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At least 1,369 records · Page 76Linked to original sources
PubMed1975

Dental students paired for DAU training.

In summary, policy has been established at the University of Oklahoma College of Dentistry which pairs dental students for their clinical experiences during the first two years of their dental education--alternating the roles of dentist and assistant. A modified program for third-year dental students has been designed which includes assignment of trained dental assistants and some limited solo operations as well as a continuation of the pairing. It is anticipated that this approach will also be employed during the fourth year with more emphasis being placed upon utilization of trained assistants. The formal DAU course is given first semester of freshman year; and the principles are reinforced in each subsequent year. The advantages of this program seem to be (1) early integration of DAU principles into the curriculum, (2) increased efficiency while operating in pairs, (3) experience for training assistants for further private practice, (4) reduced appointment time for patients and (5) better use of clinical space. The application of the pairing concept will be continuously reevaluated to determine if such benefits are forthcoming.

Curriculum↗
PubMed1987

The prevalence of baby bottle tooth decay among two native American populations.

Baby bottle tooth decay (BBTD) is a disease characterized by severe dental caries in the primary dentition that may have significant short-term and long-term implications for the health of children. Its prevalence and various etiologic factors have not been addressed fully in the dental literature. In 1985, 514 Native American Head Start children in Alaska and Oklahoma were screened to establish the prevalence of BBTD in those populations. The prevalence of BBTD ranged between 17 and 85 percent, with a mean of 53 percent. BBTD is clearly a significant health problem for this population group. Concerted intervention efforts to lower the prevalence of this preventable condition should be instituted and their effectiveness evaluated for potential utility among other affected groups.

Alaska↗
PubMed1989

Assessment of a dental disease prevention program after three years.

This assessment compared routine data on selected clinical services provided within the Oklahoma City Area of the Indian Health Service during the first six months of fiscal year 1984, prior to implementation of a program emphasizing oral health promotion and disease prevention, to comparable data from 1987. The assessment revealed: similar absolute numbers of routine examinations and completed treatment among children; a 10 percent increase in total visits for persons of all ages, accomplished with comparable numbers of dental personnel; and an increase in the percent of services that were preventive, as well as a concomitant decrease in basic restorative services. The ratio of pit and fissure sealants to one-surface amalgam restorations was reversed dramatically. Although counts of services rendered do not measure oral health status directly, some conclusions are warranted. Clinical dental personnel can be reoriented to devote an increased proportion of available patient care time to primary preventive services, accomplishing a substantial increase in these services. That increase is associated with a corresponding decrease in the proportion of basic restorative services.

Adolescent↗
PubMed1990

Infection control in the Indian Health Service Dental Program: estimated costs and effects on productivity.

The dental literature contains many recommendations defining standards for infection control. Little information is available, however, documenting the cost of implementing these standards. This article describes the cost incurred by the Indian Health Service Dental Program in the Oklahoma area between 1985 and 1988 for infection control. During this period, comprehensive infection control recommendations were published for oral health programs serving Native Americans and data were collected on supply utilization. While productivity data were collected for that same time period do not support the premise that infection control practices lead to decreased clinical productivity, infection control supply costs did increase over fourfold during this period.

Budgets↗
PubMedDate not supplied

Using beepers to keep family members involved in the patient's care.

The 1994 Veterans Health Administration (VHA) National Customer Feedback Survey of 43,594 recently discharged inpatients revealed that problems relating to emotional support were reported two to three more frequently by VHA patients than by patients in the private sector. The scores related to emotional support that were reported by 130 Oklahoma City Veterans Affairs Medical Center surgery respondents were the facility's least favorable scores in benchmark comparisons with all VHA surgery patients and with surgery patients at Picker Institute, a nonprofit, private sector research and education organization. These scores prompted the initiation of a successful program to loan radio and digital beepers to patients' family members.

Awareness↗
PubMed1962

Strontium-90 in the 1959 United States wheat crop.

A broad sampling of the 1959 United States wheat crop has been analyzed for the presence of strontium-90. The level of strontium-90 found in these samples is in general agreement with the findings of other investigators, with the exception that the highest levels of strontium-90 in wheat were found in samples from Oklahoma.

Agriculture↗
PubMed1976

Oil degradation in soil.

The environmental effects of adding certain selected petroleum products to field soils at widely separated geographical locations under optimum conditions for biodegradation were studied. The locations selected for study of soil biodegradation of six oils (used crankcase oil from cars, used crankcase oil from trucks, an Arabian Heavy crude oil, a Coastal Mix crude oil, a home heating oil no. 2, and a residual fuel oil no. 6) were Marcus Hook, Pennsylvania, Tulsa, Oklahoma, and Corpus Christi, Texas. The investigative process, covering a period of 1 year at each location, was conducted in 14 fields plots (1.7 by 3.0 m) to which the oils were added in a single application at a rate of 11.9 m3/4 X 10(3) m2. One-half of the plots at each location were fertilized, and the incorporation of the oils and fertilizers was accomplished with rototillers to a depth of 10 to 15 cm. Concentrations of all oils decreased significantly at all locations. The average reduction ranged from 48.5 to 90.0% depending upon the type of oil and location. Rates of degradation did not exceed 2.4 m3/4 X 10(3) m2 per month. Compositional changes in the oil with time were investigated using silica gel fractionation, gas chromatography, and ultraviolet absorbance. With the possible exception of the two fuel oils, the compositional changes were generally in the same direction for all of the oils. The silica gel fractionation and gravimetric data on residual oils show that all classes of compounds were degraded, but the more polar type degrade more slowly. Analysis of runoff water, leachate, and soils indicated that at the concentration applied no oil less was observed from these plots via water movement. No significant movement of lead compounds added to the soils in the used crankcase oils was observed. Significant increases in hydrocarbon-utilizing microorganisms were demonstrated in all treated plots using either the pure hydrocarbon, n-hexadecane, or the applied oils as the growth substrate. These increases were usually sustained throughout the year. Significant increases in hydrocarbon-utilizing fungi were not demonstrated by the plating technique used. The concentrations of residual oils or their oxidation products were of sufficient magnitude in the treated plots, 9 months after application, to cause significant inhibition of plant growth. From the data obtained, it was not possible to determine the type of compounds causing this inhibition or their long-term environmental effects.

Bacteria↗
PubMed2003

Bacterial diversity and sulfur cycling in a mesophilic sulfide-rich spring.

An artesian sulfide- and sulfur-rich spring in southwestern Oklahoma is shown to sustain an extremely rich and diverse microbial community. Laboratory incubations and autoradiography studies indicated that active sulfur cycling is occurring in the abundant microbial mats at Zodletone spring. Anoxygenic phototrophic bacteria oxidize sulfide to sulfate, which is reduced by sulfate-reducing bacterial populations. The microbial community at Zodletone spring was analyzed by cloning and sequencing 16S rRNA genes. A large fraction (83%) of the microbial mat clones belong to sulfur- and sulfate-reducing lineages within delta-Proteobacteria, purple sulfur gamma-Proteobacteria, epsilon -Proteobacteria, Chloroflexi, and filamentous Cyanobacteria of the order Oscillatoria as well as a novel group within gamma-Proteobacteria. The 16S clone library constructed from hydrocarbon-exposed sediments at the source of the spring had a higher diversity than the mat clone library (Shannon-Weiner index of 3.84 compared to 2.95 for the mat), with a higher percentage of clones belonging to nonphototrophic lineages (e.g., Cytophaga, Spirochaetes, Planctomycetes, Firmicutes, and Verrucomicrobiae). Many of these clones were closely related to clones retrieved from hydrocarbon-contaminated environments and anaerobic hydrocarbon-degrading enrichments. In addition, 18 of the source clones did not cluster with any of the previously described microbial divisions. These 18 clones, together with previously published or database-deposited related sequences retrieved from a wide variety of environments, could be clustered into at least four novel candidate divisions. The sulfate-reducing community at Zodletone spring was characterized by cloning and sequencing a 1.9-kb fragment of the dissimilatory sulfite reductase (DSR) gene. DSR clones belonged to the Desulfococcus-Desulfosarcina-Desulfonema group, Desulfobacter group, and Desulfovibrio group as well as to a deeply branched group in the DSR tree with no representatives from cultures. Overall, this work expands the division-level diversity of the bacterial domain and highlights the complexity of microbial communities involved in sulfur cycling in mesophilic microbial mats.

Bacteria↗
PubMed2004

Survey of archaeal diversity reveals an abundance of halophilic Archaea in a low-salt, sulfide- and sulfur-rich spring.

The archaeal community in a sulfide- and sulfur-rich spring with a stream water salinity of 0.7 to 1.0% in southwestern Oklahoma was studied by cloning and sequencing of 16S rRNA genes. Two clone libraries were constructed from sediments obtained at the hydrocarbon-exposed source of the spring and the microbial mats underlying the water flowing from the spring source. Analysis of 113 clones from the source library and 65 clones from the mat library revealed that the majority of clones belonged to the kingdom Euryarchaeota, while Crenarchaeota represented less than 10% of clones. Euryarchaeotal clones belonged to the orders Methanomicrobiales, Methanosarcinales, and Halobacteriales, as well as several previously described lineages with no pure-culture representatives. Those within the Halobacteriales represented 36% of the mat library and 4% of the source library. All cultivated members of this order are obligately aerobic halophiles. The majority of halobacterial clones encountered were not affiliated with any of the currently described genera of the family Halobacteriaceae. Measurement of the salinity at various locations at the spring, as well as along vertical gradients, revealed that soils adjacent to spring mats have a much higher salinity (NaCl concentrations as high as 32%) and a lower moisture content than the spring water, presumably due to evaporation. By use of a high-salt-plus-antibiotic medium, several halobacterial isolates were obtained from the microbial mats. Analysis of 16S rRNA genes indicated that all the isolates were members of the genus Haloferax. All isolates obtained grew at a wide range of salt concentrations, ranging from 6% to saturation, and all were able to reduce elemental sulfur to sulfide. We reason that the unexpected abundance of halophilic Archaea in such a low-salt, highly reduced environment could be explained by their relatively low salt requirement, which could be satisfied in specific locations of the shallow spring via evaporation, and their ability to grow under the prevalent anaerobic conditions in the spring, utilizing zero-valent sulfur compounds as electron acceptors. This study demonstrates that members of the Halobacteriales are not restricted to their typical high-salt habitats, and we propose a role for the Halobacteriales in sulfur reduction in natural ecosystems.

Archaea↗
PubMed1984

Wound infections caused by Vibrio vulnificus, a marine vibrio, in inland areas of the United States.

Vibrio vulnificus is a halophilic marine vibrio which may produce infection in wounds exposed to seawater or raw shellfish. The Centers for Disease Control has received two isolates from wounds exposed to inland waters, a New Mexico creek and an Oklahoma reservoir. Halophilic organisms were recovered from both the creek and the reservoir, and the water in both sites was found to be brackish. Both clinical isolates of V. vulnificus grew in salt concentrations as low as those found in the creek and reservoir. These cases illustrate the potential for pathogenic halophilic Vibrio species to live in brackish inland waters and produce infections in patients living in inland areas of the United States.

Adolescent↗
PubMed1983

Analysis of mammography: a blind interpretation of BCDDP radiographs.

An ROC curve analysis of mammography is presented. This study is based on a blind interpretation of radiographs of patients who underwent screening during the Oklahoma Breast Cancer Detection Demonstration Project (BCDDP). In particular, we evaluated the accuracy of mammography based on 38 incidence cancer cases. Incidence cases are those that develop in a patient after an initial visit and at least one additional annual visit before a biopsy is performed. Using 40 normal subjects, a sensitivity of 72% was attained at a 28% false positive rate. We also evaluated the contribution of viewing radiographs of both breasts (right and left) simultaneously as compared with viewing radiographs of the individual breasts singly. In cases on the threshold of detectability, the breast that did not result in the cancer diagnosis was occasionally identified as the most suspicious for cancer. When mammograms of the two breasts were compared, the false positive rate was lower. These results can be used to assess various screening strategies and to yield a more realistic accuracy estimate of mammography on a rescreened population than is currently available.

Biopsy↗
PubMed2006

Changing relative prevalence of Alzheimer disease versus non-Alzheimer disease dementias: have we underestimated the looming dementia epidemic?

The relative prevalence of neurodegenerative dementias in our Veterans' Affairs dementia clinic has shifted from predominantly Alzheimer disease (AD) to predominantly non-AD diagnoses. Because our clinic was the only Veterans' Affairs clinic in Oklahoma that could initiate cholinesterase inhibitors, we had a captured patient referral source. If future epidemiologic studies establish that non-AD dementias are as, or more, prevalent than AD, then the looming dementia epidemic in the United States will be greater in magnitude than currently predicted.

Aged↗
PubMed2002

Genetic influences on aortic root size in American Indians: the Strong Heart Study .

Aortic root dilatation is a major pathophysiological mechanism for aortic regurgitation and predisposes the aortic root to dissection or rupture. However, only a small proportion of the variance of aortic root size can be explained by its known clinical and demographic correlates. The present study was undertaken to determine the heritability of echocardiographically derived aortic root diameter in the American Indian participants in the second Strong Heart Study examination. Echocardiograms were analyzed in 1373 SHS participants who had > or =1 family member in the cohort. Heritability calculations were performed by using variance component analysis as implemented in SOLAR, a computer analysis program. In a polygenic model, the variables entered and identified as covariates of larger aortic root diameter were older age, male sex, and center (P<0.001), which accounted for 35% of the overall variability of aortic root diameter. After simultaneous adjustment was made for these significant covariates, the proportion of phenotypic variance due to additive genetic contribution or residual heritability (h2) was 0.51 (SE=0.08, P<0.001). Additionally, simultaneous adjustment for height, weight, and systolic and diastolic BPs yielded slightly lower residual h2 of aortic root diameter (h2=0.44, SE=0.08, P<0.001), which accounted for 26% of the overall variance of aortic root size. Because center effects were identified as significant covariates in the analyses, h2 analyses were performed separately in Arizona, Oklahoma, and North/South Dakota centers, which confirmed that a significant proportion of the phenotypic variance of aortic root diameter is due to additive genetic contribution. Heredity explains a substantial proportion of the variability of aortic root size that is not accounted for by age, sex, body size, and blood pressure. Echocardiographic screening of family members with aortic root dilatation may identify other individuals predisposed to aortic dissection or rupture.

Aged↗
PubMed1999

Rising tide of cardiovascular disease in American Indians. The Strong Heart Study.

BACKGROUND: Although cardiovascular disease (CVD) used to be rare among American Indians, Indian Health Service data suggest that CVD mortality rates vary greatly among American Indian communities and appear to be increasing. The Strong Heart Study was initiated to investigate CVD and its risk factors in American Indians in 13 communities in Arizona, Oklahoma, and South/North Dakota. METHODS AND RESULTS: A total of 4549 participants (1846 men and 2703 women 45 to 74 years old) who were seen at the baseline (1989 to 1991) examination were subjected to surveillance (average 4.2 years, 1991 to 1995), and 88% of those remaining alive underwent a second examination (1993 to 1995). The medical records of all participants were exhaustively reviewed to ascertain nonfatal cardiovascular events that occurred since the baseline examination or to definitively determine cause of death. CVD morbidity and mortality rates were higher in men than in women and were similar in the 3 geographic areas. Coronary heart disease (CHD) incidence rates among American Indian men and women were almost 2-fold higher than those in the Atherosclerosis Risk in Communities Study. Significant independent predictors of CVD in women were diabetes, age, obesity (inverse), LDL cholesterol, albuminuria, triglycerides, and hypertension. In men, diabetes, age, LDL cholesterol, albuminuria, and hypertension were independent predictors of CVD. CONCLUSIONS: At present, CHD rates in American Indians exceed rates in other US populations and may more often be fatal. Unlike other ethnic groups, American Indians appear to have an increasing incidence of CHD, possibly related to the high prevalence of diabetes. In the general US population, the rising prevalence of obesity and diabetes may reverse the decline in CVD death rates. Therefore, aggressive programs to control diabetes and its risk factors are needed.

Aged↗
PubMed2006

Prediction of coronary heart disease in a population with high prevalence of diabetes and albuminuria: the Strong Heart Study.

BACKGROUND: The present article presents equations for the prediction of coronary heart disease (CHD) in a population with high rates of diabetes and albuminuria, derived from data collected in the Strong Heart Study, a longitudinal study of cardiovascular disease in 13 American Indian tribes and communities in Arizona, North and South Dakota, and Oklahoma. METHODS AND RESULTS: Participants of the Strong Heart Study were examined initially in 1989-1991 and were monitored with additional examinations and mortality and morbidity surveillance. CHD outcome data through December 2001 showed that age, gender, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein cholesterol, smoking, diabetes, hypertension, and albuminuria were significant CHD risk factors. Hazard ratios for ages 65 to 75 years, hypertension, LDL cholesterol > or = 160 mg/dL, diabetes, and macroalbuminuria were 2.58, 2.01, 2.44, 1.66, and 2.11 in men and 2.03, 1.69, 2.17, 2.26, and 2.69 in women, compared with ages 45 to 54 years, normal blood pressure, LDL cholesterol <100 mg/dL, no diabetes, and no albuminuria. Prediction equations for CHD and a risk calculator were derived by gender with the use of Cox proportional hazards model and the significant risk factors. The equations provided good discrimination ability, as indicated by a c statistic of 0.70 for men and 0.73 for women. Results from bootstrapping methods indicated good internal validation and calibration. CONCLUSIONS: A "risk calculator" has been developed and placed on the Strong Heart Study Web site, which provides predicted risk of CHD in 10 years with input of these risk factors. This may be valuable for diverse populations with high rates of diabetes and albuminuria.

Aged↗
PubMed2003

Use of mental health services by veterans with PTSD after the terrorist attacks of September 11.

OBJECTIVE: Community surveys have demonstrated significant psychological distress since the terrorist attacks of Sept. 11, 2001. Since people with posttraumatic stress disorder (PTSD) and other mental illnesses are especially vulnerable to stressful events, the authors examined the use of PTSD treatment services and other mental health services at Department of Veterans Affairs (VA) medical centers in New York City and elsewhere after the attacks. METHOD: Analysis of variance was used to compare changes in average daily service use in the 6 months before and the 6 months after September 11, with changes in service use across the same months in the 2 previous years. Chi-square tests were used to examine differences from previous years in the proportion of new patients (i.e., who had not received treatment in the previous 6 months) entering treatment after September 11. RESULTS: There was no significant increase in the use of VA services for the treatment of PTSD or other mental disorders or in visits to psychiatric or nonpsychiatric clinics in New York City after September 11 and no significant change in the pattern of service use from previous years. Nor was there a significant increase in PTSD treatment in the greater New York area, Washington, D.C., or Oklahoma City or in the proportion of new patients. CONCLUSIONS: No increase was observed in the use of mental health services among VA patients with PTSD or other mental illnesses in response to the terrorist attacks of September 11.

Adaptation, Psychological↗
PubMed2000

Posttraumatic stress among young children after the death of a friend or acquaintance in a terrorist bombing.

The effects of traumatic loss on children who reported a friend or acquaintance killed in the 1995 Oklahoma City bombing of a federal office building were examined. Twenty-seven children who lost a friend or acquaintance and 27 demographically matched controls were assessed eight to ten months after the bombing. All but three of the children continued to experience posttraumatic stress symptoms. Those who lost a friend watched significantly more bombing-related television coverage than those without losses. Those who lost a friend had significantly more posttraumatic stress symptoms at the time of the assessment than those who lost an acquaintance. Parents and those working with children should be alert to the impact of loss even when it involves nonrelatives.

Attitude to Death↗
PubMed1980

Improving psychiatric care for prisoners.

While psychiatry has been ambivalent about treating mentally ill offenders, recent mandates for better mental health care for prisoners will require the profession's intervention. The authors, whose study of mental health care needs of inmates in Oklahoma is reported in the article following this one, believe that because the prison is a community, a community-mental-health-like system offering a continuum of services is indicated. Some of the services they propose for prisons include outpatient and partial hospital services, an acute inpatient unit, a residential tertiary care unit, and an intermediate living unit. They also believe that mental health professionals should help improve the environment of prisons, and can do so by sharing lessons learned in their own institutional settings about the effects of a therapeutic community and a legitimate patient government.

Health Services Needs and Demand↗