Knowledge and Attitudes of Physicians in Kansas Regarding Domestic Minor Sex Trafficking

INTRODUCTION: Domestic minor sex trafficking (DMST) has been reported increasingly in the news as a problem in Kansas. It is essential that healthcare providers are educated about the topic and feel confident in their ability to identify and report a victim. The purpose of this study was to explore Kansas physicians’ knowledge, attitude, and training regarding DMST. METHODOLOGY: A 20-question survey was e-mailed to 1,668 physicians registered with the Kansas Board of Healing Arts in the specialties: family medicine, pediatrics, obstetrics/ gynecology, and emergency medicine. RESULTS: Of those emailed, 69 (4%) responded to the survey. Those that responded agreed that DMST was a problem in the US (86%; n = 59) and Kansas (80%; n = 55). Of the respondents, only 12% (n = 8) felt confident in identifying a victim and only 11% (n = 8) screened patients for DMST. Over half (61%; n = 42) reported encountering possible signs of DMST in patients, however, only few suspected DMST. CONCLUSION: Physicians reported encountering victims of DMST in their practices, which indicated the existence of DMST in Kansas. Survey respondents were lacking in knowledge regarding DMST. Further, their suspicion of DMST victimization (based on presentation), was rarely followed through with reporting. Training, for symptom recognition, victim identification, and proper reporting, is necessary for Kansas physicians as they are often the only professional to come in contact with DMST victims

Successes and Challenges of Optimal Trauma Care for Rural Family Physicians in Kansas

Introduction. Kansas has a regionalized trauma systemwith formal mechanisms for review, however, increasedcommunication with rural providers can uncover opportunitiesfor system process improvement. Therefore, thisqualitative study explored perceptions of family medicinephysicians staffing emergency departments (ED) in rural areas,specifically to determine what is going well and what areasneeded improvement in relation to the trauma system. Methods. A focus group included Kansas rural family physiciansrecruited from a local symposium for family medicinephysicians. Demographic information was collected via surveyprior to the focus group session, which was audiotaped.Research team members read the transcription, identifiedthemes, and grouped the findings into categories for analysis. Results. Seven rural family medicine physicians participated inthe focus group. The majority were male (71%) with the mean age46.71 years. All saw patients in the ED and had treated injuriesdue to agriculture, falls, and motor vehicle collisions. Participantsidentified successes in the adoption and enforcement of standardizedprocesses, specifically through level IV trauma centercertification and staff requirements for Advanced Trauma LifeSupport training. Communication breakdown during patient dischargeand skill maintenance were the most prevalent challenges. Conclusions. Even with an established regionalized traumasystem in the state of Kansas, there continues to be opportunitiesfor improvement. The challenges acknowledged byfocus group participants may not be identified through patientcase reviews (if conducted), therefore tertiary centersshould conduct system reviews with referring hospitals regularlyto improve systemic concerns. KS J Med 2017;10(1):12-16

Associations between Fall Distance, Age, and Trauma Outcomes in Older Adult Patients

Introduction. Falls are the leading cause of injury death amongolder adults. This study sought to determine if there are differencesbetween fall distance (ground level vs greater than groundlevel) and age (old vs very old) in terms of in-hospital mortality,orthopedic consultations, and neurological consultations. Methods. A retrospective trauma registry review was conductedof older adult patients (aged > 65 years), admitted to aMidwestern Level I trauma facility (2005 - 2010) due to a fall.Results. Of the 1,064 patients analyzed, the majority fell fromground level compared to greater than ground level (64% and36%, respectively). Median age was 80 years. Fall distance wasnot associated significantly with in-hospital mortality (OR0.88; CI 0.50 - 1.54) or neurological consultations (OR 1.02; CI0.72 - 1.43), but was associated with orthopedic consultations(OR 1.49; CI 1.09 - 2.04). Age was not associated with in-hospitalmortality or neurological or orthopedic consultations. Conclusions. Fall distance was not associated with in-hospitalmortality or receiving a neurological consultation.However, older adults who fell from greater than groundlevel were more likely to receive orthopedic consultations.There were no differences in in-hospital mortality or receivinga neurological or orthopedic consultation based onage. These findings indicated that as the older adult populationincreases, burden of care will increase for trauma centersand neurological services. KS J Med 2016;9(3):54-57

The Development of School Psychology Assessment Centers as Training, Service Delivery, and Research Sites

School Psychologists have an ongoing responsibility to promote and support healthy schools, families, and communities, while contributing to knowledge, research, teaching, and supervision. Consequently, School Psychology programs should seek to meet these goals by providing their students with opportunities to engage in research and effective service delivery, participate in outreach services, and continued professional development. During Fall of 2013, faculty, students, and personnel of the School Psychology Program at Stephen F. Austin State University successfully developed a School Psychology Assessment Center, which is maintained on the university’s campus. The primary objective of this university-approved Center is the enhancement of service delivery to the on-campus student population and surrounding community and positive impact on training and professional development of masters and doctoral-level School Psychology trainees. This article describes the steps involved in the development and maintenance of School Psychology Assessment Centers

Diversity Of Diagnoses And Student Learning Experiences In An On-Campus School Psychology Assessment Center: Future Directions And Focus

School Psychology Assessment Centers (SPAC) developed at the University-level are crucial in developing competent school psychologists. While many models on how to develop mental health centers are in existence, a new model exists for creating a SPAC on a University campus that is specifically designed to serve the diverse surrounding community and postsecondary students (see Ellis-Hervey et al., 2016). The community’s needs were reviewed, including missing service links in the region, and identification of potential clients who would benefit most from services provided. Senior students who work with clients in the SPAC gain assessment skills and build supervision skills through close interactions and consultation with junior students. New goals of the SPAC is to develop and implement academic, behavioral, social skills and therapy/counseling services

Promoting Safe Sleep, Tobacco Cessation, and Breastfeeding to Rural Women During the COVID-19 Pandemic: Quasi-Experimental Study

BackgroundSafe Sleep Community Baby Showers address strategies to prevent sleep-related infant deaths. Due to the COVID-19 pandemic, these events transitioned from in-person to virtual. ObjectiveThis study describes outcomes of transitioning Safe Sleep Community Baby Showers to a virtual format and compares outcomes to previous in-person events. MethodsParticipants from four rural Kansas counties were emailed the presurvey, provided educational materials (videos, livestream, or digital documents), and completed a postsurvey. Those who completed both surveys received a portable crib and wearable blanket. Within-group comparisons were assessed between pre- and postsurveys; between-group comparisons (virtual vs in-person) were assessed by postsurveys. ResultsBased on data from 145 in-person and 74 virtual participants, virtual participants were more likely to be married (P<.001) and have private insurance (P<.001), and were less likely to report tobacco use (P<.001). Both event formats significantly increased knowledge and intentions regarding safe sleep and avoidance of secondhand smoke (all P≤.001). Breastfeeding intentions did not change. Differences were observed between in-person and virtual meetings regarding confidence in the ability to avoid secondhand smoke (in-person: 121/144, 84% vs virtual: 53/74, 72%; P=.03), intention to breastfeed ≥6 months (in-person: 79/128, 62% vs virtual: 52/66, 79%; P=.008), and confidence in the ability to breastfeed ≥6 months (in-person: 58/123, 47% vs virtual: 44/69, 64%; P=.02). ConclusionsAlthough both event formats demonstrated increased knowledge/intentions to follow safe sleep recommendations, virtual events may further marginalize groups who are at high risk for poor birth outcomes. Strategies to increase technology access, recruit priority populations, and ensure disparities are not exacerbated will be critical for the implementation of future virtual events

Infant Safe Sleep Promotion: Increasing Capacity of Child Protective Services Employees

Sleep-related infant deaths, including Sudden Infant Death Syndrome (SIDS), are the number one cause of death in infants between 28 days and one year of life. Nearly half of families experiencing a sleep-related infant death in Kansas were involved with the Department of Children and Families Child Protective Services (CPS), making CPS staff a priority for safe sleep training. This study assessed the impact of the two-day Kansas Infant Death and SIDS (KIDS) Network Safe Sleep Instructor (SSI) train-the-trainer program on CPS staffs’ knowledge of the American Academy of Pediatrics safe sleep recommendations. Training was attended by 43 participants, 27 (63%) of whom were employed by CPS. CPS staff had significantly lower baseline knowledge on the 10-item pretest (t = 3.33, p = 0.002), but both CPS and other attendees showed significant improvement by posttest (t = 8.53, p &lt; 0.001 and t = 4.44, p &lt; 0.001, respectively). Following SSI certification, CPS SSIs provided more safe sleep training to professionals than other SSIs (1051 vs. 165, respectively), and both groups of SSIs were able to significantly increase the knowledge of their trainees. Overall, the KIDS Network SSI training was successful. The innovative partnership with CPS allowed for provision of training to a group not historically targeted for safe sleep education

Early probiotic supplementation and the risk of celiac disease in children at genetic risk

Abstract Probiotics are linked to positive regulatory effects on the immune system. The aim of the study was to examine the association between the exposure of probiotics via dietary supplements or via infant formula by the age of 1 year and the development of celiac disease autoimmunity (CDA) and celiac disease among a cohort of 6520 genetically susceptible children. Use of probiotics during the first year of life was reported by 1460 children. Time-to-event analysis was used to examine the associations. Overall exposure of probiotics during the first year of life was not associated with either CDA (n = 1212) (HR 1.15; 95%CI 0.99, 1.35; p = 0.07) or celiac disease (n = 455) (HR 1.11; 95%CI 0.86, 1.43; p = 0.43) when adjusting for known risk factors. Intake of probiotic dietary supplements, however, was associated with a slightly increased risk of CDA (HR 1.18; 95%CI 1.00, 1.40; p = 0.043) compared to children who did not get probiotics. It was concluded that the overall exposure of probiotics during the first year of life was not associated with CDA or celiac disease in children at genetic risk