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PubMed1999

Fabricated trauma exposure: an analysis of cognitive, behavioral, and emotional factors.

The 1995 Oklahoma City bombing was a disaster of unparalleled dimension in the United States. The professional response included the development of systematic clinical and research programs. This article describes the case of a child who, as a participant in a research study, appeared to fabricate a story of bomb-related loss. The research and clinical records of this child were examined and analyzed according to the factors and conditions that might underlie this fabrication. These include issues related to memory and suggestibility, symptom contagion, and mass hysteria. The report describes the role of psychological vulnerability in trauma and this child's coping and adaptation.

Adaptation, Psychological↗
PubMed2001

Evaluation of myelotoxicity in cotton rats (Sigmodon hispidus) exposed to environmental contaminants. II. Myelotoxicity associated with petroleum industrial wastes.

Various chemical mixtures exist in soil contaminated with petrochemical wastes, yet no comprehensive assessment of their impact on terrestrial ecosystems has been conducted. The purpose of this study was to evaluate hematotoxicity risks to wild populations of cotton rats (Sigmodon hispidus) residing in habitats previously contaminated by petroleum industrial wastes. Resident cotton rats were monitored on nine contaminated sites and nine ecologically matched reference sites in Oklahoma. The possible toxicological interactions of petrochemical wastes on bone marrow was investigated by using the assay of colony formation of granulocyte-macrophage progenitor cells. There was a consistent significant 21 to 39% decrease in the number of colony-forming units of granulocyte-macrophage (CFU-GM) in cotton rats from petrochemical-contaminated sites compared to matched reference sites, with no marked changes in hematological or histopathological parameters. These results suggest that bone-marrow progenitor cell culture is a sensitive indicator for the assessment of ecotoxicity risks associated with petrochemical wastes that are generated by the oil refining industry. Long-term exposure to hazardous wastes associated with the petroleum industry may represent a subtle risk to the hematopoietic system in humans.

Animals↗
PubMed2001

Widespread risks of dental fluorosis in cotton rats (Sigmodon hispidus) residing on petrochemical waste sites.

Fluoride has been identified as a ubiquitous contaminant of soils where petrochemical wastes have been disposed. The purpose of this study was to assess how widespread toxicity risks are to resident vertebrates from chronic exposure to fluoride in the soil of petrochemical-contaminated waste sites. In total, 573 wild cotton rats (Sigmodon hispidus) were examined. The rats that were seasonally collected from 12 contaminated and 12 ecologically matched reference sites across Oklahoma over a 3-yr period. The risks of cotton rats exposed to fluoride were analyzed by means of gross examination, histopathology, and scanning electron microscopy of rat incisors. Cotton rats from reference sites showed no pathologic changes in incisors (98%). In comparison, 46% of cotton rats from contaminated sites had various degrees of dental lesions. The prevalence and severity of dental lesions in cotton rats from contaminated sites were significantly influenced by season. There was a 45% increase in prevalence and a 65% increase in severity of dental lesions from summer to winter. This study demonstrated that cotton rats are very sensitive biomonitors for assessing toxicity risks from soils contaminated with fluoride and that such assessments should consider seasonal influences.

Animals↗
PubMed2003

Pancreatitis in wild zinc-poisoned waterfowl.

Four waterfowl were collected in the Tri-State Mining District (Oklahoma, Kansas and Missouri, USA), an area known to be contaminated with lead, cadmium and zinc (Zn). They were part of a larger group of 20 waterfowl collected to determine the exposure of birds to metal contamination at the site. The four waterfowl (three Branta canadensis, one Anas platyrhynchos) had mild to severe degenerative abnormalities of the exocrine pancreas, as well as tissue (pancreas, liver) concentrations of Zn that were considered toxic. The mildest condition was characterized by generalized atrophy of exocrine cells that exhibited cytoplasmic vacuoles and a relative lack of zymogen. The most severe condition was characterized by acini with distended lumens and hyperplastic exocrine tissue that completely lacked zymogen; these acini were widely separated by immature fibrous tissue. Because the lesions were nearly identical to the lesions reported in chickens and captive waterfowl that had been poisoned with ingested Zn, and because the concentrations of Zn in the pancreas and liver of the four birds were consistent with the concentrations measured in Zn-poisoned birds, we concluded that these waterfowl were poisoned by Zn. This may be the first reported case of zinc poisoning in free-ranging wild birds poisoned by environmental Zn.

Animals↗
PubMedDate not supplied

Measures of American Indian traditionality and its relationship to cervical cancer screening.

The goal of this study was to evaluate the relationship between culture and attitudes about cervical cancer screening among young American Indian women living and working in northeast Oklahoma. A cohort of 199 American Indian women, ages 18-40, were surveyed to determine their blood quantum, self-identification, and beliefs and practices regarding traditional behavior in order to develop a traditional behavior scale (the degree to which an individual maintained traditional tribal ways or behaviors). The use of this scale indicated that the degree of American Indian blood quantum, blood quantum for primary tribe, and self-identification are correlated to the traditional behavior scale. The scale, however, was unable to predict intention to get a Pap test. Results indicate that it is useful to understand the variation of traditional behavior within the specific population group to be served when planning and implementing culturally appropriate interventions for American Indian women. It is also useful to evaluate which segments of the population current programs are reaching.

Acculturation↗
PubMed2003

Ecotoxicological risks associated with land treatment of petrochemical wastes. I. Residual soil contamination and bioaccumulation by cotton rats (Sigmodon hispidus).

Petrochemical waste contains both organic and inorganic contaminants that can pollute soil and may pose significant ecological risks to wildlife. Petrochemical waste typically is disposed of in land treatment units, which are widespread throughout Oklahoma and the United States. Few studies have been conducted evaluating possible toxicity risks to terrestrial organisms residing on these units. In this study, the extent of soil contamination with fluoride (F), metals, and organic hydrocarbons, the bioaccumulation of F and metals in cotton rats (Sigmodon hispidus), the relationship between contaminants in soil and in tissues of cotton rats, and the level of potentially toxic polycyclic aromatic hydrocarbons (PAHs) in soil were determined on land treatment units. Over a 2-yr period, cotton rats and soils were collected and analyzed from 5 land treatment and matched reference units. The number of land treatment units with soil metal contamination (in parentheses) included: Cr, Cu, Pb (5). Al, As, Ni, Sr, Zn (4). Ba (3). and Cd, V (2). The number of land treatment units with soil PAH contamination (in parentheses) were naphthalene, phenanthrene, benzo[g,h,i]perylene (3). acenaphthene, anthracene, pyrene, benz[a]anthracene, chrysene, benzo[b]fluoranthene, benzo[a]pyrene, indeno[1,2,3-c,d]pyrene, dibenz[a,h]anthracene (2). and acenaphthylene, fluorene, fluoranthene, benzo[k]fluoranthene (1). Total PAH and total petroleum hydrocarbons (TPH) were elevated at all five land treatment units. Mean sums of benzo[a]pyrene (BaP) equivalents (BaPequiv ) were not affected on

Animals↗
PubMed2003

Ecotoxicological risks associated with land treatment of petrochemical wastes. III. Immune function and hematology of cotton rats.

Landfarming is a widely used method of treating petrochemical waste through microbial bio-degradation. The effects of residual petrochemical contamination on wildlife, especially terrestrial mammals, are poorly understood. The effects of contaminants on the immune system and hematology of cotton rats (Sigmodon hispidus) living on five abandoned petrochemical landfarms (units 1-5) in Oklahoma were studied. Cotton rats were sampled seasonally (summer and winter) from each landfarm and from five ecologically matched reference sites for 2 yr (1998-2000) and returned to the laboratory for immunological and hematological assays. Overall analysis indicated that rats inhabiting landfarms exhibited decreased relative spleen size compared to rats collected from reference sites, with the landfarm at unit 1 showing the greatest reduction. Cotton rats collected from landfarms also had increased hemoglobin, hematocrit, and platelet levels and decreased blood leukocytes during summer. During winter, an increase in the number of popliteal node white blood cells was observed from rats collected on landfarms. No marked difference was detected for lymphocyte proliferation in response to concanavalin A, pokeweed, or interleukin-2. Lymphokine-activated killer cell lytic ability showed a seasonal pattern, but no treatment differences. No differences between landfarm and reference sites were detected in the hypersensitivity reaction of rats given an intradermal injection of phytohemagluttinin (PHA-P). Comparisons within individual sites indicated that two sites (units 1 and 3) had the greatest effects on immune function and hematology of cotton rats. The results of this study suggest that residual petrochemical waste affects the immune system and hematology of cotton rats living on abandoned landfarms during summer and is complicated by variation in the contaminants found on individual petroleum sites.

Agriculture↗
PubMedDate not supplied

Seasonal changes in the physiology of male Virginia opossums (Didelphis virginiana): signs of the Dasyurid semelparity syndrome?

Semelparity, which is multiplying once in a lifetime, is a rare reproductive strategy among mammals. Several species of the marsupial family Dasyuridae experience 100% male mortality following an intense mating period. We investigated seasonal physiological changes that may be associated with early mortality in the male Virginia opossum (Didelphis virginiana; Didelphidae) and compared these changes with those of semelparous, male dasyurids. Free-ranging male Virginia opossums (n=36) were collected during 2001 at the Oklahoma State University Cross Timbers Experimental Range. Seasonal data were collected on hematological, morphological, and helminth parameters of these individuals. We used one-way ANOVA to determine whether there were seasonal differences among means for each parameter. It appeared that male Virginia opossums experienced some physiological changes similar to those of male dasyurids exhibiting semelparity. All males collected in summer (August) were juveniles of the year. Lack of adult males in August suggests high mortality of this cohort during the breeding season. Opossum characteristics exhibiting the dasyurid semelparity syndrome included packed cell volume, adrenal mass, and helminth numbers. Minor lymphocytopenia, neutrophilia, and testosterone concentrations also were similar to semelparous dasyurids. However, a lack of change in serum cortisol concentration and body mass and dynamics in immunoglobulin protein, serum protein, and testes mass were not consistent with previous reports of semelparous dasyurid physiology. Evolutionary divergence and differences in breeding behavior between dasyurids and didelphids may be responsible for the lack of consistency between the taxa.

Animals↗
PubMed2004

Borderline science: expert testimony and the Red River boundary dispute.

The 1918 discovery of oil in the bed of the Red River, which forms the border between Texas and Oklahoma, led to a U.S. Supreme Court case that involved the extensive use of expert witnesses in fields such as geology, geography, and ecology. What began as a dispute between the two states soon became a multisided controversy involving those states, the federal government, Native Americans, and individual placer-mining claimants. After the federal attorneys introduced scientific experts into the dispute, including the plant ecologist Henry Chandler Cowles and the geographer Isaiah Bowman, fresh from negotiations at the Paris Peace Conference, Texas attorneys fielded their own team of opposing experts. Charged with the task of determining the location of the border, defined as the south bank of the river at the time of the 1819 treaty with Spain, the scientific experts presented the court with volumes of evidence and elaborate arguments, much of it contradictory and involving creative interpretations of existing theories. The case exhibited all the now-familiar features of a trial using expert witnesses, for which it represents an early, overlooked, and particularly complex example.

Dissent and Disputes↗
PubMed2004

A large nosocomial outbreak of hepatitis C and hepatitis B among patients receiving pain remediation treatments.

BACKGROUND AND OBJECTIVE: In August 2002, the Oklahoma State Department of Health received a report of six patients with unexplained hepatitis C virus (HCV) infection treated in the same pain remediation clinic. We investigated the outbreak's extent and etiology. DESIGN, SETTING, AND PARTICIPANTS: We conducted a retrospective cohort study of clinic patients, including a serologic survey, interviews of infected patients, and reviews of medical records and staff infection control practices. Patients received outpatient pain remediation treatments one afternoon a week in a clinic within a hospital. Cases were defined as HCV or hepatitis B virus (HBV) infections among patients who reported no prior diagnosis or risk factors for disease or reported previous risk factors but had evidence of acute infection. RESULTS: Of 908 patients, 795 (87.6%) were tested, and 71 HCV-infected patients (8.9%) and 31 HBV-infected patients (3.9%) met the case definition. Multiple HCV genotypes were identified. Significantly higher HCV infection rates were found among individuals treated after an HCV-infected patient during the same visit (adjusted odds ratio [AOR], 6.2; 95% confidence interval [CI95], 2.4-15.8); a similar association was observed for HBV (AOR, 2.9; CI95, 1.3-6.5). Review of staff practices revealed the nurse anesthetist had been using the same syringe-needle to sequentially administer sedation medications to every treated patient each clinic day. CONCLUSIONS: Reuse of needles-syringes was the mechanism for patient-to-patient transmission of HCV and HBV in this large nosocomial outbreak. Further education and stricter oversight of infection control practices may prevent future outbreaks.

Adolescent↗
PubMed2006

A large, travel-associated outbreak of legionellosis among hotel guests: utility of the urine antigen assay in confirming Pontiac fever.

BACKGROUND: During March 2004, a large outbreak of legionnaires disease and Pontiac fever occurred among hotel guests in Oklahoma. An investigation was conducted to identify the source and evaluate the utility of the Legionella urine antigen assay and serologic testing for the identification of Pontiac fever. METHODS: A retrospective cohort investigation of hotel guests and employees and an environmental evaluation were performed. Participants were interviewed, and clinical specimens were collected from consenting individuals. RESULTS: Six cases of legionnaires disease and 101 cases of Pontiac fever were identified. Exposure to the indoor pool and hot tub area was associated with legionellosis (relative risk, 4.4; 95% confidence interval, 2.8-6.9). Specimens from the pool and hot tub tested positive for Legionella pneumophila serogroup 1 by polymerase chain reaction. For Pontiac fever, the sensitivity and positive predictive value were 35.7% and 100%, respectively, for the urine antigen assay, and 46.4% and 90%, respectively, for serologic testing. The specificity and negative predictive value were 100% and 47.8%, respectively, for the urine antigen assay, and 89.3% and 45.5%, respectively, for serologic testing. CONCLUSIONS: Urine antigen testing, with or without serologic testing, can be used to confirm outbreak-associated cases of Pontiac fever caused by L. pneumophila serogroup 1.

Adolescent↗
PubMed2006

Making the business case for telemedicine: an interactive spreadsheet.

The objective of this study was to demonstrate the business case for telemedicine in nonrural areas. We developed an interactive spreadsheet to conduct multiple financial analyses under different capital investment, revenue, and expense scenarios. We applied the spreadsheet to the specific case of poststroke rehabilitation in urban settings. The setting involved outpatient clinics associated with a freestanding rehabilitation hospital in Oklahoma. Our baseline scenario used historical financial data from face-to-face encounters as the baseline for payer and volume mix. We assumed a cost of capital of 10% to finance the project. The outcome measures were financial breakeven points and internal rate of return. A total of 340 telemedicine visits will generate a positive net cash flow each year. The project is expected to recoup the initial investment by the fourth year, produce a positive present value dollar return of more than $2,000, and earn rate of return of 20%, which exceeds the hospital's cost of capital. The business case is demonstrated for this scenario. Urban telemedicine programs can be financially self-sustaining without accounting for reductions in travel time by providers or patients. Urban telemedicine programs can be a sound business investment and not depend on grants or subsidies for start-up funding. There are several key decision points that affect breakeven points and return on investment. The best business strategy is to approach the decision as whether or not to build a new clinic.

Accounting↗
PubMed1998

Historical and contextual correlates of parallel services for elders in African American communities.

Employing ethnographic and historical research methods, this article examines the organization and delivery of parallel services (locally generated alternatives to formal, externally controlled services) for older residents in four of the all-Black towns of Oklahoma. These towns are rural, social-ecological enclaves that generally have remained totally African American since they were established in the late 1800s and early 1900s. Elders, even impaired older people, are prominent agents in the production of alternative services, and the organization of parallel services can be directly related to historical and contextual characteristics of the communities. The results demonstrate the value of taking into account community history and context, as well as the mix of parallel services, when developing formal services for minority communities.

Black or African American↗
PubMed2000

An exploration of the influence of family on cigarette smoking among American Indian adolescents.

American Indians have the highest smoking rate of all major racial/ethnic groups in the US, despite significant variation across tribes and regions of the country. Yet, little research has been conducted on smoking initiation among American Indian adolescents. In an effort to identify the mechanisms through which families influence teen smoking, both positively and negatively, 20 focus groups were conducted with 144 non-reservation American Indian teens in Oklahoma. Findings indicated that most of the antismoking messages from family members were given by parents and grandparents, and focused on the long-term health consequences of smoking and addiction. Parental responses to teen smoking varied widely, with some responses sending mixed messages to the teens. Many teens discussed obtaining their first cigarette in a family setting and the teens felt that having smokers in their families influenced them to try smoking. Teens were able to discuss the traditional role of tobacco in their culture and were aware of its presence at Indian events, but felt ceremonial and traditional use was distinct from recreational use. Additional research is necessary to assess whether these results are generalizable to other tribes and regions, and to other racial/ethnic groups.

Adolescent↗
PubMed2004

Anti-smoking socialization beliefs among rural Native American and White parents of young children.

This study assesses similarities and differences in anti-smoking socialization beliefs of White and Native American parents in a low-income, rural population in northeastern Oklahoma. Data are from a population-based, cross-sectional children's environmental health study in which in-home interviews were conducted with 356 parents (56.2% White, 43.8% Native American), primarily mothers, of young children. Approximately 65% of the participants had a high school education or less and over 50% smoked. The Native American participants represented numerous tribes and did not live on reservations. Multivariate logistic regression models were used to examine associations between race/ethnicity, education, smoking status and six anti-smoking socialization beliefs. Results showed that White and Native American parents in this study were very similar in their anti-smoking socialization beliefs, with the one exception that Native American parents were less likely to believe that schools are better than parents in teaching children about the dangers of cigarette smoking. Parental education was significantly associated with the beliefs that all children will try smoking and that forbidding children to smoke will only make them want to smoke more, with less-educated parents more likely to share these beliefs. Findings suggest that interventions to promote anti-smoking socialization beliefs among parents with high school education or less may be important in low-income, rural communities with high smoking rates.

Adult↗
PubMed1997

The SAFE project: community-driven partnerships in health, mental health, and education to prevent early school failure.

This article presents a case study of an innovative school-based health and mental health project that prevents early school failure in one county in Oklahoma. Success is attributed to social work development of broad-based partnerships involving families, schools, communities, and public policy officials. Citizen-driven, these partnerships have meshed previously fixed institutional boundaries in health, mental health, and education to prevent early school failure. The article describes school-family partnerships that form the core of the project's service intervention model. Statistics on service activities and outcomes are presented, along with a discussion of lessons learned for implementation of the project.

Adolescent↗
PubMed1977

Wound infection by an indigenous Pseudomonas pseudomallei-like organism isolated from the soil: case report and epidemiologic study.

A 27-year-old farmer in the Oklahoma panhandle was pinned under his overturned tractor for 2 hr and received superficial and deep lacerations. He contracted an infection of a pelvic wound with an organism that had cultural and biochemical characteristics identical to those of Pseudomonas pseudomallei. Identical organisms were recovered from soil taken from the site of the accident. The organism isolated from the wound proved to be less virulent in guinea pigs than usual laboratory strains of P. pseudomallei; fatty acid analysis showed a distinctly different pattern from that of laboratory strains of P. pseudomallei. The infecting organism may be a variant of P. pseudomallei or a new species of Pseudomonas.

Adult↗
PubMed1991

Meningococcal disease in the United States--1986. Meningococcal Disease Study Group.

Active surveillance for invasive meningococcal disease was conducted during 1986 and 1987 in six areas of the United States with a total population of approximately 34 million persons. The incidence of meningococcal disease was 1.3:10(5). The highest incidence of disease among the surveillance areas was in Los Angeles County (1.65:10(5). Neisseria meningitidis serogroups B and C caused about equal amounts of disease, which reflects a recent increase in the incidence of group C disease. Group C caused more than half of the cases of meningococcal disease in Los Angeles and Tennessee but less than one-third of the cases in Missouri and Oklahoma. Multilocus enzyme electrophoresis demonstrated that a group of closely related isolates of N. meningitidis was prevalent in Los Angeles during the surveillance period and was associated with an increased incidence of meningococcal disease there.

Adolescent↗