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PubMed1994

Colorado rejects regulations to limit Medicaid coverage for abortion.

In a 3-3 vote on May 19, (1994) the Colorado Social Services Board rejected proposed emergency regulations that would have limited Medicaid coverage for abortions to circumstances in which federal matching funds are available. The regulations were proposed in response to U.S. District Court Judge Edward Nottingham's May 5 ruling, which permanently enjoined a state constitutional amendment and state statutes that prohibit public funds for abortion except where the life of the woman is endangered. Judge Nottingham found that the state measures are invalid because they conflict with the current Hyde Amendment, which provides federal Medicaid funds for abortions in cases of life endangerment, rape, and incest. In the absence of any restrictive provisions, Colorado is required to fund all medically necessary abortions. CRLP (Center for Reproductive Law and Policy), which represented plaintiffs in Hern v. Beye, provided testimony against the proposed emergency regulations during a hearing before the Board vote. Meanwhile, some other states are moving toward complying with federal Medicaid law. The Nebraska Department of Social Services is considering regulations that would extend state funding for abortion to include pregnancies resulting from rape or incest. A May 19 public hearing was held on the proposal, which is awaiting final approval. When the Louisiana legislature convenes for a special session on June 6, Governor Edwin Edwards is expected to introduce a bill to authorize Medicaid coverage for abortions in cases of rape and incest. Finally, Indiana and Ohio are reportedly moving toward compliance with the federal mandate. In contrast, however, Missouri Department of Social Services Director Gary Stangler filed suit in federal court on May 24 against Health and Human Services officials for issuing the federal directive requiring compliance with the Hyde Amendment. Pennsylvania officials filed a similar action in mid-March. Lawsuits filed by CRLP against Arkansas, Louisiana, Michigan, North Dakota, Oklahoma, and Pennsylvania for non-compliance are still pending; similar challenges were also filed by Planned Parenthood in Michigan and Montana.

Abortion, Induced↗
PubMed2002

[Genetic structure of populations of the Colorado potato beetle Leptinotarsa decemlineata (Coleoptera: Chrysomelidae)].

The genetic structure of a Colorado potato beetle population from Kiev oblast was examined by cluster analysis of individual RAPD patterns. The obtained clustering indicates that the population is structured. This may be explained by adaptation to pyrethroid insecticides used for controlling the population size of this pest. Micro-evolutionary factors affecting the genetic structure of local populations of Colorado potato beetle are discussed.

Animals↗
PubMed2004

Manufacturer's recall of rapid cartridge assay kits on the basis of false-positive Cryptosporidium antigen tests--Colorado, 2004.

The Colorado Department of Public Health and Environment (CDPHE) has determined that a fourfold increase in the number of reported cryptosporidiosis cases in Colorado during January-February 2004 might be attributed primarily to false-positive test results. Since January 1, 2004, a total of 13 in-state cases and one out-of-state case were reported to CDPHE. During the previous 7 years, an average of three cases were reported during January-February. In eight of 14 patients, rapid testing was performed by using the ImmunoCard STAT! Cryptosporidium/Giardia Rapid Assay (Meridian Bioscience, Inc., Cincinnati, Ohio). This assay is a solid-phase qualitative immunochromatographic assay designated to detect and distinguish between Giardia intestinalis (lamblia) and Cryptosporidium parvum in aqueous extracts of human fecal specimens. Seven of these samples were tested by using lot no. 081093 (expires August 11, 2004). Of the seven samples that tested positive initially for Cryptosporidium with this lot number, four were retested by using other, more specific tests. One patient sample was positive by direct microscopy, one was negative by direct microscopy, and two were negative by direct fluorescent-antibody testing, suggesting that results for three of the four samples were false positive. The results of testing for Giardia intestinalis (lamblia) with these kits are unclear. Several other states have noted increases in the number of reported cryptosporidiosis cases that also might be associated with use of these rapid assays.

Animals↗
PubMed2006

Hospital choice by rural medicare beneficiaries: does hospital ownership matter?--a Colorado case.

About 45 percent of rural patients in Colorado bypassed their local rural hospitals during the 1990s. The effect of this phenomenon is a reduction in occupancy rates and a decrease in the competitiveness of rural hospitals, thereby ultimately causing rural hospitals to close and adversely affecting the communities that they were designed to serve. This study tests whether hospital ownership affects hospital choice by patients after controlling for institutional and individual dimensions. A conditional logistic regression is used to analyze Colorado Inpatient Discharge Data (CIDD) on 85,529 patients in addition to hospital data. Rural Medicare beneficiaries are influenced to choose a particular hospital by a combination of hospital characteristics (the number of beds, the number of services, accreditation, ownership type, and distance from patient residence) and patient characteristics (medical condition, age, gender, race, and total charge for services). Increasing rural hospitals' survivability, collaborating with other rural hospitals, expanding the number of available services, making strategic alliance with other providers are possible strategies that may help ward off encroachment by urban competitors.

Choice Behavior↗
PubMed2006

Cluster of tick paralysis cases--Colorado, 2006.

Tick paralysis is a rare disease characterized by acute, ascending, flaccid paralysis that is often confused with other acute neurologic disorders or diseases (e.g., Guillain-Barré syndrome or botulism). Tick paralysis is thought to be caused by a toxin in tick saliva; the paralysis usually resolves within 24 hours after tick removal. During May 26-31, 2006, the Colorado Department of Public Health and Environment received reports of four recent cases of tick paralysis. The four patients lived (or had visited someone) within 20 miles of each other in the mountains of north central Colorado. This report summarizes the four cases and emphasizes the need to increase awareness of tick paralysis among health-care providers and persons in tick-infested areas.

Aged↗
PubMed2006

Factors associated with adherence to recommendations for screening mammography among American Indian women in Colorado.

OBJECTIVE: To compare adherence to screening mammography recommendations of American Indian and non-Hispanic White women in the Denver, Colorado, area. DESIGN/SETTING/PARTICIPANTS: This study retrospectively examined adherence patterns in 229 American Indian and 60,197 non-Hispanic White women > or = 40 years and older, with at least one screening mammogram in the Colorado Mammography Project (CMAP), from January 1, 1999, to December 31, 2003. The CMAP was a prospective study of women receiving mammograms at participating clinics around Denver. MAIN OUTCOME MEASURES: Using logistic mixed models, we defined two dependent variables as annual and biennial adherence from the intervals between screening mammograms for each woman. RESULTS: Biennial adherence was substantially higher than annual adherence for both American Indian and non-Hispanic White women in our analyses. American Indian women were less likely than non-Hispanic White women to adhere to biennial recommendations in multivariate models controlling for age, family history of breast cancer, and economic status (zip code): odds ratio (OR) .4 and 95% confidence interval (CI) .2-.6. The association between American Indian race/ethnicity and annual adherence was similar, although not as strong (OR .5, 95% CI .3-.8). CONCLUSIONS: American Indian women in the CMAP cohort were less likely than non-Hispanic White women to adhere to recommendations for screening mammography, both annually and biennially. Additional research is needed to explore the effect of biennial screening and other barriers among American Indian women.

Adult↗
PubMed1991

Work-related aviation fatalities in Colorado 1982-1987.

On-the-job deaths related to aviation are the seventh leading cause of fatal occupational injury in the United States. In Colorado, they comprise 37% of all air transport deaths. A review of all occupational aviation-related fatalities in Colorado during 1982-1987 identified 86 deaths. Data sources were death certificates, Workers' Compensation records, and National Transportation Safety Board reports. Of the fatalities, 5 involved commercial air service, 16 were military personnel, and 65 (76%) were associated with general aviation. Non-military occupations included 21 pilots, 5 flight instructors, 4 crop sprayers, and 3 search and rescue workers or firefighters. There were 18 people going to or from work sites. The 15 weather cases, 7 aircraft malfunctions, and 4 power transmission wire strikes were the most significant factors in two-thirds of the crashes of civilian aircraft. Even experienced pilots exercised poor judgement. The prominence of general aviation in work-related aviation fatalities indicates a need for greater attention to the safety of workers whose jobs entail flying.

Accidents, Aviation↗
PubMed1991

Outbreak of Kawasaki syndrome in Denver, Colorado: association with rug and carpet cleaning.

Between October 1984 and January 1985, the largest outbreak of Kawasaki syndrome reported to date in the continental United States (62 cases) occurred in the Front Range of the Rocky Mountains, extending from Colorado Springs, Colorado, to Cheyenne, Wyoming. Fifty-two (84%) of these Kawasaki syndrome patients lived in the Denver metropolitan area. A case-control study revealed that 16 (62%) of 26 Kawasaki syndrome patients compared with 10 (20%) of 49 matched control subjects had a history of exposure to shampooed (19%) or spot-cleaned (81%) rugs or carpets within 30 days of the Kawasaki syndrome onset date (odds ratio = 5, P less than .01). The time of exposure to shampooed or spot-cleaned rugs or carpets for 9 of 10 Kawasaki syndrome patients who had a single exposure and for all 6 Kawasaki syndrome patients who had multiple exposures were clustered within an interval 13 to 30 days before the onset of illness. Although the reason for this unusually large outbreak remains obscure, it is the third in which a statistically significant association between Kawasaki syndrome and rug or carpet cleaning has been found.

Case-Control Studies↗
PubMed1991

Annual disease incidence in Colorado cow-calf herds participating in rounds 2 and 3 of the National Animal Health Monitoring System from 1986 to 1988.

Thirty-nine and 47 randomly selected Colorado cow-calf operations participated in the National Animal Health Monitoring System (NAHMS) during rounds 2 (October 1986 to September 1987) and 3 (October 1987 to September 1988), respectively. Data on the incidence of disease conditions within each herd were collected by federal and state Veterinary Medical Officers and university veterinarians through monthly visits to the ranches. Annual disease incidence for disease classes and the most frequently reported individual disease conditions were determined and expressed on a per 100 cow basis. The mean annual disease incidences for all diseases in these herds were 48.8 and 47.7 new cases per 100 cows for rounds 2 and 3, respectively. The ranges for herd annual disease incidence were wide in both study years. The enteric disease class had the highest mean annual disease incidence in both years of the study, and this was primarily because of diarrhea of unknown cause in calves. Diarrhea of unknown cause accounted for approximately 25% of all new disease cases in both rounds of the study. The mean annual disease incidences were not different for any disease class between the two rounds. The data indicate that, on the average, diarrhea of unknown cause, pneumonia, dystocia, foot rot (interdigital necrobacillosis), pinkeye (infectious keratoconjunctivitis), respiratory tract infection, death of unknown cause, and nonpregnancy had the highest incidences in these Colorado beef herds during the study period. However, because of the wide variation of the predominant disease problems between herds, a herd's disease history as well as the common disease problems in the geographic area of a herd must be considered in designing a herd health program.

Animals↗
PubMed1990

Comparison of pit and fissure sealant utilization by pediatric and general dentists in Colorado.

The purpose of this study was to conduct a survey of Colorado pediatric and general dentists concerning attitudes toward and use of sealants. The survey results indicated that sealants were used in the following manner by pediatric vs. general dentists, respectively: 1) Routinely 73.4% vs. 40.1%; 2) Occasionally 15.6% vs. 32.6%; 3) Seldom 6.6% vs. 10.0%; 4) Do Not Use 4.4% vs. 17.3%. Reasons for limited or non-utilization of sealants by both groups included: 1) Not covered by insurance; 2) Inadvertent sealing in caries; 3) Do not last; 4) Not cost effective. Delegation of primary responsibility for sealant placement differed as follows between pediatric and general dentists, respectively: 1) Dentist 73.3% vs. 64.8%; 2) Hygienist 0% vs. 17.8%; 3) Assistant 26.7% vs. 17.4%. Continuing education courses on sealants had been attended by 62% of pediatric dentists and 16.9% of their auxiliaries and by 29.1% of general dentists and 6.3% of their auxiliaries. Approximately 50% of pediatric and general dentists expressed an interest in attending sealant courses. This study indicates that: 1) Colorado dentists report a relatively high sealant utilization rate. 2) Pediatric dentists place sealants more frequently than general dentists. 3) The most frequent reason for restricting sealant placement was lack of insurance coverage. 4) A need for continuing education of dentists and auxiliaries exists.

Colorado↗
PubMed1986

The management of ruptured abdominal aortic aneurysms in rural Colorado. With a historical note on Kit Carson's death.

Kit Carson died of a ruptured aneurysm in rural Colorado in 1868. Since that time, techniques for management of aortic aneurysms have been developed and disseminated to rural areas with small hospitals. A survey of six Colorado rural hospitals' experience with ruptured abdominal aortic aneurysms is presented. Fifty-seven ruptured aneurysms had been managed during periods ranging from three to ten years. The average time to the operating room was 3.5 to 4.0 hours after hospital arrival and less than 45 minutes after diagnosis. Of those cases arriving with a systolic blood pressure less than 100 mm Hg, the mortality was 56%. The overall mortality was 53%. Groups are analyzed according to preoperative delay, occurrence of shock, and other risk factors. The results are compared with several series from metropolitan hospitals. Techniques of management that are of potential benefit in low-volume vascular case settings are discussed.

Aorta, Abdominal↗
PubMed1979

Tick-borne relapsing fever in Colorado. Historical review and report of cases.

Since 1915 the front range of the Colorado Rocky Mountains has been postulated as a focus of endemic tick-borne relapsing fever. However, the disease has rarely been identified: only two cases have been reported in Colorado since 1944. Three sporadic cases in 1977--tightly grouped geographically and temporally--prompted an epidemiologic review. Tick-borne relapsing fever should be considered in the differential diagnosis of recurrent paroxysmal fever--with or without known presence of ticks--whenever exposure in an endemic area is part of a patient's history.

Adult↗
PubMedDate not supplied

Campylobacter jejuni infection in Colorado: unexplained excess of cases in males.

Between January 1, 1981, and December 31, 1982, the Colorado Department of Health received reports of 1,185 culture-confirmed cases of Campylobacter jejuni infection. Incidence rates were highest among infants less than 1 year old and among persons aged 20-29 years. The distribution of cases by sex showed a predominance among males at all ages except 40-59 years, the most marked predominance occurring in infants under 1 year. The higher rates for males were also significant for all ages combined, for ages 10-19 years, and for ages 5-9 years. Neither Salmonella nor Shigella infections reported in Colorado during the same period showed the preponderance among males found for C. jejuni infections. Giardia infections, however, showed a weak male predominance, especially among children less than 10 years old. The preponderance of C. jejuni cases among males disclosed by this study was remarkable. The reasons for this phenomenon are not clear and need further research.

Adolescent↗
PubMedDate not supplied

Asbestos in Colorado schools.

Forty-one public schools in Colorado were drawn at random and surveyed for asbestos-containing materials. After bulk samples of possible asbestos materials from the schools were collected and analyzed, the K2 asbestos screening test was used to eliminate samples that did not contain asbestos. Samples with positive results on the K2 test were analyzed by an outside laboratory by polarized light microscopy. The risk of potential exposure presented by these materials was then assessed for each site from which a sample was taken. Of 113 samples collected, results were negative for asbestos for only 10.6 percent by the K2 test. Of the 101 samples for which results were positive, 56 actually contained 1 or more forms of asbestos. Twelve of these 56 samples were from sprayed material; the remaining 44 were from other materials containing asbestos. Of the 41 schools sampled, 31 had asbestos materials in one of more locations. The potential exposure values for these materials ranged from very low to very high, but the majority had high-exposure potentials. Estimates based on the survey of the 41 schools indicated that 63 to 89 percent of the public schools in Colorado have asbestos materials that present potentially serious hazards, not only to the children, teachers, and staff, but also to members of the community who use the school buildings after regular school hours.

Asbestos↗
PubMed1994

Injuries among construction workers during the raising of wood-framed walls--Colorado and California.

In Colorado, traumatic spinal cord injuries that produce documentable motor, sensory, bowel, and/or bladder impairments must be reported to the state or local health department. Persons with such injuries are interviewed by staff of the Colorado Department of Public Health and Environment (CDPHE) Spinal Cord Injury Early Notification System (ENS)*; injuries that occur in workplaces are investigated by staff of the CDPHE Sentinel Event Notification System for Occupational Risk (SENSOR) program. This report describes the investigation of a construction-related spinal cord injury reported to the CDPHE SENSOR program on February 8, 1993, and summarizes information about a similar case in California.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Occupational↗
PubMed1994

Interstate measles transmission from a ski resort--Colorado, 1994.

During April 1-May 25, 1994, a chain of measles transmission began in Breckenridge, Colorado, and extended into nine additional states; a total of 247 measles cases were reported, representing 36% of all U.S. measles cases reported to the National Notifiable Diseases Surveillance System (excluding those reported from U.S. territories) through July 2 (week 26). The source of exposure was unknown but is believed to have been an out-of-state tourist who probably visited Breckenridge during March because 1) no measles cases had previously been reported in Colorado during 1994, and 2) the only common exposure appeared to have been at a ski resort visited by many out-of-state travelers. Persons associated with spread of measles from Breckenridge were predominantly school- and college-aged. This report summarizes the investigation of this chain of interstate measles transmission.

Adolescent↗
PubMed1993

Recognition of Hantavirus infection in the rural setting: report of first Colorado resident to survive.

Since May 1993, there has been an outbreak of an acute illness with nonspecific symptoms and signs that rapidly progresses to death. The majority of the cases identified have occurred in the rural southwestern United States, predominantly in the four-corners area comprising New Mexico, Arizona, Utah, and Colorado. Findings of preliminary investigation by the Centers for Disease Control and Prevention suggest that the etiologic agent is a previously unidentified strain of Hantavirus. In reported cases, infection with this virus has a very high mortality. The authors describe the primary care of the first Colorado resident of the four Coloradans infected to survive documented Hantavirus-associated disease. There are potential implications for rural healthcare delivery as rapid recognition and early intervention with supportive care could improve survival.

Adult↗