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1.
BMJ Open ; 12(4): e058510, 2022 Apr 04.
Article in English | MEDLINE | ID: covidwho-1774967

ABSTRACT

OBJECTIVES: Men who have sex with men who use pre-exposure prophylaxis (PrEP) have not traditionally been targets for human papillomavirus (HPV) vaccine programmes, despite their high risk for HPV-related cancers and HPV vaccine being approved by the U.S. Food and Drug Administration (FDA) for people up to age 45. The objective of this study was to assess attitudes and barriers towards HPV vaccine for adult PrEP users in the primary care context. METHODS: Semistructured phone interviews of 16 primary care patients taking PrEP in the Kansas City metropolitan area were conducted, with interviews assessing HPV vaccination status, and attitudes, beliefs and perceived barriers surrounding HPV vaccine. Interview notes were open-coded by student authors, and themes were generated through code review and consensus. Data were then analysed using thematic analysis. RESULTS: The results showed that most patients believed that preventative health was important and felt the HPV vaccine was important. Most patients were open to vaccination if recommended by their primary care physician and covered by insurance. Most participants believed HPV infection to be far worse in women, and there were gaps in knowledge surrounding HPV and its effects in men. CONCLUSIONS: While more research is needed to better understand facilitators of a linkage between PrEP and HPV vaccine in clinical settings for groups at high risk for HPV-related cancers, getting primary care providers involved in educating high-risk patients about the importance of HPV vaccination and actively recommending the vaccine to those patients has the potential to prevent HPV-related cancers.


Subject(s)
Papillomavirus Infections , Papillomavirus Vaccines , Sexual and Gender Minorities , Adult , Female , Health Knowledge, Attitudes, Practice , Homosexuality, Male , Humans , Kansas , Male , Middle Aged , Missouri , Papillomavirus Vaccines/therapeutic use , Patient Acceptance of Health Care , Primary Health Care , Vaccination
2.
Medicine (Baltimore) ; 101(7): e28924, 2022 Feb 18.
Article in English | MEDLINE | ID: covidwho-1774440

ABSTRACT

ABSTRACT: Extensive evidence in the literature supports the mandatory use of facemasks to reduce the infection rate of severe acute respiratory syndrome coronavirus 2, which causes the coronavirus disease (COVID-19). However, the effect of mask use on the disease course remains controversial. This study aimed to determine whether mandatory mask use influenced the case fatality rate in Kansas, USA between August 1st and October 15th 2020.This study applied secondary data on case updates, mask mandates, and demographic status related to Kansas State, USA. A parallelization analysis based on county-level data was conducted on these data. Results were controlled by performing multiple sensitivity analyses and a negative control.A parallelization analysis based on county-level data showed that in Kansas, counties with mask mandate had significantly higher case fatality rates than counties without mask mandate, with a risk ratio of 1.85 (95% confidence interval [95% CI]: 1.51-2.10) for COVID-19-related deaths. Even after adjusting for the number of "protected persons," that is, the number of persons who were not infected in the mask-mandated group compared to the no-mask group, the risk ratio remained significantly high at 1.52 (95% CI: 1.24-1.72). By analyzing the excess mortality in Kansas, this study determines that over 95% of this effect can solely be attributed to COVID-19.These findings suggest that mask use might pose a yet unknown threat to the user instead of protecting them, making mask mandates a debatable epidemiologic intervention.The cause of this trend is explained herein using the "Foegen effect" theory; that is, deep re-inhalation of hypercondensed droplets or pure virions caught in facemasks as droplets can worsen prognosis and might be linked to long-term effects of COVID-19 infection. While the "Foegen effect" is proven in vivo in an animal model, further research is needed to fully understand it.


Subject(s)
COVID-19 , Masks , Humans , Kansas/epidemiology
3.
Health Educ Behav ; 49(2): 194-199, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1741850

ABSTRACT

In this commentary, we briefly describe our methodology in conducting a remote qualitative investigation with essential workers from southwest Kansas, and then describe some key considerations, challenges, and lessons learned in recruiting and conducting interviews remotely. From August 4, 2020 through August 26, 2020, Centers for Disease Control and Prevention (CDC) staff conducted five phone interviews with culturally and linguistically diverse employees in southwest Kansas to understand COVID-19 knowledge, attitudes, and practices and communication preferences. Our experience details the potential challenges of the federal government in recruiting individuals from these communities and highlights the possibilities for more effectively engaging health department and community partners to support investigation efforts. Optimizing recruitment strategies with additional participation from community partners, developing culturally and linguistically appropriate data collection tools, and providing supportive resources and services may augment participation from refugee, immigrant, and migrant (RIM) communities in similar remote investigations.


Subject(s)
COVID-19 , Emigrants and Immigrants , Limited English Proficiency , Refugees , Humans , Kansas
4.
Int J Environ Res Public Health ; 18(21)2021 11 01.
Article in English | MEDLINE | ID: covidwho-1488605

ABSTRACT

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The United States (U.S.) has the highest number of reported COVID-19 infections and related deaths in the world, accounting for 17.8% of total global confirmed cases as of August 2021. As COVID-19 spread throughout communities across the U.S., it became clear that inequities would arise among differing demographics. Several researchers have suggested that certain racial and ethnic minority groups may have been disproportionately impacted by the spread of COVID-19. In the present study, we used the daily data of COVID-19 cases in Kansas City, Missouri, to observe differences in COVID-19 clusters with respect to gender, race, and ethnicity. Specifically, we utilized a retrospective Poisson spatial scan statistic with respect to demographic factors to detect daily clusters of COVID-19 in Kansas City at the zip code level from March to November 2020. Our statistical results indicated that clusters of the male population were more widely scattered than clusters of the female population. Clusters of the Hispanic population had the highest prevalence and were also more widely scattered. This demographic cluster analysis can provide guidance for reducing the social inequalities associated with the COVID-19 pandemic. Moreover, applying stronger preventive and control measures to emerging clusters can reduce the likelihood of another epidemic wave of infection.


Subject(s)
COVID-19 , Pandemics , Female , Humans , Kansas/epidemiology , Male , Minority Groups , Missouri/epidemiology , Retrospective Studies , SARS-CoV-2 , United States
5.
Viruses ; 13(10)2021 10 19.
Article in English | MEDLINE | ID: covidwho-1481013

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) descriptions of infection and transmission have been increasing in companion animals in the past year. Although canine susceptibility is generally considered low, their role in the COVID-19 disease cycle remains unknown. In this study, we detected and sequenced a delta variant (AY.3) from a 12-year-old Collie living with owners that previously tested positive for SARS-CoV-2. It is unclear if the dogs' symptoms were related to SARS-CoV-2 infection or underlying conditions. The whole genome sequence obtained from the dog sample had several unique consensus level changes not previously identified in a SARS-CoV-2 genome that may play a role in the rapid adaptation from humans to dogs. Within the spike coding region, 5/7 of the subconsensus variants identified in the dog sequence were also identified in the closest in-house human reference case. Taken together, the whole genome sequence, and phylogenetic and subconsensus variant analyses indicate the virus infecting the animal originated from a local outbreak cluster. The results of these analyses emphasize the importance of rapid detection and characterization of SARS-CoV-2 variants of concern in companion animals.


Subject(s)
COVID-19/veterinary , Dog Diseases/virology , Genome, Viral/genetics , SARS-CoV-2/genetics , Animals , COVID-19/mortality , COVID-19/transmission , Disease Reservoirs/virology , Dogs , Kansas , Male , SARS-CoV-2/isolation & purification , Whole Genome Sequencing
6.
Int J Environ Res Public Health ; 18(8)2021 04 16.
Article in English | MEDLINE | ID: covidwho-1378392

ABSTRACT

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 < 0.001 and t = 4.44, p < 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.


Subject(s)
Child Protective Services , Sudden Infant Death , Child , Humans , Infant , Infant Care , Kansas , Sleep , Sudden Infant Death/prevention & control , United States
8.
Contraception ; 104(3): 262-264, 2021 09.
Article in English | MEDLINE | ID: covidwho-1279563

ABSTRACT

OBJECTIVES: To explore racial/ethnic disparities in family planning telehealth use. STUDY DESIGN: We analyzed telehealth and in-clinic visits (n = 3142) from ten family planning clinics (April 1-July 31, 2020) by race/ethnicity and month. RESULTS: Telehealth comprised 1257/3142 (40.0%) of overall visits. Telehealth was used by 242/765 (31.6%) of Black/African American and 31/106 (29.2%) multiracial patients. Patients with unknown (162/295, 54.9%), White (771/1870, 41.2%), and other (51/106, 48.1%) identities comprised the majority of telehealth visits. CONCLUSIONS: Our study found differences in telehealth use during the COVID-19 pandemic response. IMPLICATIONS: Understanding barriers and facilitators to telehealth is critical to reducing disparities in access.


Subject(s)
COVID-19/prevention & control , Facilities and Services Utilization/statistics & numerical data , Family Planning Services/methods , Health Services Accessibility/statistics & numerical data , Healthcare Disparities/ethnology , Patient Acceptance of Health Care/ethnology , Telemedicine/statistics & numerical data , Arkansas , Family Planning Services/statistics & numerical data , Female , Healthcare Disparities/statistics & numerical data , Humans , Kansas , Minority Groups , Missouri , Oklahoma , Patient Acceptance of Health Care/statistics & numerical data
10.
J Am Board Fam Med ; 34(3): 522-530, 2021.
Article in English | MEDLINE | ID: covidwho-1259318

ABSTRACT

INTRODUCTION: COVID-19 has spread rapidly, with vast global implications. This study assessed how family physicians in Kansas were responding to COVID-19 and the effects of the pandemic on their well-being. METHODS: The authors conducted a cross-sectional survey of 113 family physicians in Kansas between May 22, 2020 and June 25, 2020. The study participants completed an anonymous, 36-item survey assessing their concerns about being exposed to COVID-19 and levels of personal depression, anxiety, stress, and burnout in addition to demographic information. RESULTS: There was a 45.6% response rate, with 50.4% (n = 57) of the respondents reporting manifestations of burnout. The physicians who personally treated any presumptive or confirmed COVID-19 patient, compared with those who did not, were more likely to report at least 1 manifestation of burnout, experience emotional exhaustion, and feel a higher level of personal stress. CONCLUSION: Our findings demonstrate that the COVID-19 pandemic may be taking an emotional toll on family physicians in Kansas. This study provides a baseline from which to continue further monitoring of outcomes. Data can help drive initiatives at local, state, and national levels to help diminish the negative impact of the COVID-19 pandemic on physicians.


Subject(s)
Anxiety , Burnout, Professional , COVID-19/psychology , Depression/epidemiology , Physicians, Family/psychology , Anxiety/epidemiology , Burnout, Professional/epidemiology , Cross-Sectional Studies , Humans , Kansas/epidemiology , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
11.
J Subst Abuse Treat ; 129: 108378, 2021 10.
Article in English | MEDLINE | ID: covidwho-1253259

ABSTRACT

AIMS: During the early months of the U.S. COVID-19 outbreak, women suffered disproportionate burdens of pandemic-related psychological and economic distress. We aimed to describe the experiences of women in substance use disorder (SUD) recovery programs by (1) exploring the pandemic's impact on their lives, sobriety, and recovery capital and (2) tracking COVID-19 perceptions and preventative behaviors. METHODS: We conducted monthly semistructured interviews with women in residential and outpatient SUD recovery programs in Kansas City in April, May, and June 2020. Participants described the pandemic's impact on their life and sobriety and completed survey items on factors related to COVID-19 preventative behaviors. We interpreted qualitative themes longitudinally alongside quantitative data. RESULTS: In 64 interviews, participants (n = 24) described reduced access to recovery capital, or resources that support sobriety, such as social relationships, housing, employment, and health care. Most experienced negative impacts on their lives and feelings of stability in March and April but maintained sobriety. Four women described relapse, all attributed to pandemic stressors. Participants described relief related to societal re-opening in May and June, and increased engagement with their communities, despite rising infection rates. CONCLUSIONS: For women recovering from SUDs during COVID-19, securing recovery capital often meant assuming greater COVID-19 risk. As substance use appeared to have increased during the pandemic and COVID-19 transmission continues, public health planning must prioritize adequate and safe access to recovery capital and timely distribution of vaccines to people struggling with SUDs.


Subject(s)
COVID-19 , Substance-Related Disorders , Female , Humans , Kansas/epidemiology , Longitudinal Studies , Pandemics , SARS-CoV-2 , Substance-Related Disorders/epidemiology
12.
J Community Health ; 46(6): 1148-1154, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1227886

ABSTRACT

The COVID-19 pandemic brought forward the challenge of dispersing accurate medical information to the public rapidly. Credible and non-credible sources may impact public reactions to the virus. The purpose of this study is to assess those reactions of women located in or near Kansas. A survey was conducted in July 2020 with questions on knowledge of COVID-19, attitudes and behaviors towards COVID-19, and primary sources of information. 305 survey respondents met criteria for further analysis, and descriptive statistical analyses were applied. Participants were generally knowledgeable of the pandemic, with a mean knowledge score of 11.40 out of 13 (SD 1.3). The attitude statement with the highest rate of agreement was that "social distancing is an effective way of controlling COVID-19 spread" (n = 265, 86.9%) and that with the highest rate of disagreement was, "I am not worried about my friends' and family members health" (n = 253, 83.0%). The most-implemented behaviors as indicated by participants were avoiding contact with sick individuals and washing hands with soap and water often (n = 294, 96.4%), and the least implemented was avoiding meat consumption (n = 257, 84.3%). Finally, most participants indicated that health officials were their primary source of information (n = 215, 70.5%). Participants of this survey had fairly good knowledge of the virus. Attitudes of participants as a whole may be described as cautious without being overly fearful. Reported behaviors also align well with current public health recommendations. These responses may be reflective of where participants are receiving their information, which, for the majority, is from public health officials.


Subject(s)
COVID-19 , Pandemics , Female , Health Knowledge, Attitudes, Practice , Humans , Kansas/epidemiology , SARS-CoV-2
13.
Am J Public Health ; 111(6): 1035-1039, 2021 06.
Article in English | MEDLINE | ID: covidwho-1216999

ABSTRACT

We report on data we collected from a 2018 survey examining jails' human papillomavirus virus vaccine delivery capacity and on a secondary analysis we conducted to describe factors similarly associated with delivery planning for the COVID-19 vaccine. We provide recommendations for delivering the COVID-19 vaccine in jails, based on evidence from Kansas, Iowa, Nebraska, and Missouri. Our key finding is that jails have limited staff to implement vaccination and will require collaboration between jail administrators, jail medical staff, and local health departments.


Subject(s)
COVID-19 Vaccines/administration & dosage , Health Personnel , Immunization Programs , Jails , Public Health , COVID-19/prevention & control , Female , Humans , Iowa , Kansas , Male , Missouri , Papillomavirus Vaccines/administration & dosage
14.
J Prim Care Community Health ; 12: 2150132721995451, 2021.
Article in English | MEDLINE | ID: covidwho-1088493

ABSTRACT

The purpose of this study was to describe knowledge and beliefs about SARS-CoV2 and COVID-19 and explore the gaps between current media coverage of health risks and what the general public knows about the virus and its outcome. A 37-question survey was developed and administered to a community collaborative group in a Midwestern state in the United States. Fifty-three participants completed the survey. When asked where participants found their information, a majority reported the internet (33.9%, n = 18/53) and radio and/or tv (28.3%, n = 15/53). Most participants showed a basic level of COVID-19 knowledge, but few could identify the 3 most frequent symptoms of COVID-19 (7.5%, n = 4/53). The results from this study highlight the continued need for increased public health communication. Educational efforts should focus on social media and internet outlets to address COVID-19 misinformation, strategies to address vaccine hesitancy, and the associated communication gap to help address related health disparities.


Subject(s)
COVID-19 , Health Knowledge, Attitudes, Practice , SARS-CoV-2 , Adolescent , Adult , Aged , Aged, 80 and over , Consumer Health Information , Female , Humans , Information Seeking Behavior , Kansas/epidemiology , Male , Mass Media , Middle Aged , Risk Assessment , Surveys and Questionnaires , Young Adult
15.
Am Surg ; 86(6): 599-601, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-657599

ABSTRACT

The chief of surgery of a 264-bed acute care facility and clinic system in Topeka, KS, USA, gives a chronology that illustrates the rapid and profound clinical, economic, and emotional impact of the SARS-CoV-2 outbreak on his hospital and community. In his view, the pandemic has laid bare the weaknesses of several factors basic to the modern US health care system and the resulting economic crisis: just-in-time supply chain technology; foreign sourcing of masks, gowns, and critical equipment, all at critical shortages during the crisis; rural hospital closings; lack of excess capacity through maximization of utilization for efficiency; and an overreliance on high revenue elective procedures and tests. His team was tested by an emergency operation for bowel obstruction that put all the isolation protocols into action. Despite their readiness and the success of the operation and the potential for telemedicine as an alternative to in-person evaluations and outpatient visits, the forced cancellation of all elective operations have led to the loss of revenue for both hospital system and providers, furlough and termination of workers, and financial hardship and uncertainty.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Hospitals, Community/economics , Medical Staff, Hospital/psychology , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Betacoronavirus , COVID-19 , Clinical Protocols , Elective Surgical Procedures/economics , Health Facility Closure/economics , Humans , Infection Control/methods , Intestinal Obstruction/surgery , Kansas/epidemiology , Patient Isolation , Personal Protective Equipment/supply & distribution , Personnel Downsizing/economics , SARS-CoV-2 , Telemedicine
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