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PubMedDate not supplied

Preparation of a heterogeneous conjugate to detect Mycoplasma iowae by immunofluorescence.

Fluorescent antibody technique has been used as a diagnostic tool for the identification of pathogenic avian Mycoplasma species. Fluorescein-conjugated antisera for Mycoplasma iowae prepared from rabbit hyperimmune serum against one serotype (I) has not always been reliable, giving false-negative results. A fluorescein-conjugated antisera was prepared with antibody against the six identified serotypes (I, J, K, N, Q, and R) that comprise the species M. iowae. This heterogeneous conjugate was used to positively identify M. iowae in field isolates and lab strains, while maintaining specificity. Polymerase chain reaction specific for M. iowae was used to determine specificity.

Animals↗

PubMedDate not supplied

Comparison of strains of Mycoplasma iowae.

Comparison of biochemical test results and protein electrophoretic patterns of 21 strains of Mycoplasma iowae indicated that all were similar. Comparison of agglutination test results indicated marked within-species antigenic variation. None of 21 antigens prepared from different strains were effective in demonstrating turkey antibody against five reference strains. Examination of sera from turkeys exposed by intra-air-sac inoculation to two pathogenic strains also indicated antigenic variation. Neither the M. iowae type-strain, Iowa 695, nor the other reference strains were effective in demonstrating antibody against both strains used to expose the turkeys. These findings suggest that antigenic variation may be a major problem in effective serodiagnosis of M. iowae infections.

Agglutination Tests↗

PubMed1984

Effect of Mycoplasma iowae infection on the immune system of the young turkey.

Studies were conducted in turkey poults of the effect of Mycoplasma iowae on the humoral antibody response to sheep red blood cells (SRBC) and on the weight and histological appearance of the bursa of Fabricius. Day-old turkeys were infected with M. iowae via the air sac and control turkeys received sterile broth. In the first experiment infected and control birds were inoculated intravenously with SRBC at 12 and 33 days of age, and hemagglutination (HA) tests were carried out on serum collected at intervals. Infected birds showed a slightly delayed response compared with control birds, but there was no delay in secondary response. Moreover, those birds with clinical disease gave significantly higher peak HA titres than did clinically healthy birds. In the second experiment the body weight and bursa to body weight ratio of M. iowae infected turkeys were compared with those of the control birds at 7 and 21 days of age. There was no significant difference in body weight, but at 7 days the mean bursa to body weight ratio of infected birds was significantly less (P less than 0.01) than that of the control birds and microscopic changes were seen in some bursae. These preliminary observations suggest that M. iowae infection of young turkeys may cause temporary damage to the bursa of Fabricius, accompanied by a transient immunosuppression.

Animals↗

PubMedDate not supplied

A model for testing the efficacy of enrofloxacin (Baytril) administered to turkey hens in the control of Mycoplasma iowae infection in eggs and embryos.

In a preliminary experiment, a field infection with Mycoplasma iowae was simulated by inoculating turkey eggs with various doses of two strains of M. iowae immediately before incubation. The strain and dose chosen for further study were those that best multiplied and resulted in infection of embryos from which the organism could be isolated after 25 days of incubation. Ten turkey hens free from infection with mycoplasmae were housed in isolation. The hens were given enrofloxacin in the drinking water at a concentration of 50 ppm on 3 successive days, on two occasions at intervals of 14 days. Within 48 hours of lay, their eggs were each inoculated with 0.1 ml of the selected strain and dose (10(5) colony-forming units/ml) of M. iowae. M. iowae was recovered from almost all eggs laid by hens before the initial medication but not from any of the eggs laid for several days after each period of medication. Thereafter, the organism could be recovered from a high proportion of inoculated eggs. The treatment of infected turkey laying flocks with enrofloxacin at strategic periods might be helpful in the control of this Mycoplasma by limiting both vertical and horizontal transmission.

Animals↗

PubMed1985

Iowa's system for screening and tracking high-risk infants.

A statewide system for the screening, tracking and referral of high-risk infants has been in operation in Iowa since 1978. During the first five years of the Iowa High-Risk Infant Follow-up Program, pediatric nurse-practitioners have screened 1,440 infants at ages 4, 9, 18, and 30 months. Nineteen percent of the infants failed screening and were referred to developmental centers for further evaluation. Infants meeting criteria related to preterm birth comprised most of the flagged group; the highest failure rates were found for infants who experienced neonatal seizures or who were hypotonic at discharge from the hospital. Most children who failed screening did so by the nine-month checkpoint. A year-by-year comparison of failure rates for high-risk children in Iowa suggests a statistically significant pattern of decreasing developmental morbidity.

Child Health Services↗

PubMed1985

The Iowa record-linkage study. III. Excess mortality among patients with 'functional' disorders.

Our investigation of the pattern of mortality among former inpatients in nine diagnostic groups was based on deaths found among 4,869 former inpatients of the University of Iowa Psychiatric Hospital, Iowa City, during a ten-year period. Comparisons were made with expected values based on a relevant Iowa control population. The first two years of follow-up was a period of great risk but not after. Excessive mortality from "unnatural" causes was found among patients of either sex with an affective disorder, schizophrenia, alcohol or other drug abuse, and personality disorders, among men with acute schizophrenia or neuroses, and among women with depressive neuroses. Women with acute schizophrenia or a psychophysiologic disorder or special symptom were at risk for a "natural" death. These findings confirm the risk of reduced life span that patients in all nine categories share.

Adult↗

PubMed1996

Tobacco control activities of Iowa dental hygienists.

The purpose of this study was to determine the type and extent of tobacco control activities provided to dental patients by Iowa dental hygienists. Surveys were mailed to 1056 dental hygienists who had active Iowa dental hygiene licenses. Forty-one were returned by the post office and 138 did not meet all of the criteria for the survey. Of the remaining pool of 877-340 were completed and returned for a response rate of 38.8%. Only 4.6% of the hygienists routinely asked their patients about their tobacco use. Thirty-five percent routinely advised smokers to stop and 57% routinely advised smokeless tobacco users to stop. Thirteen percent routinely assisted smokers to stop and 20% routinely assisted smokeless tobacco users in stopping. None of the hygienists routinely engaged in follow-up to tobacco cessation activities. Cessation practice activities and amounts varied by several categorical variables. The majority of Iowa dental hygienists who responded to this survey did not routinely ask, advise, assist or arrange for or about their patients' tobacco use or cessation. Recommendations are given on how to improve tobacco prevention and cessation programs in dental offices.

Adult↗

PubMed1998

Implementation of Medicaid Managed Mental Health Care in Iowa: problems and solutions.

Under the terms of a 1915(b) waiver, Iowa implemented a statewide carve-out program in 1995 for the management of mental health services for Medicaid recipients by contracting with a private for-profit corporation. In this commentary, the strategy used to develop the Medicaid managed care contract in Iowa is briefly summarized. Problems that were encountered in program implementation and regulatory attempts to address those issues are described. Suggestions for other states regarding the development, implementation, and oversight of contracts for managed care so that they might be able to deliver comprehensive mental health care services with acceptable standards of care quality are offered. By including appropriate contract specifications, providing mechanisms for oversight, and enforcing standards of care in Medicaid managed care contracts, many problems that occurred in Iowa may have been minimized or avoided. This experience can provide a valuable lesson for similar program initiatives in other states.

Contract Services↗

PubMed1993

Cost savings associated with increased safety belt use in Iowa, 1987-1988.

Although safety belt use increases after passage of a safety belt law, the statewide direct and indirect cost savings associated with increased safety belt use after a belt use law has been enacted is not known. We analyzed a subset of data from the Iowa Safety Restraint Assessment consisting of 997 injured motor vehicle occupants treated at any of 11 Iowa hospitals from throughout the state between November 1987 and March 1988. We found that injuries were more serious and that more deaths and cases of permanent disability occurred among persons who did not wear safety belts. Failure to use safety belts was independently associated with higher payments to hospitals by health care insurers and individuals in nearly all age, sex, and vehicle speed categories. Lifetime direct and indirect cost savings associated with Iowa's safety belt law for persons injured in one year were estimated to be $69.5 million.

Adolescent↗

PubMed1986

The effect of ten years of regionalized perinatal health care in Iowa, U.S.A.

In 1973, Iowa, a rural, midwestern state in the U.S.A., established a Statewide Perinatal Care Program. A major objective was to develop and maintain a regionalized system of care. Such a system has been developed but differed from traditional systems by using regional level II centers. Iowa's low population density necessitated this modification. The development and maintenance of Iowa's system is described. Evaluation is provided by analysis of commonly available birth and mortality data. Improved birth-weight-specific neonatal and fetal mortality rates suggest an overall improvement in care. A more favorable birth weight distribution and evidence of screening and selective referral of high-risk patients provide evidence of improvements in prenatal care. Data are presented to show that a stratified system of care is evidence in the state. Level I hospitals currently manage low-risk patients and report very low mortality rates. Level II facilities receive high-risk referrals, but selective referral occurs since the tertiary center accounts for a disproportionate number of fetal and neonatal deaths, and births weighting less than 1500 g. Other regions may benefit from similar approaches to development of regionalized systems of care and evaluation of the same.

Birth Rate↗

PubMed2004

Prostate cancer mortality in Connecticut, Iowa and New Mexico African American men.

We sought to assess trends in prostate cancer incidence, treatment and mortality in African American men by means of analysis of prostate cancer data from three states, Connecticut, Iowa and New Mexico, all participants in the Surveillance, Epidemiology, and End Results (SEER) Program. Compared with levels before prostate specific antigen (PSA) testing, prostate cancer incidence increased in all three states after widespread testing. For men diagnosed with localized or regional prostate cancer, the respective increases in radical prostatectomy in Connecticut, Iowa, and New Mexico were 3.2, 2.3, and 4.9 times pre-test levels. Age-standardized mortality in Connecticut and Iowa increased slightly; in New Mexico the 104.7 deaths per 100,000 in 1979-1986, 62.1 in 1987-1990, dropped to 47.6 in 1991-1998, an amount of decline that was statistically significant. Introduction of PSA testing influenced early detection and treatment of prostate cancer in all three states. Although decline in prostate cancer mortality in New Mexico over time may be linked with use of the PSA test and definitive therapy, the relationship among these factors, and thus the proper treatment for the early stages of this condition, is unclear on the basis of these data.

Black or African American↗

PubMed1997

Association of smoking, body mass, and physical activity with risk of prostate cancer in the Iowa 65+ Rural Health Study (United States).

Smoking, obesity, alcohol, and physical activity can modulate the endocrine system, and therefore have been hypothesized to play a role in the etiology of prostate cancer. At baseline in 1982, 80 percent (n = 3,673) of the noninstitutionalized persons age 65+ in two rural Iowa (United States) counties were enrolled into the Iowa 65+ Rural Health Study. Follow-up for mortality was complete through 1993, and cancer experience was determined by linkage to the State Health Registry of Iowa cancer database for the years 1973-93. We analyzed data on 1,050 men aged 65 to 101 years (mean age 73.5) with a full interview in 1982 and with no documented cancer in the 10 years prior to baseline. Through 1993 (8,474 person-years of follow-up), there were 71 incident cases of prostate cancer. In a multivariate model, age, cigarette smoking (relative risk [RR] = 2.9 for currently smoking 20 or more cigarettes per day compared with never smoking; P trend = 0.009), greater body mass index (BMI) (wt/ht2) (RR = 1.7 for BMI > 27.8 kg/m2 compared with < 23.6; P trend = 0.1), and greater level of physical activity (RR = 1.9 for high activity level cf inactive; P trend = 0.05) were independent predictors of prostate cancer, and these associations were stronger for regional or disseminated disease at diagnosis. Percent change in BMI from age 50 to baseline was associated positively with risk (P trend = 0.01), and this association appeared to be stronger in heavier men. There were no data on diet. These findings suggest that smoking, overweight, and weight gain in later life are risk factors for prostate cancer and support a hormonal etiology; the positive association for physical activity confirms some previous reports, but remains without a credible biologic mechanism.

Age Distribution↗

PubMedDate not supplied

Bystander Trauma Care training in Iowa.

OBJECTIVE: The Iowa Bystander Trauma Care program trained citizens to provide initial care at the scene of a motor vehicle crash. The development, implementation, and evaluation of the program are described. METHODS: The National Highway Traffic Safety Administration's curriculum was used as the basis for developing the Iowa Bystander Trauma Care program. Emergency medical technicians (EMTs) were trained to be instructors in a two-hour course offered at each of four community colleges. The EMTs, in turn, provided instructions to the general populace. Five hundred participants were given a questionnaire before the one-hour Bystander Trauma Care training session, immediately after the training and six months later. The questionnaire obtained background data and assessed attitudes regarding willingness to stop and assist, and knowledge obtained. RESULTS: One hundred twenty EMT instructors trained more than 2,000 citizen bystanders in a 17-county area in central Iowa. Immediately after the training program, participants were more likely to provide assistance (p < 0.001), and understand the sequence of actions to be performed at the scene of a crash and how to prioritize the information provided to 911 (p < 0.05). There was also evidence of retention of the knowledge six months after training. CONCLUSIONS: Citizens readily volunteered for the Bystander Trauma Care training program. Results of the questionnaire suggest citizens can be successfully trained to recognize the needs of, and provide initial care for, acutely injured persons, and the positive effects of such training are maintained over time.

Community Networks↗

PubMed1992

Dietary assessment of older Iowa women with a food frequency questionnaire: nutrient intake, reproducibility, and comparison with 24-hour dietary recall interviews.

The authors report the results of a dietary survey of 38,121 Iowa women, 55-69 years of age in 1986, based on a semiquantitative food frequency questionnaire previously tested among Boston-area women aged 34-59 years. The Iowa women, compared with the younger Boston-area women, consumed a similar amount of calories (1,767 vs. 1,844 kcal) and a similar amount of total calories from fat (35 vs. 37%) but had markedly greater intake of the following micronutrients after including supplement use: iron (+18%), calcium (+33%), vitamin A (+43%), riboflavin (+46%), thiamine (+50%), and pyridoxine (+122%). The reproducibility of the questionnaire was examined in two more administrations to 44 of the Iowa women in January and June of 1988. Reproducibility was highest for alcohol (Pearson's r = 0.99), caffeine (r = 0.95), and vitamin E (r = 0.90) and lowest for sucrose (r = 0.53), polyunsaturated fat (r = 0.56), and iron (r = 0.59). Micronutrient intakes were generally more reproducible than macronutrient intakes. The agreement between the June 1988 questionnaire and the average of five 24-hour dietary recalls was also assessed in the 44 subjects. The median correlations of energy-adjusted intake were as follows: for macronutrients, r = 0.45; for micronutrients without supplements, r = 0.33; and for micronutrients with supplements, r = 0.64. This food frequency questionnaire appears to be reasonably reproducible and accurate, so that its use may be extended to epidemiologic studies of older women with a broad range of socioeconomic backgrounds.

Energy Intake↗

PubMed2001

Municipal drinking water nitrate level and cancer risk in older women: the Iowa Women's Health Study.

Nitrate contamination of drinking water may increase cancer risk, because nitrate is endogenously reduced to nitrite and subsequent nitrosation reactions give rise to N-nitroso compounds; these compounds are highly carcinogenic and can act systemically. We analyzed cancer incidence in a cohort of 21,977 Iowa women who were 55-69 years of age at baseline in 1986 and had used the same water supply more than 10 years (87% > 20 years); 16,541 of these women were on a municipal supply, and the remainder used a private well. We assessed nitrate exposure from 1955 through 1988 using public databases for municipal water supplies in Iowa (quartile cutpoints: 0.36, 1.01, and 2.46 mg per liter nitrate-nitrogen). As no individual water consumption data were available, we assigned each woman an average level of exposure calculated on a community basis; no nitrate data were available for women using private wells. Cancer incidence (N = 3,150 cases) from 1986 through 1998 was determined by linkage to the Iowa Cancer Registry. For all cancers, there was no association with increasing nitrate in drinking water, nor were there clear and consistent associations for non-Hodgkin lymphoma; leukemia; melanoma; or cancers of the colon, breast, lung, pancreas, or kidney. There were positive associations for bladder cancer [relative risks (RRs) across nitrate quartiles = 1, 1.69, 1.10, and 2.83] and ovarian cancer (RR = 1, 1.52, 1.81, and 1.84), and inverse associations for uterine cancer (RR = 1, 0.86, 0.86, and 0.55) and rectal cancer (RR = 1, 0.72, 0.95, and 0.47) after adjustment for a variety of cancer risk/protective factors, agents that affect nitrosation (smoking, vitamin C, and vitamin E intake), dietary nitrate, and water source. Similar results were obtained when analyses were restricted to nitrate level in drinking water from 1955 through 1964. The positive association for bladder cancer is consistent with some previous data; the associations for ovarian, uterine, and rectal cancer were unexpected.

Age Factors↗

PubMed1998

Iowa survey of waterborne 222Rn concentrations in private wells.

The major objective of the survey was to describe the distribution of waterborne 222Rn concentrations in Iowa's private well-water supplies. Well-water samples were obtained and analyzed for 222Rn from a random sample of 352 Iowa wells. The well-water 222Rn concentrations for the well sites were lognormally distributed and ranged from background concentrations to 87 Bq L-1, with a median value of 12 Bq L-1. The arithmetic mean 222Rn concentration for the sites was 16 Bq L-1 +/- 13 Bq L-1. The geometric mean 222Rn concentration was 12 Bq L-1 with a geometric standard deviation of 2.2. Over half of the samples (52%) exceeded 11 Bq L-1. Both well depth and indoor air 222Rn screening levels correlated with waterborne 222Rn concentrations; however, these correlations had very little predictive value. Glacial drift aquifers tended to have the highest 222Rn concentrations, although there was significant variance of 222Rn concentrations within all the aquifer classifications. In light of the estimate that 370 Bq L-1 of 222Rn in water may lead to 37 mBq L-1 in indoor air, the contribution of well-water derived indoor air 222Rn is minimal compared to ground sources in Iowa.

Air Pollutants, Radioactive↗

PubMed1994

Developing an outpatient prospective payment system based on APGs for the Iowa Medicaid program.

This article describes the development of an outpatient prospective payment system (PPS) based on ambulatory patient groups (APGs) for the Iowa Medicaid Program. Currently, hospitals in Iowa are reimbursed for outpatient services on the basis of cost. Because of concern about escalating costs, the Iowa General Assembly mandated development of a hospital outpatient payment system to promote efficient use of resources and high quality care. The first use of APGs for payment across the full spectrum of services will be a testing ground that should have long term implications for outpatient prospective payment and quality improvement efforts.

Ambulatory Care↗

PubMed2002

An innovative model of health care delivery: the care management program of the University of Iowa.

The Indigent Patient Care Program (legislatively enacted in 1915) provides comprehensive health care to indigent Iowans without health insurance. The University of Iowa Hospitals and Clinics, a leading academic medical center, was designated as the health care provider for these medically and socially complex patients. The Care Management Program of the University of Iowa (CMPUI) is an innovative care delivery model responsible for total health management of patients enrolled in the indigent program. The CMPUI is a solution to preserve the tripartite missions of an academic medical center while ensuring the preservation of the historic Indigent Patient Care Program in Iowa.

Academic Medical Centers↗