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Occurrence and seasonal incidence of mosquitoes on Indian reservations in Iowa, Nebraska and South Dakota during 1983.

A mosquito surveillance program designed to prevent future human cases of Western equine encephalitis or Saint Louis encephalitis was established in 1983 on Indian reservations under the jurisdiction of the Aberdeen Area Indian Health Service in Iowa, Nebraska and South Dakota. Standard New Jersey light traps were operated on all reservations throughout the summer season while CDC miniature and encephalitis virus surveillance traps were employed for shorter periods of time on 4 reservations. Aedes vexans was the most abundant species except on the Pine Ridge, Rosebud, Winnebago and Yankton Sioux reservations in which Culex tarsalis predominated and for the Sac-n-Fox where Aedes trivittatus occurred with the greatest frequency.

Animals↗

Seminal vesiculitis and orchitis caused by Brucella abortus biovar 1 in young bison bulls from South Dakota.

Specimens of blood, lymph nodes, spleens, and genitalia were collected at slaughter from seven 3- and 4-year-old male bison that had recently become seropositive for brucellosis. The animals were from a captive herd of approximately 3,500 bison located in central South Dakota. Brucella abortus biovar 1 was isolated from 2 or more specimens from each of 6 bison. Severe necrotizing and pyogranulomatous orchitis was present in 1 testicle from 1 bull, and 4 animals had mild to marked seminal vesiculitis. Immunohistochemical staining labeled organisms in seminal vesicles and the testicle with orchitis. Ultrastructurally, intact bacilli were present in cytoplasmic vacuoles of some macrophages; other macrophages contained intracytoplasmic aggregates of calcified coccobacilli.

Abscess↗

Improving rural health care in South Dakota.

This study was designed to find ways to improve the quality of health care in rural settings. The study includes three components: a telephone survey of a rural community, a patient quiz, and interviews with ten rural family practice doctors in the southeast corner of South Dakota. This study was conducted in a rural community of about 1,500 people. The results of the survey suggest that rural health care can be improved by more education of the public on what is offered for preventative medicine, especially for the men 55 or younger, a female doctor who is willing to do obstetrical/gynecological services to meet the local demand, and physicians learning new procedures such as colonoscopy, colposcopy, and stress testing to better serve their patients.

Family Practice↗

The Medication Reduction Project: combating polypharmacy in South Dakota elders through community-based interventions.

The Medication Reduction Project (MED RED) is a community-based program addressing polypharmacy issues in elders. Using educational presentations and one-on-one medication reviews conducted by a pharmacist specializing in geriatrics, MED RED reached over 1,100 older adults in rural and urban southeastern South Dakota communities during 1993. Analysis of the longitudinal data indicate that older adults participating in one-on-one reviews were on fewer medications, had dosage reductions, were more likely to take their medications as directed, and increased their use of non-pharmacological alternatives. These elders also reported feeling better, spent less money per month on medications, and offered indications of improved functioning and increased levels of independence. These findings suggest that education about medication use is a dynamic tool in empowering community-based older adults to be assertive participants in their own health care.

Aged↗

Survey of the prevalence of HIV infection in an antenatal population in South Dakota.

Vertical transmission of the Human Immunodeficiency Virus is the major cause of pediatric AIDS cases. It is known that zidovudine therapy will substantially reduce the incidence of perinatal vertical transmission. Some authorities have made recommendations for universal HIV screening based on these findings. However, in an area of low prevalence of HIV, such as South Dakota, the benefits of such testing are questionable. We undertook a survey of one thousand consecutive deliveries in which a sample of cord blood was tested for HIV in an anonymous fashion. In all cases, the ELISA test was negative. Based on this extremely low incidence of HIV in our population, it is reasonable at the present time to undertake a selective screening protocol for testing for HIV during the antepartum period, based on the presence of risk factors, rather than applying universal screening to our population.

Costs and Cost Analysis↗

Distribution of astigmatism among Sioux Indians in South Dakota.

BACKGROUND: Previous studies have reported a greater prevalence of high astigmatism and vision disorders among Native Americans than occurs in the general U.S. population. The majority of these studies, however, have focused on Native American schoolchildren. This study assessed the distribution of astigmatism in a general clinic population at the Rosebud Indian Reservation in South Dakota. METHODS: From examination of 174 patients, demographic information, visual acuities, refractive error, binocular vision status, and eye health were recorded. RESULTS: The data showed more high astigmatism than would be expected in a general U.S. population. Three or more diopters of astigmatism were found in 9.2% of the right eyes and 10.8% of the left eyes in the study population. High astigmatism was noted less frequently among those ages 40 years and older (3.3% right eyes, 6.3% left eyes). Most of the astigmatism was with-the-rule, but a shift toward against-the-rule and oblique astigmatism was found in older individuals. No significant gender differences were noted. CONCLUSIONS: The results suggest an ethnic difference in astigmatism and emphasize thee need for continued and expanded vision services for Native American populations.

Adolescent↗

Outbreak of Salmonella enteritidis associated with nationally distributed ice cream products--Minnesota, South Dakota, and Wisconsin, 1994.

From September 19 through October 10, 1994, a total of 80 confirmed cases of Salmonella enteritidis (SE) infection were reported to the Minnesota Department of Health (MDH); in comparison, 96 cases were reported statewide during all of 1993. Cases were characterized by diarrhea, abdominal cramps, and fever. Recent increases in SE cases also were reported from South Dakota (14 cases during September 6-October 7, compared with 20 cases during all of 1993) and Wisconsin (48 cases during September 6-October 7, compared with 187 during all of 1993). This report summarizes preliminary findings from the outbreak investigation.

Disease Outbreaks↗

Takayasu's arteritis in western South Dakota.

Takayasu's arteritis is an inflammatory condition affecting the large arteries. While most reported cases are from Latin America and the Orient, the disease has a worldwide distribution. Patients frequently complain of claudication, arthralgias and fatigue, and physical examination is remarkable for vascular bruits and pulse deficits. The diagnosis is established by angiography and a typical clinical presentation. Prednisone is adequate treatment in the majority of patients. Cyclophosphamide and vascular bypass surgery are reserved for more severe cases. Two cases identified in western South Dakota are presented followed by a detailed literature review.

Adolescent↗

Tele-echocardiography in neonates: utility and benefits in South Dakota primary care hospitals.

BACKGROUND: Live transmission of echocardiography can provide a rapid and accurate diagnosis in identifying neonates who need emergent transfer to a tertiary care center. This prevents a delay in management and/or unnecessary transport. OBJECTIVE: The purpose of this study was to review the utility, accuracy, and benefits of tele-echocardiography in primary care hospitals in South Dakota to assess neonates with suspected congenital heart disease. METHOD: Two primary care hospitals established a telemedicine link to our tertiary care center. A pediatric cardiologist interpreted neonatal tele-echocardiograms and results with recommendations were immediately communicated to the attending physicians. RESULTS: Seventy-six neonatal studies were performed over 30 months, 72 at the primary care sites and 4 at the tertiary care center. Cardiac diagnosis was identified in 30 patients (40%). Neonatal transport was deemed necessary in 8 patients (11%), 5 with major cardiovascular disease and 3 with persistent pulmonary hypertension of the newborn. Two pre-term infants at the tertiary center were diagnosed with patent ductus arteriosus and required medical intervention. CONCLUSION: Tele-echocardiography accurately distinguished neonates who required tertiary cardiac care from those with less critical cardiac disease fostering prompt diagnosis and appropriate care while subjecting a minimal number of patients to costly emergency transport.

Delivery of Health Care↗

Importing employer-based managed care initiatives to rural areas: the experience of the South Dakota state employees group.

In urban areas, employers are frequently in the forefront of efforts to implement managed care initiatives at the community level, either individually or through coalitions. While employer-driven managed care initiatives also exist in rural areas, they are less common and much less is known about them. This article describes and analyzes the early experience of a large rural employer--the state of South Dakota--in its attempt to develop and implement a managed care initiative. Several aspects of that experience suggest that employer-driven managed care models in urban sites may require reexamination and redefinition for implementation in rural areas.

Community Networks↗

Civilian outbreak of adenovirus acute respiratory disease--South Dakota, 1997.

Adenoviruses are human pathogens that commonly infect the respiratory and gastrointestinal tracts. Adenovirus infections are endemic, particularly among children, but also may cause epidemics of pharyngoconjunctival fever, keratoconjunctivitis, gastroenteritis, and acute respiratory disease (ARD) among military trainees. Outbreaks of ARD among adults in the civilian sector are rare. In March 1997, an outbreak of acute respiratory disease (ARD) caused by adenovirus serotype 11 occurred among students at a job training facility in South Dakota. This report summarizes the epidemiologic and clinical features of this outbreak and discusses the change in availability of adenovirus vaccines for military use.

Acute Disease↗

Dr. T. F. Riggs and the Johns Hopkins connection: an early graduate medical experience in South Dakota.

Theodore F. Riggs, MD was born to missionary parents in Dakota Territory in 1874. His early education was a mixture of a mission school with Indian children and more conventional elementary schools in eastern communities. He graduated from Beloit College, and in 1903 received his medical degree at Johns Hopkins. After training in surgery, he began his practice in Pierre, South Dakota in 1909. In 1919 he contacted friends in Baltimore, seeking assistance with the burgeoning practice. Help came in the form of a third year medical student, Richard TeLinde (who later became head of Gynecological Surgery at Hopkins). TeLinde was so impressed by his Pierre encounter that subsequently each year he would select a recent Hopkins graduate to go to Pierre and work with Dr Riggs at St. Mary's Hospital. The Pierre rotation became a regular option in the residency program of the Brady Urological Institute. The program continued through World War II, ending after the death of Dr Hugh Young and the retirement of Dr Riggs in the early 1950's. Forty-five residents or medical students had a part of their training with T. F. Riggs at St. Mary's Hospital. Twenty-seven were from Johns Hopkins, while others were local South Dakotans or individuals known to Dr. Riggs. Of the total group, seventeen became urologists, five surgeons, five internist, two otolaryngologists, two psychiatrists and one gynecologist (Richard TeLinde). Dr Riggs died in 1962. He said his greatest joy in life was the experience he had with those men who had been at St. Mary's Hospital over the years and the friendships that were formed.

Baltimore↗

The reproducibility and validity of a self-administered semiquantitative food frequency questionnaire in subjects from South Dakota and Wyoming.

Most validation studies of food frequency questionnaires have been done in populations capable of reporting their diet with unusual accuracy. In this study of ranchers and subjects selected at random, we compared nutrient intakes as assessed with multiple diet records with those assessed with a self-administered food frequency questionnaire (the Harvard-Willett instrument with 116 food items). One hundred thirty-eight subjects from South Dakota and Wyoming, 64 males and 74 females, completed at least one food frequency questionnaire and multiple 1-day diet records (mean = 5 days) during a 6-month to 1-year period. Of invited subjects, 88% participated; 59% of participants had a high school education or less. For 22 dietary nutrients (excluding supplements) and alcohol, the median crude correlation between intakes based on diet records and the food frequency questionnaire completed before the diet records was 0.42; after adjustment for energy, age, and sex, and after correction for attenuation in the correlation coefficients due to error from a limited number of diet records, the median correlation was 0.52. Correlations for men and women were similar. The validity of the food frequency questionnaire in this population was similar to that reported previously and supports the use of self-administered food frequency questionnaires in studies of general populations.

Data Collection↗

Emergency contraceptive pills: dispensing practices, knowledge and attitudes of South Dakota pharmacists.

CONTEXT: Despite a decision by the Food and Drug Administration to deny over-the-counter status to emergency contraceptive pills, pharmacists play a crucial role in a woman's access to this medication, especially in areas with large rural populations. Pharmacists' knowledge about and attitudes toward emergency contraceptive pills may affect whether pharmacies carry the medication and whether individual pharmacists dispense it. METHODS: In October 2003, all registered pharmacists living and working in South Dakota were mailed a survey to assess their dispensing practices for, knowledge about, and attitudes toward emergency contraceptive pills. Data for 501 respondents were analyzed through chi-square testing and multivariate logistic regression. RESULTS: Fifty-four percent of respondents worked in pharmacies that carried emergency contraceptive pills. Of these, 67% had dispensed the medication in 2003, and 24% were not comfortable providing customer counseling about the method. Thirty-seven percent of all pharmacists did not understand its mechanism of action; 43% and 21%, respectively, incorrectly answered questions about the medication's link to birth defects and health risks. Only 5% correctly answered all three questions. Eighty-four percent of surveyed pharmacists believed that the medication should not be made available over the counter. Multivariate analysis showed that knowledge of emergency contraception and support for over-the-counter status were relatively low among pharmacists working in small communities. CONCLUSIONS: The education of pharmacists about emergency contraceptive pills must be strengthened to ensure that women receive accurate medical information and access to all contraceptive services.

Attitude of Health Personnel↗

An illustrative example of infant and child death review in South Dakota: "the 1998 annual report of the Regional Infant and Child Mortality Review Committee".

Local, regional, or state infant and child death review teams provide an excellent mechanism for identifying risk factors for infant and childhood deaths along with establishing a conduit for effecting preventive measures to reduce the number of deaths in these particularly vulnerable age groups. In 1997, a predecessor of the current Regional Infant and Child Mortality Review Committee was established in Minnehaha County as South Dakota's first non-Indian review committee for infant and childhood deaths. The 1998 Review Committee's annual report to the public is presented in this paper as an illustration of what can be expected from such a committee along with the specific public health concerns identified and their potential remedies. Especially noted in the committee's 1998 report is an alarming increase in Sudden Infant Death Syndrome (SIDS) death in the region and the educational role the Back to Sleep Campaign can play in the prevention of SIDS. The annual report serves as an example to illustrate how local review mechanisms can identify community strategies that may promote the health and well being of infants and children in their review areas.

Adolescent↗

OBRA--its effect on the mentally ill in South Dakota nursing homes.

Mental illness is quite prevalent in the nursing home population. The Omnibus Budget Reconciliation Act of 1987 (OBRA), as it relates to nursing homes, has many facets including preadmission screening, periodic assessment, formalized patient rights, and gives reviewers a broader list of sanctions for offending facilities. OBRA does away with the designation of skilled and intermediate levels of care. It provides for evaluation of special needs of the mentally retarded and developmentally disabled and expects relocation of residents in need of specialized treatments. Similarly, it requires evaluation of the mentally ill in nursing homes for appropriateness of placement and discourages admission of potential nursing home residents with mental illness. This last aspect of OBRA and its potential effect of the long term care system, the mental health system, and the budget of the state of South Dakota are the subject of this paper.

Aged↗

Description of three data sets: Collaborative Study on the Genetics of Asthma (CSGA), the German Affected-Sib-Pair Study, and the Hutterites of South Dakota.

Three different data sets with clinical data and markers from genome-wide screens were submitted for analysis at Genetic Analysis Workshop 12. In each study, participants were carefully characterized for asthma and related phenotypes. Testing for bronchial hyper-responsiveness using methacholine and standardized protocols was performed. Total serum IgE levels were measured using standardized techniques. In addition, similar questionnaire data on symptoms and relevant environmental exposures were obtained. Relevant clinical data and genotypes for the polymorphic markers used for each genome-wide screen were submitted. The data set from the United States Collaborative Study on the Genetics of Asthma represents a heterogeneous population consisting of both Caucasian and African American families ascertained through two siblings with clinical asthma from multiple centers. Likewise, the families from the German Asthma Genetics Group were also ascertained through two siblings with asthma at multiple centers. In a contrast to these data sets, Dr. Carole Ober and her collaborators submitted data from the inbred Hutterite population in South Dakota.

Adolescent↗