The Impact of COVID-19 on Pre-K-12 Students and Staff in a Mid-sized Metropolitan Area

Objective: During fall 2020, schools used a variety of learning modes based on anticipated risk of viral transmission within schools. Methods: De-identified SARS-CoV-2 data from 11 school districts in the Wichita, Kansas metropolitan area from August 1 to November 15, 2020, was collated for analysis. The Sedgwick County Health Department (SCHD) and Kansas Department of Health and Environment (KDHE) databases were accessed for community-level and contact tracing data. Results: Altogether, 13,573 staff and 54,479 students receiving full or partial on-site (hybrid) education were included. Few students (1.4%) or staff (4.7%) tested positive for SARSCoV- 2. District rates varied from 0.1% to 3.3% in students and 0.7% to 8.7% in staff. Students in grades 9-12 had a higher rate of positive tests and cases were more likely linked to school-based exposure. Staff rate by grade level did not show an identifiable trend; staff rates were higher in nonattendance centers. Conclusions: Low SARS-CoV-2 student case rates suggests on-site learning formats may be appropriate. School trends reflected community rate reinforcing that communitylevel interventions are necessary to decrease transmission. As new variants arise, transmission characteristics must be studied. Health and education partnership is important to ensure the greatest well-being for students and staff.

Great Plains

The chapter “Great Plains” explains about scientific and technological sites of adult interest in Kansas, Missouri, Nebraska, North Dakota, Oklahoma, and South Dakota, including Sedgwick County Zoo, Glore Psychiatric Museum, Hastings Museum, Theodore Roosevelt National Park, Woolaroc, and Mammoth Site. The traveler is provided with essential information, including addresses, telephone numbers, hours of entry, handicapped access, dining facilities, dates open and closed, available public transportation, and websites. Nearly every site included here has been visited by the authors. Although written with scientists in mind, this book is for anyone who likes to travel and visit places of historical and scientific interest. Included are photographs of many sites within each state.

Assessing Loneliness and Other Types of Emotional Distress among Practicing Physicians

Introduction. Loneliness has been linked to clinician burnout and other types of emotional distress. Research assessing the prevalence of loneliness among physicians is growing. Little is known, however, about how loneliness relates to other types of emotional distress among practicing physicians. The objectives of the study were to determine the prevalence of loneliness, and to explore the relationship between loneliness, burnout, depressive symptoms, and suicidal ideation among active member physicians of the Medical Society of Sedgwick County (MSSC). Methods. The study involved a convenience sample of 197 practicing physicians who were active members of the MSSC. The 3-item University of California, Los Angeles Loneliness Scale, the Abbreviated Maslach Burnout Inventory, and 2-item Primary Care Evaluation of Mental Disorders Patient Health Questionnaire were used to measure prevalence of loneliness, manifestations of burnout, and symptoms of depression, respectively. Results. Using an email survey, 442 practicing physicians received an invitation to participate; 197 (44%) completed the survey. The prevalence of loneliness was 43%. Loneliness prevalence was associated positively with age (p = 0.017) and more likely in those who reported manifestations of burnout (p < 0.01) or screened positive for depression (p < 0.01). Depression (OR = 2.24; 95% CI, 0.97-5.19) and emotional exhaustion (OR = 1.05; 95% CI, 0.39-2.84) were significantly associated with loneliness, including when adjusted for participants’ sex, age, and duty hours. Conclusion. Loneliness is prevalent among active member physicians of the Medical Society of Sedgwick County. Given that loneliness is associated with burnout and other emotional distress, there is an important need to understand its implications better.

Burnout and Quality of Life among Active Member Physicians of the Medical Society of Sedgwick County

Introduction. The medical literature suggests disturbingly high ratesof burnout among US physicians. The objective of this study was todetermine the rates of burnout, other forms of distress, and overallquality of life among physicians in Sedgwick County.Methods.xThe study involved a convenience sample of 197 physicianswho were active member physicians of the Medical Society of SedgwickCounty (MSSC). Between July and August 2018, we surveyed872 physicians who were active members of the MSSC. The surveyassessed manifestations of burnout, symptoms of depression and suicidalideation, fatigue, and quality of life. The authors used standarddescriptive summary statistics, Mann-Whitney U test/independentsamples t-Test, Fisher’s exact test, and correlations to analyze thedata.Results. The participation rate was 44.6%, with 49.5% of therespondents reporting manifestations of burnout. Although 85% ofthe participants rated their overall quality of life as good/very good,45% screened positive for depression, 5% had thoughts of suicideduring the past year, and 44% reported excessive fatigue during thepast week. Those with manifestations of burnout were 2.13 (100%vs 46.9%, p < 0.01) times more likely to report thoughts of suicidalideation, 2.43 (72.6% vs 30.4%; p < 0.001) times more likely to screenpositive for depression, and 1.89 (67.5% vs 35.8%; p < 0.001) timesmore likely to have high degrees of fatigue. All of the participants whohad suicidal ideation reported manifestations of burnout.Conclusions. Burnout was prevalent among active member physiciansof the MSSC. Burnout among the participants was associatedwith symptoms of depression, fatigue, suicidal ideation, and intentionof leaving the medical profession via early retirement and/or careerchange. Kans J Med 2019;12(2):33-39.

Maternal Knowledge, Attitudes, and Practices Concerning Interpregnancy Interval

Introduction. Few studies have examined maternal intentions andpractices related to interpregnancy interval (IPI). IPI less than 18months has been linked to increased preterm birth and infant mortality.This manuscript reports on a cross-sectional survey of mothersconducted to understand maternal knowledge, attitudes, and practiceof IPI in Sedgwick County, Kansas. Methods. New and expectant mothers and mothers of neonatalinfant care unit (NICU) graduates (n = 125) were surveyed regardingthe issues surrounding IPI. Front desk staff handed out self-administeredsurveys, which were returned to a nurse upon completion.NICU participants were emailed a link to the survey hosted on SurveyMonkey®. Results. Fewer than 30% of mothers reported previously receivinginformation about IPI from any source. When asked about risks associatedwith IPI, women frequently (n = 58, 45%) identified increasedrisk for birth outcomes with no known association with short IPI.Findings regarding maternal attitudes surrounding optimal IPI weremixed with many mothers defining ideal IPI as less than 18 months(n = 52, 42%), while broadly reporting they believed that a woman’sbody needs time to heal between pregnancies. Respondents from theNICU sample generally reported shorter optimal IPI values than theother participants. When IPI was estimated from participants’ pastpregnancies, half of IPIs were less than 18 months. Mothers reportedthey favored healthcare providers as a source for IPI education. Faceto-face discussions or printed materials were the preferred modes ofeducation. Conclusions. Women were aware of the need for spacing betweenpregnancies, however, that knowledge was unassociated with pastbehavior. These findings should be taken into consideration whenformulating future interventions. Kans J Med 2018;11(4):86-90.

Lead Poisoning Surveillance: A Collaborative Effort between Epidemiology and WIC

IntroductionThere is no safe level of lead in the body, and elevated lead inchildren can lead to decreased Intelligence Quotients (IQ) andbehavioral problems. The American Academy of Pediatricsrecommends lead testing of children with a positive risk assessment.Children who live in low socioeconomic areas may be at higher riskfor lead exposure. As recent events have shown, having an elevatedlead poisoning surveillance system can be critical to ensure that thereis not a community-wide lead exposure. To reach the children thatmay not have been screened by a primary care physician, on March1, 2016 the Sedgwick County Health Department Women, Infants,and Children (WIC) program began offering lead screenings to allchildren in the WIC program and their mothers. Per Centers forDisease Control and Prevention (CDC) guidelines, the SedgwickCounty Health Department Epidemiology program (Epi) investigatesanyone who has an elevated blood lead test (5μg/dL or greater).There are two types of lead tests – screening (capillary finger stick)and confirmatory (venous blood draw).MethodsSedgwick County WIC clients are offered screening lead testingat their WIC appointments. Education to reduce lead exposure isprovided at the time the test is performed. The filter papers used in thistesting are sent to the Kansas Health and Environmental Laboratories(KHEL) for analysis, and the results are reported to Epi. Epi reportsthe lead testing results to WIC, who track the results in their patientcharts. Epi receives KHEL results of <5μg/dL via fax and resultsof >= 5μg/dL via electronic laboratory reporting in the EpiTraxdisease investigation software maintained by the Kansas Departmentof Health and Environment. Epi notifies any WIC clients with results>= 5μg/dL, while WIC staff notify all other clients about their results.Education is provided to the client a second time by Epi staff and/ora WIC nurse or dietician. For clients with elevated blood lead tests,Epi interviews the case or guardian using an enhanced blood leadexposure questionnaire which asks about potential lead exposures,both in the home and at other locations (work, hobbies, etc.). If only ascreening test was performed, Epi recommends confirmatory testing.WIC lead testing program measures, including types of exposuresidentified, are monitored over time using data obtained from EpiTrax.ResultsBetween March 1 and July 21, of the 2,150 WIC clients offeredlead testing, 89% self-reported never having received a lead testpreviously. Of the 1,427 clients with WIC lead screening results,seven cases of elevated blood lead were identified. Of the seven, fivedid not have a previous elevated lead test in EpiTrax. The averagescreening test result was 8.6μg/dL (range 6.8 to 13.4). The averageage of the cases was 2 years (range 1-4). Of the seven cases, two(29%) were confirmed as 10.0 and 11.0μg/dL through venous testingat their primary care provider’s office. The remaining five cases havenot received confirmatory testing. One of the three cases interviewedreported that their babysitter lived in an old home, which could bethe source of lead exposure. While interviewing a child’s guardianabout an elevated 2016 test (7.9μg/dL), Epi discussed a previous2015 elevated lead test (6.0μg/dL) of which the client’s guardianwas unaware.ConclusionsThe ease of access to lead testing in the Sedgwick County WICprogram and the joint effort between WIC and Epi to implement anenhanced lead poisoning surveillance system identified six childrenwith elevated lead levels whose guardians did not know they hadelevated lead levels. This new surveillance program educates WICparents about lead, determines the lead levels in children for guardianknowledge (low level) and further follow-up (elevated level), andidentifies lead exposures of WIC children with elevated lead tests.