Forward, Spring 2010

Newsletter for the Iowa Commission on the Status of Women. Forward is the quarterly newsletter published by the Iowa Commission on the Status of Women. We are sure that you will continue to find information of use for Iowa’s women and girls.

Johne’s Disease–Beef, Spring 2010, Vol. 1, no. 4

Newsletter about controlling animal diseases, tips and techniques on how prevention works and the transportation of livestock.

Advantages and disadvantages of combination treatment with antipsychotics ECNP Consensus Meeting, March 2008, Nice.

TERMINOLOGY AND PRINCIPLES OF COMBINING ANTIPSYCHOTICS WITH A SECOND MEDICATION: The term "combination" includes virtually all the ways in which one medication may be added to another. The other commonly used terms are "augmentation" which implies an additive effect from adding a second medicine to that obtained from prescribing a first, an "add on" which implies adding on to existing, possibly effective treatment which, for one reason or another, cannot or should not be stopped. The issues that arise in all potential indications are: a) how long it is reasonable to wait to prove insufficiency of response to monotherapy; b) by what criteria that response should be defined; c) how optimal is the dose of the first monotherapy and, therefore, how confident can one be that its lack of effect is due to a truly inadequate response? Before one considers combination treatment, one or more of the following criteria should be met; a) monotherapy has been only partially effective on core symptoms; b) monotherapy has been effective on some concurrent symptoms but not others, for which a further medicine is believed to be required; c) a particular combination might be indicated de novo in some indications; d) The combination could improve tolerability because two compounds may be employed below their individual dose thresholds for side effects. Regulators have been concerned primarily with a and, in principle at least, c above. In clinical practice, the use of combination treatment reflects the often unsatisfactory outcome of treatment with single agents. ANTIPSYCHOTICS IN MANIA: There is good evidence that most antipsychotics tested show efficacy in acute mania when added to lithium or valproate for patients showing no or a partial response to lithium or valproate alone. Conventional 2-armed trial designs could benefit from a third antipsychotic monotherapy arm. In the long term treatment of bipolar disorder, in patients responding acutely to the addition of quetiapine to lithium or valproate, this combination reduces the subsequent risk of relapse to depression, mania or mixed states compared to monotherapy with lithium or valproate. Comparable data is not available for combination with other antipsychotics. ANTIPSYCHOTICS IN MAJOR DEPRESSION: Some atypical antipsychotics have been shown to induce remission when added to an antidepressant (usually a SSRI or SNRI) in unipolar patients in a major depressive episode unresponsive to the antidepressant monotherapy. Refractoriness is defined as at least 6 weeks without meeting an adequate pre-defined treatment response. Long term data is not yet available to support continuing efficacy. SCHIZOPHRENIA: There is only limited evidence to support the combination of two or more antipsychotics in schizophrenia. Any monotherapy should be given at the maximal tolerated dose and at least two antipsychotics of different action/tolerability and clozapine should be given as a monotherapy before a combination is considered. The addition of a high potency D2/3 antagonist to a low potency antagonist like clozapine or quetiapine is the logical combination to treat positive symptoms, although further evidence from well conducted clinical trials is needed. Other mechanisms of action than D2/3 blockade, and hence other combinations might be more relevant for negative, cognitive or affective symptoms. OBSESSIVE-COMPULSIVE DISORDER: SSRI monotherapy has moderate overall average benefit in OCD and can take as long as 3 months for benefit to be decided. Antipsychotic addition may be considered in OCD with tic disorder and in refractory OCD. For OCD with poor insight (OCD with "psychotic features"), treatment of choice should be medium to high dose of SSRI, and only in refractory cases, augmentation with antipsychotics might be considered. Augmentation with haloperidol and risperidone was found to be effective (symptom reduction of more than 35%) for patients with tics. For refractory OCD, there is data suggesting a specific role for haloperidol and risperidone as well, and some data with regard to potential therapeutic benefit with olanzapine and quetiapine. ANTIPSYCHOTICS AND ADVERSE EFFECTS IN SEVERE MENTAL ILLNESS: Cardio-metabolic risk in patients with severe mental illness and especially when treated with antipsychotic agents are now much better recognized and efforts to ensure improved physical health screening and prevention are becoming established.

4th International LIS-EPI meeting: una mirada al futuro de la información

Informe sobre el 4th International LIS-EPI Meeting que tuvo lugar en Valencia en noviembre de 2009 bajo el lema ¿La información en 2015¿. Los temas que se trataron fueron el futuro del sector de la información y de las bibliotecas, las rich internet applications (RIAs), el software libre en bibliotecas, el acceso abierto y los dispositivos móviles

Johne’s Disease–Dairy, Spring 2010, Vol. 1, no. 4

Newsletter about controlling animal diseases, tips and techniques on how prevention works and the transportation of livestock.

The White Cane Magazine, Spring 2010, Vol. 1, no. 2

Quarterly newsletter produced by the Iowa Department of Blind, about the information and activities that are on going.

Changes in leg-spring behavior during a 5000 m self-paced run in differently trained athletes

Summary Aims.-To explore whether fatigue-induced changes in spring-mass behavior during a 5000m self-paced run varied according to the runner's training status. Methods and results.-Six highly- and six well-trained triathletes completed a 5000m time trial. Running velocity and vertical stiffness decreased significantly (P < 0.05) with fatigue, whereas leg stiffness remained constant. None of these parameters displayed a significant interaction between fatigue and training status, despite vertical stiffness being higher (P < 0.05) in highly-trained triathletes. Conclusions.-During a 5000m self-paced run, impairments in leg-spring behavior that occur with fatigue are not affected by athletes' training status. © 2009 Elsevier Masson SAS. All rights reserved. Objectifs.-Étudier, chez des athlètes de niveaux différents, les modifications de raideur mécanique liées à l'apparition de la fatigue lors d'une course de 5000 m. Synthèse des faits.-Six triathlètes très entraînés et six autres bien entraînés ont réalisé une course de 5000 m. La vitesse de course et la raideur verticale diminuaient significativement (p < 0,05) avec la fatigue, alors que la raideur de la jambe demeurait inchangée. Aucune interaction entre la fatigue et le niveau d'entraînement n'a été détectée, malgré des niveaux de raideur verticale plus élevés (p < 0,05) chez les sujets les mieux entraînés.

Targeted Small Business Link, Spring 2011, Vol. 4, no. 2

Targeted Small Business News from the Iowa Department of Economic Development, Spring 2011, Volume 4, Number 2

Understanding and meeting the needs of the older population: a global challenge.

BACKGROUND: In the past century, there has been a significant rise in life expectancy in almost all regions of the world, contributing to an increasingly older population. The aging of the population, in conjunction with urbanization and industrialization, has resulted in an important epidemiological transition marked by a widespread increase in the prevalence of chronic diseases and their sequelae. Current trends suggest that the transition will have a greater impact on developing countries compared to developed countries. An adequate response to the transition requires a strong emphasis on primary prevention and adequate resource allocation.

Changes in running mechanics and spring-mass behaviour induced by a 5-hour hilly running bout.

Abstract The aim of this study was to investigate changes in running mechanics and spring-mass behaviour with fatigue induced by 5-hour hilly running (5HHR). Running mechanics were measured pre- and post-5HHR at 10, 12 and 14 km · h(-1) on an instrumented treadmill in eight ultramarathon runners, and sampled at 1000 Hz for 10 consecutive steps. Contact (t(c) ) and aerial (t(a) ) times were determined from ground reaction force (GRF) signals and used to compute step frequency (f). Maximal GRF, loading rate, downward displacement of the centre of mass (Δz), and leg length change (ΔL) during the support phase were determined and used to compute both vertical (K(vert) ) and leg (K(leg) ) stiffness. A significant decrease in t(c) was observed at 12 and 14 km · h(-1) resulting in an increase of f at all speeds. Duty factor and F(max) significantly decreased at 10 km · h(-1). A significant increase in K(vert) and K(leg) was observed at all running speeds with significant decreases in Δz and ΔL. Despite the shorter duration, the changes in running mechanics appeared to be in the same direction (increased f and K(vert) , decrease in Δz and F(max) ) but of lower amplitude compared with those obtained after an ultra-trail or an ultramarathon.

Iowa EHDI News, Spring 2008

The purpose of the newsletter is to communicate with parents and professionals about newborn hearing screening in Iowa. We will share information about: Hearing screenings Intervention Resources available for parents and professionals “Best practices” by hospitals, AEAs (Area Education Agencies), or private practive audiology offices System goals Family stories Highlights from the EHDI Advisory Committee Updates on Iowa’s EHDI program It is important to point out that we are a diverse team of individuals working together to ensure that all newborns and toddlers with hearing loss are identified as early as possible and provided with timely and appropriate audiological, educational and medical intervention. Each newsletter will introduce you to various team members of the EHDI system in Iowa.

Iowa EHDI News, Spring 2009

The purpose of the newsletter is to communicate with parents and professionals about newborn hearing screening in Iowa. We will share information about: Hearing screenings Intervention Resources available for parents and professionals “Best practices” by hospitals, AEAs (Area Education Agencies), or private practive audiology offices System goals Family stories Highlights from the EHDI Advisory Committee Updates on Iowa’s EHDI program It is important to point out that we are a diverse team of individuals working together to ensure that all newborns and toddlers with hearing loss are identified as early as possible and provided with timely and appropriate audiological, educational and medical intervention. Each newsletter will introduce you to various team members of the EHDI system in Iowa.

Iowa EHDI News, Spring 2010

The purpose of the newsletter is to communicate with parents and professionals about newborn hearing screening in Iowa. We will share information about: Hearing screenings Intervention Resources available for parents and professionals “Best practices” by hospitals, AEAs (Area Education Agencies), or private practive audiology offices System goals Family stories Highlights from the EHDI Advisory Committee Updates on Iowa’s EHDI program It is important to point out that we are a diverse team of individuals working together to ensure that all newborns and toddlers with hearing loss are identified as early as possible and provided with timely and appropriate audiological, educational and medical intervention. Each newsletter will introduce you to various team members of the EHDI system in Iowa.