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PubMed2003

Direct versus indirect emotional consequences on the Iowa Gambling Task.

The Iowa Gambling Task has been widely used in the assessment of neurological patients with ventro-mesial frontal lesions. The Iowa Group has claimed that the Gambling Task is too complex for participants to follow using cognition alone, so that participants must rely on emotion-based learning systems (somatic markers). The present study investigates whether similar tasks can be performed without direct somatic markers. In a 'Firefighter' task closely matched to the classic Gambling Task, participants evaluate the performance of others--so that they experience reward and punishment indirectly. In contrast to the gradual improvement in performance seen on the classic Iowa Gambling Task, participants on the Firefighter Task showed no learning effect, mirroring the performance of patients with ventro-mesial frontal lesions, and suggesting that the task is very difficult to perform without direct somatic marker information. The use of this task as empirical measure of 'empathy' are discussed.

Adult↗
PubMed2002

In vitro development of resistance to enrofloxacin, erythromycin, tylosin, tiamulin and oxytetracycline in Mycoplasma gallisepticum, Mycoplasma iowae and Mycoplasma synoviae.

The in vitro emergence of resistance to enrofloxacin, erythromycin, tylosin, tiamulin, and oxytetracycline in three avian Mycoplasma species, Mycoplasma gallisepticum, Mycoplasma synoviae and Mycoplasma iowae was studied. Mutants were selected stepwise and their MICs were determined after 10 passages in subinhibitory concentrations of antibiotic. High-level resistance to erythromycin and tylosin developed within 2-6 passages in the three Mycoplasma species. Resistance to enrofloxacin developed more gradually. No resistance to tiamulin or oxytetracycline could be evidenced in M. gallisepticum or M. synoviae after 10 passages whereas, resistant mutants were obtained with M. iowae. Cross-sensitivity tests performed on mutants demonstrated that mycoplasmas made resistant to tylosin were also resistant to erythromycin, whereas mutants made resistant to erythromycin were not always resistant to tylosin. Some M. iowae tiamulin-resistant mutants were also resistant to both macrolide antibiotics. Enrofloxacin and oxytetracycline did not induce any cross-resistance to the other antibiotics tested. These results show that Mycoplasma resistance to macrolides can be quickly selected in vitro, and thus, providing that similar results could be obtained under field conditions, that development of resistance to these antibiotics in vivo might also be a relatively frequent event.

Animals↗
PubMed1999

Utilization of the Iowa Model in establishing evidence-based nursing practice.

Clinical practice based on tradition or established rituals appears to be widespread amongst a variety of nurses and practice settings. However, tradition-based practice may not necessarily be based on sound scientific evidence and could potentially be harmful to patients or result in inappropriate utilization of resources. Conversely, evidence-based practice is the utilization of the best available empirical evidence in the practice setting, to facilitate sound clinical decision-making. Suctioning ventilated patients is a necessary and important aspect of patient care. However, normal saline instillation prior to suctioning, in order to loosen secretions, remains a common nursing procedure despite research suggesting that there is no clear benefit and in some instances may be harmful. Several models have been developed over the past few years to facilitate nursing practice that is based on research or the best available evidence. The Iowa Model, developed at the University of Iowa Hospitals and Clinics, serves as a framework to improve patient outcomes, enhance nursing practice and monitor health care costs. Moreover, it facilitates the application of empirical evidence to clinical practice. This paper will discuss the utilization of the Iowa Model to promote evidence-based nursing practice, with regard to normal saline instillation prior to suctioning, in the critical care unit of a 100-bed hospital in Hong Kong. Patient, staff and fiscal outcomes will also be reported.

Algorithms↗
PubMed2000

Self-report of smoking, obesity and hypertension history and survival among a cohort of iowa renal cell carcinoma cases.

PURPOSE: Smoking, obesity and hypertension are well-established risk factors for the development of renal cell carcinoma (RCC). However, little is known regarding the ability of RCC patient history regarding these characteristics to predict future survival.METHODS: To evaluate this question, we conducted follow-up on a cohort of incident RCC cases first assembled in Iowa from 1986-1989 for case-control analysis. We report data on 364 cases aged 40-86 years who reported detailed anthropometric and lifestyle history on a mailed questionnaire. Mortality experiences through 1998 were determined by linkage to the Iowa Cancer Registry and other databases; 233 deaths were identified during the 2,470 total years of follow-up, with 145 of those having RCC listed as the underlying cause of death on the death certificate. The Cox Proportional Hazards model was used to estimate the risk associated with each potential prognostic characteristic.RESULTS: After adjustment for age, a suggestion of an association with survival was noted for history of hypertension [Relative Risk (RR) = 0.8; 95% Confidence Interval (CI) 0.5-1.1] but no association was noted for either smoking or weight history. After further adjustment for tumor stage at diagnosis, evidence of an association for either smoking or obesity remained absent. However, after similar adjustment, the protective effect of history of hypertension actually strengthened slightly (RR = 0.7; CI 0.5-0.9).CONCLUSIONS: Data from this follow-up study of incident RCC cases in Iowa suggests that after adjustment for the strongest independent predictor of survival, a reported history of hypertension is associated with better survival.

Journal Article↗
PubMed2000

An investigation of the biological basis of an interaction of abdominal fat distribution and family history of breast cancer. A nested study of sisters in the Iowa Women's Health Study (United States).

OBJECTIVE: The present study examined whether levels of testosterone, sex hormone binding globulin (SHBG), or insulin levels might underlie an increased risk of postmenopausal breast cancer in women with both high waist-to-hip ratio and a family history of breast cancer disease that was noted earlier in the Iowa Women's Health Study. METHODS: Participants for the current study were selected from 1922 sister groups (3978 women) in the Iowa Women's Health Study cohort. Two groups were included: (1) those with no family history of breast cancer and at least one sister with a high waist-to-hip ratio; or (2) those with a positive family history of breast cancer and at least one sister with a high waist-to-hip ratio. Testosterone, SHBG and insulin were measured by radioimmunoassay from 245 fasting blood samples. RESULTS: Familial correlations among members of 66 families were estimated at 0.32, 0.28 and 0.25 for serum insulin, free testosterone and SHBG; respectively. Fasting serum insulin was significantly higher in breast cancer family history negative women than in family history positive women, in direct opposition to our a priori hypothesis. No significant differences were observed in serum SHBG or free testosterone across family history categories. CONCLUSION: This study corroborates a genetic component to fasting serum insulin, free testosterone and SHBG levels. It seems unlikely that insulin, SHBG, or testosterone explain the interaction between waist-to-hip ratio and family history of breast cancer among participants in the Iowa Women's Health Study.

Abdomen↗
PubMed1975

The Iowa 500: field work in a 35-year follow-up of depression, mania, and schizophrenia.

This paper reports a follow-up and family study being carried out at the University of Iowa College of Medicine on primary affective disorders and schizophrenia in patients hospitalized thirty-five years ago. The purpose of this project is to obtain objective data to shed light on our understanding of these two major functional psychoses -- their diagnostic validity, clinical features, course and outcome, heterogeneity, life histories, related illnesses and characteristics of familial association. This research started with 525 patients selected from inpatients consecutively admitted to the Iowa Psychopathic Hospital between 1934 and 1944, and with a stratified random sample of 160 surgical patients admitted to the University General Hospital during the same period. A specially designed structured interview form -- the Iowa Structured Psychiatric Interview (ISPI) -- is used to follow up all living index patients, and as many of their living first-degree relatives as possible. At this time, over one-third of the estimated total study population of three thousand patients and relatives have been personally interviewed, and the preliminary findings are reported here.

Bipolar Disorder↗
PubMed1991

Relations among scores on Matrix Analogies Test, Draw-A-Person, and the Iowa Tests of basic skills for low socioeconomic children.

82 normal Grade 4 students of low socioeconomic status were administered the Matrix Analogies Test, Draw-A-Person Test, and the Iowa Tests of Basic Skills. The partial correlation coefficient between the Matrix Analogies Test and the Iowa Tests was .51 while that between the Draw-A-Person Test and the Iowa Tests was .30. The correlation coefficient between the Matrix Analogies Test and the Draw-A-Person Test was .32. Implications of these findings are discussed.

Achievement↗
PubMedDate not supplied

Antigenic heterogeneity in Mycoplasma iowae demonstrated with monoclonal antibodies.

Western blots of proteins of 14 Mycoplasma iowae strains and isolates resolved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis were probed with three monoclonal antibodies (MAbs), MI6, MI7, and MI8. MAb MI6 reacted with one or more antigens with apparent molecular weights of 60,000, 70,000, and 94,000. In three strains (N-PHN-D13, R-D2497, and K 1805), antigens located on a single peptide band were recognized, while in others additional epitopes at different molecular-weight positions were revealed. A similar pattern was observed with MAb MI7, although it reacted with fewer antigens than did MAb MI6 and failed to recognize antigens in strains N-PHN-D13 and R-D2497. MAb MI8 reacted with an antigen at an apparent molecular-weight position of 28,000 in four of the 14 strains and isolates. The diverse reaction patterns observed with the MAbs in the 14 M. iowae strains and isolates confirms the occurrence of antigenic variation within this species. Antigenic variation in M. iowae may be pivotal in determining host-parasite interactions, pathogenesis, and the outcome of disease.

Animals↗
PubMedDate not supplied

Use of an avidin-biotin enhanced dot-immunobinding assay to detect antibodies for avian mycoplasma in sera from Iowa market turkeys.

A dot-immunobinding assay, amplified with avidin and biotin (DAB assay), was used to detect serum antibodies to Mycoplasma iowae in immunized turkeys. The DAB assay was used to test serum samples from 122 commercial market turkey flocks obtained from four Iowa processing plants. The samples were pooled and tested for the presence of antibodies to four species of Mycoplasma spp. considered to be important pathogens for turkeys: M. gallisepticum (MG), M. iowae (MI), M. meleagridis (MM), and M. synoviae (MS). The occurrence of antibodies against these mycoplasmas, as determined by the DAB assay, were 5.7% for MG, 18.0% for MI, 77.9% for MM, and 9.8% for MS.

Animals↗
PubMedDate not supplied

Colonization of the intestine of turkey embryos exposed to Mycoplasma iowae.

Eight-day-old turkey embryos were inoculated into the yolk sac with 3 X 10(5) colony-forming units of Mycoplasma iowae strain D112 in order to study the growth-depressing effect, the histopathological changes, and colonization of the intestinal tract. The embryo: egg weight ratio was significantly lower in the inoculated eggs than in controls. Histologically, there were infiltrations in parenchymatous organs and chorioallantoic membranes with heterophilic granulocytes. M. Iowae was demonstrated on the intestinal mucosa by antibody fluorescent microscopy and by transmission electron microscopy. Attaching mycoplasmas had a distinct morphology; the segment in contact with enterocytes was cone-shaped and had finely granulated cytoplasma which was abruptly separated from the distal coarsely granulated area. We conclude that M. iowae has a predilection for the intestinal tract of avian hosts.

Animals↗
PubMed1985

The Iowa record-linkage study. II. Excess mortality among patients with organic mental disorders.

Of 543 patients with organic mental disorders hospitalized at the University of Iowa Psychiatric Hospital, Iowa City, during a ten-year period, 87 died. This mortality was significant based on a control population. Patients of all ages were at risk for early death, especially those younger than 40 years. Risk was greatest during the first two years of follow-up; thereafter the observed death rate approached the expected rate. Patients were at special risk for death from "natural" causes, particularly cancer and heart disease among women, and influenza or pneumonia or "other" natural causes among men. During the first two years of follow-up, men were also at risk for death from accidents or suicide. Women with alcohol- and drug-related psychoses were at risk for death early in follow-up, but the diagnosis was not associated with risk from "unnatural death" in either sex.

Accidents↗
PubMed1990

Cancer in Iowa farmers: recent results.

Previous analysis of Iowa death certificates from 1971 through 1978 identified several cancers with significantly elevated mortality in farmers. Subsequent ecological studies identified farm practices, including pesticide usage, that might be associated with these mortalities. These results led to several case-control studies and a similar analysis of more recent death certificates. 'Usual occupation' has been added to the death certificate tapes for the years 1979-1986. Cancer mortality in Iowa farmers for this period is very similar to that for 1971-1978. Case-control studies for acute lymphocytic leukemia and multiple myeloma indicated that farming in general is not a risk factor for either cancer type. However, exposure to general classes of insecticides and herbicides is associated with an elevated odds ratio in farmers for incidence of multiple myeloma. The odds ratios are not statistically significant at the 5% level, probably due to relatively small numbers of cases and controls exposed to any one class of pesticides.

Agricultural Workers' Diseases↗
PubMed1990

Iowa Agricultural Health and Safety Service Project.

A model community-based comprehensive agricultural occupational health and safety service program has been implemented in Iowa. The functional center of coordination is based in the College of Medicine at the University of Iowa. The community-based hub of the service is the community hospital, where the majority of the direct client services originate. The University provides training of hospital staff, programming, direction, consultation, and referral. The services offered include primary care, health surveillance, industrial hygiene and safety, and education. Through a detailed evaluation of the project's objectives we will be able to evaluate, modify, and disseminate a model agricultural health and safety services delivery program. This model should be effective in changing the farming population's health and safety attitudes and behaviors through a community-based program.

Accidents, Occupational↗
PubMed2003

Electronic doors to education: study of high school website accessibility in Iowa.

The Americans with Disabilities Act (ADA), and Sections 504 and 508 of the Rehabilitation Act, prohibit discrimination against people with disabilities in all aspects of daily life, including education, work, and access to places of public accommodations. Increasingly, these antidiscrimination laws are used by persons with disabilities to ensure equal access to e-commerce, and to private and public Internet websites. To help assess the impact of the anti-discrimination mandate for educational communities, this study examined 157 website home pages of Iowa public high schools (52% of high schools in Iowa) in terms of their electronic accessibility for persons with disabilities. We predicted that accessibility problems would limit students and others in obtaining information from the web pages as well as limiting ability to navigate to other web pages. Findings show that although many web pages examined included information in accessible formats, none of the home pages met World Wide Web Consortium (W3C) standards for accessibility. The most frequent accessibility problem was lack of alternative text (ALT tags) for graphics. Technical sophistication built into pages was found to reduce accessibility. Implications are discussed for schools and educational institutions, and for laws, policies, and procedures on website accessibility.

Persons with Disabilities↗
PubMed1992

The Iowa Medical Information Network: a concept.

Iowa Methodist Medical Center (IMMC) was one of the nation's early developers of a "hospital/physician" system, entering the arena during October 1985, under the direction of Ginny Wagner. Their "MOLI-Link" system now serves over 150 physicians in 50 locations, and is currently undergoing significant enhancement. MOLI-Link was originally developed using Annson Systems (IBAX) products, and has recently migrated to Wallace Computer Services (Wal-Link) software. Over the past 4 years, IMMC has investigated wide-area medical information networking, and is now actively investigating development of the Iowa Medical Information Network. It is envisioned that IMIN would provide clinical, administrative, and educational information services throughout the IMMC 37 county referral area.

Hospital Information Systems↗
PubMed1988

Organization and operation of the hospital-infection-control program of the University of Iowa Hospitals and Clinics.

The University of Iowa Hospitals and Clinics is located in the center of the United States in Eastern Iowa, has 1,000 hospital beds, and is the largest university owned teaching hospital in the country. Over 35,000 patients are admitted each year. The infection control efforts began in 1969 and were broadened in 1976 with the establishment and implementation of the Program of Epidemiology directed by W.J. Hierholzer, Jr., M.D., hospital epidemiologist. Hospital-wide surveillance is routinely performed by three and a half full-time equivalent LPN practitioners who assess problems and evaluate data essential to realistic identification of nosocomial infection rates, implementation of controls and evaluation of control measures. Nosocomial infection surveillance, utilizing modified CDC criteria, has been performed since July 1976. Ward rounds are made by staff, utilizing nursing care and medication Kardex's, microbiology, hematology and X-ray reports. Importantly, the surveillance system is being validated by concurrent prospective surveys to determine the sensitivity and specificity of reporting data. Outbreaks/epidemics of infections, such as Legionella pneumonia, diarrhea of unknown species, and wounds, as well as burns from manufactured changes in cautery grounds, have been identified and controlled before they have become major epidemics. Surveillance has identified one epidemic per 10,000 patients admitted.(ABSTRACT TRUNCATED AT 250 WORDS)

Cross Infection↗
PubMedDate not supplied

The Iowa Managed Substance Abuse Care Plan: access, utilization, and expenditures for Medicaid recipients.

The Iowa Managed Substance Abuse Care Plan (IMSACP) used a behavioral health care organization to manage expenditures for treatment of alcohol and drug dependence financed through Medicaid, block grants, and state appropriations but maintained relatively distinct eligibility and benefit structures for Medicaid-eligible individuals. Medicaid claims, encounters, and eligibility files were reviewed for 2 years before and 3 year after implementation of IMSACP to evaluate changes in access, utilization, and expenditures. The rate of substance abuse treatment doubled, use of inpatient hospital services decreased, and residential and outpatient services increased. Direct care costs decreased, while total expenditures held steady. The Iowa experience suggests that a well-planned initiative can control costs and improve access and utilization.

Cost Control↗
PubMed2006

Comparison of nitrate levels in raw water and finished water from historical monitoring data on Iowa municipal drinking water supplies.

Nitrate contamination of water sources is a concern where large amounts of nitrogen fertilizers are regularly applied to soils. Ingested nitrate from dietary sources and drinking water can be converted to nitrite and ultimately to N-nitroso compounds, many of which are known carcinogens. Epidemiologic studies of drinking water nitrate and cancer report mixed findings; a criticism is the use of nitrate concentrations from retrospective drinking water data to assign exposure levels. Residential point-of-use nitrate data are scarce; gaps in historical data for municipal supply finished water hamper exposure classification efforts. We used generalized linear regression models to estimate and compare historical raw water and finished water nitrate levels (1960s-1990s) in single source Iowa municipal supplies to determine whether raw water monitoring data could supplement finished water data to improve exposure assessment. Comparison of raw water and finished water samples (same sampling date) showed a significant difference in nitrate levels in municipalities using rivers; municipalities using other surface water or alluvial groundwater had no difference in nitrate levels. A regional aggregation of alluvial groundwater municipalities was constructed based on results from a previous study showing regional differences in nitrate contamination of private wells; results from this analysis were mixed, dependent upon region and decade. These analyses demonstrate using historical raw water nitrate monitoring data to supplement finished water data for exposure assessment is appropriate for individual Iowa municipal supplies using alluvial groundwater, lakes or reservoirs. Using alluvial raw water data on a regional basis is dependent on region and decade.

Cities↗