Iowa Plan for Energy Independence, 2007

Iowa’s first annual Energy Independence Plan kicks off a new era of state leadership in energy transformation. Supported by Governor Chet Culver, Lieutenant Governor Patty Judge, and the General Assembly, the Office of Energy Independence was established in 2007 to coordinate state activities for energy independence. The commitment of the state to lead by example creates opportunities for state government to move boldly to achieve its goals, track its progress, measure the results, and report the findings. In moving to energy independence, the active engagement of every Iowan will be sought as the state works in partnership with others in achieving the goals. While leading ongoing efforts within the state, Iowa can also show the nation how to effectively address the critical, complex challenges of shifting to a secure energy future of affordable energy, cost-effective efficiency, reliance on sustainable energy, and enhanced natural resources and environment. In accordance with House File 918, “the plan shall provide cost effective options and strategies for reducing the state’s consumption of energy, dependence on foreign sources of energy, use of fossil fuels, and greenhouse gas emissions. The options and strategies developed in the plan shall provide for achieving energy independence from foreign sources of energy by the year 2025.” Energy independence is a term which means different things to different people. We use the term to mean that we are charting our own course in the emerging energy economy. Iowa can chart its own course by taking advantage of its resources: a well-educated population and an abundance of natural resources, including rich soil, abundant surface and underground water, and consistent wind patterns. Charting our own course also includes further developing our in-state industry, capturing renewable energy, and working toward improved energy efficiency. Charting our own course will allow Iowa to manage its economic destiny while protecting our environment, while creating new, “green collar” industries in every corner of Iowa. Today Iowa is in a remarkable position to capitalize on the current situation globally and at home. Energy drives the economy and has impacts on the environment, undeniable links that are integral for energy security and independence. With the resources available within the state, the combination of significant global changes in energy and research leading to new technologies that continue to drive down the costs of sustainable energy, Iowa can take bold strides toward the goal of energy independence by 2025. The Office of Energy Independence, with able assistance from hundreds of individuals, organizations, agencies, and advisors, presents its plan for Iowa’s Energy Independence.

Association of working conditions with self-reported work-related symptoms: results from the Swiss dataset of the European Working Conditions Survey

Working conditions are important determinants of health. The aims of this article are to 1) identify working conditions and work characteristics that are associated with workers' perceptions that their work is harmful to their health and 2) identify with what symptoms these working conditions are associated.We used the Swiss dataset from the 2005 edition of the European Working Conditions Survey. The dependent variable was based on the question "Does your work affect your health?". Logistic regression was used to identify a set of variables collectively associated with self-reported work-related adverse health effects.A total of 330 (32%) participants reported having their health affected by work. The most frequent symptoms included backache (17.1%), muscular pains (13.1%), stress (18.3%) and overall fatigue (11.7%). Scores for self-reported exposure to physicochemical risks, postural and physical risks, high work demand, and low social support were all significantly associated with workers' perceptions that their work is harmful to their health, regardless of gender or age. A high level of education was associated with stress symptoms, and reports that health was affected by work was associated with low job satisfaction.Many workers believe that their work affects their health. Health specialists should pay attention to the potential association between work and their patients' health complaints. This is particularly relevant when patients mention symptoms such as muscular pains, backache, overall fatigue, and stress. Specific attention should be given to complaints of stress in highly educated workers.

Development of Self-Cleaning Box Culvert Design – Phase II, TR-619, 2013

Culverts are common means to convey flow through the roadway system for small streams. In general, larger flows and road embankment heights entail the use of multibarrel culverts (a.k.a. multi-box) culverts. Box culverts are generally designed to handle events with a 50-year return period, and therefore convey considerably lower flows much of the time. While there are no issues with conveying high flows, many multi-box culverts in Iowa pose a significant problem related to sedimentation. The highly erosive Iowa soils can easily lead to the situation that some of the barrels can silt-in early after their construction, becoming partially filled with sediment in few years. Silting can reduce considerably the capacity of the culvert to handle larger flow events. Phase I of this Iowa Highway Research Board project (TR-545) led to an innovative solution for preventing sedimentation. The solution was comprehensively investigated through laboratory experiments and numerical modeling aimed at screening design alternatives and testing their hydraulic and sediment conveyance performance. Following this study phase, the Technical Advisory Committee suggested to implement the recommended sediment mitigation design to a field site. The site selected for implementation was a 3-box culvert crossing Willow Creek on IA Hwy 1W in Iowa City. The culvert was constructed in 1981 and the first cleanup was needed in 2000. Phase II of the TR 545 entailed the monitoring of the site with and without the selfcleaning sedimentation structure in place (similarly with the study conducted in laboratory). The first monitoring stage (Sept 2010 to December 2012) was aimed at providing a baseline for the operation of the as-designed culvert. In order to support Phase II research, a cleanup of the IA Hwy 1W culvert was conducted in September 2011. Subsequently, a monitoring program was initiated to document the sedimentation produced by individual and multiple storms propagating through the culvert. The first two years of monitoring showed inception of the sedimentation in the first spring following the cleanup. Sedimentation continued to increase throughout the monitoring program following the depositional patterns observed in the laboratory tests and those documented in the pre-cleaning surveys. The second part of Phase II of the study was aimed at monitoring the constructed self-cleaning structure. Since its construction in December 2012, the culvert site was continuously monitored through systematic observations. The evidence garnered in this phase of the study demonstrates the good performance of the self-cleaning structure in mitigating the sediment deposition at culverts. Besides their beneficial role in sediment mitigation, the designed self-cleaning structures maintain a clean and clear area upstream the culvert, keep a healthy flow through the central barrel offering hydraulic and aquatic habitat similar with that in the undisturbed stream reaches upstream and downstream the culvert. It can be concluded that the proposed self-cleaning structural solution “streamlines” the area upstream the culvert in a way that secures the safety of the culvert structure at high flows while producing much less disturbance in the stream behavior compared with the current constructive approaches.

Support for a colleague

As collaborators of Anders Pape Møller, we were shocked and surprised to read that he was accused of data fabrication ("Ecologists roiled by misconduct case," G. Vogel, F. Proffitt, R. Stone, News of the Week, 30 Jan., p. 606). We have never had cause to be concerned about any aspect of our collaborations with Møller. He is an amazing scientist, and his great organizational skills are a model for how to be productive in the face of competing time demands. Most of us are capable of much more than we actually accomplish, but we lack the dedication and self-discipline to follow through like Anders Møller. This is the secret of his phenomenal effectiveness that has been so puzzling to the scientific community. His achievements may have caused negative responses from some of his competitors. We would like to see a full, objective, and independent inquiry into the allegations. Our experience tells us that Anders Møller has an exceptionally complete focus on any task at hand, be it fieldwork, data analysis, or paper writing; this, combined with more than a little natural talent, is sufficient to explain his exceptional productivity. We have worked with him on a variety of projects, including collecting data, sometimes under arduous conditions, and in all our dealings with him, his behavior has been beyond reproach. We would ask colleagues to restrain from further public condemnation until such time as any allegations have been proven beyond doubt.

Iowa State Plan for Brain Injury 2013-2018

Traumatic Brain Injury (TBI) impacts the lives of thousands of Iowans each year. The effects of brain injury (often called the "silent epidemic" because resulting injury is often not visible to others) are cognitive, emotional, and social but may also result in physical disability. This state plan, created by the Governor's Advisory Council on Brain Injuries, is intended to provide guidance for brain injury services and prevention activities in Iowa. This is the fourth Iowa State Plan for Brain Injury. In addition to a statewide needs assessment, development of this plan included recommendations made by the Mental Health and Disability Services Redesign Brain Injury Work-group. For the first time in the history of TBI surveillance in Iowa, the numbers and rates of TBI deaths are decreasing, however hospitalizations and emergency department visits resulting from TBI are steadily increasing. This trend is likely due to the decrease in motor vehicle accidents and improved hospitalization protocols. Looking to the future, the Advisory Council on Brain Injuries identified goals in each of four focus areas. These focus areas are: #1 Individual and family access; dedicated to the enhancement of the lives of individuals with brain injuries and their families. #2 Service and support availability; #3 Service system enhancements; continued funding growth and public awareness campaigns that draw attention to the impact of brain injury. #4 Brain injury prevention; working to prevent and reduce three of the most common causes of brain injury are falls, no helmet use, and motor vehicle crashes.

Addressing non-communicable diseases in the Seychelles: towards a comprehensive plan of action.

This article reviews the different steps taken during the past 20 years for the prevention and control of non-communicable diseases (NCDs) in the Seychelles. National surveys revealed high levels of several cardiovascular risk factors and prompted an organized response, starting with the creation of an NCD unit in the Ministry of Health. Information campaigns and nationwide activities raised awareness and rallied increasingly broad and high-level support. Significant policy was developed including comprehensive tobacco legislation and a School Nutrition Policy that bans soft drinks in schools. NCD guidelines were developed and specialized 'NCD nurses' were trained to complement doctors in district health centers. Decreasing smoking prevalence is evidence of success, but the raising so-called diabesity epidemic calls for an integrated multi-sector policy to mould an environment conducive to healthy behaviors. Essential components of these efforts include: effective surveillance mechanisms supplemented by focused research; generating broad interest and consensus; mobilizing leadership and commitment at all levels; involving local and international expertise; building on existing efforts; and seeking integrated, multi-disciplinary and multi-sector approaches.

Parents living with HIV in a high-income country: do patients need specific support?

The number of HIV-infected persons with children and caregiving duties is likely to increase. From this statement, the present study was designed to establish how HIV infected caregivers organise their parenting routines and to determine their support needs. A further aim was to ascertain caregivers' perception of conspicuous behaviours displayed by their children. Finally, it sought to determine the extent to which the caregivers' assessment of their parenting activity is influenced by the required support and their children's perceived conspicuous behaviours. The study design was observational and cross-sectional. Sampling was based on the 7 HIV Outpatient Clinics associated with the national population-based Swiss HIV Cohort Study. It focused on persons living with HIV who are responsible for raising children below the age of 18. A total of 520 caregivers were approached and 261 participated. An anonymous, standardised, self-administered questionnaire was used for data collection. The data were analysed using descriptive statistical procedures and backward elimination multiple regression analysis. The 261 respondents cared for 406 children and adolescents under 18 years of age; the median age was 10 years. The caregivers' material resources were low. 70% had a net family income in a range below the median of Swiss net family income and 30% were dependent on welfare assistance. 73% were undergoing treatment with 86% reporting no physical impairments. The proportion of single caregivers was 34%. 92% of the children were living with their HIV infected caregivers. 80% of the children attended an institution such as a school or kindergarten during the day. 89% of the caregivers had access to social networks providing support. Nevertheless, caregivers required additional support in performing their parenting duties and indicated a need for assistance on the material level, in connection with legal problems and with participation in the labour market. 46% of the caregivers had observed one or more conspicuous behaviours displayed by their children, which indicates a challenging situation. However, most of these caregivers assessed their parenting activity very favourably. Backward elimination multiple regression analysis indicated that a smaller number of support needs, younger age of the eldest child and fewer physical impairments on the part of the caregiver enhance the caregivers' assessment of their parenting activity. Physicians should speak to caregivers living with HIV about their parenting responsibilities and provide the necessary scope for this subject in their consultation sessions. Physicians are in a position to draw their patients' attention to the services available to them.

Ethical issues in nutrition support of severely disabled elderly persons: a guide for health professionals.

Providing or withholding nutrition in severely disabled elderly persons is a challenging dilemma for families, health professionals, and institutions. Despite limited evidence that nutrition support improves functional status in vulnerable older persons, especially those suffering from dementia, the issue of nutrition support in this population is strongly debated. Nutrition might be considered a basic need that not only sustains life but provides comfort as well by patients and their families. Consequently, the decision to provide or withhold nutrition support during medical care is often complex and involves clinical, legal, and ethical considerations. This article proposes a guide for health professionals to appraise ethical issues related to nutrition support in severely disabled older persons. This guide is based on an 8-step process to identify the components of a situation, analyze conflicting values that result in the ethical dilemma, and eventually reach a consensus for the most relevant plan of care to implement in a specific clinical situation. A vignette is presented to illustrate the use of this guide when analyzing a clinical situation.

Governor’s Office of Drug Control Policy Performance Plan, FY 2014

The Agency Performance Report for the Governor’s Office of Drug Control Policy is published in accordance with the Accountable Government Act. The information provided illustrates accountability to stakeholders and citizens. The report is indicative of the agency’s progress in achieving goals consistent with the enterprise strategic plan, the agency strategic plan and agency performance plan.

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.

Metric Plan Reading Course, HR-324, 1997

This Plan Reading Course was developed by the Department of Civil and Construction Engineering of Iowa State University under contract with the Iowa Highway Research Board, Project HR-324. It is intended to be an instructional tool for Iowa DOT, county and municipal employees within the state of Iowa. Under this contract, a previous Plan Reading Course, prepared for the Iowa State Highway Commission in 1965, has been completely revised using a new format, new plans, updated specifications, and new material. This course is a self-taught course consisting of two parts; Highway Plans, and Bridge and Culvert plans. Each part consists of a self-instruction book, a set of plans, a question booklet, and an answer booklet. This is the self-instruction book for the Bridge and Culvert Plans part of the course. The example structures included in this part of the course are a prestressed concrete beam bridge and a reinforced concrete box culvert.

Local Agency Pavement Marking Plan, TR-551, 2010

The proposed Federal Highway Administration (FHWA) amendments to the Manual of Uniform Traffic Control Devices (MUTCD) will change the way local agencies manage their pavement markings and places a focus on pavement marking quality and management methods. This research effort demonstrates how a pavement marking maintenance method could be developed and used at the local agency level. The report addresses the common problems faced by agencies in achieving good pavement marking quality and provides recommendations specific towards these problems in terms of assessing pavement marking needs, selecting pavement marking materials, contracting out pavement marking services, measuring and monitoring performance, and in developing management tools to visualize pavement marking needs in a GIS format. The research includes five case studies, three counties and two cities, where retroreflectivity was measured over a spring and fall season and then mapped to evaluate pavement marking performance and needs. The research also includes over 35 field demonstrations (installation and monitoring) of both longitudinal and transverse durable markings in a variety of local agency settings all within an intense snow plow state.

Iowa In Motion: State Transportation Plan, 1997

What is Iowa in Motion? The Iowa Department of Transportation is continuing the journey to develop Iowa’s future transportation system. This ongoing planning process, known as Iowa in Motion, was developed in response to the Intermodal Surface Transportation Efficiency Act (ISTEA) and Iowa’s changing transportation needs. The completion of Parts I, II and III of Iowa in Motion has led to development of this State Transportation Plan. Part IV includes activities, both current and future, to support the plan. This State Transportation Plan represents the thoughts and concerns of thousands of Iowans. Individuals, metropolitan planning organizations (MPOs), regional planning affiliations (RPAs), associations and organizations have become involved and have made recommendations concerning which direction should be followed regarding transportation investments. This plan represents their extensive input into the Iowa in Motion process and consensus building as we moved towards adoption of this State Transportation Plan. The adopted plan serves as a guide for development of transportation policies, goals, objectives, initiatives and investment decisions through the year 2020.

Extreme self-monitoring, fear of hypoglycemia and obsessive-compulsive disorder in type 1 diabetes mellitus: when less is better

Background: Pre-existing psychological factors can strongly influence coping with type 1 diabetes mellitus and interfere with self-monitoring. Psychiatric disorders seem to be positively associated with poor metabolic control. We present a case of extreme compulsive blood testing due to obsessive fear of hypoglycemia in an adolescent with type 1 diabetes mellitus. Case report: Type 1 diabetes mellitus (anti GAD-antibodies 2624 U/l, norm < 9.5) was diagnosed in a boy aged 14.3 years [170 cm (+ 0.93 SDS), weight 50.5 kg (+ 0.05 SDS)]. Laboratory work-up showed no evidence for other autoimmune disease. Family and past medical history were unremarkable. Growth and developmental milestones were normal. Insulin-analog based basal-bolus regime was initiated, associated to standard diabetic education. Routine psychological evaluation performed at the onset of diabetes revealed intermittent anxiety and obsessivecompulsive traits. Accordingly, a close psychiatric follow-up was initiated for the patient and his family. An adequate metabolic control (HbA1c drop from >14 to 8%) was achieved within 3 months, attributed to residual -cell function. In the following 6 months, HbA1c rose unexpectedly despite seemingly adequate adaptations of insulin doses. Obsessive fear of hypoglycemia leading to a severe compulsive behavior developed progressively with as many as 68 glycemia measurements per day (mean over 1 week). The patient reported that he could not bear leaving home with glycemia < 15 mmol/l, ending up with school eviction and severe intra-familial conflict. Despite intensive psychiatric outpatient support, HbA1c rose rapidly to >14% with glycemia-testing reaching peaks of 120 tests/day. The situation could only be discontinued through psychiatric hospitalization with intensive behavioral training. As a result, adequate metabolic balance was restored (HbA1c value: 7.1 %) with acceptable 10-15 daily glycemia measurements. Discussion: The association of overt psychiatric disorders to type 1 diabetes mellitus is very rare in the pediatric age group. It can lead to a pathological behavior with uncontrolled diabetes. Such exceptional situations require long-term admissions with specialized psychiatric care. Slow acceptation of a "less is better" principle in glycemia testing and amelioration of metabolic control are difficult to achieve.

Iowa Comprehensive Heart Disease and Stroke Plan, 2010-2014, March 22, 2010

Heart disease is the number one cause of death for both men and women nationally as well as in the state of Iowa, while stroke is the third leading cause of death. These two diseases are often grouped together under the broader term ―cardiovascular disease‖ (CVD), which accounts for one-third of all deaths within the state. Ongoing efforts to increase prevention of, and improve care for, those who experience CVD have resulted in a decline in the number of deaths in Iowa caused by these conditions. In 1991, the death rate as a result of cardiovascular disease was 344.9 per 100,000 people; by 2006, that number had fallen to 239.9. Deaths as a result of stroke have also dropped, from 74.7 in 1991 to 57.4 in 2006.1 Although progress has been made; these illnesses are still major causes of death and serious disability for many Iowans. Despite the fact that some progress has been made through past efforts, current data show that the journey must continue to achieve the long, quality filled lives that Iowans deserve, free of chronic disease. Up to this point, there has been a lack of involvement by stakeholders against heart disease and stroke in Iowa. Causes of CVD are largely known and preventable, and more must be done to educate and spread this information throughout the state. This comprehensive statewide plan is a call to action to improve prevention, treatment, and management of heart disease and stroke in Iowa. Through the commitment and collaborative efforts of many, the Iowa Comprehensive Heart Disease and Stroke Plan 2010-2014 provides a guide to improve the health status of all Iowans. The people of Iowa have a long history of working together to do the right thing. We must rise to the challenge of lowering the incidence of heart disease and stroke through early and ongoing education that stresses prevention and healthy lifestyle choices, medical services that provide evidence-based, effective treatment and long term care management without disparity, and environmental policies that support the prevention of heart disease and stroke in our schools, work sites, and communities. This strategic plan is a guide to improving cardiovascular health in Iowa through 2014.