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In the United States, for various reasons, fewer farm families rely solely on their farming operations for their livelihoods. As the structure of agriculture changes and farm families adjust their livelihood strategies, do the discourses around gender relations in households also change? This article analyzes the portrayal of women's roles in farming households by drawing on interviews with Kansas field crop farmers, primarily regarding their land-use decisions, but also inquiring about their farms and communities. The article addresses the following question: How do farmers' discourses compare to Brandth's (2002a) categorizations of three dominant discourses in the literature on gender in European family farming--the discourse of the family farm, the discourse of masculinization, and the discourse of detraditionalization and diversity? While Brandth finds the discourse of the family farm prevalent in the literature, overall, the discourse apparent from 30 farmer interviews is more characteristic of detraditionalization and diversity. Although men are primarily the principal operators in farming, overall, women were not portrayed simply as helpers. Rather, their roles are depicted as diverse and important to farm operations. (Contains 1 footnote.)

Anaplasma bovis is primarily an infectious agent of ruminants, and has most commonly been reported in Asia, the Middle East, and Africa. Although the primary cause of human anaplasmosis is Anaplasma phagocytophilum, humans may rarely be infected by other Anaplasma spp. Human disease attributed to A. bovis has been occasionally reported, including an A. bovis-like agent in the United States. DNA of an A. bovis-like agent has been amplified from humans and the tick Dermacentor variabilis in the central region of the U.S., but larger prevalence studies among potential vectors or reservoir hosts in the U.S. have not been reported. The aim of this study was to evaluate the prevalence of A. bovis-like agent among D. variabilis and cattle in the Southcentral U.S. Previously extracted DNA from adult D. variabilis collected from Oklahoma (n = 38) and Kansas (n = 93), and blood of cattle from Oklahoma (n = 140) were tested by conventional PCR. Overall prevalence of A. bovis-like DNA within ticks was determined to be 3.1% (4/131), and all positive ticks originated from Oklahoma. Overall prevalence in bovine blood was determined to be 0% (0/140). These findings confirm the presence of an A. bovis-like agent, a potentially zoonotic pathogen, among ticks in the Southcentral U.S.; this agent is likely underrecognized and has been detected in parts of the U.S. that lie outside of the established geographic range for A. phagocytophilum. Further investigation and surveillance are necessary to elucidate possible reservoirs of A. bovis in the U.S., further evaluate the burden of human infection, and fully characterize genetic differences between the A. bovis-like agent detected in the U.S. and A. bovis in other regions of the world., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appears to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier GmbH.)

Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) Kansas worked with 10 Kansas counties from November 2020 through June 2022 to form local health equity action teams (LHEATs), develop COVID-19 testing strategies, foster communication about COVID-19, and share best practices through a learning collaborative. Participating counties documented 693 distinct COVID-19 testing and 178 communication activities. Although the intervention was not associated with changes in the proportion of positive COVID-19 tests, LHEATs in the learning collaborative implemented new testing strategies and responded to emerging COVID-19 challenges. ( Am J Public Health . 2024;114(11):1202-1206. https://doi.org/10.2105/AJPH.2024.307771).

The Communities Organizing to Promote Equity (COPE) Project was implemented in 20 counties across Kansas to build capacity to address health equity by forming local health equity action teams (LHEATS), hiring and training community health workers, facilitating state-wide learning collaboratives, and tailoring communication strategies. We conducted interviews and focus groups with project stakeholders who identified pragmatic recommendations related to LHEAT formation and leadership, establishing trust, nurturing autonomy, and optimizing impact. Insights can improve future community-based health equity efforts. ( Am J Public Health . 2024;114(S7):S570-S574. https://doi.org/10.2105/AJPH.2024.307802).

Background: The COVID-19 pandemic has disproportionately impacted rural and under-resourced urban communities in Kansas. The state's response to COVID-19 has relied on a highly decentralized and underfunded public health system, with 100 local health departments in the state, few of which had prior experience engaging local community coalitions in a coordinated response to a public health crisis., Methods: To improve the capacity for local community-driven responses to COVID-19 and other public health needs, the University of Kansas Medical Center, in partnership with the Kansas Department of Health and Environment, will launch Communities Organizing to Promote Equity (COPE) in 20 counties across Kansas. COPE will establish Local Health Equity Action Teams (LHEATs), coalitions comprised of community members and service providers, who work with COPE-hired community health workers (CHWs) recruited to represent the diversity of the communities they serve. CHWs in each county are tasked with addressing unmet social needs of residents and supporting their county's LHEAT. LHEATs are charged with implementing strategies to improve social determinants of health in their county. Monthly, LHEATs and CHWs from all 20 counties will come together as part of a learning collaborative to share strategies, foster innovation, and engage in peer problem-solving. These efforts will be supported by a multilevel communications strategy that will increase awareness of COPE activities and resources at the local level and successes across the state. Our mixed methods evaluation design will assess the processes and impact of COPE activities as well as barriers and facilitators to implementation using aspects of both the Consolidated Framework for Implementation Research (CFIR) and Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) models., Discussion: This protocol is designed to expand community capacity to strategically partner with local public health and social service partners to prioritize and implement health equity efforts. COPE intentionally engages historically resilient communities and those living in underserved rural areas to inform pragmatic strategies to improve health equity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Pacheco, Bridges, Ellerbeck, Ablah, Greiner, Chen, Collie-Akers, Ramírez, LeMaster, Sykes, Parente, Corriveau, Miras Neira, Scott, Knapp, Finocchario-Kessler and COPE Team.)

Background: In addition to the state-mandated case investigation and contact tracing, the Unified Government Public Health Department of Wyandotte County, Kansas implemented social support services for COVID-19 cases and contacts; however, did not have the systems in place to document the provision of these services. Our team worked with the health department to develop and implement the COVID Tracking System (CTS), an eHealth system that linked multiple involved teams. Here, we describe the development and evaluation of the CTS. The objective of this manuscript is to describe and evaluate the development and implementation process of the Covid Tracking System., Methods: Drawing from concepts of user-centered design, we took a 4-phase approach to development: understanding context, specifying needs, designing solutions, and evaluating. A mixed-methods evaluation of the development and implementation process using RE-AIM was conducted. Quantitative CTS data captured between February 1, 2021, and September 30, 2021 were exported. Descriptive statistics were calculated for categorical variables and means (SD, range) or median (IQR) for continuous variables. Qualitative discussions with key users supplemented the quantitative data., Results: There were 1,152 cases entered into the CTS, of whom 307 (26.6%) requested a letter be sent to their workplace to excuse them during their quarantine period, 817 (70.9%) requested and had food and cleaning supplies delivered, 21 (1.8%) requested guidance on applying for federal assistance, and 496 (43.1%) requested to be contacted by a community health worker. While a few technical glitches slowed down early implementation, these were quickly resolved and key users felt that the CTS streamlined client referral and simplified their workflow, allowing them to spend more time on patient care and follow up, rather than documentation. After study implementation ended, the Unified Government Public Health Department of Wyandotte County continued using the CTS for client tracing and follow up., Discussion: This project provides a roadmap of how user centered design can be applied to the development and evaluation of eHealth software to support program intervention implementation, even in situations where urgent action is needed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Wexler, Dixon, Oyowe, Lapke, Conner, Shoemaker, Corriveau, Greiner and Finocchario-Kessler.)

Introduction: Rural and under-resourced urban communities face unique challenges in addressing patients' social determinants of health needs (SDoH). Community health workers (CHWs) can support patients experiencing social needs, yet little is known about how rural and under-resourced primary care clinics are screening for SDoH or utilizing CHWs., Methods: Interviews were conducted with primary care clinic providers and managers across a geographically large and predominately rural state to assess screening practices for SDoH and related community resources, and perspectives on using CHWs to address SDoH. Interviews were conducted by phone, recorded, and transcribed. Data were analyzed using thematic analysis. We completed interviews with 27 respondents (12 providers and 15 clinic managers) at 26 clinics., Results: Twelve (46.1%) clinics had a standardized process for capturing SDoH, but this was primarily limited to Medicare wellness visits. Staffing and time were identified as barriers to proper SDoH screening. Lack of transportation and affordable medication were the most cited SDoH. While respondents were all aware of CHWs, only 8 (30.8%) included a CHW on their care team. Perceived barriers to engaging CHWs included cost, space, and availability of qualified CHWs. Perceived benefits of engaging CHWs in their practice were: assisting patients with navigating resources and programs, relieving clinical staff of non-medical tasks, and bridging language barriers., Conclusions: Rural and under-resourced primary care clinics need help in identifying and addressing SDoH. CHWs could play an important part in addressing social needs and promoting preventive care if financial constraints could be addressed and local CHWs could be trained., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Context and Setting: Kansas City, Missouri, experiences substantial racial/ethnic health disparities, particularly associated with that city's high level of residential segregation. Among the risk factors for poor health are substandard housing, particularly common in African American neighborhoods, which lead to asthma and therefore to school absences. A 2018 ballot initiative in Kansas City, Missouri, would allow health inspectors to investigate complaints of poor or hazardous conditions in rental housing., Objectives: Because the Kansas City, Missouri Health Department cannot legally advocate directly for voter support of public health policies, department staff used outside consultants to demonstrate the potential positive impact of environmental initiatives., Design: The Win-Win model provides a standardized, unbiased economic analysis of interventions to help public health officials make informed policy and program decisions and engage in cross-sectoral collaboration., Results: The Win-Win model found that if an asthma home remediation program were provided for almost 7000 low-income children in Kansas City, it would result in 55 000 fewer days of missed school annually among other promising outcomes. The model also showed a $1.67 return-on-investment to local and state government for each dollar spent and a 3-year breakeven point. The results from the Win-Win model were integrated into Kansas City's Community Health Improvement Plan and made available on the Win-Win Project Web site. The proposed law to promote rental inspections passed with 57% of the vote., Conclusions: The model results allowed for an informed, unbiased point of evidence that the health department could present to community groups and elected officials leading up to the vote on the health inspection initiative., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: To determine potential best practices for assessment of team-ready behaviors of pharmacy students participating in interprofessional advanced pharmacy practice experiences (APPEs)., Methods: Preceptors received training on two interprofessional behavioral assessment tools, the modified interprofessional collaborator assessment rubric (mICAR) and individual teamwork observation and feedback tool (iTOFT). Preceptors evaluated students at midpoint and end of APPE using each tool. Preceptors completed a utility survey on each tool to determine a preference. Focus groups were conducted with a subset of preceptors to elicit further perspectives. Experts in interprofessional education (IPE) and accrediting board members were interviewed to determine a national perspective of best practices., Results: Nineteen preceptors participated in the study. Of these, 12 completed all components of the study. No significant difference was found comparing utility of mICAR to iTOFT, although mICAR trended toward being easier to use/understand (p = 0.29). Focus group participants (n = 8) felt using a tool led to enhanced feedback and interprofessional experiences and all preferred mICAR. IPE experts and accrediting board members perceived best practices to include using a tool that aligns with IPE collaborative competencies, embedding the tool into existing APPE evaluation processes, and that is applicable to all health professional learners/evaluators., Conclusions: Preceptors preferred mICAR to iTOFT, though no significant difference was observed. Additional research is needed to confirm these results and for best practices to emerge. Future steps include evaluating interprofessional teamwork using a tool in a 360-evaluation of the individual learner by preceptors outside of the learner's own profession., Competing Interests: Declaration of competing interest None., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Health sciences libraries are often challenged to make decisions regarding physical space allocation without quantitative data to support specific user preferences. This multisite, longitudinal study sought to answer the following questions related to academic health sciences libraries: (1) Which library spaces are popular with health sciences patrons? (2) How does time of day and allocated seating space affect patron choices? (3) What similarities and differences occur in space usage across four different health sciences libraries? Results suggest health sciences libraries must develop a nuanced understanding of their patrons' preferences to best serve patrons' needs regarding space allocation. Libraries can benefit from these types of methodological studies that target specific populations, supporting more informed space allocation decision making.

Amblyomma maculatum (the Gulf Coast tick), an aggressive, human-biting, Nearctic and Neotropical tick, is the principal vector of Rickettsia parkeri in the United States. This pathogenic spotted fever group Rickettsia species has been identified in 8-52% of questing adult Gulf Coast ticks in the southeastern United States. To our knowledge, R. parkeri has not been reported previously from adult specimens of A. maculatum collected in Kansas or Oklahoma. A total of 216 adult A. maculatum ticks were collected from 18 counties in Kansas and Oklahoma during 2011-2014 and evaluated by molecular methods for evidence of infection with R. parkeri. No infections with this agent were identified; however, 47% of 94 ticks collected from Kansas and 73% of 122 ticks from Oklahoma were infected with "Candidatus Rickettsia andeanae" a spotted fever group Rickettsia species of undetermined pathogenicity. These preliminary data suggest that "Ca. R. andeanae" is well-adapted to survival in populations of A. maculatum in Kansas and Oklahoma, and that its ubiquity in Gulf Coast ticks in these states may effectively exclude R. parkeri from their shared arthropod host, which could diminish markedly or preclude entirely the occurrence of R. parkeri rickettsiosis in this region of the United States., (Published by Elsevier GmbH.)

Purpose: Determine availability of emergency contraception (EC) at rural and urban pharmacies in Kansas., Methods: A sample of 201 Kansas pharmacies was selected using a random integer generator. We measured ability to dispense EC within 24 hours and whether it was in stock at the time of the survey call. We examined EC availability based on geographic differences and pharmacy type., Findings: Of the sample, 186 pharmacists agreed to be interviewed. Of these, 19% (n = 36) were unable to provide EC within 24 hours. There were essentially no differences in availability of EC between rural (75% could dispense in 24 hours) and urban pharmacies (85% could dispense in 24 hours) (P= .105). Corporate pharmacies were more likely to be able to provide EC within 24 hours compared to independent pharmacies (OR = 3.79, CI 1.71-8.43). Thirty-one percent (n = 57) of pharmacists did not carry EC at the time of the survey call. With this sample, urban pharmacies were more than twice as likely to report carrying EC compared to rural pharmacies (OR = 2.47, CI 1.31-4.68), and corporate pharmacies were also more likely to report carrying EC compared to independent pharmacies (OR = 7.77, CI 3.72-16.21)., Conclusions: In a sample of Kansas pharmacies, there were no differences between rural and urban pharmacies in 24-hour EC availability; however, there were differences in those who stocked EC at the time of the survey call. Corporate pharmacies were more likely to dispense EC within 24 hours and have it in stock compared to independent pharmacies, suggesting differences in availability of EC., (© 2012 National Rural Health Association.)

Objective: Although colorectal cancer (CRC) mortality rates in the US population have shown a decline, American Indian (AI) CRC mortality rates appear to be increasing. CRC screening rates of AIs remain low when compared with other ethnic groups. The research team explored women's perceptions toward CRC screening, existing barriers, and suggestions to promote education and screening among AI women in Kansas and Missouri., Methods: Using a community-based participatory research approach, the authors conducted 7 focus groups with AI women older than 50 years (N = 52) to better understand their perceptions of and attitudes toward CRC screening., Results: Women recognized barriers to screening, such as embarrassment, privacy issues, fear, insurance, and cost. They countered perceived barriers through inventive suggestions for education and awareness via social support systems and intergenerational relationships., Discussion: CRC screening interventions for AI must be culturally tailored.

To prevent youth substance abuse, a state prevention system aims to support implementation of best practices statewide. A critical component is the prevention support system; that is, the network of people and organizations that build capacity within communities to implement prevention activities. This study describes the Kansas Prevention Network (KPN), the prevention support system within Kansas. It examines how KPN uses monitoring and evaluation to guide support for implementation of prevention activities. From 2009 to 2011, support organizations implemented nearly 4,000 activities to build capacity of local coalitions to better implement interventions. Activities focused primarily on building capacity for community-based processes, such as assessment and planning, and for dissemination of information. This report describes innovative approaches to documenting and monitoring the statewide effort as well as structured approaches for using the data to guide decision making and technical assistance.

Two new benzyl benzoate glycosides were isolated from the leaves and stems of the native North American prairie plant Oligoneuron rigidum (stiff goldenrod). The glycosides were isolated as a mixture of benzoate and acetate esters, which were subjected to mild base hydrolysis to facilitate full structural characterization using LCMSMS and 1D and 2D NMR data.

This study tested the feasibility of promoting 1-800-4-CANCER through partnerships with organizations serving African American and Hispanic communities. Small-media and client reminders about human papillomavirus vaccination were made available through local agents to 28 community organizations. Organizations ordered 79 932 resources and distributed them to young women and parents of girls-;African Americans in St Louis, Missouri, and Hispanics in the Lower Rio Grande Valley of Texas. Pre- to postintervention calls to 1-800-4-CANCER increased 38% in these communities, while declining 15% in comparison communities of Kansas City, Missouri, and El Paso, Texas (F = 8.6, P = .004) and 1.4% in the United States as a whole.

Objective: This study reports student outcomes for the Kansas Consumers as Providers (CAP) training program. Graduates provide mental health services to other consumers in the community. CAP is a semester-long class plus a 104-hour internship in a social service agency., Methods: This paper reports on the results of a two-year quantitative, longitudinal study of people with psychiatric disabilities who completed the program., Results: Graduates had statistically significant pre-post differences in employment and post-secondary education enrollment at all three follow-up points., Conclusion: Results suggest that CAP graduates can and do provide valuable mental health services to other consumers.

Aim: The purpose of this study was to evaluate the reliability and validity of an instrument used to measure nursing workload of federally mandated assessments. Specifically, the instrument measures the nursing workload of the resident assessment instrument the mandated assessment tool used in nursing facilities., Background: It is imperative that nursing managers and nurse executives in health care organizations have a process to budget Registered Nurse full-time equivalents required for federally mandated assessments., Methods: The sample (N=48) included nursing facility minimum data set Coordinators. Reliability and validity scores of the nursing workload instrument are calculated using Pearson correlation coefficients (r)., Results: The nursing workload instrument demonstrated reliability and validity. Total nursing workload to complete the minimum data set for nursing facilities is summarized., Conclusion: The results provide support for a reliable and valid instrument to measure nursing workload for standardized minimum data set assessments.

Purpose: We designed this study to examine the reliability of the nursing home survey process in the state of Kansas using regular and simultaneous survey teams. In particular, the study examined how two survey teams exposed to the same information at the same time differed in their interpretations., Design and Methods: The protocol for simultaneous surveys consists of having one in-region and one out-of-region team survey a facility together., Results: The regular and simultaneous survey teams generally agreed about the number of deficiencies. The intraclass correlation coefficient was 0.87 for total deficiencies and 0.76 for deficiencies with scores of G or higher. But in a substantial number of instances the teams did not agree about the scope and severity of the deficiency or about what regulation the nursing home had breached., Implications: The survey process is reliable when assessing aggregate results, but it is only moderately reliable when examining individual citations. Stakeholders (i.e., consumers, policy makers, nursing home administrators) should be aware of the limitations of the survey process. It needs to be modified to reduce variability.

Objective: The purpose of this study was to explore the perceptions and knowledge of, and access to, Papanicolaou (Pap) testing among Hispanic and Native-American women., Design: A cross-sectional descriptive study was conducted by surveying Hispanic and Native-American women. The survey was developed with the constructs of the Preventive Health Model and was designed to assess background characteristics, representation factors, social influence factors, and program factors among Hispanic and Native-American females., Participants: Hispanic (n=48) and Native-American (n=68) women aged 18 to 89 years., Setting: The surveys were distributed in several community health event sites throughout the Kansas City Metropolitan Area., Main Outcome Measures: The primary response (dependant) variables include knowledge, cervical screening intentions, and perceptions regarding the use of the Pap test., Results: Most of the women surveyed (97%) had heard about Pap testing and reported having had a Pap test. Abnormal Pap test results were reported by 36% of the respondents. Acculturation and less income were significant factors in whether respondents could afford a Pap test, had health insurance, had a regular healthcare provider, and worried that a Pap test would uncover cervical cancer. Income was additionally related to having a doctor recommend Pap testing, the ability to get to the doctors' office during office hours, and fear of a cervical cancer diagnosis., Conclusion: Acculturation (or language) and income were determinants of Pap screening behavior among Native-American and Hispanic women.

Consumers providing direct services at mental health centers contribute positive qualities to the service delivery system; however, there are few instructional programs to prepare consumers for these roles. Of the few consumer-provider training programs that exist, those conducting research have focused on employment and hospitalization outcomes. No program has researched changes in students' perceptions of subjective well-being. Research with students in the Kansas Consumer as Provider (CAP) training program found significant differences in students' perception of hope, self-esteem, and recovery after the training program.

Despite increased attention to consumer-providers, there remains a lack of models that prepare, support, and sustain consumers in provider roles. This article describes the Consumer as Provider (CAP) Training program at the University of Kansas School of Social Welfare, which creates opportunities for individuals with severe psychiatric disabilities to develop knowledge and skills to be effective as human service providers. CAP fosters a partnership between colleges and community mental health centers where students experience classroom and internship activities. Outcome from a 2-year longitudinal study on CAP graduates indicates increased employability, especially in social services field, and higher post-secondary educational involvement.

Background: Chronic fatigue syndrome (CFS) is a debilitating illness with no known cause or effective therapy. Population-based epidemiologic data on CFS prevalence and incidence are critical to put CFS in a realistic context for public health officials and others responsible for allocating resources and for practicing physicians when examining and caring for patients., Methods: We conducted a random digit-dialing survey and clinical examination to estimate the prevalence of CFS in the general population of Wichita, Kan, and a 1-year follow-up telephone interview and clinical examination to estimate the incidence of CFS. The survey included 33 997 households representing 90 316 residents. This report focuses on 7162 respondents aged 18 to 69 years. Fatigued (n = 3528) and randomly selected nonfatigued (n = 3634) respondents completed telephone questionnaires concerning fatigue, other symptoms, and medical history. The clinical examination included the Diagnostic Interview Schedule for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, laboratory testing, and a physical examination., Results: The overall weighted point prevalence of CFS, adjusted for nonresponse, was 235 per 100,000 persons (95% confidence interval, 142-327 per 100,000 persons). The prevalence of CFS was higher among women, 373 per 100,000 persons (95% confidence interval, 210-536 per 100,000 persons), than among men, 83 per 100,000 persons (95% confidence interval, 15-150 per 100,000 persons). Among subjects nonfatigued and fatigued for less than 6 months, the 1-year incidence of CFS was 180 per 100,000 persons (95% confidence interval, 0-466 per 100,000 persons)., Conclusions: Chronic fatigue syndrome constitutes a major public health problem. Longitudinal follow-up of this cohort will be used to further evaluate the natural history of this illness.

Nurses in practice have verified the need for nursing education curricula to include content related to care of the dying patient. Nurse educators are initiating curricular changes to assure students have the knowledge and attitudes needed to provide quality care at the end of life. The authors discuss one university undergraduate program's development of both a theory and practicum course.

This is a brief review of the process the Kansas State Board of Nursing would utilize when investigating a complaint and determining discipline against a licensee, and does not include all points of law that could apply. Although the Kansas Administrative Procedures Act was discussed, there are many sections of the statute that were not addressed. The Board of Nursing has published two pamphlets "Your Rights Before the Kansas State Board of Nursing" and "The Investigative Process" which are valuable to the nurse in understanding the process. These are available on the KSBN's website www.ksbn.org or by mail.