An Overview of Tobacco Policies in Kansas Unified School Districts

Introduction. In 2019, 25.8% of Kansas high school youth reported using any form of tobacco product. Schools can prevent and reduce youth tobacco use by adopting comprehensive tobacco policies, which include all tobacco products, on school grounds and at school-sponsored, off-campus events, for all individuals at all times, and integrate cessation services for students who violate the tobacco policy. The purpose of this study was to determine the prevalence of comprehensive tobacco policies in unified school districts (USD) across Kansas to determine how many schools have adopted such policies. Methods. All 286 USDs in Kansas were eligible to participate in this study; this includes elementary, middle, and high schools. Participating schools were asked to upload their policies to a website developed by Kansas Department of Health and Environment (KDHE). Frequencies and percentages were computed to identify the type of tobacco products prohibited, the locations where tobacco use is prohibited, who is prohibited from using tobacco, when tobacco is prohibited, and consequences of students’ violation of tobacco policy. Results. Several USD policies meet some of these recommendations; however, 97.9% (n = 280) do not. In other words, 2.1% of USD policies (n = 6) are comprehensive in Kansas. Conclusions. Nearly all USDs in Kansas have an opportunity to strengthen their tobacco policies. Relatively simple edits can be made to prohibit all tobacco products, prohibit use on school grounds and at school-sponsored, off-campus events, ensure these policies apply to everyone, at all times, and integrate cessation resources for students who violate the tobacco policy

Workplace Stress and Productivity: A Cross-Sectional Study

INTRODUCTION. The primary purpose of this study was to evaluate the association between workplace stress and productivity among employees from worksites participating in a WorkWell KS Well-Being workshop and assess any differences by gender and race. METHODS. A multi-site, cross-sectional study was conducted to survey employees across four worksites participating in a WorkWell KS Well Being workshop to assess levels of stress and productivity. Stress was measured by the Perceived Stress Scale (PSS) and productivity was measured by the Health and Work Questionnaire (HWQ). Pearson correlations were conducted to measure the association between stress and productivity scores. T-tests evaluated differences in scores by gender and race. RESULTS. Of the 186 participants who completed the survey, most reported being white (94%), female (85%), married (80%), and having a college degree (74%). A significant inverse relationship was observed between the scores for PSS and HWQ, r = -0.35, p < 0.001; as stress increased, productivity appeared to decrease. Another notable inverse relationship was PSS with Work Satisfaction subscale, r = -0.61, p < 0.001. One difference was observed by gender- males scored significantly higher on the HWQ Supervisor Relations subscale compared with females, 8.4 (2.1) vs. 6.9 (2.7), respectively, p = 0.005. CONCLUSIONS. Scores from PSS and the HWQ appeared to be inversely correlated; higher stress scores were significantly associated with lower productivity scores. This negative association was observed for all HWQ subscales, but was especially strong for work satisfaction. This study also suggests that males may have better supervisor relations compared with females, although no gender differences were observed by perceived levels of stress

The Influence of Loan Repayment and Scholarship Programs on Healthcare Provider Retention in Underserved Kansas

Background. In an effort to redistribute healthcare providersto underserved areas, many states have turned to financialincentive programs. Despite substantial research on theseprograms on a national scale, little is known about the successof such programs in Kansas. The purpose of this studywas to provide insight into the relationship between financial incentive programs and provider retention in Kansas. Methods. A cross-sectional telephone survey was conducted inApril and May of 2011 with participants who had completedtheir obligations to the Kansas State Loan Repayment Program(SLRP), the National Health Service Corps (NHSC) Loan Repaymentprogram, or the National Health Service Corps Scholar shipprogram in Kansas between January 2006 and January 2011. Results. Of the 112 providers included in the study, 54.4% (n = 61)had left their program sites sometime after finishing their commitment,with the mean length of stay after the obligation periodended being 7.3 (median = 3) months. Of the 54 participants whohad left their program sites and whose current locations wereknown, 33.3% (n = 18) were located in new Health ProfessionalShortage Areas (HPSA), 25.9% (n = 14) were in a new non-HPSA,and 40.7% (n = 22) had left the state. Family satisfaction with thecommunity and attending a professional school in Kansas wereassociated statistically with retention of physicians in Kansas. Conclusions. Nearly half of all participants had remained attheir sites even after their obligation period ended, with familysatisfaction with the community appearing to be the strongestpredictor for retention among those who had stayed.Efforts to match a provider’s family with the community successfullyand to support the family through networking mayimprove future provider retention. KS J Med 2016;9(1):6-11

Time Since Last Dental Clinic Visit and Self-Reported Health among the Elderly

Background. This study determined the association between time since last dental clinic visit and self-reported health among the elderly (age ≥ 65 years). Methods. Data were from the 2010 Behavioral Risk Factor Surveillance System. A logistic regression analysis was conducted to identify factors that affect the self-reported general health of the elderly. Additionally, a negative binomial regression analysis was conducted to explore the association of time since last dental clinic visit and the self-reported number of physically unhealthy, mentally unhealthy, and sad days during the past 30 days. Results. Six predictors were identified affecting the self-reported general health of the elderly. Respondents were more likely to self-report “good, very good, or excellent” general health if they: visited the dental clinic within the past year, were non-Hispanic, had healthcare coverage, had fewer permanent teeth removed, received better education and were younger. A larger lapse of time since respondents’ last dental clinic visits was associated with increased number of mentally and physically unhealthy days and an increased number of sad days during the past 30 days. Conclusions. The positive association between better general health, fewer mentally and physically unhealthy days, and fewer sad days during the past 30 days and shorter periods of time between dental visits warrants further investigation to determine a possible causal relationship between overall health and dental visits

Contribution of the BioFire® FilmArray® Meningitis/Encephalitis Panel:: Assessing Antimicrobial Duration and Length of Stay

Introduction. Traditional evaluation of meningitis includes cerebrospinalfluid (CSF) culture and gram stain to pinpoint specific causalorganisms. The BioFire® FilmArray® Meningitis/Encephalitis (ME)Panel has been implemented as a more timely evaluation method.This study sought to assess if the BioFire® ME Panel was associatedwith a decreased length of stay or decreased antimicrobial durationwhen used in the diagnosis of meningitis or encephalitis.Methods.xA case, historical-control, chart review was performed onpatients admitted to a regional medical center with CSF pleocytosisduring Cohort 1 (the year prior to BioFire® ME Panel implementation)and Cohort 2 (the year after BioFire® ME Panel implementation).Length of hospital stay, duration of antimicrobials, and BioFire® MEPanel result were gathered and analyzed.Results. Average length of stay for both cohorts was about fourhospital days. Approximately three-fourths of all patients receivedantibiotic/antiviral treatment with an average of three days duration.No significant differences were observed between groups. The mean(median) duration of antimicrobials in the year prior to and afterthe BioFire® ME Panel implementation was 3.6 (3) and 3.1 (2) days,respectively (p = 0.835). The mean (median) length of stay in the yearprior to and after the BioFire® ME Panel implementation was 5.8 (4)and 5.4 (4) days, respectively (p = 0.941). Among the patients admittedafter the implementation of the BioFire® ME Panel, 4.3 % (n =2) had a positive bacterial result, 38.3% (n = 18) had a positive viralresult, and 57.4% (n = 27) had a negative result. Of the 27 negativeresults, 77.8% (n = 21) were treated with antimicrobial medication.Conclusions. This study suggested there is no difference betweenlength of stay or antimicrobial duration in presumed meningitis casesassessed with traditional methods as compared to the BioFire® MEPanel. Kans J Med 2019;12(1):1-3

Use of Ultrasound-Guided Tendon Fenestration and Injection Procedures for Treatment of Tendinosis

Introduction. Overuse injuries such as tendinosis are a common complaint at sports medicine clinics. When conservative management for tendinosis has failed, ultrasound-guided tendon fenestration and injection procedures such as dry needling, needling tenotomy, autologous whole blood injections, and prolotherapy can be utilized for treatment. This study examined the effectiveness of these procedures for pain improvement and ability to return to activity for patients with tendinosis. Methods. This study included patients 15 years or older who underwent at least one treatment for tendinosis at a sports medicine clinic between January 1, 2014 through April 17, 2019. A CPT code query was used to screen patient charts for study inclusion. Results. In total, 680 patients’ data were reviewed, and 343 patients met inclusion criteria. Patients underwent a total of 598 unique procedures. Dry needling represented most procedures (62.8%, n=375). Most patients reported diminished pain at follow up (73.0%, n=268). Prolotherapy had the highest percentage of patients reporting diminished pain (81.0%, n=17). Most patients were able to return to activity (47.4%, n=172) at follow-up. A greater proportion of patients with autologous whole blood injection were able to return to activity (60.7%, n=85). Conclusions. Most patients with tendinosis who underwent tendon fenestration or injection procedures reported diminished pain at follow-up. Autologous whole blood injection may be more likely to diminish patient pain and allow return to activity than other procedure types. More research is needed across all anatomical sites to compare the generalized effectiveness of these procedures

Disparities in Oral Health among School-Aged Children in Kansas

A grant from the One-University Open Access Fund at the University of Kansas was used to defray the author's publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.Background: The effects of age, rural-urban geographic location, and percentage of Free and Reduced Price Meal Program (FRPMP) participation on children’s oral health outcome measures (untreated decay, treated decay, and sealants) have not been fully explored in Kansas. Methods: The current study utilized a surveillance sample of 140,217 children (grades K through 12) attending 200 schools in Kansas, which requested screening assistance from the Kansas Department of Health and Environment (KDHE) from 2012 to 2013. Multilevel logistic regression analysis was conducted to identify significant factors associated with oral health outcome measures. Results: Older children were associated with decreased odds of having untreated decay, and increased odds of having treated decay and sealants. Children attending very rural schools had increased odds of untreated and treated decay and decreased odds of presence of sealants. For every 5% increase in the school-level %FRPMP, the odds of having untreated and treated decay increased by 5% and 3%, respectively. However, %FRPMP was not statistically associated with the presence of sealants. Conclusions: Children attending schools in very rural and rural areas appear to have worse oral health outcomes, as measured by higher proportions of untreated and treated decay, and a smaller proportion of presence of sealants