Utah

Gaps exist in inpatient asthma care. Our aims were to assess the impact of an evidence-based care process model (EB-CPM) 5 years after implementation at Primary Children's Hospital (PCH), a tertiary care facility, and after its dissemination to 7 community hospitals. Participants included asthmatics 2 to 17 years admitted at 8 hospitals between 2003 and 2013. The EB-CPM was implemented at PCH between January 2008 and March 2009, then disseminated to 7 community hospitals between January and June 2011. We measured compliance using a composite score (CS) for 8 quality measures. Outcomes were compared between preimplementation and postimplementation periods. Confounding was addressed through multivariable regression analyses. At PCH, the CS increased and remained at >90% for 5 years after implementation. We observed sustained reductions in asthma readmissions (P = .026) and length of stay (P < .001), a trend toward reduced costs (P = .094), and no change in hospital resource ...

We examined familial aggregation and risk of age-related macular degeneration in the Utah population using a population-based case-control study. Over one million unique patient records were searched within the University of Utah Health Sciences Center and the Utah Population Database (UPDB), identifying 4764 patients with AMD. Specialized kinship analysis software was used to test for familial aggregation of disease, estimate the magnitude of familial risks, and identify families at high risk for disease. The population-attributable risk (PAR) for AMD was calculated to be 0.34. Recurrence risks in relatives indicate increased relative risks in siblings (2.95), first cousins (1.29), second cousins (1.13), and parents (5.66) of affected cases. There were 16 extended large families with AMD identified for potential use in genetic studies. Each family had five or more living affected members. The familial aggregation of AMD shown in this study exemplifies the merit of the UPDB and supports recent research demonstrating significant genetic contribution to disease development and progression.

Rape in Utah: The Secret that Everyone Knows There is something to be said about that way our fellow Utahans go through their daily lives with a sort of unwavering optimism. I have often heard from visitors that we have some of the nicest and happiest people they have ever meet. Why is that? Is it because there is such a strong religious presence in our state? Is it because we get to experience all four seasons, or that we usually have at least one really good sports team each year? Perhaps it is all of these reasons. But far more likely it is because so many of us in the happy valley have learned an ability to ignore the unpleasant truths of life. One such unpleasant truth is rape and sexual assault. There are however some groups that are bringing these dark topics to light here in Utah. As such I would like to talk about the Rape Recovery Center of Utah and what they are doing to combat this growing and disturbing problem. SOCIAL CONTEXT Before I get specifically address The Rape Recovery Center, I would like to talk about rape and how it applies to our lives here in Utah. Many people feel as though Utah is one of the safest places in the country. The truth is that those who feel that way are for the most part right. According to a study called " Rape in Utah: A Survey of Utah Women about Their Experience with Sexual Violence, " Utah is typically at least one half to one third below the national average for all violent crimes, all except rape that is. In fact rape is the only violent crime that has a rate Lueck 1

During the nineteenth century, English-speaking natives of Utah exhibited variation in three phonological variables (among others): the cot-caught merger, the cord-card merger, and /ai/-monophthongization. Based on an analysis of audio recordings of twenty-six natives of Utah born during the nineteenth century, changes in these variables over apparent time are tracked. The analysis finds a trend toward completion of the two mergers and increased /ai/-monophthongization. This is contrasted with the current situation, in which the cot-caught merger has progressed to a state of completion in perception and very small differences in production, the cord-card merger is being abandoned, and /ai/-monophthongization exists only at a very low level. Possible reasons for this include a movement toward regional rather than local norms resulting from greater contact between varieties in the Intermountain West during the twentieth century.

Contributing to extant discourses about corporate environmental
advocacy, this paper argues that corporations can embed discursive
rhetorical strategies in material places and spaces. This argument
contributes to environmental communication by bridging divisions
between discursive and materialist approaches to corporate rhetoric.
Corporate materiality is realized in the study of Rio Tinto Kennecott
(RTK) at places of corporate community where RTK enunciates a
dominant environmental discourse about the necessity of the Bingham
Canyon Mine through strategies such as the technological shell game,
the hypocrite’s trap, and corporate heterotopia, which are made
manifest materially alongside cultural values such as epistemic trust,
technological progress, community, and home. Using participatory
critical rhetoric as a methodology, I analyse RTK’s material rhetoric at the
Natural History Museum of Utah, the Rio Tinto Soccer Stadium, and the
Daybreak suburban community. This case study reveals that
corporations are assemblages that assert many different, and sometimes
competing, arguments that can deflect environmental criticism, materially.

Intermountain Healthcare has a long history of using coded terminology and detailed clinical models (DCMs) to govern storage of clinical data to facilitate decision support and semantic interoperability. The latest iteration of DCMs at Intermountain is called the clinical element model (CEM). We describe the lessons learned from our CEM efforts with regard to subjective decisions a modeler frequently needs to make in creating a CEM. We present insights and guidelines, but also describe situations in which use cases conflict with the guidelines. We propose strategies that can help reconcile the conflicts. The hope is that these lessons will be helpful to others who are developing and maintaining DCMs in order to promote sharing and interoperability. We have used the Clinical Element Modeling Language (CEML) to author approximately 5000 CEMs. Based on our experience, we have formulated guidelines to lead our modelers through the subjective decisions they need to make when authoring mo...

In the United States, undocumented students must navigate complex sociopolitical realities to access and succeed in higher education. These complex sociopolitical realities are shaped by federal policies on education and immigration, state-specific legislation on education and public policy, as well as general attitudes regarding race, immigration, and nationalism in the U.S. In this manuscript, I weave in counter-storytelling to document some of the ways one undocumented student accessed and navigated U.S. higher education. I begin by reviewing the national and state policy contexts that affect undocumented students in the U.S. I focus a state policy analysis in Utah, as one example of how national and state policies interact and sometimes contradict one another to impact the ways in which undocumented students navigate higher education. Second, I analyze the existing literature on the barriers undocumented students face in higher education, as well as the emerging literature on undocumented student support services in higher education. Third, I present current higher education programs in U.S. colleges and universities that consider sociopolitical contexts and respond to the particular needs of undocumented students. Finally, I draw implications for improved practice in undocumented student services in higher education.

This essay reviews the exhibition 'No Place Like Home: Selections from the Sue and John Wieland Collection of Contemporary Art.'
The show, curated by Jeff Lambson, includes works of contemporary art which ruminate on the theme of Home. As such, broader questions are raised about the compatibility of Mormonism with contemporary art.

Detrital Zircon U-Pb Geochronological Provenance of Lower Cretaceous Deposits, Foreland Basin, Utah

Gary J. Hunt1
Timothy F. Lawton2
James I. Kirkland1

1Utah Geological Survey, Salt Lake City; 2New Mexico State University, Las Cruces

ABSTRACT

U-Pb ages of detrital zircon (DZ) grains from Lower Cretaceous foreland basin quartzite conglomerate clasts and sandstones—and from potential sources of quartzite clasts and sandstones—record unroofing of the Sevier fold-thrust belt of Utah and the Mogollon Highlands of Arizona.  The oldest Cretaceous deposits in Utah, the Buckhorn Conglomerate (Berremian-Aptian) of the Cedar Mountain Formation, contain sandstone and quartzite clasts with DZ age spectra statistically indistinguishable to Mississippian-Jurassic sandstones on the Colorado Plateau and in Sevier thrust sheets.  Medial Albian Cedar Mountain Formation conglomerates on the western San Rafael Swell (Short Canyon Conglomerate) and basal Cedar Mountain conglomerates on the Wasatch Plateau in central Utah and the Markagunt Plateau in southwest Utah contain quartzite clasts derived from the Ordovician-Devonian interval in the thrust belt. Middle Albian-lower Cenomanian San Pitch and Sanpete Formations of the lower Indianola Group and upper Dakota Sandstone in central Utah were supplied with Cambrian-Precambrian quartzite clasts, thus recording full incision into approximately 16,000 m of allochthonous strata in the central Utah thrust belt by mid Albian.  These three geochronological provenance intervals define three inverted chronofacies in Lower Cretaceous and basal Upper Cretaceous synorogenic deposits, thus recording a complete unroofing sequence of allochthonous strata in the central Utah thrust belt. 
The Buckhorn Conglomerate on the San Rafael Swell and the Poison Strip Sandstone in eastern Utah do not share a common provenance.  The Poison Strip contains significant proportions of Cordilleran arc derived grains that are also commonly found in the lower Burro Canyon Formation to the southeast, whereas in the Buckhorn Conglomerate they are rare.  Whether this phenomenon is due to temporal or sediment dispersal differences are unclear, it may signal the onset of longitudinal trunk river development subsequent to Buckhorn deposition and coeval with orogenesis.  An additional source of Mesozoic volcanic arc DZ grains might include recycling from tephras within Mesozoic strata from local and southern sources in the Mogollon Highlands.

Immunizing the population is a vital public health priority. This article describes a resident-led continuous quality improvement (CQI) project to improve the immunization rates of children under 3 years old at two urban Family Medicine (FM) residency clinics in Salt Lake City, Utah, as well as a break-even cost analysis to the clinics for the intervention. Immunization records were distributed to provider-medical assistant teamlets daily for each pediatric patient scheduled in clinic to decrease missed opportunities. An outreach intervention by letter, followed by telephone call reminders, was conducted to reach children under the age of 3 who were behind on recommended immunizations for age (total n=457; those behind on immunizations n=101). Immunization rates at 3 months were monitored. A break-even analysis to the clinics for the outreach intervention was performed. Immunizations were improved from a baseline of 75.1% (n=133) and 79.6% (n=223) at the two clinics to 92.1% (n=163)...

To develop expeditiously a pragmatic, modular, and extensible software framework for understanding and improving healthcare value (costs relative to outcomes). In 2012, a multidisciplinary team was assembled by the leadership of the University of Utah Health Sciences Center and charged with rapidly developing a pragmatic and actionable analytics framework for understanding and enhancing healthcare value. Based on an analysis of relevant prior work, a value analytics framework known as Value Driven Outcomes (VDO) was developed using an agile methodology. Evaluation consisted of measurement against project objectives, including implementation timeliness, system performance, completeness, accuracy, extensibility, adoption, satisfaction, and the ability to support value improvement. A modular, extensible framework was developed to allocate clinical care costs to individual patient encounters. For example, labor costs in a hospital unit are allocated to patients based on the hours they s...