Prognostication in comatose survivors of cardiac arrest: An advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine.

OBJECTIVES: To review and update the evidence on predictors of poor outcome (death, persistent vegetative state or severe neurological disability) in adult comatose survivors of cardiac arrest, either treated or not treated with controlled temperature, to identify knowledge gaps and to suggest a reliable prognostication strategy. METHODS: GRADE-based systematic review followed by expert consensus achieved using Web-based Delphi methodology, conference calls and face-to-face meetings. Predictors based on clinical examination, electrophysiology, biomarkers and imaging were included. RESULTS AND CONCLUSIONS: Evidence from a total of 73 studies was reviewed. The quality of evidence was low or very low for almost all studies. In patients who are comatose with absent or extensor motor response at ?72h from arrest, either treated or not treated with controlled temperature, bilateral absence of either pupillary and corneal reflexes or N20 wave of short-latency somatosensory evoked potentials were identified as the most robust predictors. Early status myoclonus, elevated values of neuron specific enolase at 48-72h from arrest, unreactive malignant EEG patterns after rewarming, and presence of diffuse signs of postanoxic injury on either computed tomography or magnetic resonance imaging were identified as useful but less robust predictors. Prolonged observation and repeated assessments should be considered when results of initial assessment are inconclusive. Although no specific combination of predictors is sufficiently supported by available evidence, a multimodal prognostication approach is recommended in all patients.

Report on the Iowa School for the Deaf, Council Bluffs, Iowa for the year ended June 30, 2013

Report on the Iowa School for the Deaf, Council Bluffs, Iowa for the year ended June 30, 2013

Audit report on the Iowa Egg Council for the years ended June 30, 2013 and 2012

Audit report on the Iowa Egg Council for the years ended June 30, 2013 and 2012

Audit report on the Council Bluffs Airport Authority for the year ended June 30, 2014

Audit report on the Council Bluffs Airport Authority for the year ended June 30, 2014

Audit report on the City of Council Bluffs, Iowa for the year ended June 30, 2014

Audit report on the City of Council Bluffs, Iowa for the year ended June 30, 2014

The costs of disorders of the brain in Switzerland: an update from the European Brain Council Study for 2010.

BACKGROUND: In 2005, findings of the first "cost of disorders of the brain in Europe" study of the European Brain Council (EBC) showed that these costs cause a substantial economic burden to the Swiss society. In 2010 an improved update with a broader range of disorders has been analysed. This report shows the new findings for Switzerland and discusses changes. METHODS: Data are derived from the EBC 2010 census study that estimates 12-month prevalence of 12 groups of disorders of the brain and calculates costs (direct health-care costs, direct non-medical costs and indirect costs) by combining top-down and bottom up cost approaches using existing data. RESULTS: The most frequent disorder was headache (2.3 million). Anxiety disorders were found in 1 million persons and sleep disorders in 700,000 persons. Annual costs for all assessed disorders total to 14.5 billion Euro corresponding to about 1,900 EUR per inhabitant per year. Mood, psychotic disorders and dementias (appr. 2 billion EUR each) were most costly. Costs per person were highest for neurological/neurosurgery-relevant disorders, e.g. neuromuscular disorders, brain tumour and multiple sclerosis (38,000 to 24,000 EUR). CONCLUSION: The estimates of the EBC 2010 study for Switzerland provide a basis for health care planning. Increase in size and costs compared to 2005 are mostly due to the inclusion of new disorders (e.g., sleep disorders), or the re-definition of others (e.g., headache) and to an increase in younger cohorts. We suggest coordinated research and preventive measures coordinated between governmental bodies, private health-care and pharmaceutical companies.

Indian Creek Channel: the evolution & significance of an historic public works administration flood control facility, Council Bluffs, Iowa, 2010

Plagued for nearly a century by the perennial flooding of Indian Creek, the City begins construction on a massive channelization project designed to confine the creek to its banks. Funded largely through a grant from the recently established Public Works Administration (PWA), the Indian Creek Channel, upon its completion two years later, would become the largest PWA undertaking in the State of Iowa. Though it did not completely end flooding in Council Bluffs, construction of the Indian Creek Channel did substantially reduce both the number and severity of the city's subsequent floods. It also profoundly impacted the residential and commercial development of Council Bluffs, as well as the city's sanitary conditions. The effects of the Indian Creek channelization, both practical and historical, are still realized today. In 2009, plans for a City road and bridge construction project at the intersection of North Broadway Street and Kanesville Boulevard proposed to replace a 221-foot-long segment of the Indian Creek Channel with a concrete box culvert. In compliance with the National Historic Preservation Act, a cultural resources study was conducted at the proposed construction site, the findings of which concluded that the historic character of the Indian Creek Channel would be compromised by the impending construction. As a means of mitigating these damages, an agreement was reached among the City, the Iowa State Historic Preservation Office, and the Federal Highway Administration that resulted in detailed research and documentation of the historical significance of the Indian Creek Channel. The findings of that study are summarized in this publication.

Iowa Arts Council: A Division of the Iowa Department of Cultural Affairs 2012-2015 Strategic Plan

The Iowa Arts Council is excited to accomplish goals on behalf of Iowa while helping support the strategic direction of the Department of Cultural Affairs. With an eye to the future, the Iowa Arts Council remains committed to honoring its 45-year legacy while staying true to its mission of enriching the quality of life in Iowa through support of the arts.

Agreed–upon procedures report on the Iowa Turkey Marketing Council for the period January 1, 2013 through December 31, 2014

Agreed–upon procedures report on the Iowa Turkey Marketing Council for the period January 1, 2013 through December 31, 2014

Report on the Iowa School for the Deaf, Council Bluffs, Iowa for the year ended June 30, 2014

Report on the Iowa School for the Deaf, Council Bluffs, Iowa for the year ended June 30, 2014

Audit report on the Iowa Egg Council for the years ended June 30, 2014 and 2013

Audit report on the Iowa Egg Council for the years ended June 30, 2014 and 2013

Journal of the Council [Currently known as the Senate Journal], 1839-1842

The published daily journals of the transactions of the Senate for the current legislative session and the official bound journals printed after adjournment for previous legislative sessions.

Journal of the Council [Currently known as the Senate Journal], 1842-1845

The published daily journals of the transactions of the Senate for the current legislative session and the official bound journals printed after adjournment for previous legislative sessions.Four consecutive volumes bound as one.