Report of Recommendations to the Iowa Department of General Services, June 30, 2003

State Agency Audit Report

Relève en médecine interne générale: enjeux et perspectives [Perspectives and challenges to guarantee training and renewal in general internal medicine]

Training new doctors in general internal medicine represents a challenge. This requires to define future needs, which result from interest that are not necessarily convergent between patients, doctors, insurers and politicians. Problems related to medical demography in Switzerland, with the ageing of the population, the increase in health care costs and the place of Switzerland within the European Community require the implementation of specific objectives to train new physicians in general internal medicine. The success of these opportunities depends on social factors, political choices and choices from physician's association. In this article we will approach these challenges by formulating some proposals--nonexhaustive--in order to guarantee sufficient renewal in general internal medicine.

Report of Recommendations to Iowa State University of Science and Technology on the Review of Selected General and Application Controls over the University's Accounts Receivable System, April 6th - May 14th 2004

State University Audit Report

Report of Recommendations to the University of Northern Iowa on a Review of Selected General and Application Controls over the Modern Executive Management Financial Information System, June 7, 2004 through July 29, 2004

State University Audit Report

La maladie de Wilson: un caméléon clinique auquel il faut penser [A primer on Wilson disease for the general practitioner].

Wilson disease (WD) is an inherited disorder of hepatic copper excretion leading to toxic accumulation of copper in the liver as well as the brain, cornea, and other organs. The defect is due to mutations of the copper-transporting ATPase ATP7B. Clinical manifestations are highly variable and comprise acute liver failure, chronic hepatitis and cirrhosis as well as neurological or psychiatric symptoms. The Kayser-Fleischer corneal ring is pathognomonic but absent in about 50% of patients with hepatic manifestations alone. A high index of suspicion in clinically compatible situations is key, with a combination of laboratory tests allowing the diagnosis of WD. Treatment is based on the use of chelating agents, D-penicillamine or trientine. Liver transplantation should be considered for patients with acute liver failure or advanced cirrhosis.

Report of Recommendations to State University of Iowa on the Review of Selected General and Application Controls Over the Purchasing/Accounts Payable System, June 2 to June 27, 2003

State University Audit Report

Report of Recommendations to the University of Northern Iowa on the Review of Selected General and Application Controls Over the Modern Executive Management Financial Information, June 2 to July 17, 2003

State University Audit Report

Report of Recommendations to Iowa State University of Science and Technology on the Review of Selected General and Application Controls over the Tuition System, April 23 to May 23, 2003

State University Audit Report

Report of Recommendations to the State University of Iowa on the Review of Selected General Controls over the University's Accounts Receivable System, June 7th, 2004 to July 23rd, 2004

State University Audit Report

Report of Recommendations to the Iowa Department of Workforce Development on the Review of Selected General Controls, May 10, 2004 to May 28, 2004

State Agency Audit Report

A Review of the State's Leased Space and the Leasing Process, General Services Enterprise of the Department of Administrative Services, July 1, 1998 through June 30, 2003

Other Audit Reports - State Leasing

Report of Recommendations to the Iowa Department of Transportation on a Review of Selected General and Application Controls Over the Contractor Pay System, April 5, 2004 through May 21, 2004

State Agency Audit Report

General practitioners can evaluate the material, social and health dimensions of patient social status

OBJECTIVE: To identify which physician and patient characteristics are associated with physicians' estimation of their patient social status.DESIGN: Cross-sectional ulticentric survey. SETTING: Fourty-seven primary care private offices in Western Switzerland. PARTICIPANTS: Random sample of 2030 patients ≥ 16, who encountered a general practitioner (GP) between September 2010 and February 2011. MAIN MEASURES: PRIMARY OUTCOME: patient social status perceived by GPs, using the MacArthur Scale of Subjective Social Status, ranging from the bottom (0) to the top (10) of the social scale.Secondary outcome: Difference between GP's evaluation and patient's own evaluation of their social status. Potential patient correlates: material and social deprivation using the DiPCare-Q, health status using the EQ-5D, sources of income, and level of education. GP characteristics: opinion regarding patients' deprivation and its influence on health and care. RESULTS: To evaluate patient social status, GPs considered the material, social, and health aspects of deprivation, along with education level, and amount and type of income. GPs declaring a frequent reflexive consideration of their own prejudice towards deprived patients, gave a higher estimation of patients' social status (+1.0, p = 0.002). Choosing a less costly treatment for deprived patients was associated with a lower estimation (-0.7, p = 0.002). GP's evaluation of patient social status was 0.5 point higher than the patient's own estimate (p<0.0001). CONCLUSIONS: GPs can perceive the various dimensions of patient social status, although heterogeneously, according partly to their own characteristics. Compared to patients' own evaluation, GPs overestimate patient social status.