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PubMed2004

Asthma prevalence and morbidity among rural Iowa schoolchildren.

BACKGROUND: There are conflicting findings about the prevalence of asthma among farm and nonfarm children. OBJECTIVES: We sought to estimate asthma prevalence and morbidity and determine differences between farm and nonfarm children. METHODS: The study population consisted of all children aged 6 to 14 years enrolled in 10 school districts in 2 noncontiguous rural Iowa counties from 2000 through 2002. The mailed parental screening questionnaire included the International Study of Asthma and Allergies in Childhood core questionnaire, items from the Functional Severity Index, and items on physician diagnosis and medication and urgent care use. RESULTS: The response rate was 86.6%. The 12-month prevalence of wheeze was 19.1%. Self-reported physician diagnosis of asthma was reported by 13.4%. On multivariable analysis controlling for age, sex, and county, children who lived on farms were less likely than those who lived in town to have ever wheezed (odds ratio, 0.71; 95% CI, 0.58-0.87) or to have wheezed during the past year (odds ratio, 0.77; 95% CI, 0.60-0.98). However, this protective association with farming was only observed in one of the study counties. Among those who wheezed, farm and nonfarm children were equally likely to have been given a diagnosis of asthma and had comparable morbidity. CONCLUSION: By using a standardized questionnaire with a high response rate in this large, rural, population-based study, asthma prevalence rivaled that in large Midwestern cities. Unmeasured risk factors might account for the apparent protective effect in Keokuk County. These findings cast doubt on a protective effect of rural life for the development of childhood asthma.

Adolescent↗
PubMed2004

Microbiological evaluation of foodservice contact surfaces in Iowa assisted-living facilities.

A study of 40 assisted-living facilities in Iowa was conducted to assess the microbiological quality of food-contact surfaces (work tables/counters, cooking equipment such as mixing bowls, and cutting boards) and a surface that could cross-contaminate food (refrigerator or freezer handles) to determine the effectiveness of cleaning and sanitation. Standards were set for foodservice for aerobic plate count, Enterobacteriaceae, and Staphylococcus aureus . Two facilities met standards for all five surfaces for each of the three tests. Fewer facilities met the standard for aerobic plate count than for the other two tests, and nearly three fourths of the facilities failed to meet the aerobic plate count for cutting boards. Critically, cross-contamination from these surfaces could result in contamination of food; thus, attention needs to be given to training and supervision to ensure proper hand washing and appropriate cleaning and sanitation procedures to reduce or eliminate cross-contamination.

Assisted Living Facilities↗
PubMedDate not supplied

Association of knowledge of adult protective services legislation with rates of reporting of abuse in Iowa nursing homes.

OBJECTIVE: To determine if there is an association between abuse reporting to state authorities by nursing home administrators and directors of nursing and their characteristics and knowledge of the law. DESIGN: Survey. SETTING: Iowa's 409 Medicare certified nursing homes. PARTICIPANTS: Four hundred nine administrators and 409 directors of nursing. MEASUREMENTS: Nursing home abuse incidents, reports, and substantiations, Medicare's Nursing Home Compare Reports, Urban Influence Codes, and county census demographics. RESULTS: A single or double response was received from 369 (90%) of the 409 nursing homes. Being a male administrator and having a higher level of education is associated with higher substantiation rates. A greater knowledge of the dependent adult protective services law is associated with higher incident and report rates for directors of nursing. CONCLUSIONS: Nursing home administrators' and directors of nursing's knowledge of the law and their characteristics are associated with nursing home incident, report, and substantiation of abuse allegations.

Adult↗
PubMedDate not supplied

Weight management strategies reported by rural men and women in Iowa.

OBJECTIVE: This study compares the specific behavioral strategies that rural men and women use when trying to lose weight. DESIGN: A cross-sectional, in-person survey. SETTING: Participants were part of a larger study in rural Iowa (n = 407) intended to identify community health promotion issues. PARTICIPANTS: 184 adults (56 men, 128 women) who reported currently trying to lose weight VARIABLES MEASURED: Measures capture strategies for dealing with the social environment, food choice and preparation, physical activity planning, social support, self-efficacy, outcome expectations, dietary intake and physical activity level. ANALYSIS: T-tests, chi-square, Cronbach alpha, descriptive statistics. RESULTS: Women reported greater use of nearly all strategies measured. Men reported more social support for diet, whereas women reported more social support for physical activity. Results for self-efficacy and outcome expectations were mixed. No gender differences were found for fat intake, fruit and vegetable servings, or physical activity level. CONCLUSIONS AND IMPLICATIONS: Men and women differ in the specific strategies they use to lose weight, including those related to the social environment. Practitioners planning weight management programs should be aware that men and women may have different levels of experience in using specific behavioral strategies.

Adult↗
PubMed2002

Cigarette smoking and the risk of rheumatoid arthritis among postmenopausal women: results from the Iowa Women's Health Study.

PURPOSE: To determine whether cigarette smoking increases the risk of rheumatoid arthritis among postmenopausal women. SUBJECTS AND METHODS: We followed a cohort of 31 336 women in Iowa who were aged 55 to 69 years in 1986 and who had no history of rheumatoid arthritis. Through 1997, 158 cases of rheumatoid arthritis were identified and validated based on review of medical records and supplementary information provided by physicians. Multivariable Cox proportional hazards regression was used to derive rate ratios (RRs) and 95% confidence intervals (CIs) for the association between cigarette smoking and rheumatoid arthritis. RESULTS: Compared with women who had never smoked, women who were current smokers (RR = 2.0; 95% CI: 1.3 to 2.9) or who had quit 10 years or less before study baseline (RR = 1.8; 95% CI: 1.1 to 3.1) were at increased risk of rheumatoid arthritis, but women who had quit more than 10 years before baseline were not at increased risk (RR = 0.9; 95% CI: 0.5 to 2.6). Both the duration and intensity of smoking were associated with rheumatoid arthritis. Multivariable adjustments for age, marital status, occupation, body mass index, age at menopause, oral contraceptive use, hormone replacement therapy, alcohol use, and coffee consumption did not alter these results. CONCLUSION: These results suggest that abstinence from smoking may reduce the risk of rheumatoid arthritis among postmenopausal women.

Aged↗
PubMed2000

Herbicides and herbicide degradates in shallow groundwater and the Cedar River near a municipal well field, Cedar Rapids, Iowa.

Water samples were collected near a Cedar Rapids, Iowa municipal well field from June 1998 to August 1998 and analyzed for selected triazine and acetanilide herbicides and degradates. The purpose of the study was to evaluate the occurrence of herbicides and herbicide degradates in the well field during a period following springtime application of herbicides to upstream cropland. The well field is in an alluvial aquifer adjacent to the Cedar River. Parent herbicide concentrations generally were greatest in June, and decreased in July and August. Atrazine was most frequently detected and occurred at the greatest concentrations; acetochlor, cyanazine and metolachlor also were detected, but at lesser concentrations than atrazine. Triazine degradate concentrations were relatively small (< 0.50 microg/l) and generally decreased from June to August. Although the rate of groundwater movement is relatively fast (approx. 1 m per day) in the alluvial aquifer near the Cedar River, deethylatrazine (DEA) to atrazine ratios in groundwater samples collected near the Cedar River indicate that atrazine and DEA probably are gradually transported into the alluvial aquifer from the Cedar River. Deisopropylatrazine (DIA) to DEA ratios in water samples indicate most DIA in the Cedar River and alluvial aquifer is produced by atrazine degradation, although some could be from cyanazine degradation. Acetanilide degradates were detected more frequently and at greater concentrations than their corresponding parent herbicides. Ethanesulfonic-acid (ESA) degradates comprised at least 80% of the total acetanilide-degradate concentrations in samples collected from the Cedar River and alluvial aquifer in June, July and August; oxanilic acid degradates comprised less than 20% of the total concentrations. ESA-degradate concentrations generally were smallest in June and greater in July and August. Acetanilide degradate concentrations in groundwater adjacent to the Cedar River indicate acetanilide degradates are transported into the alluvial aquifer in a manner similar to that indicated for atrazine and DEA.

Acetamides↗
PubMed2001

Risk factors for injury in rural Iowa: round one of the Keokuk County Rural Health Study.

BACKGROUND: Unintentional injuries represent a major cause of morbidity and mortality in rural communities. This study aimed to determine the distribution of injury risk factors in a rural Iowa community and to identify the rural subgroups at highest risk for injury. METHODS: We reported on 1583 participants, aged > or =25 years, from Round One of the Keokuk County Rural Health Study, a longitudinal panel study of a rural community. The self-reported data were collected during face-to-face interviews. RESULTS: Our data suggested that several risk factors for injury are not uniformly distributed among rural populations. Male farmers were significantly less likely to wear their seatbelts than townspeople or rural nonfarmers. However, farm women were as likely to wear seatbelts as other women. Both male and female farmers were more likely to use all-terrain vehicles than townspeople or rural nonfarmers. In contrast, townspeople were more likely to ride bicycles than either farmers or rural nonfarmers. Townspeople were less likely to have firearms in their homes than either farmers or rural nonfarmers. Farmers were most likely to have fired a gun in the last year. Male farmers aged <65 years were less than half as likely as other men the same age to report a history of alcohol abuse. Binge drinking was equally frequent among farmers, rural nonfarmers, and townspeople. CONCLUSIONS: These differences in risk behavior in a rural county suggest the possibility of targeting specific rural injury prevention interventions at those with the highest risk for dangerous behavior.

Adult↗
PubMed2000

Lifestyle and anthropometric risk factors for prostate cancer in a cohort of Iowa men.

PURPOSE: Several lines of evidence suggest that prostate cancer has a hormonal etiology. We evaluated factors known to modulate the endocrine system, including alcohol and tobacco use, physical activity, and obesity as risk factors for prostate cancer. METHODS: Cancer-free controls who participated in a population-based case-control study from 1986-1989 (81% response rate) were followed through 1995 for cancer incidence by linkage to the Iowa Cancer Registry; 101 incident prostate cancers were identified. RESULTS: Compared with non-users of alcohol, men who consumed <22 grams alcohol per week (relative risk [RR] = 1.1; 95% Confidence Interval [CI] 0.6-2.1), 22-96 grams alcohol per week (RR = 2.6; 95% CI 1.4-4. 6) and >96 grams alcohol per week (RR = 3.1; 95% CI 1.5-6.3) were at increased risk of prostate cancer after adjustment for age, family history of prostate cancer, body mass index, total energy, and intake of carbohydrate, linoleic acid, lycopene, retinol, and red meat (p for trend < 0.0001). The respective RRs were similar when assessing type of alcohol consumed (beer, wine or liquor) or when well-differentiated, localized tumors were excluded. Body mass index was only weakly and positively associated with prostate cancer after adjustment for age, but this association strengthened after multivariate adjustment and exclusion of well-differentiated, localized tumors. For the latter tumors, men with a BMI of 24.1-26.6 kg/m(2) and >26.6 kg/m(2) were at elevated risk compared to men with a BMI <24.1 kg/m(2). Tobacco use (cigarettes, cigar/pipe, chewing tobacco and snuff use), height, weight, and both leisure and occupational physical activity were not associated with risk of prostate cancer in this cohort. CONCLUSIONS: These data suggest that in white men obesity is a risk factor for more clinically significant prostate cancer and confirm limited previous reports showing that alcohol consumption is positively associated with prostate cancer and that this risk is not limited to any specific type of alcohol.

Adult↗
PubMed1993

Psychogeriatric outreach to rural families: the Iowa and Virginia models.

Elderly residents of rural areas are at significant risk for mental health problems, yet have less access to mental health services. Thus, most mental health problems among rural elderly remain either undiagnosed or untreated. We describe two models of mental health outreach programs to rural elderly in Iowa and Virginia, serving demographically, culturally, and epidemiologically different populations in geographically and economically dissimilar regions. Programs are compared on the basis of initiation, community partnerships, target population, target region, clinical disciplines involved, coordinating discipline, referral sources, operational model, initial home assessment, care planning, sustainability, cost, patient demographics, and primary and secondary diagnosed. Outreach programs are argued to be effective models of delivering services to geographically and/or socially isolated elderly populations. The experiences of our programs, though limited to rural populations, may be of relevance to any outreach program attempting to serve elderly presenting with or at risk for mental health problems.

Aged↗
PubMed2003

Watershed vulnerability to herbicide transport in northern Missouri and southern Iowa streams.

Herbicide contamination of streams has been well documented, but little is currently known about the specific factors affecting watershed vulnerability to herbicide transport. The primary objectives of this study were (1) to document herbicide occurrence and transport from watersheds in the northern Missouri/southern Iowa region; (2) to quantify watershed vulnerability to herbicide transport and relate vulnerability to soil properties; and (3) to compute the contribution of this region to the herbicide load of the Missouri and Mississippi Rivers. Grab samples were collected under baseflow and runoff conditions at 21 hydrologic monitoring stations between April 15 and July 15 from 1996 to 1999. Samples were analyzed for commonly used soil-applied herbicides (atrazine, cyanazine, acetochlor, alachlor, metolachlor, and metribuzin) and four triazine metabolites (deisopropylatrazine, deethylatrazine, hydroxyatrazine, and cyanazine amide). Estimates of herbicide load and relative losses were computed for each watershed. Median parent herbicide losses, as a percentage of applied, ranged from 0.33 to 3.9%; loss rates that were considerably higher than other areas of the United States. Watershed vulnerability to herbicide transport, measured as herbicide load per treated area, showed that the runoff potential of soils was a critical factor affecting herbicide transport. Herbicide transport from these watersheds contributed a disproportionately high amount of the herbicide load to both the Missouri and Mississippi Rivers. Based on these results, this region of the Corn Belt is highly vulnerable to transport of herbicides from fields to streams, and it should be targeted for implementation of management practices designed to reduce herbicide losses in surface runoff.

Agriculture↗
PubMed2005

Gas-phase concentrations of current-use pesticides in Iowa.

Local and regional atmospheric transport of current-use pesticides is an important source of these compounds to nontarget plants and ecosystems. Current-use pesticides were measured at urban, rural, and suburban sites in eastern Iowa during 2000-2002. The most detected compounds were hexachlorobenzene and trifluralin, which were found in 89% and 78% of the samples, respectively. As expected, many pesticides showed a strong seasonal trend with the most detections and highest concentrations occurring during the spring and early summer. The average detected concentrations of five heavily used herbicides were 0.52 ng/ m3 for trifluralin, 4.6 ng/m3 for acetochlor, 2.3 ng/m3 for metolachlor, 1.1 ng/m3 for alachlor, 1.7 ng/m3 for pendimethalin, and 1.2 ng/m3 for atrazine. The most frequently detected insecticides were phorate and chlorpyrifos, which were found in 20% and 19% of the samples, respectively. The average phorate and chlorpyrifos concentrations were 25 ng/m3 and 1.0 ng/m3, respectively. The maximum phorate concentration, the highest measured for all pesticides, was 91.2 ng/m3. The most frequently detected current-use fungicides were chloroneb and etridiazole, which were found in 14% and 10% of the samples, respectively.

Air Pollutants↗
PubMed2006

Concentrated animal feeding operations, row crops, and their relationship to nitrate in eastern Iowa Rivers.

Concentrated animal feeding operations (CAFO) and fertilizer application to row crops may contribute to poor water quality in surface waters. To test this hypothesis, we evaluated nutrient concentrations and fluxes in four Eastern Iowa watersheds sampled between 1996 and 2004. We found that these watersheds contribute nearly 10% of annual nitrate flux entering the Gulf of Mexico, while representing only 1.5% of the contributing drainage basin. Mass budget analysis shows streamflow to be a major loss of nitrogen (18% of total N output), second only to crop harvest (63%). The major watershed inputs of nitrogen include applied fertilizer for corn (54% of total N input) and nitrogen fixation by soybeans (26%). Despite the relatively small input from animal manure (approximately 5%), the results of spatial analysis indicate that row crop and CAFO densities are significantly and independently correlated to higher nitrate concentration in streams. Pearson correlation coefficients of 0.59 and 0.89 were found between nitrate concentration and row crop and CAFO density, respectively. Multiple linear regression analysis produced a correlation for nitrate concentration with an R2 value of 85%. High spatial density of row crops and CAFOs are linked to the highest river nitrate concentrations (up to 15 mg/L normalized over five years).

Agriculture↗
PubMed1998

Diet and risk of colon cancer in a large prospective study of older women: an analysis stratified on family history (Iowa, United States).

OBJECTIVE: The purpose was to investigate whether dietary associations with risk of colon cancer in women differ by family history of the disease. METHODS: Data were analyzed from a prospective cohort study of 35,216 Iowa (United States) women aged 55 to 69 years at baseline. Through 31 December 1995, 241 colon cancers were identified through record linkage with the State Health Registry. The cohort was stratified on family history of colon cancer in first-degree relatives; nutrient intakes were divided into tertiles. RESULTS: Analyses using Cox regression revealed that the association of most dietary components with colon cancer incidence were similar for individuals with and without a family history. However, total calcium intake was associated inversely with colon cancer among women with a negative family history (relative risk [RR] = 0.50 for upper cf lower tertile, P < 0.001), but was unrelated to incidence for women with a positive family history (RR = 1.1 for upper cf lower tertile, P = 0.69). Similarly, total vitamin E intake was associated with lower risk among women with a negative family history (RR = 0.67 for upper cf lower tertile, P = 0.04), but not among women with a positive family history (RR = 0.87 for upper cf lower tertile, P = 0.67). High intakes of fiber, fruits, and vegetables were each weakly inversely associated with risk among family-history negative women, but not among family-history positive women. CONCLUSIONS: These data, if corroborated, suggest that dietary factors typically associated with lower risk may be less effective risk-reduction interventions against colon cancer for individuals with a family history of colon cancer.

Age Factors↗
PubMed1998

Retrospective temporal and spatial mobility of adult Iowa women.

Human exposure assessments require a linkage between toxicant concentrations in occupied spaces and the receptor's mobility pattern. Databases reporting distinct populations' mobility in various parts of the home, time outside the home, and time in another building are scarce. Temporal longitudinal trends in these mobility patterns for specific age and gender groups are nonexistent. This paper describes subgroup trends in the spatial and temporal mobility patterns within the home, outside the home, and in another building for 619 Iowa females that occupied the same home for at least 20 years. The study found that the mean time spent at home for the participants ranged from a low of 69.4% for the 50-59 year age group to a high of 81.6% for the over 80-year-old age group. Participants who lived in either one- or two- story homes with basements spent the majority of their residential occupancy on the first story. Trends across age varied for other subgroups by number of children, education, and urban/rural status. Since all of these trends were nonlinear, they indicate that error exists when assuming a constant, such as a 75% home occupancy factor, which has been advocated by some researchers and agencies. In addition, while aggregate data, such as presented in this report, are more helpful in deriving risk estimates for population subgroups, they cannot supplant good individual-level data for determining risks.

Adult↗
PubMed2006

Contemplation of moral dilemmas eliminates sex differences on the Iowa gambling task.

Men outperform women on the Iowa Gambling Task (IGT; A. Bechara, H. Damasio, D. Tranel, & A. R. Damasio, 1997). In this study, the authors show that sex differences are not due to differences in general emotional arousal or the abilities to calculate or reverse responses. Imaging studies have shown that, during the IGT, men increase activity in the right dorsolateral prefrontal cortex (PFC) and lateral orbital PFC, whereas women increase activity in the left medial orbital PFC. Deliberation of personal moral (PM) dilemmas also increases activity in medial and lateral dorsal PFC, whereas deliberation of moral impersonal (MI) dilemmas increases activity in lateral dorsal PFC. In the present study, men and women performed the IGT during PM, MI, or control deliberations. Deliberation of only PM dilemmas increased women's IGT performance to the level of men.

Adolescent↗
PubMed2005

Urinary and hand wipe pesticide levels among farmers and nonfarmers in Iowa.

In the spring and summer of 2001, as part of a larger study investigating farm family pesticide exposure and home contamination in Iowa, urine and hand wipe samples were collected from 24 male farmers and 23 male nonfarmer controls. On two occasions approximately 1 month apart, one hand wipe sample and an evening and morning urine sample were collected from each participant. The samples were analyzed for the parent compound or metabolites of six commonly used agricultural pesticides: alachlor, atrazine, acetochlor, metolachlor, 2,4-dichlorophenoxyacetic acid (2,4-D) and chlorpyrifos. For atrazine, acetochlor, metolachlor and 2,4-D, farmers who reported applying the pesticide had significantly higher urinary metabolite levels than nonfarmers, farmers who did not apply the pesticide, and farmers who had the pesticide commercially applied (P-value <0.05). Generally, there were no differences in urinary pesticide metabolite levels between nonfarmers, farmers who did not apply the pesticide, and farmers who had the pesticide commercially applied. Among farmers who reported applying 2,4-D themselves, time since application, amount of pesticide applied, and the number of acres to which the pesticide was applied were marginally associated with 2,4-D urine levels. Among farmers who reported applying atrazine themselves, time since application and farm size were marginally associated with atrazine mercapturate urine levels. Farmers who reported using a closed cab to apply these pesticides had higher urinary pesticide metabolite levels, although the difference was not statistically significant. Farmers who reported using closed cabs tended to use more pesticides. The majority of the hand wipe samples were nondetectable. However, detection of atrazine in the hand wipes was significantly associated with urinary levels of atrazine above the median (P-value <0.01).

Agriculture↗
PubMed2006

Neonatal illicit drug screening practices in Iowa: the impact of utilization of a structured screening protocol.

OBJECTIVE: The purpose of the study was to determine the neonatal illicit drug screening practices of Iowa birthing hospitals. STUDY DESIGN: Cross-sectional survey design was implemented. The impact of structured screening protocols on the numbers of neonates screened and positive testing in 2004 was reviewed. RESULTS: Of 81 birthing hospitals, 53 (65%) participated in the study. Screening and positive test rates were higher in hospitals utilizing a structured screening protocol compared to those not utilizing one (10.9 versus 2.1% and 0.9 versus 0.2%, respectively, P < 0.0001). Hospitals with higher population, numbers of outpatients, inpatients, deliveries, and availability of drug abuse treatment services utilized a structured screening protocol more often. CONCLUSION: Utilization of a structured screening protocol increases the number of neonates screened for illicit drugs and positive testing rate regardless of urbanization. Regional standardization of structured screening protocols may improve the recognition of perinatal illicit drug exposure and provision of treatment services.

Clinical Protocols↗
PubMed2000

The prevalence of radiographically evident mandibular tori in the University of Iowa dental patients.

OBJECTIVES: To evaluate the radiographic prevalence of mandibular tori and to determine the attributes which make tori radiographically evident. METHODS: The prevalence of mandibular tori was determined from 1600 radiographic surveys of patients attending the College of Dentistry, University of Iowa, 200 for each decade of life from the first to the eighth. Dry skulls were evaluated at the National Museum of Natural History. Mandibular tori were measured, classified and radiographed to correlate the radiographic findings with the physical characteristics. RESULTS: Overall, 16.9% of the patient population had radiographically detectable mandibular tori with some cohorts within the population as high as 33%. Lobulated tori extending 4 mm or more mediolaterally were radiographically detectable. CONCLUSIONS: This study revealed one of the higher prevalence rates of mandibular tori in the literature for a population within the United States. Radiographic threshold analysis suggests that this group of Iowans has a high percentage of medium to large discretely lobulated tori.

Adolescent↗