Kansas Health Institute

Malnutrition in early childhood can hinder children’s development and their potential in their upcoming productive ages. The prevalence of wasting among children under five in Indonesia was 7.4% in 2025. This study developed a complementary feeding product in the form of milk pudding with the addition of mung beans, soybeans, and red beans. The study aimed to analyze the protein content, protein digestibility, and acceptability of the legume-based milk pudding. A completely randomized design (CRD) was used, consisting of treatment groups with the addition of mung beans, soybeans, and red beans (F1, F2, F3) and a control group (FK). Each treatment group was replicated twice, resulting in a total of eight experimental units. The results showed that pudding F2, with the addition of 120 g mung beans, 60 g soybeans, and 120 g red beans, had the highest total protein content (2.80%) and a protein digestibility value of 61.86%. There was a significant difference among groups in total protein content (P = 0.002), but no significant difference in protein digestibility (P = 0.834). The highest acceptance value was found in pudding F3, with color, aroma, texture, and taste scores ranging from 3.13 to 3.80. There were no differences among groups in aroma, taste, and texture (P > 0.05), whereas color showed significant differences among treatment groups (P = 0.001). Milk pudding with mung beans, soybeans, and red beans can serve as an alternative local snack food, contributing approximately 12.25% to the daily protein requirements of toddlers.

Introduction: Takotsubo cardiomyopathy (TC) is characterized by significant transient left ventricular dysfunction that is not due to obstructive coronary artery disease. Acute mitral regurgitation (MR) has been described in previous studies as a complication of TC, but short-term outcomes are not well studied. The aim of our study was to investigate the rates and outcomes of patients diagnosed with TC with acute MR in the Veteran Affairs (VA) system. Methods: We performed a retrospective study using chart review for patients diagnosed with TC between 2005 and 2018 in the VA national database. We included patients who met the Mayo Clinic diagnostic criteria for TC. We collected data for demographics, clinical course, and outcomes. Results: 287 patients (70.7% males) were included, Median age was 64 years, 18.8% were known to have coronary artery disease, 34.1% were diabetic and 60.3% had hypertension. 96% of patients had apical variant of TC. Moderate to severe MR was present in 8.7%; of those 48% were either new or significantly worsened MR when compared to previous echocardiograms prior to TC. MR was mostly diagnosed in patients with apical TC (91.7%). There was no significant difference in the rates of diagnosis of new MR in men compared to women (3.4% vs 6% p=0.34). There was also no significant difference in the in-hospital mortality rates between patients with new moderate-severe MR vs no-trivial MR (0% vs 8.7%, p = 0.61). At 30-day follow up there was no significant difference in mortality rates in patients with moderate-severe MR compared to no-trivial MR (9.1% vs 2.5%, p = 0.22). On follow up echo for patients who survived, all patients had resolution of the MR. Conclusions: In patients diagnosed with TC with new moderate-severe MR, there was no significant difference in mortality rates in the hospital or at 30-day follow up.

Clinical descriptionFreeman-Burian syndrome (FBS) is a rare congenital myopathic craniofacial syndrome. Considerable variability in severity is seen, but diagnosis requires the following: microstomia, whistling-face appearance (pursed lips), H or V-shaped chin defect, and prominent nasolabial folds. Some patients do not have limb malformations, but essentially all do, typically camptodactyly with ulnar deviation of the hand and talipes equinovarus. Neuro-cognitive function is not impaired.EpidemiologyPopulation prevalence of FBS is unknown.AetiologyEnvironmental and parental factors are not implicated in pathogenesis. Allelic variations in embryonic myosin heavy chain gene are associated with FBS. White fibrous tissue within histologically normal muscle fibres and complete replacement of muscle by fibrous tissue, which behaves like tendinous tissue, are observed.ManagementOptimal care seems best achieved through a combination of early craniofacial reconstructive surgery and intensive physiotherapy for most other problems. Much of the therapeutic focus is on the areas of fibrous tissue replacement, which are either operatively released or gradually stretched with physiotherapy to reduce contractures. Operative procedures and techniques that do not account for the unique problems of the muscle and fibrous tissue replacement have poor clinical and functional outcomes. Important implications exist to facilitate patients’ legitimate opportunity to meaningfully overcome functional limitations and become well.

Policy and environmental strategies are part of a comprehensive approach to obesity prevention. We investigated the association between public attitudes about how the environment influences health and support for a sugar-sweetened beverage (SSB) tax in Kansas. We collected data via a 2014 representative dual-frame (cellular and landline) telephone survey of 2,203 adult Kansans regarding healthy eating policy support and beliefs about obesity causes and solutions. A significant proportion of Kansas adults (40%) support an SSB tax. Support was significantly stronger among females, young people, and liberals. Causal and responsibility attributions of obesity were significantly associated with policy support. Individuals who attribute more responsibility for the solution to the obesity epidemic to environmental factors were more likely to support a tax, regardless of their political affiliation. Messaging that focuses on the role of the environment in creating opportunities for health may be useful in framing discussions around SSB taxes.

While many authors have surveyed the contributions of Victor Almon McKusick, MD (21 October 1921-22 July 2008) to establishing the field of medical genetics, no authors have reviewed his significant contributions as an historian to the field of the history of medicine. In discussing relevant biographical themes and their functional influence in his life, his philosophical approach to the study of the history of medicine and his unique historiography, blending various major schools of thought into a hybrid analytical approach to historical research, was evaluated. The evaluation drew on a series of interviews conducted with McKusick in 2004 and 2005, review of a selection of his published historical contributions, and review of secondary sources.

To determine how well the Kansas Clean Indoor Air Act was being observed and enforced. A survey inquired about complaints, citations, and fines or sanctions after the implementation of the Kansas Clean Indoor Air Act; inquiry was also made about the law's effectiveness. Descriptive statistics and Poisson tests of statistical significance were used. Each of the 55 Kansas cities with more than 5000 in population. Law enforcement personnel. Monthly rates of complaints, citations, fines or sanctions, and reports of the law's effectiveness during the 30-month period after implementation of the act. Responses were received from 100% of the sampled cities. The number of citizen complaints and citations decreased over time from 4.33 to 2.42 per month and from 3.17 to 0.92 per month, respectively. The number of fines or sanctions decreased from 1.67 per month to 0.50 per month. In 51 of 55 cities (92.7%), respondents reported that the Kansas Clean Indoor Act appeared to be working effectively. There was a statistically significant difference between the first and second and first and third time periods for citations and fines or sanctions. However, there was only a statistically significant difference between the first and third time periods for citizen complaints. The law appears to be functioning effectively. This approach could be used to supplement measured or self-reported exposures to secondhand smoke in future studies in other jurisdictions, particularly in identifying areas with potential problems. Given the conservative nature of Kansas, adoption of such a law in the remaining states seems realistic.

Individuals with chronic pain often report using cigarettes to cope, and smoking and chronic pain appear prevalent among US veterans. Pain may be a barrier to cigarette cessation and abstinence in this population. Because of physiological effects, smoking cigarettes may also interfere with pain management. A better understanding of how cigarette use relates to pain may assist in veteran cigarette cessation and pain management efforts. To assist these efforts, we searched the literature using keywords, such as "pain," "smoking," and "veteran," to identify 23 journal articles published from 1993 to 2013 that reported on studies examining pain and smoking variables among military or veteran populations. Studies found that veterans reported using cigarettes to cope with pain, there was greater occurrence of pain and disability among smokers in the military, and smoking increased the odds of veterans receiving an opioid prescription for pain and misusing opioids. Studies also found increased odds of pain and smoking among Veterans Health Administration patients with post-traumatic stress disorder when compared with those without post-traumatic stress disorder. Studies support an interaction between pain and smoking among veterans. However, the mechanisms underlying this relationship remain unclear. Future studies focused on this interaction would benefit veteran populations.

This book composes and refi nes numerous ideas I have explored in law review articles and opinion editorials over the past ten years.Since 2000, when I wrote Islam as Intellectual Property, a law review article, my views about Islamic law have taken a clear path that instructs me that divine texts, the Qur'an and the Prophet's Sunnah, must never be confused with opinions of the Prophet's companions and wives, and with the opinions of the founders of Islamic fi qh.I believe that great errors are built upon simple confusions.The doctrine of taqlid is just such a confusion that merged Islamic divine texts with human fi qh.We write this book to reverse the confusion and the consequent error.In doing so, we do not propose to cast away the treasures of fi qh.Fiqh will always remain an integral part of Islamic law.However, fi qh is open to modifi cation and even repeal on a case-by-case basis.We identify contemporary sources of Islamic law, such as constitution, legislation, and case law and propose a simple method, the submission principle, to distinguish between secular law and Islamic law.On another note, I want to thank Professor Hisham Ramadan for supporting this project.

This study estimated the prevalence of twenty-two 12-month and lifetime psychiatric disorders in a sample of 744 low-income pregnant women and the frequency that women with psychiatric disorders received treatment. To identify psychiatric disorders, the Diagnostic Interview Schedule (DIS) was administered to Medicaid or Medicaid-eligible pregnant women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). The sample was stratified by the rural or urban location of the WIC sites in southeastern Missouri and the city of St. Louis. Eligible women were enrolled at each site until their numbers were proportional to the racial distribution of African American and Caucasian pregnant women served there. The 12-month prevalence of one or more psychiatric disorders was 30.9%. Most common were affective disorders (13.6%), particularly major depressive disorder (8.2%) and bipolar I disorder (5.2%). Only 24.3% of those with a psychiatric disorder reported that they received treatment in the past year. Lifetime prevalence of at least one disorder was 45.6%, with affective disorders being the most frequent (23.5%). Caucasian women were more likely than African Americans to have at least one 12-month disorder, with the difference largely accounted for by nicotine dependence. Higher prevalence of lifetime disorders was also found in Caucasian women, particularly affective disorders and substance use disorders. There were no differences in the prevalence of 12-month or lifetime psychiatric disorders by the urban or rural residence of subjects. With nearly one third of pregnant women meeting criteria for a 12-month psychiatric disorder and only one fourth receiving any type of mental health treatment, comprehensive psychiatric screening during pregnancy is needed along with appropriate treatment.