Benefit News: Employee Benefit News, Department of Administrative Services, March 2015

Benefit News, brought to you by the DAS Benefits Team, providing you with the most up-to-date information about the state of Iowa’s employee benefits.

Benefit News: Employee Benefit News, Department of Administrative Services, May 2015

Benefit News, brought to you by the DAS Benefits Team, providing you with the most up-to-date information about the state of Iowa’s employee benefits.

French Swiss physicians' attitude toward palliative sedation: Influence of prognosis and type of suffering.

OBJECTIVE: Palliative sedation is a last resort medical act aimed at relieving intolerable suffering induced by intractable symptoms in patients at the end-of-life. This act is generally accepted as being medically indicated under certain circumstances. A controversy remains in the literature as to its ethical validity. There is a certain vagueness in the literature regarding the legitimacy of palliative sedation in cases of non-physical refractory symptoms, especially "existential suffering." This pilot study aims to measure the influence of two independent variables (short/long prognosis and physical/existential suffering) on the physicians' attitudes toward palliative sedation (dependent variable). METHODS: We used a 2 × 2 experimental design as described by Blondeau et al. Four clinical vignettes were developed (vignette 1: short prognosis/existential suffering; vignette 2: long prognosis/existential suffering; vignette 3: short prognosis/physical suffering; vignette 4: long prognosis/physical suffering). Each vignette presented a terminally ill patient with a summary description of his physical and psychological condition, medication, and family situation. The respondents' attitude towards sedation was assessed with a six-point Likert scale. A total of 240 vignettes were sent to selected Swiss physicians. RESULTS: 74 vignettes were completed (36%). The means scores for attitudes were 2.62 ± 2.06 (v1), 1.88 ± 1.54 (v2), 4.54 ± 1.67 (v3), and 4.75 ± 1.71 (v4). General linear model analyses indicated that only the type of suffering had a significant impact on the attitude towards sedation (F = 33.92, df = 1, p = 0.000). Significance of the results: The French Swiss physicians' attitude toward palliative sedation is more favorable in case of physical suffering than in existential suffering. These results are in line with those found in the study of Blondeau et al. with Canadian physicians and will be discussed in light of the arguments given by physicians to explain their decisions.

Benefit News: Employee Benefit News, Department of Administrative Services, December 2015

Benefit News, brought to you by the DAS Benefits Team, providing you with the most up-to-date information about the state of Iowa’s employee benefits.

Affections pulmonaires et attitude [High altitude and preexisting lung diseases].

Today, a growing number of people, some of them suffering from lung diseases, travel to high altitude resorts. It is sometimes not easy for the general practitioner to adequately counsel these patients. Based on our knowledge of physiopathology and clinical studies, the present paper addresses the effects of high altitude in patients with preexisting lung diseases and provides recommendations in order to optimize the sojourn at high altitude.

State of Iowa Employee Handbook, 2015

This information is based on Iowa Department of Administrative Services (DAS) rules and policies and does not create an employment contract. 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 rules and policies, DAS rules and policies prevail.

Benefit News: Employee Benefit News, Department of Administrative Services, January 2016

Benefit News, brought to you by the DAS Benefits Team, providing you with the most up-to-date information about the state of Iowa’s employee benefits.

The Highway Surveys Program A Summary Statement Fiscal 1977-1978, HR-198, 1978

This final report summarizes the activities of the archaeological surveys contract for primary roads, secondary roads, and urban systems. The contract is negotiated annually between the Iowa Department of Transportation and the University of Iowa. The information contained in this section of the report is composed of summaries abstracted from completed cultural resource reports on file with the Department of Transportation, the Office of Historic Preservation, and the Office of the State Archaeologist.

CR1Dmod: A Matlab program to model 1D complex resistivity effects in electrical and electromagnetic surveys

We have constructed a forward modelling code in Matlab, capable of handling several commonly used electrical and electromagnetic methods in a 1D environment. We review the implemented electromagnetic field equations for grounded wires, frequency and transient soundings and present new solutions in the case of a non-magnetic first layer. The CR1Dmod code evaluates the Hankel transforms occurring in the field equations using either the Fast Hankel Transform based on digital filter theory, or a numerical integration scheme applied between the zeros of the Bessel function. A graphical user interface allows easy construction of 1D models and control of the parameters. Modelling results are in agreement with other authors, but the time of computation is less efficient than other available codes. Nevertheless, the CR1Dmod routine handles complex resistivities and offers solutions based on the full EM-equations as well as the quasi-static approximation. Thus, modelling of effects based on changes in the magnetic permeability and the permittivity is also possible.

Attitude de prescription chez la femme enceinte : exemple de prise en charge d'un état dépressif

- Comment prescrire à une femme enceinte? L'attitude optimale réalise un compromis entre d'une part l'indication au traitement, et d'autre part l'importance du risque que celui-ci fait courir au foetus et à la mère. Le respect de quelques principes simples peut aider dans cette démarche: - La relative carence en connaissances dans ce domaine impose avant tout une attitude basée sur le principe de précaution. - La période (1er, 2e ou 3e trimestre) pendant laquelle le foetus sera exposé au traitement envisagé est un élément prépondérant dans la réflexion. - Le traitement de choix est celui qui, parmi les alternatives efficaces, présente le meilleur profil de sécurité pendant la grossesse selon les observations humaines disponibles. - Le rapport bénéfice/risque pour la patiente et le foetus peut s'inverser pendant la grossesse. - Toute exposition médicamenteuse problématique pendant la grossesse doit faire l'objet d'une annonce à l'un des centres suisse de pharmacovigilance. Ces données de tératovigilance sont indispensables pour alimenter les connaissances dans ce domaine. - Afin d'illustrer ces principes généraux, un exemple typique de prescription chez la femme enceinte a été choisi, mettant l'accent sur un problème de tératovigilance récemment identifié: les risques liés à certains antidépresseurs durant la grossesse.

Trends in cardiovascular risk factors (1984-1993) in a Swiss region: results of three population surveys.

BACKGROUND: This study attempted to assess the time trends in lifestyle and cardiovascular risk factors in the Swiss region of Vaud-Fribourg (population 784,000). METHODS: Three surveys (1984/1985, 1988/1989, and 1992/1993), based on independent representative samples (n = 3,300) of the population ages 25 to 74, were conducted within the framework of the international WHO-MONICA Project. RESULTS: The most favorable changes were observed in reported behaviors: increased physical activity in leisure time, healthier dietary habits (switch from unskimmed milk, butter, and meat to skimmed milk, margarine, and fish, with no change for fruits and vegetables), and lower prevalence of regular smoking among men (from 32 to 28%). Body mass index did not vary significantly, apart from an increase in the prevalence of obesity among men (from 11 to 15%). Total cholesterol varied only slightly, while the HDL cholesterol levels decreased steadily (from 1.37 to 1.19 mmol/L among men; from 1.59 to 1.51 among women). Average systolic blood pressure regressed among women (from 127.2 to 124.4 mm Hg), while the prevalence of untreated hypertension increased among older men. CONCLUSION: The self-reported changes in lifestyle were only partially reflected by favorable trends in objective measurements. Physical activity, even at moderate intensity, and consumption of fruits, vegetables, and fiber in general should be promoted.