Reduction in DMFT amongst Tulsa, Oklahoma children: 1955-1979. Part 1. A profile of dental health of children in the city of Tulsa.
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Adolescent↗
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Tulsa health care challenge: a compilation of issues and possible solutions.
The delivery of adequate health care to "all of the people" has become an increasing challenge in the United States. The problem of timely access to affordable health care is even more serious in Oklahoma. The University of Oklahoma-Tulsa Health Science Center, the OU College of Medicine-Tulsa, and Community HealthNET, Inc. have taken leadership roles in convening two Oklahoma Health Care Challenge summit meetings this past year. Tulsa community leaders are now addressing the seriousness of the local problem and, more importantly, are coming up with ways to alleviate it. The focus of the summits has centered on providing indigent care, which will provide relief to the Tulsa hospitals and physicians from the growing burden of charity care costs. The most beneficial results of these meetings have been a clearer definition of the problem specific to Tulsa, the recognition that the solution will require coalitions of multidisciplinary groups, and the realization that cooperation, as well as collaboration, is the key to success.
Delivery of Health Care↗
Pilot study of ER utilization at Tulsa hospitals.
CONTEXT: The Tulsa Community Access Program (TCAP) project has been developed to address the health care needs of the uninsured and underinsured population in the Tulsa MSA. One of the objectives is the development of a 24/7 Care Center. OBJECTIVE: To complete a pilot study on patient demographics and utilization patterns in the Emergency Room (ER) to determine if a 24/7 clinic is needed or would be used as an alternative site for treatment. DESIGN: A survey was randomly administered to ER clients from March 2003 to April 2003 and included 45 open-ended, closed-ended, and Likert scale questions. Acuity level of care was verified by a hospital professional. SETTING: Hillcrest Medical Center, Tulsa, provides a significant amount of indigent care; four time periods were picked for peak and varied ER usage. PARTICIPANTS: 200 ER clients, 50 per time period; survey administration and data analysis were done by University of Oklahoma-Tulsa graduate students. MAIN OUTCOME MEASURE(S): Prior assumptions: uninsured/underinsured use the ER for primary care; demographics of the ER client are low income/unemployed, low education; majority of ER clients are non-urgent/non-emergency and would use a 24/7 clinic. RESULTS: 56% have used ER 1-2 times in past year; 89% of cases were non-urgent/non-emergency; 46% graduated high school; 48% work full-time; 42% have family income 15,000 dollars or less; 76.5% favor an after hours primary care clinic. CONCLUSIONS: This survey is an important tool to determine the needs and patterns of ER utilization; there is a need for a 24/7 clinic and it would be used by the target population.
Adult↗
The emerging profile of dental manpower in Oklahoma. 2. Tulsa county.
This is the second report of a three part study. Part I focused upon the dental manpower profile of Oklahoma County between the years 1972-1989. Part II emphasizes the dental manpower profile of Tulsa County. Part III, will be inclusive of the dental manpower profile of all other Oklahoma counties. In all phases of the study, data has been assessed for general practitioners, specialists, full-time general practice dental faculty, full-time specialist dental faculty, and public health dentists. The demographic data analyzed in Part I, revealed an increasing average of the dentists from 45.33 years of age in 1972 advancing to 48.83 years of age in 1989 for Oklahoma County. The data presented in Part II documents that in Tulsa County there was an increase in age from 45.68 in 1972 to 50.60 in 1989. Trends in location of dental school education, demonstrated that the University of Oklahoma College of Dentistry is currently the primary resource for the dental manpower pool in Tulsa and Oklahoma Counties. Changes in the dental manpower pool indicate a downward turn in the percentage of dentists choosing to locate in either Tulsa or Oklahoma County.
Dentistry↗
Correlation of environmental factors with asthma and rhinitis symptoms in Tulsa, OK.
BACKGROUND: Airborne allergens, pollutants, and climatic changes are known to influence the symptoms of asthma patients. OBJECTIVE: To correlate airborne fungal spore and pollen concentrations, meteorological data, and airborne pollutants with asthma and rhinitis symptoms to develop predictive models for asthma severity. METHODS: Patients from the Tulsa community participated in this study from September 1 to October 31, 2000, by filling out daily symptom diaries and measuring morning and evening peak expiratory flow rates. Air samples were collected using a volumetric spore trap. Meteorological variables and maximum and average pollutants were also included in the analysis. Linear regression analyses were performed for all environmental variables and symptom scores. Forward stepwise multiple regression analyses were performed to determine sets of variables that could be used to predict the conditions of increased symptom severity. RESULTS: Twenty-four patients participated in this study. The predominant spore types included Cladosporium, ascospores, and basidiospores. The predominant pollen type was Ambrosia. September was unusually hot and dry in Tulsa, but 161 mm of precipitation fell in October, primarily during the last 11 days. Two periods of peak symptoms occurred during the study, the first during the peak week of Ambrosia and the second after a 22 degrees C drop in temperature over 6 days. Numerous environmental variables showed significant correlations with symptom scores; however, there was no single predictive model for all symptoms. CONCLUSIONS: Ambrosia pollen and other environmental variables, including ozone levels, were significantly correlated with asthma and rhinitis symptoms.
Adolescent↗
Evidence of mountain cedar pollen in Tulsa.
Over the past five winters atmospheric Juniperus (cedar) pollen was collected in December and January in Tulsa, Oklahoma. Evidence from phenology, wind patterns, and plant distribution indicate that this pollen is from Juniperus ashei (mountain cedar) populations in south central Oklahoma and possibly Texas. The presence of this highly allergenic pollen in the Tulsa atmosphere indicates the potential for allergy problems among sensitive individuals in northeast Oklahoma.
Air Pollutants↗
Tulsa Sexual Assault Nurse Examiners (SANE) Program.
This article describes the implementation of a new program in the Tulsa Police Department which utilizes highly trained registered nurses to do forensic examinations on victims of rape in that community. The program is a multidisciplinary effort among various medical, legal, and law enforcement entities in Tulsa, with coordination provided by the mayor's office. With a consistent as well as experienced corps of forensic nurses conducting most of the rape examinations, the quality of the forensic evidence has increased dramatically, which enables the judicial system to more effectively prosecute rapists.
Female↗
Correlation of spring spore concentrations and meteorological conditions in Tulsa, Oklahoma.
Different spore types are abundant in the atmosphere depending on the weather conditions. Ascospores generally follow precipitation, while spore types such as Alternaria and Cladosporium are abundant in dry conditions. This project attempted to correlate fungal spore concentrations with meteorological data from Tulsa, Oklahoma during May 1998 and May 1999. Air samples were collected and analyzed by the 12-traverse method. The spore types included were Cladosporium, Alternaria, Epicoccum, Curvularia, Pithomyces, Drechslera, smut spores, ascospores, basidiospores, and other spores. Weather variables included precipitation levels, temperature, dew point, air pressure, wind speed, wind direction and wind gusts. There were over 242.57 mm of rainfall in May 1999 and only 64.01 mm in May 1998. The most abundant spore types during May 1998 and May 1999 were Cladosporium, ascospores, and basidiospores. Results showed that there were significant differences in the dry-air spora between May 1998 and May 1999. There were twice as many Cladosporium in May 1998 as in May 1999; both ascospores and basidiospores showed little change. Multiple regression analysis was used to determine which meteorological variables influenced spore concentrations. Results showed that there was no single model for all spore types. Different combinations of factors were predictors of concentration for the various fungi examined; however, temperature and dew point seemed to be the most important meteorological factors.
Alternaria↗
Adolescent blood pressure survey: Tulsa, Oklahoma, 1987 to 1989.
The study goals were to document the incidence of elevated blood pressure (BP) values in public high school students in Tulsa, Oklahoma; to determine whether age and sex are risk factors; and to encourage adolescents with abnormal screening BP values to seek medical care. Over a 2-year period, 5537 adolescents aged 14 to 19 years were evaluated by a mass screening method. Blood pressure was measured once between 8:30 and 9:30 AM, with the students seated. Korotkoff phases 1 and 5 were recorded as systolic and diastolic BP. According to the criteria of the Second Task Force on Hypertension in Children and Adolescents, 334 students had elevated BP values (either systolic, diastolic, or both) (an incidence of 6%). Boys had an incidence of elevated systolic BP of 5.8%, while girls had a 2.8% incidence, a difference that might have been expected because of the generally higher incidence among men in the adult population. The incidence of elevated diastolic BP was 2.8% in boys and 2.1% in girls. Statistically significant differences between boys and girls mean systolic and diastolic elevations were found, but were not considered clinically significant. An instructional mailing was done in an effort to stimulate follow-up medical care for those with abnormal findings, but its effect was not measured.
Adolescent↗
City of Faith Medical and Research Center, Tulsa, Oklahoma.
The gold towers of the City of Faith command the viewer's attention as they soar into the Tulsa sky. Built by Evangelist Oral Roberts, the City of Faith combines a 60-story clinic and diagnostic center, a 30-story full-service hospital and a 20-story research center on one 80-acre site adjacent to the Oral Roberts University campus. Due in part to their futuristic architectural features, the campus and the City of Faith are one of the top tourist attractions in Oklahoma. Construction began in early 1978. The clinic, first opened in June 1981 with nine physicians, is now staffed with more than 80, all with faculty appointments to the Oral Roberts School of Medicine. The hospital accepted its first patient in November, 1981 and is currently certified for 294 beds (final plans call for a total of 777). The research center began operations last June and focuses on cancer, heart disease, arthritis, diabetes and geriatrics. Built entirely through contributions from followers of the Oral Roberts Ministries, the debt-free City of Faith is expected to cost more than $500 million when completed in 1988.
Central Supply, Hospital↗
Oklahoma City and Tulsa Metropolitan Medical Response System.
The tragic loss of lives on September 11 followed by the Anthrax contaminations reinforced the need for work already underway through the Metropolitan Medical Response System (MMRS). Through leadership from the Medical Director for the Medical Control Board and EMSA, Oklahoma City and Tulsa have been the beneficiaries of nearly $1.5 million dollars in funding to prepare for nuclear, chemical or bioterrorism. The two Oklahoma cities were among the second wave of cities invited in 1999 to participate in the federally funded program for Metropolitan Medical Response. Many of the requirements of the contract have already been met under the capable guidance of Michael Murphy, a 23 year paramedic with 12 years of management experience with EMSA. Among the plans completed or underway are a Development Plan, MMRS System Plan, Forward Movement of Patients Plan, Pre-hospital Response Plan, a Biological Incident Plan, a Hospital Response Plan, a Training Plan and an Equipment and Pharmaceutical Plan. Coordinated planning between the two cities bring the added benefit of seamless sharing of personnel between both ends of the turnpike should a disaster impact one rather than both communities.
Civil Defense↗
Weather patterns and ragweed pollen production in Tulsa, Oklahoma.
Levels of atmospheric Ambrosia (ragweed) pollen in the urban environment of Tulsa, Oklahoma, were determined using a Rotorod sampler. The data, representing the distinctly different growing seasons of 1980 and 1981, suggest it may be possible to predict pollen season levels based upon early summer weather patterns.
Oklahoma↗
Shigella in Tulsa County, 1993: epidemiology, day care center association, and control.
Tulsa County experienced an epidemic of Shigella sonnei infection and diarrheal disease during 1993. Of the 298 cases documented, 262 occurred in day care centers. There were 227 epidemiologically-linked secondary cases, primarily in parents and siblings. The mode of transmission was primarily person-to-person among family members and children in day care centers. In addition, transmission may also have occurred as the result of fomities in some day care centers. Control was achieved by antibiotic therapy, inspection, and retraining all day care centers' staffs in hand washing techniques and infection control concepts.
Adolescent↗
Tuberculosis in a Tulsa high school.
Following the discovery of a high school student with communicable tuberculosis, the Tulsa City-County Health Department skin tested 1,005 persons in the family, community, and school. Of the 931 persons tested at the school, 10 were reactors in March and 33 more were reactors in May. All 5 family members and 4 community contacts were tuberculin reactive. In all, 52 new tuberculin reactors were identified, evaluated, and considered for treatment or prophylaxis. This situation illustrates the conundrum that tuberculosis remains an important public health issue because of the possibility of transmission from small pockets of diseased persons to the larger community, especially in institutions of all kinds. Physicians and public health agencies must be vigilant and identify new cases for treatment and begin contact tracing to minimize the spread of tuberculosis.
Adolescent↗
Preserving access with dignity for the elderly. Tulsa's VIP program.
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Aged↗
FH Tulsa-1 and -2: two unique alleles for familial hypercholesterolemia presenting in an affected two-year-old African-American male.
A two-year-old African American boy presented with cutaneous xanthomata and extreme hypercholesterolemia. Subsequent studies revealed that the LDL-cholesterol was 1,001 mg/dl and apoB 507 mg/dl. LDL-receptor activity was almost undetectable, which is compatible with the finding of two newly described defective alleles on exon 4 of the LDL-receptor gene coding for part of the ligand-binding domain. One allele contained a 21 base-pair insertion from codon 200 to 207 whereas the other had a point mutation at codon 207. The rarity of genes for FH reported in individuals of African ancestry is discussed.
Alleles↗
Closed reduction for total hip arthroplasty dislocation. The Tulsa technique.
A different technique for closed reduction of the dislocated total hip arthroplasty is described. The maneuver is effective and efficient, may be performed without an assistant, and reduces potential risks to the surgeon.
Hip Dislocation↗
Tulsa hospital chooses Columbia.
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Health Facility Merger↗