State of Iowa HIV and AIDS Surveillance Report, December 2004

After taking a dip in 2003, HIV diagnoses were back up in 2004. There were 103 persons diagnosed in 2004, very close to our ten-year average of 100 cases per year. In 2003, there were 91 diagnoses. The increase in 2004 was limited to one demographic group: white, U.S.-born males. Most of these were men who have sex with men, but there were also small increases among injection-drug-using men and those without a known risk. Their median age was 41, slightly older than the overall median age of 38 years. Eighty percent were residents of the 10 most populous counties in Iowa, particularly the counties of Polk, Pottawattamie, Johnson, Linn, Scott, Story, and Woodbury.

State of Iowa HIV and AIDS Surveillance Report,June 2005

This quarter, we saw 17 HIV diagnoses, half the number of persons diagnosed in the first quarter of the year. For the two quarters, there were 50 diagnoses, keeping pace with last year’s number of diagnoses. Nineteen of the 50 (38%) received concurrent AIDS diagnoses. Of concern this year is the high number of persons reported without a risk. Over 40% of new cases were initially reported without a risk. Most of these cases are being investigated by disease prevention specialists. History shows us that a good proportion of these cases will be assigned to a risk category in the coming months as more is learned about their risks and the risks of their partners. Note that only 17% of cases diagnosed in 2004 remain without a known risk. There were 36 AIDS diagnoses in the first two quarters of 2005, just a bit ahead of what we saw last year. Fifteen of these were persons who had been diagnosed with HIV at least one year (fifteen years for two persons), and the rest received concurrent HIV and AIDS diagnoses.

Children in the welfare state. A social investment approach

Children occupy centre-stage in any new welfare equilibrium. Failure to support families may produce either of two undesirable scenarios. We shall see a society without children if motherhood remains incompatible with work. A new family policy needs to recognize that children are a collective asset and that the cost of having children is rising. The double challenge is to eliminate the constraints on having children in the first place, and to ensure that the children we have are ensured optimal opportunities. The simple reason why a new social contract is called for is that fertility and child quality combine both private utility and societal gains. And like no other epoch in the past, the societal gains are mounting all-the-while that families’ ability to produce these social gains is weakening.In the following 1 analyze the twin challenges of fertility and child development. I then examine which kind of policy mix will ensure both the socially desired level of fertility and investment in our children? The task is to identify a Paretian optimum that will maximize efficiency gains and social equity simultaneously.

Immigration and contested nation-building : explaining the political salience of immigration in multi-national societies

Multi-national societies present a complex setting for the politics of immigration, as migration’s linguistic, economic and cultural effects may coincide with existing contestation over nationhood between sub-units and the central state. Empirically, though, political actors only sometimes, and in some places, explicitly connect the politics of immigration to the stakes of multi-level politics. With reference to Canada, Belgium and the United Kingdom, this paper examines the conditions under which political leaders link immigration to ongoing debate about governance in multi-national societies. The paper argues that the distribution of policy competencies in the multi-level system is less important for shaping immigration and integration politics than is the perceived impact (positive or negative) on the sub-unit’s societal culture or its power relationship with the center. Immigration and integration are more often politicized where center and sub-unit hold divergent views on migration and its place in national identity.

Deep thiopental anesthesia alters steady-state glucose homeostasis but not the neurochemical profile of rat cortex.

Barbiturates are regularly used as an anesthetic for animal experimentation and clinical procedures and are frequently provided with solubilizing compounds, such as ethanol and propylene glycol, which have been reported to affect brain function and, in the case of (1)H NMR experiments, originate undesired resonances in spectra affecting the quantification. As an alternative, thiopental can be administrated without any solubilizing agents. The aim of the study was to investigate the effect of deep thiopental anesthesia on the neurochemical profile consisting of 19 metabolites and on glucose transport kinetics in vivo in rat cortex compared with alpha-chloralose using localized (1)H NMR spectroscopy. Thiopental was devoid of effects on the neurochemical profile, except for the elevated glucose at a given plasma glucose level resulting from thiopental-induced depression of glucose consumption at isoelectrical condition. Over the entire range of plasma glucose levels, steady-state glucose concentrations were increased on average by 48% +/- 8%, implying that an effect of deep thiopental anesthesia on the transport rate relative to cerebral glucose consumption ratio was increased by 47% +/- 8% compared with light alpha-chloralose-anesthetized rats. We conclude that the thiopental-induced isoelectrical condition in rat cortex significantly affected glucose contents by depressing brain metabolism, which remained substantial at isoelectricity.

Identification of care needs of patients with and without the use of a classification instrument

Objective: To analyze the agreement and disagreement between the assessments by applying or not a patient classification instrument, and to investigate the association between the agreement and personal and professional characteristics of the evaluators. Method: This is a descriptive exploratory study. 105 patients were hospitalized in a teaching hospital in the state of Sao Paulo, using the kappa statistic (weighted) and the Bootstrap method. Results: The agreement between the assessments were​​: kw 0.87 (instrument x internal evaluator), kw 0.78 (instrument x external evaluator) and kw 0.76 (between evaluators) and the influence of some personal and professional characteristics. The assessments conducted through the use of an instrument contemplated a greater number of areas of care in relation to when the instrument was not applied. Conclusion: The use of this instrument is recommended in order to more effectively identify care needs of patients.




Iowa's Adult Literacy Program State Plan Extension, 2006

The passage of the Workforce Investment Act of 1998 (WIA) [Public Law 105-220] by the 105th Congress has ushered in a new era of collaboration, coordination, cooperation and accountability. The overall goal of the Act is “to increase the employment, retention, earnings of participants, and increase occupational skill attainment by participants, and, as a result improve the quality of the workforce, reduce welfare dependency, and enhance the productivity and competitiveness of the Nation.” The key principles inculcated in the Act are: • streamlining services; • empowering individuals; • universal access; • increased accountability; • new roles for local boards; • state and local flexibility; • improved youth programs. The purpose of Title II, The Adult Education and Family Literacy Act (AEFLA) of the Workforce Investment Act of 1998, is to create a partnership among the federal government, states, and localities to provide, on a voluntary basis, adult education and literacy services in order to: • assist adults to become literate and obtain the knowledge and skills necessary for employment and self-sufficiency; • assist adults who are parents obtain the educational skills necessary to become full partners in the educational development of their children; • assist adults in the completion of a secondary school education. The major purposes of Iowa’s Adult Literacy Program State Plan Extension for Program Year 2006 are: • provide a comprehensive blue print for implementation of Title II of the Act; • serve as a basis for both immediate and long-range planning and continuous, systematic evaluation of program effectiveness; • provide basis for common understanding among Iowa’s literacy partners, other interested entities and the U.S. Department of Education. The plan extension is designed to update Iowa’s Adult Literacy State Plan for Program Year 2006 in line with the guidelines provided by the United States Department of Education: Division of Adult Education and Literacy (USDE:DAEL).

Iowa’s Adult Literacy Program State Plan Extension, 2007

The passage of the Workforce Investment Act of 1998 (WIA) [Public Law 105-220] by the 105th Congress has ushered in a new era of collaboration, coordination, cooperation and accountability. The overall goal of the Act is “to increase the employment, retention, earnings of participants, and increase occupational skill attainment by participants, and, as a result improve the quality of the workforce, reduce welfare dependency, and enhance the productivity and competitiveness of the Nation.”

Democratisation via elections in an African 'narco state'?

Recent development cooperation with Guinea-Bissau, focussing on good governance, state-building and conflict prevention, did not contribute to democratization nor to the stabilization of volatile political, military and economic structures. Both the portrayal of Guinea-Bissau as failed ‘narco state' as well as Western aid meant to stabilize this state by multi-party elections are based on doubtful concepts and assumptions. Certainly, the impact of drug trafficking could endanger democratization and state-building if continued unchecked. However, the most pressing need is not state-building, facilitated by external aid, yet poorly rooted in the social and political fabric of the country, but nation-building from below as a pre-condition for the creation of viable state institutions.

State capacity and military conflict

In 1500, Europe was composed of hundreds of statelets and principalities, with weak central authority,no monopoly over the legitimate use of violence, and overlapping jurisdictions. By 1800, only ahandful of powerful, centralized nation states remained. We build a model that explains both the emergenceof capable states and growing divergence between European powers. We argue that the impactof war was crucial for state building, and depended on: i) the financial cost of war, and ii) a country sinitial level of domestic political fragmentation. We emphasize the role of the "Military Revolution",which raised the cost of war. Initially, this caused more cohesive states to invest in state capacity, whilemore divided states rationally dropped out of the competition, causing divergence between Europeanstates. As the cost of war escalated further, all states engaged in a "race to the top" towards greater statebuilding.

State of Iowa Employee Handbook, Revised October 2003

This is your employee handbook. This information is based on Iowa Department of Administrative Services – Human Resources Enterprise (DAS-HRE) rules and policies. Much of the information in this handbook is also covered in the State’s collective bargaining agreements. Where there are differences between a collective bargaining agreement and this handbook, the collective bargaining agreement prevails for employees covered by the agreement. Where there are differences between this handbook and DAS-HRE rules and policies, DAS-HRE rules and policies prevail. Some of the employee benefit plans described in this handbook are subject to legal requirements concerning reporting and disclosure. This handbook contains highlights of those plans. For complete details about benefit plans, consult the benefit handbooks and the official plan documents. In case of any discrepancy, the official plan documents prevail. Of course, changes in laws may affect the benefit programs described in this handbook. The State of Iowa reserves the right to amend the contents of this handbook at any time without prior notice. The provisions of this handbook and other policies do not establish contractual rights or conditions of employment between the State and its employees.

Crossing the Rio Grande: Migrations, business cycles and the welfare state

In this paper we study the macroeconomic effects of an inflow oflow-skilled workers into an economy where there is capital accumulation and two types of agents. We find that there are substantial dynamic effects following unexpected migrations with adjustments that resemble those triggered by a sudden disruption of the capital stock. We look at the interrelations between these dynamic effects and three different fiscal systems for the redistribution of income and find that these schemes can change the dynamics and lead to prolonged periods of adjustments. Theaggregate welfare implications are sensitive to the welfare system: while there are welfare gains without redistribution, these gains may be turned into costs when the state engages in redistribution.

Transcatheter aortic valve implantation (TAVI): state of the art techniques and future perspectives.

Transcatheter aortic valve therapies are the newest established techniques for the treatment of high risk patients affected by severe symptomatic aortic valve stenosis. The transapical approach requires a left anterolateral mini-thoracotomy, whereas the transfemoral method requires an adequate peripheral vascular access and can be performed fully percutaneously. Alternatively, the trans-subclavian access has been recently proposed as a third promising approach. Depending on the technique, the fine stent-valve positioning can be performed with or without contrast injections. The transapical echo-guided stent-valve implantation without angiography (the Lausanne technique) relies entirely on transoesophageal echocardiogramme imaging for the fine stent-valve positioning and it has been proved that this technique prevents the onset of postoperative contrast-related acute kidney failure. Recent published reports have shown good hospital outcomes and short-term results after transcatheter aortic valve implantation, but there are no proven advantages in using the transfemoral or the transapical technique. In particular, the transapical series have a higher mean logistic Euroscore of 27-35%, a procedural success rate above 95% and a mean 30-day mortality between 7.5 and 17.5%, whereas the transfemoral results show a lower logistic Euroscore of 23-25.5%, a procedural success rate above 90% and a 30-day mortality of 7-10.8%. Nevertheless, further clinical trials and long-term results are mandatory to confirm this positive trend. Future perspectives in transcatheter aortic valve therapies would be the development of intravascular devices for the ablation of the diseased valve leaflets and the launch of new stent-valves with improved haemodynamic, different sizes and smaller delivery systems.

Office of the State Long-Term Care Ombudsman Annual Report 2008, January 2009

The State Long-Term Care Ombudsman program operates as a unit within the Iowa Department of Elder Affairs. Duties of all long-term care ombudsmen are mandated by the Older Americans Act. This office serves people living in nursing facilities, skilled nursing facilities, residential care facilities, nursing facilities in hospitals, elder group homes and assisted living programs. The long-term care system in Iowa has changed significantly over the past 10 years. Local long-term care ombudsman programs in Iowa are now well established. Iowa still ranks near the bottom of 53 ombudsman programs in the nation for ratio of paid staff to residents with one ombudsman for each 7,400 residents compared to the national average of one ombudsman for each 2,174 residents. The Resident Advocate Committee Program remains stable at 2400 volunteers and Iowa continues to be the only state in the nation with this type of program. Because volunteers do not receive training as required by the Administration on Aging, volunteers are not certified volunteer ombudsmen and the work done by these volunteers cannot be included in Iowa’s annual federal reports. With the changing population living in long-term care facilities, this volunteer job is much more challenging than in the past. Helping to build a long-term care system in Iowa that provides individualized, person-directed quality care is the long-term goal for this office.

State of Iowa Employee Handbook, Revised October 2003

I hope you will find a great deal of challenge and personal satisfaction in your employment with the State. You have an important role in accomplishing the goals of your department and of state government. The State has a proud tradition built on the excellence of its employees and their work. We challenge you to help maintain and improve upon this tradition. You soon will discover that our pride is contagious! As a state employee, it is very important that you always present the best possible image to the public. Remember to act promptly, be courteous, and treat people, our customers, respectfully. Your actions will make a lasting impression .... be sure it is a positive one. This is your employee handbook. This information is based on Iowa Department of Administrative Services – Human Resources Enterprise (DAS-HRE) rules and policies. Much of the information in this handbook is also covered in the State’s collective bargaining agreements. Where there are differences between a collective bargaining agreement and this handbook, the collective bargaining agreement prevails for employees covered by the agreement. Where there are differences between this handbook and DAS-HRE rules and policies, DAS-HRE rules and policies prevail. Some of the employee benefit plans described in this handbook are subject to legal requirements concerning reporting and disclosure. This handbook contains highlights of those plans. For complete details about benefit plans, consult the benefit handbooks and the official plan documents. In case of any discrepancy, the official plan documents prevail. Of course, changes in laws may affect the benefit programs described in this handbook. The State of Iowa reserves the right to amend the contents of this handbook at any time without prior notice. The provisions of this handbook and other policies do not establish contractual rights or conditions of employment between the State and its employees.