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PubMed2006

Effects of wind direction on coarse and fine particulate matter concentrations in southeast Kansas.

Field data for coarse particulate matter ([PM] PM10) and fine particulate matter (PM2.5) were collected at selected sites in Southeast Kansas from March 1999 to October 2000, using portable MiniVol particulate samplers. The purpose was to assess the influence on air quality of four industrial facilities that burn hazardous waste in the area located in the communities of Chanute, Independence, Fredonia, and Coffeyville. Both spatial and temporal variation were observed in the data. Variation because of sampling site was found to be statistically significant for PM10 but not for PM2.5. PM10 concentrations were typically slightly higher at sites located within the four study communities than at background sites. Sampling sites were located north and south of the four targeted sources to provide upwind and downwind monitoring pairs. No statistically significant differences were found between upwind and downwind samples for either PM10 or PM2.5, indicating that the targeted sources did not contribute significantly to PM concentrations. Wind direction can frequently contribute to temporal variation in air pollutant concentrations and was investigated in this study. Sampling days were divided into four classifications: predominantly south winds, predominantly north winds, calm/variable winds, and winds from other directions. The effect of wind direction was found to be statistically significant for both PM10 and PM2.5. For both size ranges, PM concentrations were typically highest on days with predominantly south winds; days with calm/variable winds generally produced higher concentrations than did those with predominantly north winds or those with winds from "other" directions. The significant effect of wind direction suggests that regional sources may exert a large influence on PM concentrations in the area.

Air Pollutants↗
PubMed2005

Psychotropic medication use among Kansas Medicaid youths with disabilities.

Knowledge of current patterns of psychotropic medication use by disabled youths is an important starting point for targeting future efforts to improve prescribing practices. This study provides a retrospective, descriptive analysis of the prevalence and patterns of psychotropic medication among 1022 Kansas Medicaid youths in 2001 who were enrolled with either Supplemental Security Income (SSI) or Medically Needy benefits and who were having clearly defined mental and neurological disabilities. Rates of psychotropic medication use were generally higher for the Medically Needy than for the SSI youths: Central nervous system (CNS) stimulants (24.6% versus 20.0%), antidepressants (30.9% versus 13.7%), anticonvulsants (22.0% versus 13.9%), and antipsychotics (23.3% versus 11.5%). Use of the four major drug classes varied among children with attention-deficit/hyperactivity disorder (ADHD) and disruptive disorders, pervasive developmental disabilities, mental retardation (MR) and learning disabilities, mood and anxiety disorders, and adjustment disorders. Future work should explore the appropriateness and effectiveness of these medications within specifically targeted subgroups.

Adolescent↗
PubMed2006

Pulsed-field gel electrophoresis patterns of Escherichia coli O157 isolates from Kansas feedlots.

This study investigated the prevalence and distribution of Escherichia coli O157 genetic types within and among feedlots using pulsed-field gel electrophoresis to separate XbaI-digested DNA. The study population consisted of 300 pens of cattle in 30 feedlots in Kansas that were sampled (feces, water, and water sediment) within a month of being shipped for slaughter. The prevalence of E. coli O157 was 8.5% in feces, 3.1% in water, and 4.5% in water sediment samples. A total of 424 E. coli O157 isolates were characterized by pulsed-field gel electrophoresis, and 139 subtypes (100% Dice similarity with no band differences) were identified. The majority of subtypes (70/139) was identified only once, but nine were identified 10 or more times. Identical subtypes were recovered from both feces and water tanks in 10 feedlots. The majority of subtypes were identified in only one feedlot, and the number of subtypes ranged from one to 23 within a feedlot and from one to seven within a pen. There were 10 feedlots with at least 15 positive samples. In these 10 feedlots, the most common subtype accounted for 16.9-78.6% of the isolates. Common subtypes differed among feedlots. In eight of the 10 feedlots, the most common subtype was identified in multiple pens. The results support a complex ecology for E. coli O157 in feedlot operations, with factors associated with exposure and transmission likely acting at a common level for multiple feedlots, within feedlots, and within pens of cattle.

Animals↗
PubMed1982

Yersinia enterocolitica in Kansas. Attempted recovery from 1,212 patients.

An attempt was made to isolate Yersinia enterocolitica, by cold enrichment, from the stool of 1,212 patients seen at the Wesley Medical Center in Wichita, Kansas. Y. enterocolitica was isolated from 5 (0.4%) of the patients. Shigella was isolated from 36 (3.0%) patients while either Salmonella or Campylobacter were each isolated from 15 (1.2%) patients. Two of our five Yersinia isolates were from patients admitted to the hospital with diarrhea. One was from a patient who developed transient diarrhea while in the hospital, and the other two were from patients without diarrhea. In our opinion, the data do not justify the routine examination of stool specimens for Y. enterocolitica.

Aged↗
PubMed2000

Prevalence and patterns of Gulf War illness in Kansas veterans: association of symptoms with characteristics of person, place, and time of military service.

Gulf War veterans have reported health problems that they attribute to their military service, but little is understood about the nature or extent of these conditions. To determine whether Kansas Gulf War veterans are affected by excess health problems, a population-based survey of 1,548 veterans who served in the Persian Gulf War (PGW) and 482 veterans who served elsewhere (non-PGW) was conducted in 1998. Gulf War illness, defined as having chronic symptoms in three of six domains, occurred in 34% of PGW veterans, 12% of non-PGW veterans who reported receiving vaccines during the war, and 4% of non-PGW veterans who did not receive vaccines. The prevalence of Gulf War illness was lowest among PGW veterans who served on board ship (21%) and highest among those who were in Iraq and/or Kuwait (42%). Among PGW veterans who served away from battlefield areas, Gulf War illness was least prevalent among those who departed the region prior to the war (9%) and most prevalent among those who departed in June or July of 1991 (41%). Observed patterns suggest that excess morbidity among Gulf War veterans is associated with characteristics of their wartime service, and that vaccines used during the war may be a contributing factor.

Adolescent↗
PubMed1994

Sociology, psychology, and the theoretical legacy of the Kansas City studies.

The theoretical impact of the Kansas City Studies stems from issues ignored as much as from those addressed. The largest concerted gerontological investigation of its day had a profound influence on the field through publications and through students trained through the studies. The studies advanced the search for "normal" aging but did not initially adequately address diversity. However, over time, investigators were forced to recognize diversity in their data. They contributed to viewing aging in a life course perspective, an advance over previous emphases on "the aged." The studies adopted and furthered a highly individualistic understanding of aging, while the sociological analyses from the studies lacked an adequate conceptualization of social structure.

Aged↗
PubMed1998

Entitlements, generational equity, and public-opinion manipulation in Kansas City.

To sow public doubts about Social Security and other federal old-age programs, one would need to erode their bases of support. This case study describes a year-long editorial campaign by The Kansas City Star that argued repeatedly for retrenchment of federal old-age programs and essentially promoted the policy agenda of the Concord Coalition. Generational inequity was a strong series theme. Readers, especially young people, were recruited to participate in public events that manufactured quotable support for the paper's stance. Throughout, shrill and unflattering portrayals of age-group interests did little to advance civic understanding of policy issues or forestall intergenerational tensions.

Adolescent↗
PubMed2005

Comparative susceptibility of western corn rootworm (Coleoptera: Chrysomelidae) adults to selected insecticides in Kansas.

Susceptibility of adult populations of the western corn rootworm, Diabrotica virgifera virgifera LeConte, to several insecticides was evaluated in seven Kansas counties, including Dickinson, Ford, Finney, Pottawatomie, Republic, Riley, and Stevens, between 1996 and 2002. All populations surveyed were highly susceptible to methyl parathion with the largest difference in susceptibility of only three-fold based on 16 complete bioassays for the populations from six counties over a 5-yr period. Noticeable decreases in carbaryl susceptibility were found in populations collected from Republic County between 1997 and 2001 when the cucurbitacin-carbaryl-based bait SLAM was widely used as an areawide management approach for adult corn rootworm control. However, the lowered carbaryl susceptibility returned to previous levels 1 yr after the use of SLAM was halted in the managed (treated) cornfields. This change implies possible dispersal of insects into the relatively small managed area from surrounding untreated cornfields and / or some fitness cost associated with carbaryl resistance within the population. Relative susceptibility of western corn rootworm adults also was evaluated for seven commonly used insecticides, including bifenthrin, carbaryl, chlorpyrifos, cypermethrin, fipronil, malathion, and methyl parathion. They were tested with corn rootworm adults collected from a single cornfield. Methyl parathion and bifenthrin were highly toxic to corn rootworm adults, and cypermethrin, chlorpyrifos, carbaryl, and malathion were only slightly less toxic. Although fipronil was highly toxic to adult rootworms, its activity was much slower than that of other insecticides. Thus, bifenthrin and methyl parathion were among the most effective in killing corn rootworm adults.

Animals↗
PubMed1994

Ticks (Acari: Ixodidae) collected from small and medium-sized Kansas mammals.

Seven species of hard-bodied ticks were collected from 20 species of small and medium-sized mammals in Kansas; Amblyomma americanum L., Dermacentor variabilis (Say), Haemaphysalis leporispalustris (Packard), Ixodes cookei Packard, I. kingi Bishopp, I. sculptus Neumann, and I. texanus Banks. Dermacentor variabilis was found statewide, A. americanum only in the eastern one-third of the state, and the Ixodes spp. and H. leporispalustris were widely scattered. The most common tick found was D. variabilis, both by itself and in association with other ticks. Mammals that ticks were collected from included Canis latrans Say, Cynomys ludovicianus ludovicianus (Ord), Didelphis virginianus Kerr, Geomys bursarius (Shaw), Lynx rufus (Schreber), Marmota monax bunkeri Black, Mephitis mephitis (Schreber), Microtus ochrogaster (Wagner), Mus musculus L., Peromyscus leucopus (Rafinesque), P. maniculatus (Wagner), Procyon lotor hirtus Nelson and Goldman, Reithrodontomys megalotis (Baird), Sciurus niger rufiventer Geoffroy, Sigmodon hispidus texianus (Audubon and Bachman), Sylvilagus floridanus (J. A. Allen), Taxidea taxus taxus (Schreber), and Vulpes velox velox (Say).

Animals↗
PubMed2003

The Program in Medical Humanities at the University of Missouri-Kansas City School of Medicine.

UNLABELLED: The University of Missouri-Kansas City School of Medicine opened officially in 1971, offering a combined BA/MD in a six-year program. The program has a defined goal of offering humanities courses throughout the curriculum. The Sirridge Office of Medical Humanities was established in 1992, and it assumed the responsibility of developing conveniently scheduled courses in medical humanities, making more specific requirements for such courses in the medical curriculum. The goal of these courses has been to provide students a different way of looking at things by giving them insight into the ways that reading literature and writing stories helps medical students better read patient experiences. A course entitled " LITERATURE: A Healing Art" was first offered in 1992. In 1994, The Body Image in Medicine and the Arts course was added. With the help of a Culpeper grant in 1995, five interdisciplinary undergraduate courses were created. In 1999 Medicine, LITERATURE, and Law was developed from two previous courses. Bioethics is offered as part of a series called Correlative Medicine and in a required course, Behavioral Science. The present director of the Office of Medical Humanities has resigned and at present there is a search for a replacement. A new director may decide to change some of the offerings and add new activities. The medical school remains committed to supporting the office and its programs in keeping with the goals of the original academic plan to educate safe and caring physicians.

Bioethics↗
PubMed1994

Orthopedic injuries from the Andover, Kansas, tornado.

Devastating tornados struck the state of Kansas on Friday, April 26, 1991. Twenty lives were lost and many people were injured. Property damage was extensive. Overall, the outcome of those admitted to the various hospitals was good, with few orthopedic-related complications. The low complication rate can be attributed to thorough open wound management and suspicion and recognition of other potential orthopedic complications such as compartment syndrome.

Abdominal Injuries↗
PubMedDate not supplied

Survey of tobacco cessation curricula in Kansas nursing programs.

Tobacco use is a major health risk that requires a comprehensive response by healthcare professionals. Nurse educators can contribute to the reduction of tobacco use by educating nursing students about tobacco use and smoking cessation strategies. The authors examine the breadth and depth of tobacco cessation content in Kansas registered nursing programs providing insight into the content and resources needed to teach nursing faculty and students how to assist individuals in tobacco use cessation.

Curriculum↗
PubMed1999

Public health response to metallic mercury spills in Kansas.

Local and state public health officials are called on to respond to environmental public health hazards just as they historically have been called on to respond to communicable disease outbreaks. Recent experience with metallic mercury spills in Kansas suggests that neither the legal authority nor the scientific knowledgebase is as well developed for response to environmental hazards as for communicable disease threats.

Adult↗
PubMed2005

Quantitative evaluation of "Can It Happen in Kansas: Response to Terrorism and Emerging Infections".

PURPOSE: This study describes the evaluation of a 2-year plan to train 10 percent of Kansas' multidisciplinary health professionals for response to terrorism and emerging infections. This project was part of a national effort covering 19 states funded by the Health Resources and Services Administration in 2003. METHODS: The initial training occurred in six 2-day workshops. A terrorism preparedness questionnaire was developed to assess Health Resources and Services Administration terrorism response competencies/learning objectives. These were measured before, after, and 3 months after training in a hybrid cross-sectional and cohort follow-up design. RESULTS: Health professionals' mean scores significantly improved on all four Health Resources and Services Administration terrorism self-reported competencies from pretest to posttest. Three months posttraining, health professionals' mean scores decreased slightly but remained significantly higher than their pretest scores. CONCLUSIONS: This project prepared healthcare professionals to respond to the medical consequences of terrorism. The integration of core competencies into the evaluation plan allowed for trainees to evaluate their confidence and abilities. The evaluation plan and curriculum may serve as useful tools for preparation of healthcare workers nationwide, with the potential to rebuild the public health infrastructure to assume preparedness responsibilities.

Adult↗
PubMedDate not supplied

Preparing for burn disasters: evaluation of a continuing education training course for pre-hospital and hospital professionals in Kansas.

"Preparing for Burn Disasters: A Training Course for Pre-Hospital and Hospital Professionals in Kansas," a continuing education program designed to provide licensed health care practitioners a training opportunity for multiple burn victim incidents, emphasized the challenges that the community-wide multidisciplinary team faces when responding to burn disasters. A pre-post survey design was used to assess changes in participants' knowledge and self-rated ability, confidence, and competence to perform in a burn disaster before and after training. Participants (N = 383) were predominantly female (71.1%), 40 years or older (57.7%), nurses (52.2%), were employed in a pre-hospital care setting (38%), and had worked in healthcare for 10 years or fewer (53.6%). The percentage of correct responses pre- vs post-test increased between 30% and 65% on two-thirds of the knowledge items. On the basis of paired-samples t-test analysis, statistically significant increases in participants' overall self-ratings of ability and confidence in burn management were observed in every content area. Most participants (64%) felt competent or highly competent to manage multiple burn casualties after the training program, and most participants (58%) indicated that they intended to incorporate the newly acquired knowledge into their daily practice within 2 weeks. Evaluation results demonstrate that a successful program was designed and implemented. The curriculum and teaching methods achieved desired goals for improved knowledge, which appear to have been translated to enhanced abilities, confidence and competence in burn assessment and treatment modalities.

Adult↗
PubMedDate not supplied

Implementation of in-home telemedicine in rural kansas: answering an elderly patient's needs.

The Interactive Home Health Care Program is a demonstration project evaluating the use of in-home telemedicine to provide health care for elderly and disabled people. Local cable systems interconnect a base station staffed by a telemedicine nurse with a modified television in the home. Six months into the project, 38 patients are being cared for at three sites in rural Kansas. Individual patient profiles show improvement. Technical and social challenges appear solvable. An evaluation is in progress.

Aged↗
PubMed1995

The first 18 months of mental health reform in Kansas.

OBJECTIVE: The effects of the first 18 months of implementation of the Kansas Mental Health Reform Act were evaluated. The act designated community mental health centers as gatekeepers for admission to mental health services, created screening and diversion services for state hospital admission, allocated state hospital bed days to each center, and reallocated funds from hospitals to communities. METHODS: Data from the catchment area in which reform was implemented in the 18-month study period, January 1991 to June 1992, were compared with data for that area before reform, and with data for the two state hospital catchment areas in which reform was not yet implemented. RESULTS: In the catchment area in which reform was implemented, state hospitalization decreased by about 29 percent, and state mental health funds allocated to the area's mental health centers almost doubled. Service utilization by patients discharged from the state hospital was higher than in the other two catchment areas, and most indicators of living status and vocational or educational involvement reflected improvement. CONCLUSIONS: The first 18 months of implementation suggest that state-level systems change can decrease state hospitalization and improve the utilization of community services while improving the quality of life for people with severe and persistent mental illness.

Adult↗
PubMed1995

Telemedicine for patient consultation: factors affecting use by rural primary-care physicians in Kansas.

The purpose of our study was to investigate knowledge of, attitudes to, and use of interactive telemedicine for specialist consultation among rural practitioners Kansas. We interviewed 28 rural primary-care practitioners at seven remote health-care facilities in six locations. Content analyses of the interviews showed universal but superficial knowledge of telemedicine, appreciation of the value of the technology, but relatively low usage of the telemedicine service available (32% of subjects). Physicians did not appear to be afraid of change. Telemedicine usage was not related to the professional characteristics of the physicians. Our findings suggest that further growth in the use of telemedicine will depend on efforts directed towards physicians which are aimed at creating a more user-friendly environment and at accommodating the referral practices of potential users.

Health Knowledge, Attitudes, Practice↗