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PubMed2002

Large-scale effects of timber harvesting on stream systems in the Ouachita Mountains, Arkansas, USA.

Using Basin Area Stream Survey (BASS) data from the United States Forest Service, we evaluated how timber harvesting influenced patterns of variation in physical stream features and regional fish and macroinvertebrate assemblages. Data were collected for three years (1990-1992) from six hydrologically variable streams in the Ouachita Mountains, Arkansas, USA that were paired by management regime within three drainage basins. Specifically, we used multivariate techniques to partition variability in assemblage structure (taxonomic and trophic) that could be explained by timber harvesting, drainage basin differences, year-to-year variability, and their shared variance components. Most of the variation in fish assemblages was explained by drainage basin differences, and both basin and year-of-sampling influenced macroinvertebrate assemblages. All three factors modeled, including interactions between drainage basins and timber harvesting, influenced variability in physical stream features. Interactions between timber harvesting and drainage basins indicated that differences in physical stream features were important in determining the effects of logging within a basin. The lack of a logging effect on the biota contradicts predictions for these small, hydrologically variable streams. We believe this pattern is related to the large scale of this study and the high levels of natural variability in the streams. Alternatively, there may be time-specific effects we were unable to detect with our sampling design and analyses.

Animals↗

PubMed2006

A rapid reverse transcription-PCR assay for F+ RNA coliphages to trace fecal pollution in Table Rock Lake on the Arkansas-Missouri border.

Source determination of fecal contamination is imperative to efficiently reduce the fecal material load to environmental waters. This study developed primer pairs targeting three F+ RNA bacteriophages and a simple filtration sampling method to enumerate and identify coliphages in environmental waters. Water samples were collected seasonally for one year from the watershed of Table Rock Lake on the Arkansas-Missouri border in areas predisposed to fecal contamination. Collected samples were analyzed quantitatively with most probable number and plaque assays and qualitatively with reverse transcription-PCR. We demonstrated the usefulness of F+ RNA coliphages as an indicator of fecal contamination, but were unable to distinguish between human and non-human sources. F+ coliphage numbers in Table Rock Lake showed seasonal variation with the highest level of coliphage presence during the January sampling event.

Arkansas↗

PubMed2000

Epidemiology of personal watercraft-related injury on Arkansas waterways, 1994-1997: identifying priorities for prevention.

Personal watercraft (PWC) use has increased rapidly in the past ten years. Consequences of the increased use are collisions and injuries. This study was conducted to determine the etiology and the characteristics surrounding PWC collisions and injury associated with the use of these popular water recreational vehicles and determine countermeasures. Methods included obtaining boating accident reports limited to PWCs from the Arkansas Game and Fish Commission for the years 1994 through 1997. Results show that there were 126 incidents involving 141 vessels and over $156,000 (US) in property damage. Almost two-fifths of PWC users were injured, mainly head trauma and fractures to the lower limbs. There were five reported fatalities. Study suggests that PWC collisions and injury are increasing. With increased use and popularity, this trend will continue unless sustained efforts in prevention are established. Changes in policy, education and manufacturing standards need to be considered and initiated to provide for safe PWC operation and boating environment.

Accidents↗

PubMed1998

PCDD and PCDF contamination in catfish feed from Arkansas, USA.

One combined catfish feed sample from Arkansas, USA, and its eight ingredients were analyzed for PCDDs and PCDFs. One of the ingredients, soybean meal, was highly contaminated by PCDDs, especially the toxic 2,3,7,8-substituted congeners, e.g., 7.3 pg/g dry weight or 370 pg/g lipid for the 2,3,7,8-tetra CDD. The I-TEQ value for the soybean meal was 11.4 pg/g dry weight or 576 pg/g fat. The corresponding values for the combined catfish feed concentrations were approximately 3 times lower. The congener pattern, the congener profile and the ratio sigma PCDDs/sigma PCDFs for the soybean meal were quite unique. We are not aware of any environmental sample or technical product with similar characteristics. As a result, natural formation of the PCDDs found in the soybean meal cannot be ruled out.

Animal Feed↗

PubMed2001

Mammography utilization pattern throughout the state of Arkansas: a challenge for the future.

The Mammography Data Collection Project (MDCP) was aimed at determining the 1997 mammography rate and screening practice patterns throughout the state of Arkansas. The MDCP conducted a comprehensive survey of mammography centers to collect individual patient demographic data, and mammography data. Data elements pertinent to patients' age, race, insurance, type of mammogram, date of mammogram, and the zip code were obtained from participating centers. Analysis was performed to determine the mammography rate by age group and areas of residence. Of the 112 eligible mammography centers contacted, 92 centers (82%) participated. A total of 157,976 mammography data sets were obtained. The total number of women imaged was 148,586 with 90% of them over the age of 40 years. The mammography rate was 24.1% for women 50 years of age and older and 19.4% for women 40-49 years of age. Most of the women imaged had private insurance (52%). This study revealed that only a small fraction of women ages 40 years and older obtained annual mammograms in 1997, thus highlighting the need for intensifying efforts to increase the utilization of this lifesaving test.

Adult↗

PubMed2002

Validity of the Depression-Arkansas (D-ARK) Scale: a tool for measuring major depressive disorder.

The results of 2 validation studies for an assessment tool designed specifically for quality improvement and outcomes assessment efforts in mental healthcare are presented in this paper. The studies evaluated a new tool to assess the patient outcomes for major depressive disorder following treatment in routine clinical settings called the Depression-Arkansas Scale (D-ARK). Study 1 included 54 patients recruited from 3 hospital-based clinics (2 mental health clinics and 1 primary care clinic). Study 2 includes 827 patients from 5 clinical settings including a university based outpatient clinic, a VA based mental health clinic, and a managed-care program. These 2 very different studies provide preliminary evidence that the D-ARK may be a useful tool for quality improvement efforts in the mental healthcare setting. Specifically, they indicate that the D-ARK has strong validity when compared to 2 different research assessments, the Structured Clinical Interview for DSM-III-R, Patient Edition (SCID-P) and the Inventory to Diagnose Depression (IDD), and compared to clinical assessments using both the clinical diagnosis and a clinician checklist.

Adult↗

PubMed2003

Thalidomide and CC-5013 in multiple myeloma: the University of Arkansas experience.

Based on the activity of single-agent thalidomide in relapsed/refractory multiple myeloma in a landmark phase II study of 169 patients conducted at the University of Arkansas for Medical Sciences (UAMS), UAMS initiated several trials of thalidomide and the more potent thalidomide analog CC-5013. In an ongoing trial evaluating thalidomide plus the proteasome inhibitor bortezomib and dexamethasone in patients with relapsed/refractory disease following stem cell transplantation, approximately 50% of patients have experienced a paraprotein reduction of 50% or greater. In patients without cytogenetic abnormalities, the estimated 12-month event-free and overall survival rates are 69% and 100%, respectively. In a second ongoing trial building on the UAMS Total Therapy I regimen, newly diagnosed patients are randomized to thalidomide or no thalidomide pretransplantation followed by consolidation therapy with dexamethasone and multiagent chemotherapy post-transplantation (Total Therapy II). Although the Total Therapy II regimen appears to be superior to the original Total Therapy I regimen, assessment of the effect of thalidomide on Total Therapy II is pending accrual completion. Lastly, based on the increased potency and reduced toxicity profile of CC-5013 compared with thalidomide, a study of CC-5013 in patients with relapsed/refractory disease following transplantation was initiated. Patients are randomized to CC-5013 25 mg daily for 20 days versus CC-5013 50 mg every other day for 10 days. Preliminary results indicate the superiority of the 25-mg arm, with 40% of patients randomized to that arm experiencing a paraprotein reduction of 50% or greater. These preliminary results corroborate the role for thalidomide and CC-5013 in relapsed/refractory and newly diagnosed multiple myeloma based on the UAMS phase II study as well as several other studies of these agents outside of UAMS.

Adjuvants, Immunologic↗

PubMed2002

Benefit-cost analysis of addiction treatment in Arkansas: specialty and standard residential programs for pregnant and parenting women.

A benefit-cost analysis of specialty residential treatment (Specialty) and standard residential treatment (Standard) was conducted on a sample of pregnant and parenting substance abusers from Arkansas. Economic benefits were derived from client self-reported information at treatment entry and at 6-month postdischarge with the use of an augmented version of the Addiction Severity Index (ASI). The average cost of treatment in Specialty programs was US dollars 8035 versus US dollars 1467 for Standard residential treatment. Average net benefits (benefit-cost ratios) were estimated to be US dollars 17144 (3.1) for Specialty and US dollars 8090 (6.5) for Standard. The main policy implication of this research is that investment in Specialty residential treatment for pregnant and parenting substance-abusing women appears to be economically justified, but future evaluations should analyze larger and more comparable samples to improve power and precision in the benefit-cost statistics.

Arkansas↗

PubMed2001

Factors associated with delays in accessing HIV primary care in rural Arkansas.

While debate continues at what stage of human immunodeficiency virus (HIV) disease to begin combination antiretroviral therapy, a number of clinical and public health benefits are linked to early entry into primary care soon after first testing HIV positive. However, HIV-infected patients continue to test late and delay entry into care. We used routinely collected demographic and clinical information to examine which factors are associated with delays in seeking care in a predominantly rural, economically poor area of Arkansas. The study population is 75% African American and male and 70% lack health insurance; nearly one fourth were referred from prison. At diagnosis, two thirds of the population had CD4 counts below 500 cells per microliter. Days from initial HIV diagnosis to entry into care declined from a median of 178 in 1994 to 24 in 1998. In 1998, 75% of the population entered into primary care within 2 months of diagnosis. However, CD4 counts at HIV diagnosis also declined in this period, from a median of 427 in 1995 to 208 cells per microliter in 1998. More recent year of diagnosis was associated with a shorter delay in seeking care; males, and individuals lacking health insurance took significantly longer to enter into care than females and those with insurance, respectively. Our univariate finding of extensive delays in seeking care in the prison population did not hold in the multivariate analysis. We found significant delays in time to initial HIV diagnosis, and further considerable delays in males and those lacking health insurance in the time taken to enter into primary care.

Adolescent↗

PubMed2001

The effect of telepharmacy counseling on metered-dose inhaler technique among adolescents with asthma in rural Arkansas.

The increased prevalence, morbidity, mortality, and health costs associated with asthma among children suggest the need for accessible asthma education. This study examined the effect of telepharmacy counseling, using interactive compressed video, on metered-dose inhaler (MDI) technique and patient satisfaction among adolescents with asthma in rural Arkansas. The telepharmacy counseling provided accessible education regarding MDI technique for adolescents in this study. Twenty percent of the adolescents who participated had never been shown the appropriate use of an MDI. The study used an experimental design with random assignment of participants to a telepharmacy counseling group (n = 15) or a control group (n = 21). Both groups participated in pre-test, post-test, and 2- to 4-week follow-up assessments for MDI technique and patients satisfaction (follow-up assessment only) via interactive compressed video. Results indicated that from pre-test to follow-up the telepharmacy counseling group showed more improvement in MDI technique than participants in the control group (p < 0.001). There was no significant difference between the telepharmacy counseling group and control group in satisfaction with the instructional sessions (p = 0.132). Both groups had high levels of satisfaction with the telepharmacy sessions. The study findings demonstrated that patient education provided by pharmacists via interactive compressed video was superior to education provided via written instructions on an inhaler package insert. Interactive compressed video is an effective medium for teaching and improving MDI technique in this rural, adolescent, predominantly African-American population.

Administration, Inhalation↗

PubMed1997

Rural Arkansas physicians and telemedicine technology: attitudes in communities receiving equipment.

OBJECTIVE: To assess physician attitudes toward the usefulness, effectiveness, and expected use of telemedicine, as well as interest in learning about the technology. METHODS: A survey instrument assessing attitudes toward each of the four objective domains was mailed to 46 physicians at six hospitals affiliated with the Rural Hospital Program of the University of Arkansas for Medical Sciences. Binomial probability methods were used to analyze the responses. RESULTS: The survey achieved a response rate of 59% (27/46). Physician responders agreed that telemedicine would be useful in improving patient care quality but would not be useful in improving the financial position of the hospital or in lowering patient-borne costs. Physicians were evenly split on the effectiveness and expected utilization of telemedicine for patient consults. There was significant interest in learning more about telemedicine applications. CONCLUSION: Barriers to utilization of telemedicine by physicians may remain even under a new reimbursement system unless referring physicians are convinced of the benefits to the community as well the clinical effectiveness of the technology.

Adult↗

PubMed1984

Rhinosporidiosis. A report of two cases from Arkansas.

Two human native cases of ocular-conjunctival rhinosporidiosis from Arkansas are believed to be the first documented reports in this part of the country. The common mode of infection was accidental injury to the eye by possible contaminated soil-dust. The appearance of the polypoid growth was relatively fast, 6-16 days, and unresponsive to topical antibiotic and steroid treatment. Surgical excision, with one recurrence in one case, was the elective treatment. Both patients are asymptomatic 10-12 months after treatment, respectively, with no evidence of other recurrence, dissemination, or major complications. From 1939 to September, 1983, only nine cases of conjunctival rhinosporidiosis were reported in the United States.

Adult↗

PubMed1995

Nontraditional Pharm.D. program at the University of Arkansas for Medical Sciences.

The nontraditional Pharm.D. program at the University of Arkansas for Medical Sciences is described. The nontraditional program, started in 1990, includes 21 credit hours of didactic work and 12 of clerkships. In the self-paced didactic courses, videotapes, manuals, and texts are used, along with faculty consultation in person or by telephone. Clerkships can be traditional or nontraditional. Nontraditional clerkships can be completed by self-study in the student's community after an orientation period at the preceptor's site. More than 400 pharmacists have enrolled in the program and more than 80 have entered nontraditional clerkships. Thirty-nine pharmacists have received the Pharm.D. degree. The program offers an accessible alternative for pharmacists who want to earn the Pharm.D. degree while maintaining full-time employment.

Arkansas↗

PubMed2005

Easing the burden of caregiving: the impact of consumer direction on primary informal caregivers in Arkansas.

PURPOSE: We assess the effect of consumer-directed care on the emotional, physical, and financial well-being of the primary informal caregivers of the Medicaid beneficiaries who voluntarily joined Arkansas's Cash and Counseling demonstration. DESIGN AND METHODS: The demonstration randomly assigned beneficiaries to a program in which they could direct their own disability-related supportive services (the treatment group) or rely on traditional agency services (the control group). We constructed outcome measures from telephone interviews with 1,433 caregivers who provided beneficiaries with the most unpaid assistance at baseline, and we used multivariate regression models to estimate program effects. Interviews occurred between February 2000 and April 2002, 10 months after beneficiaries' random assignment. RESULTS: At follow-up, treatment group caregivers provided fewer hours of assistance than did their control group counterparts, on average, and they reported better emotional, physical, and financial well-being. IMPLICATIONS: Permitting interested Medicaid beneficiaries to direct their own in-home supportive services reduces burden on informal caregivers, which may help reduce beneficiaries' nursing home use.

Activities of Daily Living↗

PubMed1992

Cluster of tick-borne infections at Fort Chaffee, Arkansas: Rickettsiae and Borrelia burgdorferi in ixodid ticks.

Human intrusion into pristine habitats increases the likelihood of acquiring infectious agents from potentially infective ticks. As part of a larger human serological investigation into tick-borne illnesses, 3,000 ixodid ticks were collected during May, August, and November 1990 at Fort Chaffee, Arkansas. Ticks were examined to determine whether they harbor rickettsiae, ehrlichiae, and Borrelia burgdorferi, and to assess relationship to human exposure to tick-borne infections at Fort Chaffee, Ark. The overall tick infection rates with SFG rickettsiae, B. burgdorferi, and ehrlichiae were 4.8, 0.1, and 0.3%, respectively.

Animals↗

PubMed1976

Endemic amebiasis in an Arkansas community.

Parasitologic, serologic, and epidemiologic studies were done during 1967 in Calion, Arkansas (population 544). Infection with Entamoeba histolytica was found to be endemic but was segregated along racial lines. Twenty-two (9.9%) black compared with only one (0.6%) white had E. histolytica demonstrated in one stool examination; only two blacks had symptoms suggestive of amebiasis. No positive amebiasis indirect hemaggulination titers were found in 135 white residents. In contrast, 41 (17.9%) blacks had positive titers. Age, sex, and geographic location were not associated with stool or seropositivity. Within the black population, clustering of stool and seropositivity occurred. Significantly higher rates of stool and seropositivity were seen in households with crowding and poor sanitation as evidenced by lack of indoor toilet facilities. The presence of contaminated water supplies did not correlate with stool or seropositivity. The probable importance of person-to-person transmission is suggested by the observed clustering of infection within households with crowding and unsanitary conditions. The absence of evidence for transmission by food or water further supports this hypothesis.

Adolescent↗

PubMed1999

The Arkansas AHEC model of community-oriented primary care.

This article explicates the Arkansas Area Health Education Center (AHEC) model of community-oriented primary care (COPC) and the role of the family nurse practitioner (FNP) in its implementation. The AHECs collaborate with local agencies to provide comprehensive, accessible, quality health care to specific patient populations, and offer learning opportunities to a wide variety of health professions students. The FNP demonstrates organizational and role competencies that include directing patient care, providing professional leadership, and developing the advanced practice nursing role. Two case studies are used to illustrate the FNPs' approach to COPC: (1) selection of interdisciplinary, multidisciplinary, and transdisciplinary approaches to management of a patient with chronic illnesses, and (2) the Sexual Assault Nurse Examiners Training Project.

Area Health Education Centers↗

PubMed1985

Childhood sarcoidosis in Arkansas.

Sarcoidosis, a granulomatous disease of unknown etiology, is most often seen in young adults. Childhood cases have been reported primarily from Virginia, North Carolina, and South Carolina. Thirty children have been seen in Arkansas between 1957 and 1982, which suggests that the endemic area for childhood sarcoidosis should include both the south central and southeastern United States. The median age was 11 years; 29/30 were black; and 90% were symptomatic, 60% with systemic symptoms. Manifestations included abnormal chest roentgenograms (100%), restrictive pulmonary functions (79%), lymphadenopathy (63%), splenomegaly (40%), skin lesions (30%), granulomatous uveitis (27%), hyperglobulinemia (72%), and hypercalcemia (30%). Course and prognosis were similar to those in adults at follow-up of two to 11 years. Four with uveitis had serious residua in the eyes, three had crippling restrictive lung disease, and two died of respiratory failure. Sarcoidosis seems to be an immunologic response to an unknown inhaled antigen, probably present in the southeastern and south central US.

Adolescent↗