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PubMed2005

Kentucky Homeplace Defeat Diabetes Screening Test: an analysis of rural Kentucky's challenge to overcome the growing diabetes epidemic.

The University of Kentucky Center for Rural Health original research note, "Kentucky Homeplace Defeat Diabetes Screening Test: An Analysis of Rural Kentucky's Challenge to Overcome the Growing Diabetes Epidemic," provides the results of a yearlong diabetes risk survey that included more than 3,000 participants in rural Kentucky. It is well known that diabetes poses serious health threats across our country. For various reasons, that is especially true in Kentucky, with rural Kentucky having the highest prevalence for the disease. From September 2002 through August 2003, lay health workers with the nationally recognized Kentucky Homeplace program distributed and processed 3,092 diabetes self-test surveys to their clients across five regions of the state to get a better picture of the diabetes epidemic. The screening test was developed as an educational and public awareness tool by the Defeat Diabetes Foundation Inc, a nonprofit organization based in Madeira Beach, FL. It was distributed to various health agencies across the country. Each survey contained 16 questions, ranging from determining participants' urinary frequency and family medical history to their age and weight. Zero, five, or 10 points were allotted depending on respondents' degree of incidence for each question. A score of 0-15 points suggested a low risk for having diabetes, 20-25 points suggested that a respondent was at medium risk and should be tested for the disease, and a score of 30 points or higher suggested that he/she was at very high risk and "should seek (a) medical evaluation right away." Several months of analysis of the data collected indicated that 74.6% of the Kentucky Homeplace clients who participated in the survey were at moderate to significant risk of having or developing diabetes, a much higher rate than the approximately 50% of Kentucky adults in the general population that previous studies indicated were at risk. While findings from the survey of more than 3,000 Kentucky Homeplace clients cannot be generalized to Kentucky's population as a whole, they further confirm other evidence indicating that diabetes will continue to be one of the most serious health threats facing the state's rural populations. The research note further offered some recommendations for curbing rural Kentucky's diabetes epidemic, including increasing the number of certified diabetes educators serving rural Kentucky, expanding lay health worker programs within the rural portions of the Commonwealth, and studying the method and effectiveness of diabetes education between physicians and patients.

Adult↗

PubMed2000

The burden of cancer in Kentucky. The 1998 Kentucky cancer incidence report.

The purpose of collecting this important disease burden information is just for reports like this. The real value lies in use of data for cancer control research, program planning, resource allocation, program design, and evaluation. Data in the annual KCR report and on the website should be a valuable resource for health agencies, clinicians, policymakers, voluntary organizations, etc in their assessment of health problems in their area and as critical decisions are made about how to utilize limited intervention resources. The Kentucky Cancer Registry will continue to work very closely with the Kentucky Cancer Program, Kentucky Medical Association, and programs and research efforts at the University of Kentucky Cancer Control Program (Mid South Cancer Information Service, Appalachia Cancer Network, Kentucky Prevention Research Center) and the Brown Cancer Center at the University of Louisville to make these data available to partners throughout the Commonwealth to help guide their assessment and planning processes. If you have questions about this data you are encouraged to contact Regional Coordinators for the Kentucky Cancer Program in your Area Development District. The contact information is shown in Appendix I.

Adolescent↗

PubMed1998

Epidemiology of IgA nephropathy in central and eastern Kentucky for the period 1975 through 1994. Central Kentucky Region of the Southeastern United States IgA Nephropathy DATABANK Project.

Population-based incidence data for IgA nephropathy (IgAN) are available for some countries but not for the United States. The purpose of this study was to determine the incidence of IgAN in central and eastern Kentucky for 5- and 10-yr periods between 1975 and 1994 and to examine differences among patient groups between those periods. The incidence of IgAN was 5.4 cases per one million population per year (MPPY) for period 1A (1975 through 1979), increasing to 12.4 cases per MPPY for period 2B (1990 through 1994) (P < 0.001). Males had a 2.7 times higher incidence than females for period 1 (1975 through 1984) and 2.2 times higher for period 2 (1985 through 1994). For period 1A, the incidence for Fayette County, which includes the city of Lexington, was lower than that of the rest of the study area (P=0.26), whereas for period 2 the incidence was higher for Fayette County (P=0.052). During period 1, the highest incidence of IgAN for any age and gender group was 24.3 cases per MPPY for males ages 30 through 39. For period 2, the incidence for males was similar for each decade between ages 20 and 59 (approximately 19 cases per MPPY). No African-American was diagnosed during period 1, but in period 2 incidences for blacks and whites were similar (10.7 and 10.2 cases per MPPY, respectively). For the last 5 yr of the study (1990 through 1994), the incidence of end-stage renal disease (ESRD) due to IgAN was 5.5 cases per MPPY: 8.4 for males and 2.7 for females. The incidence of IgAN in Kentucky for period 2B was still much lower than that in European studies, but the incidence of ESRD due to IgAN may be similar. Thus, IgAN may be as important a condition with respect to ESRD in Kentucky as it is in other regions of the world.

Adolescent↗

PubMed2005

Preparing Kentucky's emergency departments for a comprehensive trauma care system: the Kentucky Hospital Association emergency department survey.

Kentucky continues to lag in development of a statewide trauma care system, and objections to implementation have arisen from hospital emergency departments. In order to clarify these issues, the Kentucky Hospital Association conducted a statewide survey. Respondents represented 95% of the state's general acute care hospitals. A large majority (78%) reported that they could not meet the American College of Surgeons' (ACS) standards for verification as a trauma care facility at any level, and a similar number (81%) opposed requiring verification for facilities providing trauma care. Staffing deficiencies (particularly surgical specialists) were the primary reason cited for facilities' inability to meet ACS standards, while objections to requiring ACS verification were based on concerns about the ability of EMS to transport patients to definitive care in a timely enough manner. Recommendations included improvements in emergency department (ED) facilities and staffing as well as EMS capacity and training. Improvements in Kentucky trauma care will require additional funding to increase the number of verified facilities and enhance coordination among providers and facilities.

Certification↗

PubMed1993

Interprofessional code. Kentucky Medical Association and Kentucky Bar Association.

The Physician-Attorney Liaison Committee, composed of members of the Kentucky Medical Association and the Kentucky Bar Association, met in January at KMA. The Committee reviewed the Interprofessional Code, last revised in October 1984, and agreed to publish the Code in this issue of The KMA Journal and the spring issue of KBA's Bench and Bar, soliciting comments and suggestions from members of each profession on how the Code might be revised to more effectively deal with specific problems or concerns physicians and attorneys might have in their dealings with each other. Suggestions for revisions to the Code and comments should be addressed to the Kentucky Medical Association, 301 N Hurstbourne Parkway, #200, Louisville, KY 40222, Attention: Physician-Attorney Liaison Committee. The Committee is also exploring ways to further improve the relationship between attorneys and physicians. Suggestions made at the meeting included encouraging joint informal meetings of local bar and medical associations, participation by members of one profession in seminars on subjects of interest to the other profession, and guest articles in each association's professional publication. Anyone interested in pursuing such opportunities or suggesting others is also encouraged to contact KMA. The Committee plans to meet again in May to consider revisions to the Interprofessional Code and suggestions from each association's membership.

Clinical Medicine↗

PubMed1998

Health care for Kentucky's uninsured indigents: the perspective of providers in the Kentucky Physicians Care program.

The pressing issue of providing care for the uninsured indigent has been addressed in Kentucky by a unique private sector program that depends on physician donation of services. The Kentucky Physicians Care (KPC) program which provides health care to uninsured indigent patients in Kentucky was evaluated from the perspective of the participating physicians through in-depth interviews with 22 randomly selected physicians. The results of the interviews suggested that the KPC program is generally viewed by participating providers as a successful and personally rewarding enterprise. Suggestions for improving services included strategies to increase awareness of the program for both patients and providers. As state and federal policy continues to focus on the uninsured as a vulnerable population, integration of this private sector program into a partnership with the public sector may be a worthwhile strategy.

Interviews as Topic↗

PubMed2000

The burden of cancer in Kentucky: the 1997 Kentucky cancer incidence report.

The purpose of collecting this important disease burden information is of course not simply for reports like this one. The real value lies in use of data for program planning, resource allocation, program design, and evaluation. Data in the annual KCR report and on the website should be a valuable resource for district and county health departments in their assessment of health problems in their area and as critical decisions are made about how to utilize limited intervention resources. The Kentucky Cancer Registry will continue to work very closely with the Community Outreach Division of the Kentucky Cancer Program to make this data available on an annual basis to District Cancer Councils to help guide their assessment and planning process. District and local health departments are encouraged to actively participate in the District Cancer Councils and in the cancer control activities guided by the regional community outreach coordinators.

Adolescent↗

PubMed1980

Allergens of Kentucky Blue Grass pollen. II. Isolation of hapten-like components from Kentucky Blue Grass pollen by preparative isoelectrofocussing.

Components with hapten-like properties were isolated from the nondialyzable fraction, i.e. the retentate (R) and the dialyzable fractions of the aqueous extract of Kentucky Blue Grass pollen (KBC aq.ext.), by preparative isoelectrofocussing on Sephadex G-100 gel. These haptenic components could not elicit the passive cutaneous anaphylaxis (PCA) reactions in rats passively sensitized with a murine reaginic antiserum to R, but could inhibit completely and specifically the PCA reaction which is normally elicitable with R. It was concluded that the specificity of the murine IgE antibodies was directed to a determinant(s) which was common to either allergenic or haptenic fractions. Moreover, by employing a pool of human sera from individuals allergic to KBG pollen in the radioallergosorbent test procedure, it was apparent that most of the haptenic fractions lacked some of the specificities present on allergenic components of R that were recognized by the human IgE antibodies. Evidence was obtained to suggest that the electrophoretic heterogeneity of allergenic components present in various fractions of KBG aq.ext. may be due primarily to differences in their net charge, rather than to differences in their allergenic specificity.

Absorption↗

PubMed1989