Iowa NAPIS (National Aging Program Information System) Activity Report State Fiscal Year 2004

INAPIS (National Aging Program Information System) Activity Report collects and reports service/performance data and related program management information to the federal and state government. This report shows the number of older Iowans who receive services and the number of units by service category from Title III funding of the Older Americans Act, the Administration on Aging (AoA) and limited state general fund dollars. Additionally, it shows the number of persons served by individual services and total "unduplicated" client count across all services. In other words, if you add the total number of clients from all services it is higher than the actual number of persons served across all services, because some people need and receive more than one service.

Senior Living Program State Fiscal Year 2004 Report, July 1, 2003-June 30, 2004

This report shows the number of older low-income and moderate-income Iowans who received service from the Senior Living Program (SLP) and the number of units by service category. Additionally, it shows the number of persons served across services. In other words, if you add the total number of clients from all services it is higher than the actual number of persons served across all services, because some people need and receive more than one service. (Please note: this is preliminary data, and may be subject to change.)

Senior Living Program State Fiscal Year 2003 Report (July 1, 2002-June 30, 2003)

This report shows the number of older low-income and moderate-income Iowans who received service from the Senior Living Program (SLP) and the number of units by service category. Additionally, it shows the number of persons served across services. In other words, if you add the total number of clients from all services it is higher than the actual number of persons served across all services, because some people need and receive more than one service. (Please note: this is preliminary data, and may be subject to change.)

Perfusion and diffusion MRI of glioblastoma progression in a four-year prospective temozolomide clinical trial.

PURPOSE: This study was performed to determine the impact of perfusion and diffusion magnetic resonance imaging (MRI) sequences on patients during treatment of newly diagnosed glioblastoma. Special emphasis has been given to these imaging technologies as tools to potentially anticipate disease progression, as progression-free survival is frequently used as a surrogate endpoint. METHODS AND MATERIALS: Forty-one patients from a phase II temolozomide clinical trial were included. During follow-up, images were integrated 21 to 28 days after radiochemotherapy and every 2 months thereafter. Assessment of scans included measurement of size of lesion on T1 contrast-enhanced, T2, diffusion, and perfusion images, as well as mass effect. Classical criteria on tumor size variation and clinical parameters were used to set disease progression date. RESULTS: A total of 311 MRI examinations were reviewed. At disease progression (32 patients), a multivariate Cox regression determined 2 significant survival parameters: T1 largest diameter (p < 0.02) and T2 size variation (p < 0.05), whereas perfusion and diffusion were not significant. CONCLUSION: Perfusion and diffusion techniques cannot be used to anticipate tumor progression. Decision making at disease progression is critical, and classical T1 and T2 imaging remain the gold standard. Specifically, a T1 contrast enhancement over 3 cm in largest diameter together with an increased T2 hypersignal is a marker of inferior prognosis.

"As you receive with one hand, so should you give with the other": the mutual-help practices of Cape Verdeans on the Lisbon periphery”

Rural Cape Verdeans employ a number of mutual-help practices to mitigate the uncertainties surrounding activities fundamental to their subsistence. One of these practices is djunta mon (‘to work together’), a loosely planned, non-monetized system of allocating labor at peak intervals during the growing season. By means of djunta mon, neighbors or family members work in each other’s fields until the tasks of every landowning participant are complete. Alongside djunta mon in rural Cape Verde exist a number of other non-remunerated mutual-help practices, such as djuda mutua (‘mutual help’) and laja kaza (‘to add concrete to one’s house’). While less visible than djunta mon, they are nonetheless important in completing tasks essential to rural life in the islands. In this thesis, I will attempt to show how Cape Verdean immigrants in Lisbon have adapted the mutual-help practices of rural Cape Verde to a new, transnational context. The iterations of these practices in Lisbon differ from their rural counterparts in that they involve fewer people, occur on a year-round basis, and are concerned primarily with domestic work. They also help people find employment, access childcare, secure interest-free credit, and construct or repair houses. I will argue that extensive mutual-help ties ensure Cape Verdean migrants in Lisbon a sufficient pool of family and friends upon which they can rely for support and assistance. An additional element I will explore is the perception among Cape Verdean immigrants that these mutual-help practices seem to be occurring with less frequency. While this shift is in part due to the availability of other means of support, I will contend that the changing attitude of Cape Verdeans towards mutual help is also due to their encountering neoliberal notions of ‘self-accountability.’ Thus, Cape Verdeans perceive that their mutual-help practices are in decline, while simultaneously needing the material support that they provide.

Characteristics and outcome of knee prosthetic joint infections (PJI): A 10-year cohort study (2000-2009)

Background: Prosthetic joint infections (PJI) lead to significant long-term morbidity with high cost of healthcare. We evaluated characteristics of infections and the infection and functional outcome of knee PJI over a 10-year period. Methods: All patients hospitalized at our institution from 1/2000 through 12/2009 with knee PJI (defined as growth of the same microorganism in ≥2 tissue or synovial fluid cultures, visible purulence, sinus tract or acute inflammation on tissue histopathology) were included. Patients, their relatives and/or treating physicians were contacted to determine the outcome. Results: During the study period, 61 patients with knee PJI were identified. The median age at the time of diagnosis of infection was 73 y (range, 53-94 y); 52% were men. Median hospital stay was 37 d (range, 1-145 d). Most reasons for primary arthroplasty was osteoarthritis (n = 48), trauma (n = 9) and rheumatoid arthritis (n = 4). 23 primary surgeries (40%) were performed at CHUV, 34 (60%) elsewhere. After surgery, 8 PJI were early (<3 months), 16 delayed (3-24 months) and 33 late (>24 months). PJI were treated with (i) open or arthroscopic debridement with prosthesis retention in 26 (46%), (ii) one-stage exchange in 1, (iii) two-stage exchange in 22 (39%) and (iv) prosthesis removal in 8 (14%). Isolated pathogens were S. aureus (13), coagulase-negative staphylococci (10), streptococci (5), enterococci (3), gram-negative rods (3) and anaerobes (3). Patients were followed for a median of 3.1 years, 2 patients died (unrelated to PJI). The outcome of infection was favorable in 50 patients (88%), whereas the functional outcome was favorable in 33 patients (58%). Conclusions: With the current treatment concept, the high cure rate of infection (88%) is associated with a less favorable functional outcome o 58%. Earlier surgical intervention and more rapid and improved diagnosis of infection may improve the functional outcome of PJI.

One hundred issues of Revista Española de Financiación y Contabilidad (REFC)-insights into trends in the Spanish academic community

From the year of its foundation, until the foundation of Revista deContabilidad in 1997, REFC has been the only referred accounting journalin Spain. Published by the Spanish Association for Accounting and BusinessAdministration (AECA), this journal is at the heart of the emergence ofa distinctly Spanish academic accounting community.Our study is based on:1. An analysis of 100 issues of REFC covering the period from 1985 to 1999.2. A questionnaire to Spanish accounting academics on their perceptionsand experience of the journal.Key points emerging from this study include:a) A move away from interest in accounting concepts and rules, as wellas accounting history, and towards positive accounting theory, the impactof accounting information on capital markets, and financial analysis.b) The emergence of a small number of universities as the driving forcein Spanish accounting research.c) Spanish academics rate REFC highly compared to other Spanish journalsfor publication status, as a support for research, and as a support forteaching. A number of English language journals are rated more highly forboth publication status and as a support for teaching.

Performance Report for Fiscal Year, 2008

I am pleased to present the performance report for the Iowa Department for the Blind for fiscal year 2008. This report is provided in compliance with sections 8E.210 and 216B.7 of the Code of Iowa. It contains valuable information about results achieved because of the services that we and our partners provided to blind and visually impaired Iowans during the past fiscal year in the areas of Vocational Rehabilitation, Independent Living, Library Services, and Resource Management. We determine our competitive success in a number of ways. We look at the federal standards and indicators to learn our ranking in relation to the performance of other public rehabilitation agencies. We compare our library's production and circulation figures with those from previous years to determine trends. We set our own standards for success by looking at such factors as the number of successful case closures, average hourly wage at case closure, skills training provided, and compliance with regulations. Results show that the Department is working positively toward achieving its strategic goals of increasing the independence and productivity of blind Iowans and improving access to information for blind Iowans. Major accomplishments of the year included:  The selection of our Library as one of eight libraries to receive the new digital talking book machines and books in digital media from the National Library Service for the Blind and Physically Handicapped. Priority for distribution of the machines is given to Library patrons who are veterans.  The Department, the Iowa Braille School, and the Department of Education have been promoting the new expanded core curriculum as part of their continued efforts to improve the coordination and delivery of services to blind and visually impaired students in Iowa.  The Department's five-year grant funded Pathfinders mentoring program ended this year. A total of 49 blind youths aged 16-26 were paired with successful blind adult mentors. Assessments of the program clearly showed that participation in the program had a measurable positive effect on the youth involved.  Finally, earnings ratios and the percentage of employment for vocational rehabilitation clients of the Department are among the best in the nation, as measured by the U.S. Rehabilitation Services Administration's standards and indicators for the year ended September 30, 2007. Overall, we met or exceeded 13 of 18 targets included in this report. A discussion of the Department's services, customers, and organizational structure, and budget appears in the "Department Overview" that follows. Information pertaining to performance results appears in the final section of this document. The success of the Department's programs is evident in the success achieved by blind Iowans. It is reflected in the many blind persons who can be seen traveling about independently, going to their jobs and to the community and family activities in which they participate. Sincerely, Karen A. Keninger, Director Iowa Department for the Blind

Issuance of patient reminders for influenza vaccination by US-based primary care physicians during the first year of universal influenza vaccination recommendations.

To estimate the number of physician-reported influenza vaccination reminders during the 2010-2011 influenza season, the first influenza season after universal vaccination recommendations for influenza were introduced, we interviewed 493 members of the Physicians Consulting Network. Patient vaccination reminders are a highly effective means of increasing influenza vaccination; nonetheless, only one quarter of the primary care physicians interviewed issued influenza vaccination reminders during the first year of universal vaccination recommendations, highlighting the need to improve office-based promotion of influenza vaccination.

Perception of tobacco, cannabis, and alcohol use of others is associated with one's own use.

BACKGROUND: Interventions have been developed to reduce overestimations of substance use among others, especially for alcohol and among students. Nevertheless, there is a lack of knowledge on misperceptions of use for substances other than alcohol. We studied the prevalence of misperceptions of use for tobacco, cannabis, and alcohol and whether the perception of tobacco, cannabis, and alcohol use by others is associated with one's own use. METHODS: Participants (n=5216) in a cohort study from a census of 20-year-old men (N=11,819) estimated the prevalence of tobacco and cannabis use among peers of the same age and sex and the percentage of their peers drinking more alcohol than they did. Using the census data, we determined whether participants overestimated, accurately estimated, or underestimated substance use by others. Regression models were used to compare substance use by those who overestimated or underestimated peer substance with those who accurately estimated peer use. Other variables included in the analyses were the presence of close friends with alcohol or other drug problems and family history of substance use. RESULTS: Tobacco use by others was overestimated by 46.1% and accurately estimated by 37.3% of participants. Cannabis use by others was overestimated by 21.8% and accurately estimated by 31.6% of participants. Alcohol use by others was overestimated by more than half (53.4%) of participants and accurately estimated by 31.0%. In multivariable models, compared with participants who accurately estimated tobacco use by others, those who overestimated it reported smoking more cigarettes per week (incidence rate ratio [IRR] [95% CI], 1.17 [range, 1.05, 1.32]). There was no difference in the number of cigarettes smoked per week between those underestimating and those accurately estimating tobacco use by others (IRR [95% CI], 0.99 [range, 0.84, 1.17]). Compared with participants accurately estimating cannabis use by others, those who overestimated it reported more days of cannabis use per month (IRR [95% CI], 1.43 [range, 1.21, 1.70]), whereas those who underestimated it reported fewer days of cannabis use per month (IRR [95% CI], 0.62 [range, 0.23, 0.75]). Compared with participants accurately estimating alcohol use by others, those who overestimated it reported consuming more drinks per week (IRR [95% CI], 1.57 [range, 1.43, 1.72]), whereas those who underestimated it reported consuming fewer drinks per week (IRR [95% CI], 0.41 [range, 0.34, 0.50]). CONCLUSIONS: Perceptions of substance use by others are associated with one's own use. In particular, overestimating use by others is frequent among young men and is associated with one's own greater consumption. This association is independent of the substance use environment, indicating that, even in the case of proximity to a heavy-usage group, perception of use by others may influence one's own use. If preventive interventions are to be based on normative feedback, and their aim is to reduce overestimations of use by others, then the prevalence of overestimation indicates that they may be of benefit to roughly half the population; or, in the case of cannabis, to as few as 20%. Such interventions should take into account differing strengths of association across substances.

Iowa Commission on the Status of African Americans Annual Report, Fiscal Year 2008

This publication of our 2008 Annual Report. This past year was beset with challenges and disappointments, but we were still able to forge ahead and register some significant accomplishments along the way. Our vision to organize our collective genius in a systematic way is beginning to take shape, and these efforts are reflected in this report. From various developments, like the making of a documentary and film of the Alexander Clark, Sr. story, to the partnership between the division and principal leadership in the faith community around the OCBI’s “Ten Point Plan”, one can envision the proverbial Black “phoenix” rising, renewed from the ashes of banal ideologies and practices. We will seize this opportunity, in conjunction with all of Iowa, to work together around the entire state, to produce a plan that reflects our collective interests, passions, and needs as we help create the Governor and Lt Governor’s vision of “One Iowa with One Unlimited Future.”

Annual Report of the Iowa Grape and Wine Development Commission for Fiscal Year, 2007

FY2007 was a productive year for the Iowa Grape and Wine Development Commission. Fourteen proposals were recommended for funding totaling over $390,000 in outlays. Included in the approved proposals were funds for the establishment and staffing of a Midwest Grape and Wine Institute at Iowa State University, a newly created viticulturist position at Des Moines Area Community College, funding for the first annual Mid-American Wine Competition, and marketing and promotion of four regional cooperative wine events and one wine trail. Commission funding supported a survey of commercial wine producers and grape growers and a new brochure on Iowa’s vineyards. A committee was formed to provide details for a Scholarship Program to aid vineyard and winery staff with the expenses of accredited coursework. Based on the survey conducted and from other governmental and industry sources, the Iowa grape and wine industry appears to continue to be very viable and growth continues at a strong pace. Wine produced in the state for 2007 was estimated at a market value in excess of $12.3 million. A tabulation of the budget revealed that just over $800,000 in wine gallonage tax appropriations have been received into the Grape and Wine Development Fund from 15 FY2003 through FY2007. Expenditures have totaled just over $607,000 during that same time. Just over 80% of expenditures have gone to “Technical” spending. Over time, funds invested in “Technical” programs will translate into an increasingly educated and institutionally-supported industry. Local, regional, and statewide events also appear to be increasing in popularity and the Commission plans to continue and increase support for these events. It is hoped the Scholarship Program will be up and running and funding will need to be appropriated for that project. The Commission also believes many projects and events will become more and more self sustaining as they develop and mature. As they continue to support Iowa’s grape and wine industry, the members of the Commission look forward to working with individuals, commercial enterprises, state and federal agencies, and industry-sponsored institutions in the upcoming year and in years to come.

Estimation of percentage body fat in 6- to 13-year-old children by skinfold thickness, body mass index and waist circumference.

We evaluated the accuracy of skinfold thicknesses, BMI and waist circumference for the prediction of percentage body fat (PBF) in a representative sample of 372 Swiss children aged 6-13 years. PBF was measured using dual-energy X-ray absorptiometry. On the basis of a preliminary bootstrap selection of predictors, seven regression models were evaluated. All models included sex, age and pubertal stage plus one of the following predictors: (1) log-transformed triceps skinfold (logTSF); (2) logTSF and waist circumference; (3) log-transformed sum of triceps and subscapular skinfolds (logSF2); (4) log-transformed sum of triceps, biceps, subscapular and supra-iliac skinfolds (logSF4); (5) BMI; (6) waist circumference; (7) BMI and waist circumference. The adjusted determination coefficient (R² adj) and the root mean squared error (RMSE; kg) were calculated for each model. LogSF4 (R² adj 0.85; RMSE 2.35) and logSF2 (R² adj 0.82; RMSE 2.54) were similarly accurate at predicting PBF and superior to logTSF (R² adj 0.75; RMSE 3.02), logTSF combined with waist circumference (R² adj 0.78; RMSE 2.85), BMI (R² adj 0.62; RMSE 3.73), waist circumference (R² adj 0.58; RMSE 3.89), and BMI combined with waist circumference (R² adj 0.63; RMSE 3.66) (P < 0.001 for all values of R² adj). The finding that logSF4 was only modestly superior to logSF2 and that logTSF was better than BMI and waist circumference at predicting PBF has important implications for paediatric epidemiological studies aimed at disentangling the effect of body fat on health outcomes.

Can smaller-scale comprehensive cancer centers provide outstanding care in abdominal and thoracic pediatric solid tumor surgery? Results of a 14-year retrospective single-center analysis.

PURPOSE: Quality of care and its measurement represent a considerable challenge for pediatric smaller-scale comprehensive cancer centers (pSSCC) providing surgical oncology services. It remains unclear whether center size and/or yearly case-flow numbers influence the quality of care, and therefore impact outcomes for this population of patients. PATIENTS AND METHODS: We performed a 14-year, retrospective, single-center analysis, assessing adherence to treatment protocols and surgical adverse events as quality indicators in abdominal and thoracic pediatric solid tumor surgery. RESULTS: Forty-eight patients, enrolled in a research-associated treatment protocol, underwent 51 cancer-oriented surgical procedures. All the protocols contain precise technical criteria, indications, and instructions for tumor surgery. Overall, compliance with such items was very high, with 997/1,035 items (95 %) meeting protocol requirements. There was no surgical mortality. Twenty-one patients (43 %) had one or more complications, for a total of 34 complications (66 % of procedures). Overall, 85 % of complications were grade 1 or 2 according to Clavien-Dindo classification requiring observation or minor medical treatment. Case-sample and outcome/effectiveness data were comparable to published series. Overall, our data suggest that even with the modest caseload of a pSSCC within a Swiss tertiary academic hospital, compliance with international standards can be very high, and the incidence of adverse events can be kept minimal. CONCLUSION: Open and objective data sharing, and discussion between pSSCCs, will ultimately benefit our patient populations. Our study is an initial step towards the enhancement of critical self-review and quality-of-care measurements in this setting.

Paper 4: EUROCAT statistical monitoring: identification and investigation of ten year trends of congenital anomalies in Europe.

BACKGROUND: As part of EUROCAT's surveillance of congenital anomalies in Europe, a statistical monitoring system has been developed to detect recent clusters or long-term (10 year) time trends. The purpose of this article is to describe the system for the identification and investigation of 10-year time trends, conceived as a "screening" tool ultimately leading to the identification of trends which may be due to changing teratogenic factors.METHODS: The EUROCAT database consists of all cases of congenital anomalies including livebirths, fetal deaths from 20 weeks gestational age, and terminations of pregnancy for fetal anomaly. Monitoring of 10-year trends is performed for each registry for each of 96 non-independent EUROCAT congenital anomaly subgroups, while Pan-Europe analysis combines data from all registries. The monitoring results are reviewed, prioritized according to a prioritization strategy, and communicated to registries for investigation. Twenty-one registries covering over 4 million births, from 1999 to 2008, were included in monitoring in 2010.CONCLUSIONS: Significant increasing trends were detected for abdominal wall anomalies, gastroschisis, hypospadias, Trisomy 18 and renal dysplasia in the Pan-Europe analysis while 68 increasing trends were identified in individual registries. A decreasing trend was detected in over one-third of anomaly subgroups in the Pan-Europe analysis, and 16.9% of individual registry tests. Registry preliminary investigations indicated that many trends are due to changes in data quality, ascertainment, screening, or diagnostic methods. Some trends are inevitably chance phenomena related to multiple testing, while others seem to represent real and continuing change needing further investigation and response by regional/national public health authorities.