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PubMed1998

Child homicide in Oklahoma: a continuing public health problem.

Homicide is a leading manner of injury to cause death in children. To assess this phenomenon in Oklahoma, the demographic characteristics and causes of death of the victims of child homicide in Oklahoma have been reviewed. One hundred eleven consecutive cases of homicide in children less than age 13 years were reviewed and the demographic characteristics of the victims were analyzed. The majority of homicides occurred in Tulsa and Oklahoma Counties (55.8%). The ratio of male to female victims was approximately equal. The races of the victims were 66.6 percent White, 24.3 percent Black, 8.1 percent Native American and 0.9 percent Asian. The most common cause of death was head injury (45.9%). An unexpected finding was that in 23.4 percent of cases, an additional fatality occurred in the family due to family violence. This fatality involved either suicide of the perpetrator or homicide of a sibling. These findings indicate a continuing family violence problem in Oklahoma.

Child↗
PubMed2005

Visual impairment and eye abnormalities in Oklahoma Indians.

OBJECTIVE: To determine the prevalence of visual impairment and eye abnormalities in Oklahoma Indians. METHODS: The cross-sectional study included 1019 Oklahoma Indians, aged 48 to 82 years; 60.2% were women. All participants gave a personal interview, and all underwent an eye examination, including the determination of best-corrected visual acuity and an ophthalmoscopic examination. In addition, two 45 degrees fundus photographs were taken of each eye, and these photographs were graded by the Fundus Photography Reading Center at the University of Wisconsin, Madison. RESULTS: Among the 1019 participants, 77.4% had a visual acuity of 20/20 or better, 19.5% and 2.5% had visual acuities of between 20/25 and 20/40 and between 20/50 and 20/190, respectively; and 0.6% were legally blind, all in the better eye. Cataract was the most frequent contributing cause and age-related macular degeneration the second most frequent contributing cause of visual impairment. The overall prevalence proportions of age-related macular degeneration, cataract, diabetic retinopathy, and definite glaucoma were 33.6%, 39.6%, 20.1%, and 5.6%, respectively. Most of the other eye abnormalities were rare in the study participants, except for pinguecula (42.4%) and dermatochalasis (30.1%). CONCLUSIONS: Oklahoma Indians have a higher prevalence of visual impairment, age-related macular degeneration, and diabetic retinopathy than other ethnic groups. The implementation of adequate treatment and prevention programs for eye diseases is indicated.

Aged↗
PubMedDate not supplied

Case finding and mental health services for children in the aftermath of the Oklahoma City bombing.

The 1995 Oklahoma City bombing killed 168 people, including 19 children, and injured hundreds more. Children were a major focus of concern in the mental health response. Most services for them were delivered in the Oklahoma City Public Schools where approximately 40,000 students were enrolled at the time of the explosion. Middle and high school students in the Oklahoma City Public Schools completed a clinical assessment 7 weeks after the explosion. The responses of 2720 students were analyzed to explore predictors of posttraumatic stress symptomatology, functioning, and treatment contact. Posttraumatic stress symptomatology was associated with initial reaction to the incident and to bomb-related television exposure. Functional difficulty was associated with initial reaction and posttraumatic stress symptomatology. Only 5% of the students surveyed had received counseling. There was no relationship between posttraumatic stress symptomatology and counseling contact for students with the highest levels of posttraumatic stress. Implications for school-based services are discussed.

Child↗
PubMed1989

Differential alcohol-related mortality among American Indian tribes in Oklahoma, 1968-1978.

Tribal differences in alcohol-related mortality were examined among 11 Indian tribes living in Oklahoma. Data on alcohol-related deaths from 1968 to 1978 were compiled and assigned to various tribes on the basis of population distributions by county. Results showed significant differences in alcohol-related mortality among the various tribes. Of the 267,238 total deaths in Oklahoma during the study period, 9.3% of Indian deaths were alcohol-related while only 3.2% of those among blacks and 2.4% of those among whites were classified as such. Indian males and females are far more likely to die of alcohol-related deaths than their black and white counterparts. Cheyenne-Arapaho, Comanche and Kiowa areas (located in the western++ part of the state) have higher alcohol-related deaths than Cherokee, Choctaw, Creek, Seminole and Pawnee areas (located in eastern Oklahoma). Indian residents of the Seminole area have the lowest percentage of deaths identified as alcohol-related. The patterns which emerge may be due to different cultural and historical factors among the Indian tribes.

Adult↗
PubMed1996

The role of radiology in the Oklahoma City bombing.

PURPOSE: To evaluate the role of radiologic services in the assessment of injuries and identification of deceased victims of the bombing of the Alfred P. Murrah Federal Building in Oklahoma City, Okla. MATERIALS AND METHODS: In cooperation with the Oklahoma University Health Sciences Center Disaster Studies Group, all victims of the Oklahoma City bombing who were treated in hospitals were evaluated. All radiologic studies performed in these patients during a 4-week period after the bombing were recorded. Major injuries incurred by the victims were noted but were not documented. In addition, assistance provided by radiologic services to the medical examiner's office for identification of deceased victims was assessed. RESULTS: On the day of the bombing, 99% (480 of 485) of the imaging studies performed were either plain radiography, primarily of the extremities and chest, or computed tomography (CT), half of which were of the head. Six deceased victims were identified solely by means of characteristics on radiographs. CONCLUSION: Almost all bombing-related radiologic studies were either plain radiography or CT. Other modalities had only limited roles. In deceased victims, plain radiography aided identification, and in many other victims it allowed localization of materials that were potential pieces of evidence.

Blast Injuries↗
PubMed2004

Occurrence of the Gulf Coast tick (Acari: Ixodidae) on wild and domestic mammals in north-central Oklahoma.

Parasitic life stages of Amblyomma maculatum Koch were collected from domestic cattle and several species of wild mammals during a 3.5-yr study (May 1998-October 2001) in north-central Oklahoma. Adult ticks were the predominant life stage collected from cattle, white-tailed deer, coyotes, and raccoons, whereas only immature ticks were collected from cotton rats and white-footed mice. The prevalence of adult A. maculatum on white-tailed deer (n = 15) examined in June, July, and August 1998 was 80, 100, 100%, respectively. The prevalence of adult A. maculatum on cattle (n = 84) ranged from 52% in February 1999 to 100% in May 1999. The prevalence of adult A. maculatum on coyotes (n = 16) was 100% in April 1998 and 43% on coyotes (n = 7) examined in January 2001. The prevalence of adult A. maculatum on raccoons (n = 23) examined during May, June, and July 1999 was 13%. No A. maculatum of any life stage were recovered from opossums (n = 7). Nine hundred forty-five rodents were trapped over 294 trap-nights; prevalence of A. maculatum larvae and nymphs on cotton rats (n = 395) was 34 and 15%, respectively, whereas on white-footed mice (n = 517), prevalence was 1.5 and 1.4%, respectively. No A. maculatum were recovered from pack rats (n = 33). There were significant differences (P = 0.0001) in larval infestation prevalence between cotton rats and white-footed mice in the spring, summer, and fall and for nymphs in the spring and summer. Results of A. maculatum parasitism and seasonal occurrence on hosts in this study are compared with previous research conducted in Oklahoma and with collection records of A. maculatum in the Entomology Museum at Oklahoma State University.

Animals↗
PubMed1989

Business recession, alcohol consumption, drinking and driving laws: impact on Oklahoma motor vehicle fatalities and fatal crashes.

In 1982, Oklahoma enacted a series of drinking and driving laws. In the ensuing years, motor vehicle fatalities and fatal crashes were reduced by one-third. Factors contributing to this reduction were examined using interrupted time series analysis of monthly rates of motor vehicle deaths and fatal crashes for the period January 1980 to December 1986. Decreasing per capita alcohol consumption and increased unemployment apparently account for most of the fatality and fatal crash reduction in Oklahoma. The enactment of two traffic safety laws--one specifying the illegal blood alcohol concentration level (BAC law) and the other facilitating license withdrawal from suspected drunk drivers (administrative per se law)--together reduced Oklahoma traffic deaths and fatal crashes by about 9 percent. The effectiveness of the laws appeared to be greatest in the first two years following their enactment.

Accidents, Traffic↗
PubMed1993

Lower-extremity amputation. Incidence, risk factors, and mortality in the Oklahoma Indian Diabetes Study.

Oklahoma Indians with NIDDM (n = 1012) underwent a baseline examination in 1972-1980. The incidence of and risk factors for first lower-extremity amputation were estimated. The mortality rates of amputees using data from 875 patients who had no previous history of amputation and who underwent follow-up examination between 1987 and 1991 are presented. The mean age of the 875 patients was 51.6 +/- 10.8 yr, and the mean duration of diabetes was 6.6 +/- 6.1 yr. After a mean follow-up time of 9.9 +/- 4.3 yr, the incidence rate of first LEA among diabetic Oklahoma Indians was 18.0/1000 person-yr. The incidence rate was two times higher in men than in women. In both sexes, significant risk factors (P < 0.05) were retinopathy and duration of diabetes. Fasting plasma glucose, use of insulin, and systolic blood pressure were significant for men only. For women, plasma cholesterol and diastolic blood pressure were additional risk factors. Compared with the mortality rate of 33.5/1000 person-yr among nonamputees, the rate among amputees was 55.5/1000 person-yr. The 5-yr survival rate after first amputation was 40.4%. For the amputees, the most common causes of death were diabetes (37.3%), cardiovascular disease (29.1%), and renal disease (7.3%). The incidence and mortality rates in diabetic Oklahoma Indians were higher than those reported in Pima Indians and other diabetic populations. To lower the incidence of lower-extremity amputation in this high-risk population, preventive action through education, foot care programs, and early detection of lesions must be intensified.

Adult↗
PubMed1999

Data and simulation modeling to determine the estimated number of primary care beds in Oklahoma.

Growth in managed care has resulted in an increased need for studies in health care planning. The article focuses on the estimated number of primary care beds needed in the state to provide quality services to all Oklahoma residents. Based on the 1996 population estimations for Oklahoma and its distribution to the 77 counties, a space-filling approach is used to determine 46 service areas, each of which will provide primary care service to its area population. Service areas are constructed such that residents of an area are within an acceptable distance to a primary care provider in the area. A simulation model is developed to determine the number of primary care beds needed in each service area. Statistical analysis on actual hospital data is used to determine the distributions of inpatient flow and length of stay. The simulation model is validated for acute care hospitals before application to the service areas. Sensitivity analysis on model input parameter values is performed to determine their effect on primary care bed calculations. The effect of age distribution on the bed requirement is also studied. The results of this study will assist the Oklahoma Health Care Authority in the development of sound health care policy decisions.

Catchment Area, Health↗
PubMed2000

Reducing teen pregnancy in Oklahoma: focusing on older teens (18-19 years old).

Births to females aged 18 and 19 account for two-thirds of teen births in Oklahoma annually. It is important for Oklahoma to identify effective ways to reduce births to this age group. Nationally and locally, there are few prevention programs and little data. Oklahoma has the opportunity to lead the nation in reducing births to older teens by aggressively addressing the issue, sharing promising approaches, and building prevention efforts that include older teens in meaningful ways.

Adolescent↗
PubMedDate not supplied

Evaluating injury prevention programs: the Oklahoma City Smoke Alarm Project.

Evaluation of injury prevention programs is critical for measuring program effects on reducing injury-related morbidity and mortality or on increasing the adoption of safety practices. During the planning and implementation of injury prevention programs, evaluation data also can be used to test program strategies and to measure the program's penetration among the target population. The availability of this early data enables program managers to refine a program, increasing the likelihood of successful outcomes. The Oklahoma City Smoke Alarm Project illustrates how an evaluation was designed to inform program decisions by providing methodologically sound data on program processes and outcomes. This community intervention trial was instituted to reduce residential fire-related injuries and deaths in a geographic area of Oklahoma City that was disproportionately affected by this problem. The distribution of free smoke alarms in targeted neighborhoods was accompanied by written educational pamphlets and home-based follow-up to test whether the alarms were functioning correctly. Early evaluation during the planning and implementation phases of the program allowed for midcourse corrections that increased the program's impact on desired outcomes. During the six years following the project, the residential fire-related injury rate decreased 81% in the target population but only 7% in the rest of Oklahoma City. This dramatic decline in fire-related injuries in the target area is largely attributed to the free smoke alarm distribution as well as to educational efforts promoting awareness about residential fires and their prevention.

Adolescent↗
PubMed2001

Oklahoma dental Medicaid. A need for action.

Dental Medicaid in the State of Oklahoma must be made to work. But it will not work unless enough of us get involved and lead health officials, and legislators into the serious work that can turn Medicaid's promise into performance and a Medicaid card into meaningful dental care. Ironically, Medicaid's "EPSDT" (Early Periodic Screening, Diagnosis and Treatment) authorizes a high scope of dental coverage for the child. But trying to access care for the Medicaid eligible child is entirely another matter. Only a small number of Oklahoma dentists treat the quarter of a million Medicaid eligible persons in Oklahoma. Why is this so?

Child↗
PubMed2001

Care of acute myocardial infarction in Oklahoma: an update from the Cooperative Cardiovascular Project.

Acute myocardial infarction remains a common cause of morbidity and mortality in Oklahoma. Nearly 6,000 Oklahoma Medicare beneficiaries are admitted to the hospital with an acute myocardial infarction each year. The death rate from coronary heart disease in Oklahoma is one of the highest in the nation. Utilizing structured medical record review, we have evaluated care given to 6,104 Medicare beneficiaries with acute myocardial infarction in 1994, 1996, and 1998. Since 1994, there have been significant improvements in the use of aspirin and beta-blockers at discharge, and avoidance of calcium channel blockers in those patients with poor left ventricular function. Documentation of smoking cessation counseling decreased significantly from 1994 to 1998. Other measures of quality of care did not change significantly. Despite better performance on many of the measures of quality, we should not be too complacent about the results, as there continues to be considerable room for improvement in care.

Adrenergic beta-Antagonists↗
PubMed2002

There's a dark cloud over Oklahoma--and it's our own smoke.

The tragic events of September 11, 2001 galvanized our entire nation into action, and appropriately so. Closer to home, in Oklahoma the same number of lives are lost to the adverse health effects of tobacco each year. Fourteen thousand of our young people, under age 18, become addicted to tobacco products each year. One-third will die prematurely from tobacco-caused illness. While 48 states have seen their health improve during the decade of the 90s, Oklahoma's health status has actually declined. While not the only malady confronting our society, tobacco takes a disproportionate toll, paid in lost lives and economic impact. Meanwhile, tobacco companies spend more than $100 million annually promoting their product in Oklahoma, 50 percent more than before the state's lawsuit was filed. A two-pronged strategy that relies on policy and legislative changes as well as a comprehensive public health program that prevents and treats tobacco addiction is presented.

Cost of Illness↗
PubMed2002

Second-hand tobacco smoke in Oklahoma: a preventable cause of morbidity and mortality and means of reducing exposure.

Evidence has mounted in recent years establishing second-hand tobacco smoke exposure as a cause of morbidity and mortality in nonsmokers. The ratio of deaths is approximately one nonsmoker dying from illness caused by second-hand smoke exposure for every eight smokers who die from diseases caused by tobacco use. This is equivalent to about 750 nonsmoker deaths each year in Oklahoma caused by exposure to second-hand smoke. This article reviews the components of second-hand smoke, its health effects, its prevalence in Oklahoma, and the means of protecting children and nonsmoking adults from exposure. Oklahoma physicians are encouraged to advise their patients about the harmful effects of second-hand smoke and to actively support public policies that decrease exposure to second-hand smoke in public places and workplaces.

Cardiovascular Diseases↗
PubMed1976

Multiple myeloma in Oklahoma: racial, age, sex, geographic and time variations.

Oklahoma death certificates listing multiple myeloma as the underlying cause of death during the period 1950-1970 were examined for secular trends, and geographic and demographic characteristics associated with the disease. An upward trend in the death rates for all age, sex and race groups was found; the most dramatic increases were seen in the oldest age groups. During the 20-year period, the death rate for white males 75 years of age and older increased tenfold. For white females 75 years of age and older. It increased eightfold. White male rates were constantly higher and showed a sharper increase in age-adjusted death rates than white female rates. Because of the low number of nonwhite deaths in Oklahoma from multiple myeloma, the rates showed extreme fluctuations. After adjustments were made for age differences, the nonwhite annual rate was 2.36 per 100,000 compared with 1.62 for the white population. There was not enough information to draw conclusions about the geographic distribution of multiple myeloma. Findings for the Oklahoma population were consistent with the few previously reported studies.

Adolescent↗
PubMed1992

Prevalence of Lyme disease infection in Oklahoma.

Even though Lyme disease probably existed in Oklahoma prior to 1975 when the disease was first reported in Connecticut and even though ecological conditions favor a high prevalence, an unexpectedly low rate was evidenced in both a serological survey and the number of cases reported to the Oklahoma State Department of Health. Lyme disease does not appear to pose a significant public health threat in Oklahoma at the present time; however, the the presence of all the necessary factors for transmission and the rapidly increasing number of cases reported in nearby areas merits continued surveillance in this state. The need for consistent case definition is discussed.

Enzyme-Linked Immunosorbent Assay↗
PubMed1992

Unintended childbearing: pregnancy risk assessment monitoring system--Oklahoma, 1988-1991.

Unintended pregnancies may be associated with delays in the initiation of prenatal care and behaviors during pregnancy that increase the risk for adverse birth outcomes (1,2). Based on estimates from the 1988 National Survey of Family Growth, 28% of births were mistimed during the 3-4 years before the survey, and 12% were unwanted (3). In Oklahoma, family-planning services are provided as an element of the state's maternal and child health program efforts, and the state has made a priority of identifying mothers at high risk for unintended pregnancy. This report summarizes an analysis of data from the Oklahoma Pregnancy Risk Assessment Monitoring System (PRAMS) to assess the risk for unintended childbearing in Oklahoma during 1988-1991.

Adolescent↗