2005 Enrich Iowa: State Funding for Iowa Libraries, January 15, 2006

In accordance with 2005 IOWA ACTS Chapter 1175 (80)(4)(b), the State Library of Iowa submits this report on the uses and impact of state funding to Iowa libraries and Iowans through the Enrich Iowa Program. Enrich Iowa includes Direct State Aid to public libraries, Open Access and Access Plus. $2,298,432 was distributed to Iowa libraries through the FY05 Enrich Iowa program.

Tuberculosis comorbidity with communicable and non-communicable diseases: integrating health services and control efforts.

Recent data for the global burden of disease reflect major demographic and lifestyle changes, leading to a rise in non-communicable diseases. Most countries with high levels of tuberculosis face a large comorbidity burden from both non-communicable and communicable diseases. Traditional disease-specific approaches typically fail to recognise common features and potential synergies in integration of care, management, and control of non-communicable and communicable diseases. In resource-limited countries, the need to tackle a broader range of overlapping comorbid diseases is growing. Tuberculosis and HIV/AIDS persist as global emergencies. The lethal interaction between tuberculosis and HIV coinfection in adults, children, and pregnant women in sub-Saharan Africa exemplifies the need for well integrated approaches to disease management and control. Furthermore, links between diabetes mellitus, smoking, alcoholism, chronic lung diseases, cancer, immunosuppressive treatment, malnutrition, and tuberculosis are well recognised. Here, we focus on interactions, synergies, and challenges of integration of tuberculosis care with management strategies for non-communicable and communicable diseases without eroding the functionality of existing national programmes for tuberculosis. The need for sustained and increased funding for these initiatives is greater than ever and requires increased political and funder commitment.

Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors.

AIMS: Common carotid artery intima-media thickness (CCIMT) is widely used as a surrogate marker of atherosclerosis, given its predictive association with cardiovascular disease (CVD). The interpretation of CCIMT values has been hampered by the absence of reference values, however. We therefore aimed to establish reference intervals of CCIMT, obtained using the probably most accurate method at present (i.e. echotracking), to help interpretation of these measures. METHODS AND RESULTS: We combined CCIMT data obtained by echotracking on 24 871 individuals (53% men; age range 15-101 years) from 24 research centres worldwide. Individuals without CVD, cardiovascular risk factors (CV-RFs), and BP-, lipid-, and/or glucose-lowering medication constituted a healthy sub-population (n = 4234) used to establish sex-specific equations for percentiles of CCIMT across age. With these equations, we generated CCIMT Z-scores in different reference sub-populations, thereby allowing for a standardized comparison between observed and predicted ('normal') values from individuals of the same age and sex. In the sub-population without CVD and treatment (n = 14 609), and in men and women, respectively, CCIMT Z-scores were independently associated with systolic blood pressure [standardized βs 0.19 (95% CI: 0.16-0.22) and 0.18 (0.15-0.21)], smoking [0.25 (0.19-0.31) and 0.11 (0.04-0.18)], diabetes [0.19 (0.05-0.33) and 0.19 (0.02-0.36)], total-to-HDL cholesterol ratio [0.07 (0.04-0.10) and 0.05 (0.02-0.09)], and body mass index [0.14 (0.12-0.17) and 0.07 (0.04-0.10)]. CONCLUSION: We estimated age- and sex-specific percentiles of CCIMT in a healthy population and assessed the association of CV-RFs with CCIMT Z-scores, which enables comparison of IMT values for (patient) groups with different cardiovascular risk profiles, helping interpretation of such measures obtained both in research and clinical settings.

New anthropometry-based age- and sex-specific reference values for urinary 24-hour creatinine excretion based on the adult Swiss population (epublish)

BACKGROUND: Urinary creatinine excretion is used as a marker of completeness of timed urine collections, which are a keystone of several metabolic evaluations in clinical investigations and epidemiological surveys. METHODS: We used data from two independent Swiss cross-sectional population-based studies with standardised 24-hour urinary collection and measured anthropometric variables. Only data from adults of European descent, with estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2 and reported completeness of the urinary collection were retained. A linear regression model was developed to predict centiles of the 24-hour urinary creatinine excretion in 1,137 participants from the Swiss Survey on Salt and validated in 994 participants from the Swiss Kidney Project on Genes in Hypertension. RESULTS: The mean urinary creatinine excretion was 193 ± 41 μmol/kg/24 hours in men and 151 ± 38 μmol/kg/24 hours in women in the Swiss Survey on Salt. The values were inversely correlated with age and body mass index (BMI). CONCLUSIONS: We propose a validated prediction equation for 24-hour urinary creatinine excretion in the general European population, based on readily available variables such as age, sex and BMI, and a few derived normograms to ease its clinical application. This should help healthcare providers to interpret the completeness of a 24-hour urine collection in daily clinical practice and in epidemiological population studies.

Provision of health care actions and services for the management of HIV/AIDS from the users’ perspective

Objective To analyse the provision of health care actions and services for people living with AIDS and receiving specialised care in Ribeirão Preto, SP. Method A descriptive, exploratory, survey-type study that consisted of interviews with structured questionnaires and data analysis using descriptive statistics. Results The provision of health care actions and services is perceived as fair. For the 301 subjects, routine care provided by the reference team, laboratory tests and the availability of antiretroviral drugs, vaccines and condoms obtained satisfactory evaluations. The provision of tests for the prevention and diagnosis of comorbidities was assessed as fair, whereas the provisions of specialised care by other professionals, psychosocial support groups and medicines for the prevention of antiretroviral side effects were assessed as unsatisfactory. Conclusion Shortcomings were observed in follow-up and care management along with a predominantly biological, doctor-centred focus in which clinical control and access to antiretroviral therapy comprise the essential focus of the care provided.


Performance evaluation of primary care services for the treatment of tuberculosis

Objective Evaluating the performance of primary care services for the treatment of tuberculosis according to the assessment referential of health services (structure/process) in Cabedelo, a port city in the state of Paraíba. Method An evaluation quantitative, cross-sectional study, in which were carried out 117 interviews with health professionals using a structured instrument. The analysis was based on the construction of indicators using a standardized value for the reduced variable (z=1). Results The structural indicators showed regular performance for the following variables: professional training, access to record instruments and coordination with other services. The process indicators related to external actions and information about the disease had unsatisfactory performance. The directly observed treatment and the flows of reference/counter-reference had regular performance. Conclusion The focused professional qualification, the fragmentation of practices and the unsystematic home care constitute obstacles for carrying out actions aimed at providing expanded, continuous and resolute care.



FY06 Enrich Iowa Report State Funding for Iowa Libraries, January 15, 2007

Iowa is a state rich in libraries, with 543 public libraries; more than 80 college and university libraries; and about 1,000 school libraries. Libraries enrich Iowa and support lifelong learning. The State Library of Iowa actively champions libraries and improves library services for Iowans through its management of the Enrich Iowa program. In accordance with 2006 IOWA ACTS, Chapter 1180 (16)(6), the State Library of Iowa is pleased to submit this report on the impact of state funding on Iowans and Iowa libraries through the Enrich Iowa Program.

Reverse transcription quantitative real-time polymerase chain reaction reference genes in the spared nerve injury model of neuropathic pain: validation and literature search.

BACKGROUND: The reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) is a widely used, highly sensitive laboratory technique to rapidly and easily detect, identify and quantify gene expression. Reliable RT-qPCR data necessitates accurate normalization with validated control genes (reference genes) whose expression is constant in all studied conditions. This stability has to be demonstrated.We performed a literature search for studies using quantitative or semi-quantitative PCR in the rat spared nerve injury (SNI) model of neuropathic pain to verify whether any reference genes had previously been validated. We then analyzed the stability over time of 7 commonly used reference genes in the nervous system - specifically in the spinal cord dorsal horn and the dorsal root ganglion (DRG). These were: Actin beta (Actb), Glyceraldehyde-3-phosphate dehydrogenase (GAPDH), ribosomal proteins 18S (18S), L13a (RPL13a) and L29 (RPL29), hypoxanthine phosphoribosyltransferase 1 (HPRT1) and hydroxymethylbilane synthase (HMBS). We compared the candidate genes and established a stability ranking using the geNorm algorithm. Finally, we assessed the number of reference genes necessary for accurate normalization in this neuropathic pain model. RESULTS: We found GAPDH, HMBS, Actb, HPRT1 and 18S cited as reference genes in literature on studies using the SNI model. Only HPRT1 and 18S had been once previously demonstrated as stable in RT-qPCR arrays. All the genes tested in this study, using the geNorm algorithm, presented gene stability values (M-value) acceptable enough for them to qualify as potential reference genes in both DRG and spinal cord. Using the coefficient of variation, 18S failed the 50% cut-off with a value of 61% in the DRG. The two most stable genes in the dorsal horn were RPL29 and RPL13a; in the DRG they were HPRT1 and Actb. Using a 0.15 cut-off for pairwise variations we found that any pair of stable reference gene was sufficient for the normalization process. CONCLUSIONS: In the rat SNI model, we validated and ranked Actb, RPL29, RPL13a, HMBS, GAPDH, HPRT1 and 18S as good reference genes in the spinal cord. In the DRG, 18S did not fulfill stability criteria. The combination of any two stable reference genes was sufficient to provide an accurate normalization.

Primary Care Sensitive Hospitalization: users detect flaws on the access to services

The aim of this study is to analyze and understand the reasons for the occurrence of sensitive hospitalizations in accordance with users. Qualitative study conducted with users who were admitted to Pedreira General Hospital, in São Paulo. The data was collected through semi structured interviews and thereafter, transcribed and processed in the electronic program Alceste. When analyzing the content, the access was seized fundamentally as an empirical category, bringing up problems that later deserved, from the Brazilian Ministry of Health, a specific Program to improve the quality and access to primary care. The hierarchical and pyramidal organization shape from the health system in the city of São Paulo can be one of the important aspects for the access matter and established as an important restricting factor in the primary care role in reducing or even preventing the occurrence of these hospitalizations.

Spirometry reference equations for central European populations from school age to old age.

BACKGROUND: Spirometry reference values are important for the interpretation of spirometry results. Reference values should be updated regularly, derived from a population as similar to the population for which they are to be used and span across all ages. Such spirometry reference equations are currently lacking for central European populations. OBJECTIVE: To develop spirometry reference equations for central European populations between 8 and 90 years of age. MATERIALS: We used data collected between January 1993 and December 2010 from a central European population. The data was modelled using "Generalized Additive Models for Location, Scale and Shape" (GAMLSS). RESULTS: The spirometry reference equations were derived from 118'891 individuals consisting of 60'624 (51%) females and 58'267 (49%) males. Altogether, there were 18'211 (15.3%) children under the age of 18 years. CONCLUSION: We developed spirometry reference equations for a central European population between 8 and 90 years of age that can be implemented in a wide range of clinical settings.

Multilayered genetic and omics dissection of mitochondrial activity in a mouse reference population

The manner by which genotype and environment affect complex phenotypes is one of the fundamental questions in biology. In this study, we quantified the transcriptome--a subset of the metabolome--and, using targeted proteomics, quantified a subset of the liver proteome from 40 strains of the BXD mouse genetic reference population on two diverse diets. We discovered dozens of transcript, protein, and metabolite QTLs, several of which linked to metabolic phenotypes. Most prominently, Dhtkd1 was identified as a primary regulator of 2-aminoadipate, explaining variance in fasted glucose and diabetes status in both mice and humans. These integrated molecular profiles also allowed further characterization of complex pathways, particularly the mitochondrial unfolded protein response (UPR(mt)). UPR(mt) shows strikingly variant responses at the transcript and protein level that are remarkably conserved among C. elegans, mice, and humans. Overall, these examples demonstrate the value of an integrated multilayered omics approach to characterize complex metabolic phenotypes.

LSTA Five Year Plan, 1998-2002, 2002

The LSTA goals for Iowa, FY98-FY02, are as follows: 1. Provide all Iowans with expanded access to information and materials through the State of Iowa Libraries Online (SILO) network. 2. Improve library service to Iowans through knowledgeable, well-trained staff and wellinformed public library trustees and library users. 3. Meet Iowans’ increasing demands for information and library services by identifying and encouraging resource sharing and partnerships. 4. Provide state level leadership and services to accomplish the LSTA Five-Year Plan. The primary objectives of this evaluation are to provide: $ An assessment of the overall impact of Iowa’s LSTA funding and success in achieving the goals identified in the state’s five-year plan. $ An in-depth analysis of two specific goals from the plan: providing Iowans with expanded access to information and materials through the State of Iowa Libraries Online (SILO) network; and improving library service to Iowans through knowledgeable, well-trained staff and well-informed public library trustees and library users. LSTA built on accomplishments made possible with the federal HEA II-B grant awarded to the State Library in 1995. This grant led the way in bringing technology to Iowa libraries by creating an electronic library network for resource sharing. SILO (State of Iowa Libraries Online) became fully functional in 1997. The State Library continued funding SILO with LSTA money when the grant ended. This funding supports the SILO infrastructure, providing equitable access to information through cutting edge technology to Iowans in both small and large, rural and urban, communities. Access to electronic material and information has encouraged public libraries to increase the number of computers and public access to the Internet. LSTA funding was used to increase training opportunities for library staff and trustees. Many programs, such as librarian certification, were strengthened by an increase in continuing education opportunities.

LSTA Five Year Plan, 1998-2002, 2002

The LSTA goals for Iowa, FY98-FY02, are as follows: 1. Provide all Iowans with expanded access to information and materials through the State of Iowa Libraries Online (SILO) network. 2. Improve library service to Iowans through knowledgeable, well-trained staff and wellinformed public library trustees and library users. 3. Meet Iowans’ increasing demands for information and library services by identifying and encouraging resource sharing and partnerships. 4. Provide state level leadership and services to accomplish the LSTA Five-Year Plan. The primary objectives of this evaluation are to provide: $ An assessment of the overall impact of Iowa’s LSTA funding and success in achieving the goals identified in the state’s five-year plan. $ An in-depth analysis of two specific goals from the plan: providing Iowans with expanded access to information and materials through the State of Iowa Libraries Online (SILO) network; and improving library service to Iowans through knowledgeable, well-trained staff and well-informed public library trustees and library users. LSTA built on accomplishments made possible with the federal HEA II-B grant awarded to the State Library in 1995. This grant led the way in bringing technology to Iowa libraries by creating an electronic library network for resource sharing. SILO (State of Iowa Libraries Online) became fully functional in 1997. The State Library continued funding SILO with LSTA money when the grant ended. This funding supports the SILO infrastructure, providing equitable access to information through cutting edge technology to Iowans in both small and large, rural and urban, communities. Access to electronic material and information has encouraged public libraries to increase the number of computers and public access to the Internet. LSTA funding was used to increase training opportunities for library staff and trustees. Many programs, such as librarian certification, were strengthened by an increase in continuing education opportunities.

LSTA Five Year Plan Evaluation, 1998-2002, 2002

The LSTA goals for Iowa, FY98-FY02, are as follows: 1. Provide all Iowans with expanded access to information and materials through the State of Iowa Libraries Online (SILO) network. 2. Improve library service to Iowans through knowledgeable, well-trained staff and wellinformed public library trustees and library users. 3. Meet Iowans’ increasing demands for information and library services by identifying and encouraging resource sharing and partnerships. 4. Provide state level leadership and services to accomplish the LSTA Five-Year Plan. The primary objectives of this evaluation are to provide: $ An assessment of the overall impact of Iowa’s LSTA funding and success in achieving the goals identified in the state’s five-year plan. $ An in-depth analysis of two specific goals from the plan: providing Iowans with expanded access to information and materials through the State of Iowa Libraries Online (SILO) network; and improving library service to Iowans through knowledgeable, well-trained staff and well-informed public library trustees and library users. LSTA built on accomplishments made possible with the federal HEA II-B grant awarded to the State Library in 1995. This grant led the way in bringing technology to Iowa libraries by creating an electronic library network for resource sharing. SILO (State of Iowa Libraries Online) became fully functional in 1997. The State Library continued funding SILO with LSTA money when the grant ended. This funding supports the SILO infrastructure, providing equitable access to information through cutting edge technology to Iowans in both small and large, rural and urban, communities. Access to electronic material and information has encouraged public libraries to increase the number of computers and public access to the Internet. LSTA funding was used to increase training opportunities for library staff and trustees. Many programs, such as librarian certification, were strengthened by an increase in continuing education opportunities.

Impact of Federal Library Services and Technology Act Funds in Iowa, May 2007.

A report that Mary Wegner gave Iowa's congressmen and senators during this year's ALA Legislative Day in Washington, DC. The report reflects the important ways the State Library uses LSTA funds to help Iowa libraries provide the best service possible to their customers. LSTA funds also pay the salaries of Library Development staff.