Annual Infrastructure Report 2009, January 25, 2010

Major maintenance; health, safety, loss of use; and Americans with Disabilities Act deficiencies at the Capitol Complex and statewide for twelve agencies and divisions participating in the Vertical Infrastructure Program in collaboration with the Governor's Vertical Infrastructure Advisory Committee, including the Department of Administrative Services; the Department of Commerce, Alcoholic Beverages Division; the Department of Corrections; the Department of Cultural Affairs; the Department of Education, including Iowa Public Television and Iowa Vocational Rehabilitation Services; the Department of Human Services; Iowa Law Enforcement Academy; the Department of Public Safety; Terrace Hill; Iowa Veterans Home and Iowa Workforce Development. The advisory committee meets on a monthly basis to review the progress of the work and to make recommendations on procedures and priorities. Additional information on major maintenance projects is available in the advisory committee's Tenth Annual Report to the Governor, dated December 15, 2008.

Annual Infrastructure Report 2010 January 28, 2011

Major maintenance; health, safety, loss of use; and Americans with Disabilities Act deficiencies at the Capitol Complex and statewide for twelve agencies and divisions participating in the Vertical Infrastructure Program in collaboration with the Governor's Vertical Infrastructure Advisory Committee, including the Department of Administrative Services; the Department of Commerce, Alcoholic Beverages Division; the Department of Corrections; the Department of Cultural Affairs; the Department of Education, including Iowa Public Television and Iowa Vocational Rehabilitation Services; the Department of Human Services; Iowa Law Enforcement Academy; the Department of Public Safety; Terrace Hill; Iowa Veterans Home and Iowa Workforce Development. The advisory committee meets on a monthly basis to review the progress of the work and to make recommendations on procedures and priorities. Additional information on major maintenance projects is available in the advisory committee's Tenth Annual Report to the Governor, dated December 15, 2008.

Annual Infrastructure Report 2012, January 15, 2012

Major maintenance; health, safety, loss of use; and Americans with Disabilities Act deficiencies at the Capitol Complex and statewide for twelve agencies and divisions participating in the Vertical Infrastructure Program in collaboration with the Governor's Vertical Infrastructure Advisory Committee, including the Department of Administrative Services; the Department of Commerce, Alcoholic Beverages Division; the Department of Corrections; the Department of Cultural Affairs; the Department of Education, including Iowa Public Television and Iowa Vocational Rehabilitation Services; the Department of Human Services; Iowa Law Enforcement Academy; the Department of Public Safety; Terrace Hill; Iowa Veterans Home and Iowa Workforce Development. The advisory committee meets on a monthly basis to review the progress of the work and to make recommendations on procedures and priorities. Additional information on major maintenance projects is available in the advisory committee's Tenth Annual Report to the Governor, dated December 15, 2008.

Annual Infrastructure Report 2013, January 15, 2014

Major maintenance; health, safety, loss of use; and Americans with Disabilities Act deficiencies at the Capitol Complex and statewide for twelve agencies and divisions participating in the Vertical Infrastructure Program in collaboration with the Governor's Vertical Infrastructure Advisory Committee, including the Department of Administrative Services; the Department of Commerce, Alcoholic Beverages Division; the Department of Corrections; the Department of Cultural Affairs; the Department of Education, including Iowa Public Television and Iowa Vocational Rehabilitation Services; the Department of Human Services; Iowa Law Enforcement Academy; the Department of Public Safety; Terrace Hill; Iowa Veterans Home and Iowa Workforce Development. The advisory committee meets on a monthly basis to review the progress of the work and to make recommendations on procedures and priorities. Additional information on major maintenance projects is available in the advisory committee's Tenth Annual Report to the Governor, dated December 15, 2008.

Falls efficacy predicts functional status on month after discharge in elderly patients undergoing post-accute rehabilitation

Objective: To investigate the relationship between falls efficacy at admission and functional status reported one month after discharge from post-acute rehabilitation in a cohort of elderly patients. Methods: Participants were elderly patients admitted to postacute rehabilitation in an academic geriatric facility. Data on demographics and affective status were collected upon admission; functional status and gait speed were measured at admission and at discharge; self-reported functional status and history of falls since discharge were collected one month after discharge (follow-up). Falls efficacy was measured using the Fall Efficacy Scale, that assesses confidence in performing 12 activities of daily living without falling (range 0 to 100, higher score indicating higher confidence). Patients were classified using the median FES score at baseline (95) as cut-off to divide the population into "confident" and "fearful" groups. Results: Participants' (N=180, mean age 81.3±7.1 years, 75.6% women) mean FES score was 92.3±8.7 at baseline (range 60-100). Basic ADL score averaged 3.5±1.6 at baseline, 4.7±1.3 at discharge, and 5.5±0.7 at follow-up (self-reported). Baseline FES score was positively correlated with basic ADL at follow-up (rho=0.35, p<.001). At follow-up, 58.7% of the patients were fully independent in basic ADL, this proportion being significantly higher in confident than fearful patients (70.7% vs 42.4%, p<.001). Compared to confident patients, those fearful had significantly lower odds (OR 0.3, 95%CI 0.2-0.6, p<.001) to report full independence at follow-up. This relationship remained (adjOR = 0.4, 95%CI 0.2-0.8, p=.01) after controlling for demographics, baseline gait speed, depressive symptoms, functional status at discharge, and history of falls since discharge. Conclusion: In this cohort of older rehab patients, poor falls efficacy at admission was associated with lower function reported one month after discharge even after controlling for initial mobility performance and functional status at discharge. Further studies should determine whether interventions aiming at falls efficacy improvement will also result in improved function in fearful subjects undergoing rehabilitation.

A course on collaboration between social workers and general practitioners during their vocational training

The educational programme reported was an experiment in the vocational training scheme of the department of General Practice, Erasmus University, Rotterdam, Holland, and is now part of the course. The programme focused on the training in team function (co-operation) given to trainee GPs and social workers. It became clear that both groups during their professional training develop markedly different attitudes and views about patient (client) care. These differences form a fundamental handicap in any discussion about teamwork. During the programme the students were made aware of this divergence of viewpoint and were taught how to handle these resulting handicaps and, if possible, to eliminate them.

Improvement of rehabilitation possibilities with the MotionMaker (TM)

"MotionMaker (TM)" is a stationary programmable test and training system for the lower limbs developed at the 'Ecole Polytechnique Federale de Lausanne' with the 'Fondation Suisse pour les Cybertheses'.. The system is composed of two robotic orthoses comprising motors and sensors, and a control unit managing the trans-cutaneous electrical muscle stimulation with real-time regulation. The control of the Functional Electrical Stimulation (FES) induced muscle force necessary to mimic natural exercise is ensured by the control unit which receives a continuous input from the position and force sensors mounted on the robot. First results with control subjects showed the feasibility of creating movements by such closed-loop controlled FES induced muscle contractions. To make exercising with the MotionMaker (TM) safe for clinical trials with Spinal Cord Injured (SCI) volunteers, several original safety features have been introduced. The MotionMaker (TM) is able to identify and manage the occurrence of spasms. Fatigue can also be detected and overfatigue during exercise prevented.

Development of Evaluation, Rehabilitation, and Strengthening Concepts for Low Volume Bridges, Phase I Progress Report, HR-323, 1990

The primary objective of this project is to develop a design manual that would aid the county or municipal engineer in making structurally sound bridge strengthening or replacement decisions. The contents of this progress report are related only to Phase I of the study and deal primarily with defining the extent of the bridge problem in Iowa. In addition, the types of bridges to which the manual should be directed have been defined.

Closed loop electrical muscle stimulation in spinal cord injured rehabilitation

The effect of motor training using closed loop controlled Functional Electrical Stimulation (FES) on motor performance was studied in 5 spinal cord injured (SCI) volunteers. The subjects trained 2 to 3 times a week during 2 months on a newly developed rehabilitation robot (MotionMaker?). The FES induced muscle force could be adequately adjusted throughout the programmed exercises by the way of a closed loop control of the stimulation currents. The software of the MotionMaker? allowed spasms to be detected accurately and managed in a way to prevent any harm to the SCI persons. Subjects with incomplete SCI reported an increased proprioceptive awareness for motion and were able to achieve a better voluntary activation of their leg muscles during controlled FES. At the end of the training, the voluntary force of the 4 incomplete SCI patients was found increased by 388% on their most affected leg and by 193% on the other leg. Active mobilisation with controlled FES seems to be effective in improving motor function in SCI persons by increasing the sensory input to neuronal circuits involved in motor control as well as by increasing muscle strength.

The INTERMED questionnaire for predicting return to work after a multidisciplinary rehabilitation program for chronic low back pain.

OBJECTIVES: To evaluate the performance of the INTERMED questionnaire score, alone or combined with other criteria, in predicting return to work after a multidisciplinary rehabilitation program in patients with non-specific chronic low back pain. METHODS: The INTERMED questionnaire is a biopsychosocial assessment and clinical classification tool that separates heterogeneous populations into subgroups according to case complexity. We studied 88 patients with chronic low back pain who followed an intensive multidisciplinary rehabilitation program on an outpatient basis. Before the program, we recorded the INTERMED score, radiological abnormalities, subjective pain severity, and sick leave duration. Associations between these variables and return to full-time work within 3 months after the end of the program were evaluated using one-sided Fisher tests and univariate logistic regression followed by multivariate logistic regression. RESULTS: The univariate analysis showed a significant association between the INTERMED score and return to work (P<0.001; odds ratio, 0.90; 95% confidence interval, 0.86-0.96). In the multivariate analysis, prediction was best when the INTERMED score and sick leave duration were used in combination (P=0.03; odds ratio, 0.48; 95% confidence interval, 0.25-0.93). CONCLUSION: The INTERMED questionnaire is useful for evaluating patients with chronic low back pain. It could be used to improve the selection of patients for intensive multidisciplinary programs, thereby improving the quality of care, while reducing healthcare costs.