221 research outputs found
Case Note: Property LawâOutdoor Advertising Control Acts Slice City Funds into the BunkerâIn re Denial of Eller Media Companyâs Applications for Outdoor Advertising Device Permits in the City of Mounds View
Get PDFThis note first examines a brief history of the municipal development of the comprehensive plan and outdoor advertising control legislation, the federal governmentâs promulgation of the Highway Beautification Act, and the Minnesota Outdoor Advertising Control Act. Upon review of the background of the Eller Media case, this note highlights the opinion rendered by the Minnesota Supreme Court. An analysis of the supreme courtâs interpretation in light of the outdoor advertising control acts and regulations follows, including an examination of the policies that underlie the pertinent statutes. This note concludes that based on the state of the golf course today, the supreme courtâs strict interpretation of the advertising control statutes focused too narrowly on the zoning label instead of the actual land use
Case Note: Property LawâOutdoor Advertising Control Acts Slice City Funds into the BunkerâIn re Denial of Eller Media Companyâs Applications for Outdoor Advertising Device Permits in the City of Mounds View
Get PDFThis note first examines a brief history of the municipal development of the comprehensive plan and outdoor advertising control legislation, the federal governmentâs promulgation of the Highway Beautification Act, and the Minnesota Outdoor Advertising Control Act. Upon review of the background of the Eller Media case, this note highlights the opinion rendered by the Minnesota Supreme Court. An analysis of the supreme courtâs interpretation in light of the outdoor advertising control acts and regulations follows, including an examination of the policies that underlie the pertinent statutes. This note concludes that based on the state of the golf course today, the supreme courtâs strict interpretation of the advertising control statutes focused too narrowly on the zoning label instead of the actual land use
Risk of exposure to Coxiella burnetii from ruminant livestock exhibited at Iowa agricultural fairs
Get PDFCoxiella burnetii is a zoonotic pathogen typically associated with clinical and asymptomatic infection in ruminant livestock. A reâemerging pathogen of significant public health importance, C. burnetii has caused recent epidemics in the U.S. and Europe and public livestock exhibitions are increasingly scrutinized as a potential source of C. burnetii exposure. Although C. burnetii prevalence data among North American domestic ruminants is extremely limited, contemporary studies suggest that this pathogen is both geographically widespread and highly prevalent on a herd basis, especially in dairy cattle and goat populations. We utilized a realâtime PCR assay to detect Coxiella burnetii fecal shedding by clinically normal, nonâperiparturient beef cattle, meat goats, and sheep exhibited at Iowa agricultural fairs. Individual fecal samples were collected from beef cattle, meat goats, and sheep exhibited at twelve Iowa county fairs during the summer of 2009. The sample pool was blocked by species and fair, ten samples from each block were randomly selected for the diagnostic assay; this test pool is considered sufficient to identify with 95% confidence a shedding animal in a population prevalence of 2.85% (cattle and sheep) and 6.25% (goats). Detection of Coxiella burnetii DNA was determined through use of a real time PCR assay validated for use in bovine, ovine, and caprine feces; threshold of detection is one DNA copy per PCR (sensitivity 95.8%, specificity 100%). All tested samples were negative for Coxiella burnetii DNA. We conclude that nonâdairy, nonâperiparturient ruminants exhibited at Iowa fairs are unlikely to shed Coxiella burnetii in their feces and that this population should not be considered to be a significant exposure risk to other livestock or fair attendees
Depression diagnoses following the identification of bipolar disorder: costly incongruent diagnoses
Get PDF<p>Abstract</p> <p>Background</p> <p>Previous research has documented that the symptoms of bipolar disorder are often mistaken for unipolar depression prior to a patient's first bipolar diagnosis. The assumption has been that once a patient receives a bipolar diagnosis they will no longer be given a misdiagnosis of depression. The objectives of this study were 1) to assess the rate of subsequent unipolar depression diagnosis in individuals with a history of bipolar disorder and 2) to assess the increased cost associated with this potential misdiagnosis.</p> <p>Methods</p> <p>This study utilized a retrospective cohort design using administrative claims data from 2002 and 2003. Patient inclusion criteria for the study were 1) at least 2 bipolar diagnoses in 2002, 2) continuous enrollment during 2002 and 2003, 3) a pharmacy benefit, and 4) age 18 to 64. Patients with at least 2 unipolar depression diagnoses in 2003 were categorized as having an incongruent diagnosis of unipolar depression. We used propensity scoring to control for selection bias. Utilization was evaluated using negative binomial models. We evaluated cost differences between patient cohorts using generalized linear models.</p> <p>Results</p> <p>Of the 7981 patients who met all inclusion criteria for the analysis, 17.5% (1400) had an incongruent depression diagnosis (IDD). After controlling for background differences, individuals who received an IDD had higher rates of inpatient and outpatient psychiatric utilization and cost, on average, an additional $1641 per year compared to individuals without an IDD.</p> <p>Conclusions</p> <p>A strikingly high proportion of bipolar patients are given the differential diagnosis of unipolar depression <it>after </it>being identified as having bipolar disorder. Individuals with an IDD had increased acute psychiatric care services, suggesting higher levels of relapses, and were at risk for inappropriate treatment, as antidepressant therapy without a concomitant mood-stabilizing medication is contraindicated in bipolar disorder. Further prospective research is needed to validate the findings from this retrospective administrative claims-based analysis.</p
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