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Biomedical subjects

Kennith Culp

Publications and source records attributed to Kennith Culp.

14 recordsLinked to original sources
PubMed2006

Use of a urine color chart to monitor hydration status in nursing home residents.

To determine whether urine color, as measured by a color chart, might be a valid indicator of hydration status in frail nursing home residents, this study tested the associations between urine color and urine specific gravity. This is a descriptive correlational study set in seven nursing homes in eastern Iowa. Ninety-eight nursing home residents > or =65 years of age participated. Exclusion criteria for the study included: unstable congestive heart failure or diabetes, documented renal disease, hyponatremia (serum sodium <135 meq/L), terminal illness, acutely confused/delirious or urinary tract infection at baseline, and gastrostomy-tube dependence. Weekly urine specimens were collected. Ucol was measured first, using a urine color chart. Usg was determined using the Chemstrip Mini UA Urine Analyzer. Week-by-week Spearman rank order correlations between urine color and specific gravity for the total sample (n=98) ranged from r(s) = 0.3 - 0.7, p < .01; the PROC mixed model was significant, p < .01. In subgroup analyses (n=78), all females (r(s) = 0.67, p = .01) and both males (r(s) = 0.53, p = .01) and females (r(s) = 0.72, p =.01) with adequate renal function (Cockcroft-Gault estimated creatinine clearance [CrCl] values of > or =50 ml/min) had significant associations between average urine color and average Usg. Females with mild renal impairment (CrCl between 30 and 50 ml/min) also had significant associations between Ucol and Usg (r(s) = .64, p < .01). Ucol averaged over several individual readings offers another tool in assessing hydration status in Caucasian nursing home residents with adequate renal function measures by estimated CrCl values.

Aged↗
PubMed2006

Agricultural health in The Gambia I: Agricultural practices and developments.

This manuscript reports results of our study to characterize the historical developments of agricultural practices in The Gambia and related health risks of farm workers. It surveys the various factors that shape production agriculture in the country and examines the degrees to which hand tools, animal traction, motorized traction and manual labour all contribute to the inherent hazards of farm work. The principal objective of this study is to lay the ground work for detailed research of occupational health hazards in Gambian agriculture; and development of policies and programmes to promote the health of Gambian farmers. The authors of this paper assume the belief that one must first understand the industry and its people before effective policies and programmes can be developed. The study concludes by highlighting the need for the integration of epidemiological investigations in the country's agricultural research programme.

Accidents, Occupational↗
PubMed2006

Agricultural health in The Gambia II: A systematic survey of safety and injuries in production agriculture.

This study was undertaken to provide baseline information on the injuries and health and safety conditions in Gambian agriculture. The objective was to produce information to guide the formulation of an agricultural health and safety policy for the country, future investigations, prevention and surveillance of the adverse health effects in agriculture. A cross-sectional survey of 20 farmers, 20 nurses, and 20 agricultural extension workers was conducted in the Central and Upper River Divisions of The Gambia. The survey was implemented by the means of questionnaires, walk-through survey and hazard checklist. Seventy percent of farms reported an injury during the past year. Major sources and contributing factors for the injuries were characterized. Predisposing factors to the injuries were climatic conditions, working in static positions, bending and twisting and carrying heavy objects. Cuts and lacerations were identified as the commonest injury types and the most common sources were hand tools (hand hoe, cutlass, axe and knife) and animal-powered carts. A workshop for the major stake holders in the country's agriculture was also held to identify problems and possible solutions for health promotion of Gambian farmers.

Agriculture↗
PubMed2005

An inaugural conference on occupational health in The Gambia: exploring the world through international occupational health programs.

This conference on workplace safety was a success for both the Gambians who attended and the Americans involved in planning, implementing, and funding the conference. The Americans were delighted to bring about some understanding of worker safety to a country that has struggled with labor issues for centuries. The dialogue reflected the concern that stakeholders in both countries have for labor issues, but there is a tremendous need for ongoing partnership with industrialized countries to bring these ideas and strategies to fruition. The Gambia has received some assistance in the area of economic development, but not in improving workplace safety. A wide range of economic support activities have been initiated by the ILO in The Gambia during the past 20 years. This has included providing guidance with international labor standards, assistance to the development of labor and related services, support to employer and worker organizations, vocational training, job creation and employment policy, and small enterprise development. Many challenges lie ahead for The Gambia in improving workplace safety. Serious concerns remain related to minimum safeguards in the workplace. For example, the Labor Act specifies safety equipment that an employer must provide for employees working in designated occupations, but these are rarely offered (Culp et al., 2003). Workers are plentiful and jobs are not, so workers tend to take any employment they can without regard to working conditions. The government has not formally revoked employers who have contributed to worker deaths. Industrial inspections are conducted, although there is little consequence for violations. The cycle of poverty, younger workers, and lack of education also contribute to many worker safety issues. Farm workers cannot read instructions on pesticide containers and industrial employees cannot understand workplace hazard communications. While the Gambian constitution mandates free compulsory primary education, the current state of educational opportunities is so dismal for poor families that many will not go beyond primary school and will enter the work force without technical skills. Teachers are overworked. While some young people could develop small business enterprises related to tourism and woodcarving, the vast majority continue a downward spiral into poverty (McGrath & King, 1999).

Developing Countries↗
PubMed2004

Seasonal and migrant agricultural workers: a neglected work force.

A desperate need exists to provide occupational health services to migrant and seasonal farm workers in the United States. There are unique challenges related to this endeavor, and the authors have attempted to explain some of the issues that have not been previously discussed in a forthright manner. In doing so, it is likely that some controversy related to the topic has been introduced.

Agriculture↗
PubMed2003

Hydration and acute confusion in long-term care residents.

Although it is generally appropriate for a healthy adult to consume 2000 to 2500 ml per day, the literature does not address evaluating any standard. The objective here was to develop a weight-based hydration management intervention and evaluate the impact of this on the incidence of acute confusion (AC) using an N = 98. The intervention consisted of a fluid intake goal based on 100 ml per kg for the first 10 kg, 50 ml/kg for the next 10 kg, and 15 ml for the remaining body weight. The treatment group received instruction and assistance on the fluid goal and the control group received routine care. Measurements included serum electrolytes, bioimpedance analysis, urinalysis, Mini-Mental State Exam, and the NEECHAM. There was no difference in the incidence of AC between treatment and controls, but those individuals with > or = 90% compliance demonstrated higher ECF volumes and also lower urine leukocyte counts.

Acute Disease↗
PubMed2003

Clinical profile of acute confusion in the long-term care setting.

Aspects of acute confusion (AC) including risk factors, behavior patterns, and outcomes are not well documented in long-term care (LTC) residents. The purpose of this prospective study was to describe the clinical profile of AC in LTC including risk factors, behavior patterns, etiologies, and 3-month outcomes. Seventy-four elderly LTC residents were assessed for AC, depression, and global cognitive impairment. Risk factors associated with AC included hearing deficits, depression, pulmonary disorders, and abnormal serum sodium or potassium levels. Behavior patterns of acutely confused residents included hyperactive (n = 9, 31%), hypoactive (n = 8, 28%), and mixed (n = 7, 24%). In the majority of the AC cases, the etiology was multIfactorial infections and dehydration were the most common causes. Residents with AC had very poor 3-month outcomes. Thirty-four percent (n = 10) of the residents with AC died within 3 months of the evaluation. This study highlights the complexity and serious nature of AC in this frail population.

Acute Disease↗
PubMed2003

Reducing hydration-linked events in nursing home residents.

The authors used a quasi-experimental treatment and control group design with 49 participants from four nursing homes to test the effectiveness of an 8-week hydration intervention in reducing hydration-linked events (HLEs). A Kaplan Meier survival curve with log rank test was calculated to determine incidence and time to occurrence of a HLE. Incidence of and time to a HLE did not differ between the treatment and control groups over an 8-week period (p > .05). However, treatment group participants were found to be more frail, more cognitively impaired and more at risk for acute confusion than the control group participants. Although there were no statistically significant differences between the groups, it is clinically significant that the frailer, more at-risk participants in the treatment group had a lower incidence of HLEs.

Aged↗
PubMed2003

Risk for acute confusion in sensory-impaired, rural, long-term-care elders.

Acute confusion is a common geriatric syndrome in long-term care (LTC) elders with prevalence rates of 10% to 39%. Sensory impairment, specifically vision and hearing impairment, is even more common in LTC, with prevalence rates of 40% to 90%. The purpose of this study was to investigate the risk relationship between sensory impairment and the development of acute confusion in LTC elders. Each resident (N = 114) underwent sensory screening and then was followed for 28 days to monitor for the onset of acute confusion. Twenty residents (17.5%) developed acute confusion, 60 residents (52.6%) were found to be visually impaired, 49 (44.1%) were hearing impaired, and 28 (24.6%) were found to be dually impaired. Significant relationships between vision impairment, odds ratio (OR) = 3.67, confidence interval (CI) (1.13, 11.92), and dual sensory impairment, OR = 2.88, CI (1.04, 8.26), with the development of acute confusion were identified.

Acute Disease↗
PubMed2003

Occupational safety and health in The Gambia. Developing concern for worker health.

It is important for the occupational health nursing community to develop an international interest in worker health in countries with limited resources. The collaboration between The Gambia and the University of Iowa discussed in this article can be replicated in other settings and need not be limited to academic institutions. Corporate sponsorship and inclusion of workplace safety criteria in business contracts provide incentives for fostering change in developing countries.

Gambia↗
PubMed2002

Monitoring hydration status in elderly veterans.

Dehydration is a common water and electrolyte disorder in long-term care residents. Practical methods to detect and monitor dehydration are needed. This study determined whether urine color measured by a urine color chart reflects hydration status. The study employed a repeated measures design with two observations during a 10-hour period. Urine color was compared to the criterion standard of urine specific gravity and osmolality. The sample included 89 participants from two Veterans' Affairs facilities. Urine color was graded on an eight-level color chart. Urine specific gravity and osmolality, serum sodium and osmolality, hematocrit, blood urea nitrogen (BUN), and creatinine were measured using standard laboratory procedures. Significant positive associations existed between urine color and both urine specific gravity and urine osmolality and between urine osmolality and serum sodium and the blood urea nitrogen to creatinine ratio. Although further testing is needed, the color chart has potential as a low-cost technology to monitor dehydration.

Aged↗