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PubMed1966

Infectious diseases in wild animals in Utah. VI. Experimental infection of birds with Rickettsia rickettsii.

Lundgren, D. L. (University of Utah, Salt Lake City), B. D. Thorpe, and C. D. Haskell. Infectious diseases in wild animals in Utah. VI. Experimental infection of birds with Rickettsia rickettsii. J. Bacteriol. 91:963-966. 1966.-Chickens, pigeons, pheasants, sparrow hawks, red-tailed hawks, ravens, magpies, and a marsh hawk were inoculated with Rickettsia rickettsii, the etiological agent of Rocky Mountain spotted fever. The development and persistence of complement-fixing (CF) antibodies and rickettsemias were tested for in these birds. Rickettsiae were recovered from the blood of a number of birds up to the 16th day after inoculation, whereas only the pigeon was found to develop high CF antibody titers. It was concluded that certain species of birds have the potential of contributing to the dissemination of R. rickettsii in nature, and that the CF test is generally unsuitable for serological diagnosis of this organism in birds.

Animals↗
PubMed1985

Infections acquired in clinical laboratories in Utah.

We reviewed laboratory-acquired infections occurring in Utah from 1978 through 1982. Written and telephone interviews of supervisors of 1,191 laboratorians revealed an estimated annual incidence of 3 laboratory-acquired infections per 1,000 employees. Infections, in order of frequency, included hepatitis B (clinical cases), shigellosis, pharyngitis, cellulitis, tuberculosis (skin test conversion), conjunctivitis, and non-A, non-B hepatitis. One-half of large laboratories (over 25 employees), but only 12% of smaller laboratories, reported infections. The annual incidence, however, at smaller laboratories was more than three times greater than at large laboratories (5.0 versus 1.5 per 1,000; P less than 0.05, chi-square test). Microbiologists were at greatest risk of infection, with an incidence of almost 1%, followed by generalists and phlebotomists. Shigellosis was acquired only by microbiologists and accounted for more than half of their infections. The most common laboratory-acquired infection, hepatitis B, affected a microbiologist, a hematologist, a phlebotomist, a pulmonary blood gas technician, and a blood bank technologist who died from her illness. Clinical cases of hepatitis B occurred at a rate 10 times higher than the rate in the general U.S. population. The incidence of tuberculosis skin test conversion was intermediate between rates reported for hospital employees and for the state of Utah.

Aerosols↗
PubMedDate not supplied

Medical informatics education: the University of Utah experience.

The University of Utah has been educating health professionals in medical informatics since 1964. Over the 35 years since the program's inception, 272 graduate students have studied in the department. Most students have been male (80 percent) and have come from the United States (75 percent). Students entering the program have had diverse educational backgrounds, most commonly in medicine, engineering, computer science, or biology (59 percent of all informatics students). A total of 209 graduate degrees have been awarded, with an overall graduation rate of 87 percent since the program's start. Alumni are located in the United States (91 percent) and abroad (9 percent); half (51 percent) have remained in Utah. Former students are employed in a wide variety of jobs, primarily concerned with the application of medical informatics in sizable health care delivery organizations. Trends toward increasing managerial responsibility for medical informatics graduates and the emergence of the chief information officer role are noted.

Education, Professional↗
PubMed1999

Effects of aqueous extracts of PM(10) filters from the Utah valley on human airway epithelial cells.

We hypothesized that the reduction in hospital respiratory admissions in the Utah Valley during closure of a local steel mill in 1986-1987 was attributable in part to decreased toxicity of ambient air particles. Sampling filters for particulate matter < 10 micrometer (PM(10)) were obtained from a Utah Valley monitoring station for the year before (year 1), during (year 2), and after (year 3) the steel mill closure. Aqueous extracts of the filters were analyzed for metal content and oxidant production and added to cultures of human respiratory epithelial (BEAS-2B) cells for 2 or 24 h. Year 2 dust contained the lowest concentrations of soluble iron, copper, and zinc and showed the least oxidant generation. Only dust from year 3 caused cytotoxicity (by microscopy and lactate dehydrogenase release) at 500 microgram/ml. Year 1 and year 3, but not year 2, dust induced expression of interleukin-6 and -8 in a dose-response fashion. The effects of ambient air particles on human respiratory epithelial cells vary significantly with time and metal concentrations.

Air Pollutants, Occupational↗
PubMed2005

Childhood and adult cancer in twins: evidence from the Utah genealogy.

OBJECTIVE: Evidence suggests that the in utero environment may contribute to subsequent development of cancers in childhood and adulthood. Raised levels of estrogen during pregnancy may be the primary in utero etiologic factor. Mothers of twins have higher estrogen levels during pregnancy than mothers of singletons, therefore, assessment of cancer risk in twins may be informative. METHOD: We conducted a retrospective cohort study of cancer among twin and singleton newborns selected from the Utah Population Database, matched on birth year and sex. Cancer diagnoses were determined by linkage with the Utah state cancer register. Relative rates of all cancers in childhood and in adulthood in twins compared with singletons, and for specific cancers including testicular, breast and melanoma, were calculated using Poisson regression. RESULTS: Twin (35,271) and singleton (74,199) births were identified, among whom there were 336 and 691 cancer diagnoses, respectively. The relative risk (RR) of childhood cancer in twins compared with singletons was 0.82 [95% confidence interval (CI) 0.55-1.24] and of adult cancer was 1.06 (0.92-1.22). We found nonsignificant increases in risk among adult twins for cancers of the breast, prostate, testis, lymphatic system, thyroid, and large bowel. The largest departures from unity were for testicular cancer (RR 1.47; 95% CI, 0.73-2.95) and melanoma (RR 0.67; 95% CI, 0.42-1.06). CONCLUSIONS: These results are consistent with the body of evidence suggesting that twins have a reduced risk of cancer in childhood. Although there is no overall differential in adult cancer risk, these data support the hypothesis that the in utero environment may play an important role in specific cancers.

Adolescent↗
PubMedDate not supplied

Cerebrovascular disease in Utah, 1968--1971.

Utah mortality rates for cerebrovascular disease (ICD numbers 430--438) are 13% below U.S. rates. About 70% of Utahns are members of the Church of Jesus Christ of Latter-day Saints, commonly called Mormons of LDS, which proscribes use of tobacco and alcohol. Other studies on this group have found significantly lower occurrence of many cancers and ischemic heart disease. We tested the hypothesis that Utah's lower cerebrovascular disease (CBVD) mortality was contributed by the LDS population. We classified by religion all CBVD deaths (2,521) (except subarachnoid hemorrhage and cerebral embolism) occurring in the state in 1968--1971. No significant difference was found between LDS and non-LDS, but both groups had mortality rates below U.S. expectation. Although recent studies have reported smoking to be a risk factor for CBVD, we found no consistent difference between the LDS and non-LDS, even in the younger age groups. The results do not support the hypothesis that tobacco is an important etiologic agent in CBVD mortality.

Cerebrovascular Disorders↗
PubMed2005

Health insurance, neighborhood income, and emergency department usage by Utah children 1996-1998.

BACKGROUND: It is estimated that approximately half of emergency department (ED) usage in the U.S. and other developed countries is for non-urgent conditions and that this usage is related to availability, social, and economic factors. We examined pediatric ED usage in a U.S. state with respect to income, health insurance status, types of medical conditions, and whether introduction of managed care affected utilization by Medicaid children. METHODS: Emergency department usage rates were calculated from 1996 through 1998 using Utah ED data for children with commercial health insurance, Medicaid, for uninsured children, and by income group estimating neighborhood household income from Zip code of residence. We analyzed usage following the July 1996 transition of Utah Medicaid to managed care. RESULTS: Children with Medicaid had approximately 50% greater ED utilization rates than children with commercial health insurance or uninsured children. The majority of usage for Medicaid and uninsured children was for non-traumatic conditions. Only 35% of total ED usage was for non-emergent or non-urgent conditions and this was related to both Medicaid and low household income. Children lacking health insurance were more likely to be discharged against medical advice (OR = 2.36, 95% C.I. 1.88-2.96). There was no reduction in Medicaid ED usage following the transition to managed care. CONCLUSION: Usage of ED services is related to both health insurance status and income. Children lacking health insurance and Medicaid children have excessive usage for conditions which could be treated in a primary care setting. That managed care does not reduce Medicaid ED usage is consistent with findings of other studies.

Adolescent↗
PubMed1999

Drinking water arsenic in Utah: A cohort mortality study.

The association of drinking water arsenic and mortality outcome was investigated in a cohort of residents from Millard County, Utah. Median drinking water arsenic concentrations for selected study towns ranged from 14 to 166 ppb and were from public and private samples collected and analyzed under the auspices of the State of Utah Department of Environmental Quality, Division of Drinking Water. Cohort members were assembled using historical documents of the Church of Jesus Christ of Latter-day Saints. Standard mortality ratios (SMRs) were calculated. Using residence history and median drinking water arsenic concentration, a matrix for cumulative arsenic exposure was created. Without regard to specific exposure levels, statistically significant findings include increased mortality from hypertensive heart disease [SMR = 2.20; 95% confidence interval (CI), 1.36-3.36], nephritis and nephrosis (SMR = 1.72; CI, 1.13-2.50), and prostate cancer (SMR = 1.45; CI, 1.07-1. 91) among cohort males. Among cohort females, statistically significant increased mortality was found for hypertensive heart disease (SMR = 1.73; CI, 1.11-2.58) and for the category of all other heart disease, which includes pulmonary heart disease, pericarditis, and other diseases of the pericardium (SMR = 1.43; CI, 1.11-1.80). SMR analysis by low, medium, and high arsenic exposure groups hinted at a dose relationship for prostate cancer. Although the SMRs by exposure category were elevated for hypertensive heart disease for both males and females, the increases were not sequential from low to high groups. Because the relationship between health effects and exposure to drinking water arsenic is not well established in U.S. populations, further evaluation of effects in low-exposure populations is warranted.

Aged↗
PubMed2004

Temporal association of the appearance of mucoid strains of Streptococcus pyogenes with a continuing high incidence of rheumatic fever in Utah.

OBJECTIVE: Our objective was to confirm an observed temporal association of increased numbers of rheumatic fever cases concomitant with the appearance of an increased prevalence of mucoid strains of Streptococcus pyogenes. During the resurgence of rheumatic fever (RF) that has occurred in the Intermountain area surrounding Salt Lake City, Utah, since 1985, the largest number of cases occurred in 1985 and 1986 and 12 years later in 1997 and 1998. During the initial outbreak and the later exacerbation of the resurgence, an increased number of mucoid strains of S pyogenes were present in the community. METHODS: The referred cases of RF that fulfilled Jones criteria have been systematically reviewed by the medical staff at Primary Children's Medical Center yearly since 1985. Before the resurgence of RF, a program was initiated by the microbiology laboratory at Primary Children's Medical Center to store frozen isolates of S pyogenes. All frozen specimens were randomly selected and entered into a log; the coded entry allowed for comments regarding the origin of the isolate and whether the isolate had a mucoid appearance on the blood agar culture plate. This log was reviewed in October 2002 to determine whether the percentage of frozen mucoid isolates stored during the resurgence of RF would support the clinical and epidemiologic suspicion that mucoid isolates seemed to be present with a higher frequency during the 2 periods of high incidence of RF. The percentage of mucoid isolates was compared with the yearly number of cases of RF. A Pearson r correlation analysis was completed to determine whether there was a significant association between the percentage of mucoid isolates and the number of cases of RF. RESULTS: The highest number of cases of RF was temporally associated with the highest percentage of mucoid isolates. There was statistically significant correlation between percentage of mucoid strains and the number of RF cases. CONCLUSIONS: The Utah experience with the resurgence of RF in a civilian population during the last decade and a half of the 20th century confirmed the temporal association of mucoid strains of S pyogenes, primarily M-type 18, with a high incidence of RF.

Adolescent↗
PubMed2006

Interactions over time between cereal leaf beetle (Coleoptera: Chrysomelidae) and larval parasitoid Tetrastichus julis (Hymenoptera: Eulophidae) in Utah.

The phenology of parasitism of the cereal leaf beetle, Oulema melanopus (L.) (Coleoptera: Chrysomelidae) by Tetrastichus julis (Walker) (Hymenoptera: Eulophidae) was studied in small grain fields from 2000 to 2005 in northern Utah, after release and redistribution of the partially bivoltine larval parasitoid during the 1990s. Host larvae first occurred in May, with peak infestation typically occurring in early to mid-June. Parasitism by overwintering females of T. julis was highest among earliest developing beetle larvae. Thereafter, rates of parasitism fell to low levels (5-10% or less) by the latter half of June, when heat accumulation had reached 280-350 degree-days (based on a minimum threshold of 8.9 degrees C). With the emergence of second generation parasitoids, rates of parasitism rose to levels approaching 100% among the relatively few late-developing larvae of O. inelanopus. Clear and consistent differences over the years were not observed among different crops of small grains (barley, wheat, or oats) either in the phenology and intensity of beetle infestation, or in the rate of parasitism of beetle larvae. The rate of parasitism was especially high in 2005, and an increase in the minimum level of parasitism (observed each year at mid-season) was apparent over the course of the study. These results indicate that the parasitoid has become well established and seems to be continuing to increase in its impact on O. melanopus in northern Utah, despite a relatively hostile environment of crop management, wherein most fields are plowed and disked annually.

Animals↗
PubMed2004

Coccidioidomycosis among workers at an archeological site, northeastern Utah.

In 2001, an outbreak of acute respiratory disease occurred among persons working at a Native American archeological site at Dinosaur National Monument in northeastern Utah. Epidemiologic and environmental investigations were undertaken to determine the cause of the outbreak. A clinical case was defined by the presence of at least two of the following symptoms: self-reported fever, shortness of breath, or cough. Ten workers met the clinical case definition; 9 had serologic confirmation of coccidioidomycosis, and 8 were hospitalized. All 10 were present during sifting of dirt through screens on June 19; symptoms began 9-12 days later (median 10). Coccidioidomycosis also developed in a worker at the site in September 2001. A serosurvey among 40 other Dinosaur National Monument workers did not find serologic evidence of recent infection. This outbreak documents a new endemic focus of coccidioidomycosis, which extends northward its known geographic distribution in Utah by approximately 200 miles.

Adolescent↗
PubMed1978

Parasites of the coyote (Canis latrans) in central Utah.

Seventeen coyotes, Canis latrans, from central Utah were surveyed for parasites. Five species of parasites not reported previously from coyotes in Utah were detected: Filaroides osleri, Physaloptera sp., Spirocerca sp., Ancylostoma caninum, and Cediopsylla simplex. In all, 11 genera of parasites were observed.

Animals↗
PubMed1989

Bot fly larvae (Cephenemyia spp., Oestridae) in mule deer (Odocoileus hemionus) from Utah.

Ninety-nine mule deer (Odocoileus hemionus) from four Utah counties (Cache, Utah, Sanpete and Sevier) were examined for larvae of Cephenemyia spp. in 1985 and 1986. Numbers of first, second and third stage bot fly instars were related to age, sex, year and geographic location of the mule deer. Fawns and adult deer greater than or equal to 5.5 yr had a significantly (P less than or equal to 0.05) higher intensity (means = 37 and means = 68, respectively) of infection than the 1.5- and 2.5-yr-old age groups (means = 19 and means = 26, respectively). Infection by larvae was not significantly different between sexes. Infection was 100% in both years, but the mean intensity was significantly lower in 1986 (P less than 0.05). The decline may be related to differences in soil moisture between the 2 years. In 1985, 82% of the deer examined were infected with all three instars. Seventy-seven percent of all first instar larvae were observed in the trachea, usually in the fold immediately posterior to the epiglottis and corniculate cartilages. This new site of attachment for first instar larvae has not previously been recognized.

Analysis of Variance↗
PubMed2000

Prevalence of aneuploidy and additional anatomic abnormalities in fetuses with open spina bifida: population based study in Utah.

Data were used to determine the population prevalence of aneuploidy and additional anatomic abnormalities in fetuses with open spina bifida. The ability of sonography to predict aneuploidy and identify additional anatomic abnormalities in euploid fetuses was assessed. All cases of spina bifida occurring in the state of Utah from 1995 through 1997 were reviewed using Utah Birth Defect Network data, including stillborn, liveborn, and terminated cases. Chromosomes were known in 45 of 51 cases of open spina bifida. Of the 45 fetuses, 6 (13%) were aneuploid. Major anatomic abnormalities were present in four of six (67%) cases, and two of six (33%) cases had additional anomalies that could be missed sonographically. Of 39 euploid fetuses, 12 (31%) had additional abnormalities, but only half likely would be detected sonographically. Our 4% risk of aneuploidy in sonographically isolated spina bifida is substantially higher than the risk associated with advanced maternal age (0.37%).

Abnormalities, Multiple↗
PubMed2001

Prevalence of aneuploidy and additional anatomic abnormalities in fetuses and neonates with cleft lip with or without cleft palate: a population-based study in Utah.

OBJECTIVE: To determine the prevalence of aneuploidy and additional major anatomic abnormalities in fetuses and neonates with cleft lip with or without cleft palate. METHODS: All cases of cleft lip with or without cleft palate (cleft lip/cleft palate) occurring in Utah from 1995 through 1999 were reviewed by using the Utah Birth Defect Network population-based surveillance system. All pregnancy outcomes are included (stillborn, live born, and termination) in this analysis. RESULTS: Of 263 cases of cleft lip/cleft palate, 72 (27.4%) were unilateral cleft lip, 112 (42.6%) were unilateral cleft lip and cleft palate, 12 (4.6%) were bilateral cleft lip, and 67 (25.5%) were bilateral cleft lip and cleft palate. Fifteen (5.7%) of the 263 fetuses and neonates were aneuploid. One (1.2%) with cleft lip (unilateral and bilateral combined) was aneuploid. Five (4.5%) of the fetuses and neonates with unilateral cleft lip and cleft palate were aneuploid compared with 9 (13.4%) of fetuses and neonates with bilateral cleft lip and cleft palate. In known or presumed euploid fetuses and neonates, additional sonographically occult major anatomic abnormalities occurred in 5 (7.0%) of 71 with unilateral cleft lip, 18 (16.8%) of 107 with unilateral cleft lip and cleft palate, 1 (8.3%) of 12 with bilateral cleft lip, and 12 (20.7%) of 58 with bilateral cleft lip and cleft palate. These abnormalities primarily involved the heart and the central nervous system. CONCLUSIONS: Amniocentesis for karyotype should be offered in all cases of cleft lip/cleft palate because of the risk of aneuploidy. Patients should be counseled that sonographically occult additional anatomic abnormalities might be present with all clefts.

Amniocentesis↗
PubMed1991

HealthTrust enters Utah tax fray.

Over the course of the Utah property-tax dispute, not-for-profit hospitals have battled a typically unseen enemy--for-profit hospitals. While not-for-profits long have suspected the state's for-profit facilities of feeding unflattering information about them to tax assessors, the media and the public, recent property-tax hearings have unmasked at least one nemesis of Utah's not-for-profits: HealthTrust--The Hospital Co.

Hospitals, Proprietary↗
PubMed1997

Expenditures for mental health services in the Utah Prepaid Mental Health Plan.

This article examines the effect of a mental health carve-out, the Utah Prepaid Mental Health Plan (UPMHP), on expenditures for mental health treatment and utilization of mental health services for Medicaid beneficiaries from July 1991 through December 1994. Three Community Mental Health Centers (CMHCs) provided mental health services to Medicaid beneficiaries in their catchment areas in return for capitated payments. The analysis uses data from Medicaid claims as well as "shadow claims" for UPMHP contracting sites. The analysis is a pre/post comparison of expenditures and utilization rates, with a contemporaneous control group in the Utah catchment areas not in the UPMHP. The results indicate that the UPMHP reduced acute inpatient mental health expenditures and admissions for Medicaid beneficiaries during the first 2 1/2 years of the UPMHP. In contrast, the UPMHP had no statistically significant effect on outpatient mental health expenditures or visits. There was no significant effect of the UPMHP on overall mental health expenditures.

Capitation Fee↗
PubMed1987

Hospital administrators in a market environment: the case of Utah.

This study describes selected characteristics of hospital administrators in Utah, who are implementing a market strategy of cost containment. A mail survey was used to query hospital administrators concerning their personal backgrounds, professional practice patterns, and perceived role performance. The questionnaire elicited a 75.6 percent return from a limited universe sample. Analytical results disclose that Utah hospital administrators are relatively young, professionally dynamic, well educated, and subject to frequent career-motivated moves. Using Mintzberg's ten administrative roles, respondents identified two as key: "Leader" ranks as the role performed best, the role second most critical to survival, second best prepared for, second most time-consuming, and second most satisfying. "Entrepreneur" ranks as the role most critical to survival, most satisfying, most deserving of improvement, second least prepared for, and second best performed. Suggestions for innovative ways in which administrators can develop their skills to be better prepared to meet future challenges are listed.

Health Facility Administrators↗