared or higher educated NPs located in rural Arkansas. A survey about role preparation and employment factors was mailed to the participants. CONCLUSIONS: We found that 10% of all respondents were not currently employed in the role of an NP. The majority of rural-employed NPs had didactic content focusing on rural-practice opportunities and engaged in rural practicums while in graduate school. Rural NPs were much more likely to have graduated from research-intensive universities. Nearly 90% of NPs reported they were somewhat to very well prepared for practice in rural Arkansas. IMPLICATIONS FOR EDUCATION: The shortage of health care providers remains one of the most irresolvable problems in the U.S. health care delivery system. Compounding the shortage is the unequal distribution of health care practitioners in rural areas. Evidence indicates that NP students engaged in rural clinical practicums were more likely to practice in rural areas. In light of this information, nurse educators should expand the NP educational process beyond rurally located practicums to deliver the entire educational process to the NP students' rural homes.

Adult↗
PubMed1986

Smokeless tobacco use among rural high school students in Arkansas.

This study determined the prevalence of smokeless tobacco use among high school students in selected rural communities in Arkansas, and identified factors associated with initiation and maintenance of use. A questionnaire was distributed to 1,237 students in 13 rural high schools in different educational service regions of Arkansas during spring 1985. Results indicated 34.5% of males and 2.5% of females reported regular use of smokeless tobacco. The factor contributing most to initiation of this practice was the influence of a parent who used smokeless tobacco products. Comparisons to other recent studies and implications for health educators are discussed.

Adolescent↗
PubMed2005

Arkansas school nurses' role in statewide assessment of body mass index to screen for overweight children and adolescents.

National surveys that have tracked weight and physical activity in the United States for more than 40 years have shown a continuing increase in the number of overweight children and adolescents. Overweight children and adolescents are showing an increase in diseases related to overweight: Type II diabetes, cardiovascular disease, hypertension, and orthopedic and respiratory conditions. Overweight children are also likely to become obese adults. This article describes Arkansas's efforts to connect with families through schools to prevent or reduce overweight in children. Arkansas school nurses measured the heights and weights of more than 400,000 public school students during the 2003-2004 school year. A detailed protocol for accurate measurement of students is provided.

Adolescent↗
PubMed2004

Arkansas Tobacco Settlement Proceeds Act of 2000: results from education and engagement with policy makers and the public.

The 1998 Tobacco Master Settlement Agreement (MSA) resulted in a singular and unanticipated revenue stream flowing to state governments from U.S. tobacco companies. In response, public health leaders were challenged with an opportunity to secure funding for much needed health programs. However, state leaders have chosen to utilize these new funds for a wide variety of purposes; in many instances, expenditures totally unrelated to health or health care. In contrast, Arkansas is unique among all states in choosing to utilize MSA funds solely to establish new health-related programs. Examination of the educational and developmental process through which Arkansas designed its expenditure plan, secured political support, and initiated new health programs in a time of budgetary constraints will inform public health officials to more effectively engage policy makers at local, state, and federal levels.

Arkansas↗
PubMed2005

Teaching breast cancer screening to African American women in the Arkansas Mississippi river delta.

PURPOSE/OBJECTIVES: To determine the effectiveness of a multifaceted, culturally sensitive breast cancer education program for African American women in the Arkansas Mississippi River Delta. DESIGN: Experimental (i.e., posttest only, control group design). SETTING: African American churches and a county Extension Homemakers Club sponsored through the Arkansas Extension Homemakers council. SAMPLE: 53 African American women. The experimental group included 30 participants who had a mean age of 56 years, and the control group consisted of 23 participants with a mean age of 51 years. METHODS: After the presentation of a multifaceted, culturally sensitive breast cancer education program, a variety of instruments were administered to participants in the experimental group that measured dependent variables. Subjects in the control group completed the same instruments in the absence of a viable intervention. Data were analyzed using t tests. MAIN RESEARCH VARIABLES: Knowledge and beliefs about breast cancer. FINDINGS: The experimental group's mean scores were significantly higher than the control group's on the Breast Cancer Knowledge Test and the susceptibility scale of the Breast Cancer Screening Belief Scales. The experimental group also scored significantly higher than the control group on the confidence scale of the Breast Cancer Screening Belief Scales. CONCLUSIONS: The multifaceted, culturally sensitive breast cancer education program appeared to be responsible for the differences in scores between the experimental and control groups. IMPLICATIONS FOR NURSING: Culturally sensitive group educational programs aimed at helping African American women in the rural South become more knowledgeable about breast cancer and early detection clearly are needed. Such efforts also must focus on increasing women's confidence in effectively performing regular breast self-examination as well as their understanding of personal risk. Healthcare professionals play a major role in the development and implementation of these programs.

Black or African American↗
PubMedDate not supplied

Improving health with tobacco dollars from the MSA: the Arkansas experience.

Analyses of expenditures from the historic tobacco Master Settlement Agreement (MSA) demonstrate the difficulties in achieving support for long-term disease prevention and health promotion initiatives. We report as a policy case study the successful development, political execution, and program deployment of new state health programs funded by Arkansas' MSA funds. Arkansas' success demonstrates the need for political leadership, the development and insertion of empirical health information into the policy deliberations, in-depth knowledge of the political process, and a broad-based coalition committed to improving health.

Arkansas↗
PubMed2004

Patterns of genetic variability in Anopheles quadrimaculatis (sensu stricto) (Diptera: Culicidae) populations in eastern Arkansas.

Electrophoretically detectable isozyme differences in 15 populations of Anopheles quadrimaculatus (Say) (sensu stricto) from eastern Arkansas were compared to measure levels of genetic diversity and study the sources of the variation. All of the enzyme loci had 2-7 alleles. Average levels of polymorphism per population were 88.9%. Heterozygotes for alleles of at least 1 of the 9 loci made up an average overall loci of 0.323 +/- 0.078 of the individuals examined. F-statistic analysis suggested a small, but statistically significant interpopulation differentiation of heterozygote frequency. The reduced heterozygote frequency was not attributable to the presence of more than one species in any population nor to the preferential use of oviposition habitats by certain populations within the species. Nei's distance values for pairwise population comparisons were small (<0.06). Correlation between genetic and geographic distance matrices was not significant. Migration among populations in the agricultural areas of the Arkansas delta region is apparently sufficient to homogenize most of the genetic divergence arising because of habitat or geographic isolation between populations in the region.

Animals↗
PubMed2006

Detection of Massachusetts and Arkansas serotypes of infectious bronchitis virus in broilers.

The objective of this study was to compare the presence of the Arkansas (Ark) and Massachusetts (Mass) serotypes of infectious bronchitis virus (IBV) in the tracheas and cecal tonsils of commercial broilers after vaccination at 1 day of age by coarse spray. When given as a single serotype vaccine, the Mass strain was detected by reverse transcriptase-polymerase chain reaction (RT-PCR)-restriction fragment length polymorphism (RFLP) only in the tracheas, whereas the Ark strain was detected in both the tracheas and cecal tonsils. By in situ hybridization, the Mass and Ark nucleocapsid (Nc) genes were detected only at 7 days in the tracheas. When both strains were given in the mixed vaccine, the Mass strain was more consistently detected by RT-PCR-RFLP in the tracheas and cecal tonsils at early stages of infection (up to 14 days) and the Arkansas strain was more consistently detected at late stages of infection (21 and 28 days). By in situ hybridization, the IBV Nc gene was more consistently detected in the trachea at early stages of infection (7, 14, and 21 days) and in the cecal tonsils at late stages of infection (21, 28, and 35 days). In general, the Mass strain was more frequently recovered from the tracheal and cecal tonsil tissues at earlier stages of infection and the Ark strain was recovered at later stages of infection.

Animals↗
PubMed1991

Be a winner: Arkansas' approach to involving law enforcement officers in drug education.

This paper describes a project which is a joint venture of the Northwest Arkansas Police Institute and the Program in Health Sciences at the University of Arkansas. Funded by the U.S. Department of Education under the Drug Free Schools and Communities Act, the focus of the project has been the development of an innovative drug education program which brings uniformed law enforcement officers into the elementary school classroom. The officers lead an eight week instructional program at the fifth or sixth grade levels using our Be A Winner curriculum.

Arkansas↗
PubMed1996

Evaluation of the Arkansas Medicaid primary care physician management program.

Arkansas implemented a primary-care case-management program in February 1994. This study evaluates the program during its first 17 months. Using quarterly data collected for the Health Care Financing Administration (HCFA), a pooled cross-sectional time series analysis (1991:4-1995:2) estimates the effect of eligibles' program enrollment on expenditure (total, inpatient hospital, outpatient hospital, physicians, prescription drugs, laboratory and X-ray) and utilization measures (outpatient visits, physician visits, prescription drugs). The Arkansas Medicaid managed care program appears to have somewhat reduced growth in total vendor payments and also appears to have improved access to primary medical services.

Aid to Families with Dependent Children↗
PubMed2000

Effectiveness of aerial- and ground-applied Bacillus formulations against Anopheles quadrimaculatus larvae in Arkansas rice plots.

Experimental Bacillus larvicides designed to float on or near the water surface were compared to labeled standard Bacillus corn-cob-based larvicides using sentinel Anopheles quadrimaculatus larvae in Arkansas rice plots during the 1998 growing season. Experimental floating formulations of Bacillus thuringiensis israelensis applied at 5.58 and 11.18 kg/ha provided up to 100% control of 3rd- and 4th-stage Anopheles larvae within 24-48 h, whereas the water-dispersible granule formulations containing Bacillus sphaericus required 48-72 h to yield >75% mortality in 0.16-ha plots at 11.18 kg/ha. Detecting and targeting the smaller developmental stages (1st- and 2nd-stage larvae) could increase the effectiveness of the tested compounds against An. quadrimaculatus in Arkansas and other rice-growing regions.

Agriculture↗
PubMed2001

Older female inpatients in Arkansas.

The purpose of this study was to examine age and Major Diagnostic Categories (MDCs) and compare the variables to mortality and length of stay among inpatient women age 50 and over. Archival statistical data were obtained for 2,238 inpatients in a private, nonprofit hospital in 1998. The ages ranged from 50 to 107 years old, with a mean age of 71.21 years. Quantitative analyses were conducted to examine the data from a private, nonprofit hospital and determine if there were significant relationships between age, major diagnostic category, length of stay, and mortality in older women. The MDC distribution indicated that the highest frequency of diseases and disorders were in the following three systems: circulatory system, musculoskeletal system and connective tissue, and the digestive system. The average length of stay was 8.01 days. The 30-day readmission percentage and the 365-day readmission percentage were 12.24% and 28.02%, respectively. The mortality rate was 6%. In addition, 63.97% went home after discharge, and 67.07% were Medicare recipients. The risk of musculoskeletal diseases and disorders increased with age (p = .0001). The conditional probability of death was nearly nine times higher for the diseases of the nervous system, myeloproliferative diseases and disorders, poorly differentiated neoplasms and respiratory diseases. As age increased, the probabilities of a long hospital stay decreased. The mortality analyses found that the lowest probabilities of survival were in categories of myeloproliferative diseases and disorders, poorly differentiated neoplasms, and infectious and parasitic diseases. According to current health statistics, our society is getting older. Not only are people living longer, they are accessing more health care (American Association for World Health, 1999). Overall, the average life expectancy at birth has been identified at 76.5 years. The female has a longer life expectancy than the male, averaging 5.8 years longer. The highest life expectancy has been identified in the white female, who can expect to live to 79. The black woman has the second-highest life expectancy, 74.7 years. Peters, Kochanek, and Murphy reported an all-time-low age-adjusted death rate for the United States and a continuing trend in the decline in mortality for all age groups. With a growing number of people living longer, there is a need to know about the most common health issues that affect quality of life. The top three national causes of death in older Americans were diseases of the heart, malignant neoplasms, and cerebrovascular diseases/stroke. Arkansas health statistics mirror the national statistics. In April 1999, the Arkansas Department of Health reported that 30.5% percent of all female deaths were caused by heart disease. Malignant neoplasms were responsible for 20.1%, followed by cerebrovascular diseases at 10.8%. Other than three Connecticut hospital studies that explored the relationship of diagnosis code, mortality, and readmission, research is meager in this area. There is a need for hospital-based research that addresses the diagnosis categories and the relationship to age and other variables.

Age Factors↗
PubMed2002

Prostate cancer in Arkansas.

Prostate cancer is the most common cancer affecting men and the second leading cause of cancer deaths in U.S. males. Nationally, black men have greater prostate cancer incidence/mortality than other men. This study used focus group discussions to examine knowledge, beliefs and attitudes about prostate cancer in black and white male populations in urban and rural areas of Arkansas. The study found a general lack of knowledge about prostate cancer and its symptoms, screening and treatment. There were also subtle differences among the groups that could impact the development of interventions and policies, thus decreasing prostate cancer mortality in Arkansas.

Adult↗
PubMed2003

Allozyme diversity in Anopheles quadrimaculatus (sensu stricto) populations in northeastern Arkansas.

A comparison of electrophoretically detectable isozyme differences in 6 populations of Anopheles quadrimaculatus (sensu stricto) from northeastern Arkansas was undertaken to test the hypothesis that microgeographic variation in habitat types was promoting significant within- and between-population genetic diversity. Genetic heterogeneity within populations was substantial, with all of the enzyme loci examined having 2-7 alleles and average levels of polymorphisms per population between 54.5 and 72.7%. Heterozygotes made up an average over all loci of between 20.6 and 24.8% of the individuals examined. Only weak evidence was found for gametic disequilibrium between pairs of loci. Neither F-statistic nor genetic distance analysis suggested interpopulation divergence. The FST value averaged over loci was 0.190. All Nei distances for pair-wise population comparisons were greater than 0.010, which was much lower than published values from comparisons between populations belonging to different species of the complex. Divergence was not significantly correlated to either geographic distance or habitat type. Examination of the results suggests that little genetic divergence has occurred between populations of An. quadrimaculatus in northeastern Arkansas, possibly because of the dispersal ability and low level of discrimination between oviposition sites exhibited by this species.

Alleles↗
PubMed2003

The Arkansas River Valley Rural Health Cooperative: building a three-pronged approach to improved health and health care.

This paper describes the Arkansas River Valley Rural Health Cooperative (ARVRHC), one of the Arkansas networks jump-started with support from the Southern Rural Access Program (SRAP). The initial goal of the network was to develop a subsidized health insurance program to provide affordable medical services for the uninsured population (23%) in the 3-county service area. When planning efforts called for the network to address broader needs, the ARVRHC crafted a more comprehensive 3-pronged program model consisting of 3 interrelated programs: (1) the Health Care Access Program (HCAP), (2) the Health Education and Disease Management Program (HE&DMP), and 3) the Information and Assistance Program (I&AP). The HCAP is designed to address the financial barriers to access through a community-based health plan. The HE&DMP focuses on improving the health of individuals through education, counseling, and preventive care. The I&AP links low-income families to existing public assistance programs (e.g., Medicaid) and social support services. The Prescription Drug Assistance Program is one of the I&AP programs that helps individuals without prescription coverage obtain drugs at no cost. A key lesson learned is the importance of combining technical assistance with funding. The ARVRHC has been successful in leveraging funding, having received over $1.7 million in grant funds since 1999. A critical challenge facing the network today is the need for ongoing subsidy funding. Proposed legislation for a federal demonstration of the HCAP and similar programs would enable full implementation and evaluation of this model.

Arkansas↗
PubMed2004

Case of the month. A case report of human pulmonary dirofilariasis in Arkansas.

Our patient, a resident of Arkansas, presented with a solitary pulmonary nodule for lung resection to rule out primary lung cancer. However, pathologic examination showed the lung nodule to be a granuloma secondary to dirofilariasis. Human pulmonary dirofilariasis is a rare zoonotic disease caused by Dirofilariasis immitis (dog heartworm) that is usually transmitted from dogs to human by mosquito bite. To our knowledge, human pulmonary dirofilariasis has previously not been reported in Arkansas. In addition, awareness of this entity in the appropriate clinical and epidemiologic setting is important in the differential diagnosis of solitary pulmonary nodules.

Arkansas↗
PubMed2004

Impact of the conjugate pneumococcal vaccine in arkansas.

BACKGROUND: On the basis of the success of the early trials in the prevention of invasive pneumococcal disease in infants and children using a heptavalent conjugate pneumococcal vaccine, the American Academy of Pediatrics recommended in August 2000 that the vaccine be given concurrently with other childhood immunizations. METHODS: Data concerning invasive pneumococcal infections from 1998-2000 were compared with 2001-2003 to assess the impact of the heptavalent pneumococcal conjugate vaccine in Arkansas. Basic demographic data were gathered as well as history of vaccination with the pneumococcal vaccine, underlying medical conditions, site of infection and morbidity and mortality. Pneumococcal isolates were serogrouped or serotyped and penicillin susceptibilities were obtained. RESULTS: The incidence of invasive disease decreased from a high of 5.78/100,000 population to 3.02/100,000 population (P = 0.002). Although the percentage of White patients increased from 2001-2003, the overall incidence of disease did not change. The incidence of disease among Blacks fell from 20.5/100,000 population to 4.9/100,000 population. The greatest decrease of disease occurred in children 24 months of age or younger with the incidence rate falling from 44.2/100,00 population to 8.30/100,000 population (P < 0.02). The incidence among White children 24 months of age or younger fell from 19/100,000 population to 1.8/100,000 population, whereas that of Black children 24 months of age or younger declined from 164/100,000 to 35/100,000. From 1998 to 2000, 3.7/100 cases were from nonvaccine serogroups compared with 44/100 cases from 2001 to 2003 (P < 0.001). In children 24 months of age or younger, the number of nonvaccine isolates increased from 1.3/100 cases to 30.5/100 cases (P < 0.001). Overall 56 (44%) were nonsusceptible to penicillin from 1998 to 2000; that was not significantly different from 2001-2003 when 37 (46%) of 81 isolates were nonsusceptible to penicillin. CONCLUSIONS: A significant decrease of invasive pneumococcal disease has been documented in Arkansas. Of concern, however, is the increasing number of invasive isolates not included in the current vaccine.

Arkansas↗