Prospective determination of imipenem concentration of the plasma of critically-ill children

ABSTRACT Imipenem plasma-concentrations were measured in 19 critically-ill children (median 0.8 year, range 0.02-12.9 years). Wide inter-individual variations (2-4x at peak and >10x at through concentrations) resulted in unpredictable plasma-levels in several children. To avoid subtherapeutic drug levels we recommend at least 100 mg/kg/day of imipenem-cilastatin in critically-ill children requiring such therapy.

Mentally Ill Offenders in Community-Based Corrections, Research in Brief, Iowa Department of Corrections, April 2008

A survey of offenders supervised by the eight district departments of correctional services. This report was commissioned by the Iowa Department of Corrections Focus Group on Mental Health in Community-Based Corrections.

Council Bluffs Interstate System Improvements Project Pottawattamie County, IA and Douglas County, Nebraska, July 19, 2005

The Iowa Department of Transportation (Iowa DOT), Nebraska Department of Roads (NDOR), and the Federal Highway Administration (FHWA) are proposing improvements to the interstate system in the Omaha/Council Bluffs metropolitan area, extending across the Missouri River on Interstate 80 (I-80) to east of the Interstate 480 (I-480) interchange in Omaha, Nebraska (see Figure 1-1). The study considers long-term, broad-base transportation improvements along Interstate I-29 (I-29), I-80, and I-480, including approximately 18 mainline miles of interstate and 14 interchanges (3 system1, 11 service), that would add capacity and correct functional issues along the mainline and interchanges and upgrade the I-80 Missouri River Crossing. These improvements, once implemented, would bring the segments of I-80 and I-29 up to current engineering standards and modernize the roadway to accommodate future traffic needs.

Council Bluffs Interstate System Improvements Project Pottawattamie County, IA and Douglas County, Nebraska, July 19, 2005

The Iowa Department of Transportation (Iowa DOT), Nebraska Department of Roads (NDOR), and the Federal Highway Administration (FHWA) are proposing improvements to the interstate system in the Omaha/Council Bluffs metropolitan area, extending across the Missouri River on Interstate 80 (I-80) to east of the Interstate 480 (I-480) interchange in Omaha, Nebraska (see Figure 1-1). The study considers long-term, broad-base transportation improvements along Interstate I-29 (I-29), I-80, and I-480, including approximately 18 mainline miles of interstate and 14 interchanges (3 system1, 11 service), that would add capacity and correct functional issues along the mainline and interchanges and upgrade the I-80 Missouri River Crossing. These improvements, once implemented, would bring the segments of I-80 and I-29 up to current engineering standards and modernize the roadway to accommodate future traffic needs.

Report on the Chariton Valley Planning & Development Council of Governments for the period July 1, 2007 through August 31, 2010

Report on the Chariton Valley Planning & Development Council of Governments for the period July 1, 2007 through August 31, 2010

Report on the Iowa School for the Deaf, Council Bluffs, Iowa for the year ended June 30, 2011

Report on the Iowa School for the Deaf, Council Bluffs, Iowa for the year ended June 30, 2011

Economics of dialysis dependence following renal replacement therapy for critically ill acute kidney injury patients.

BACKGROUND: The obective of this study was to perform a cost-effectiveness analysis comparing intermittent with continuous renal replacement therapy (IRRT versus CRRT) as initial therapy for acute kidney injury (AKI) in the intensive care unit (ICU). METHODS: Assuming some patients would potentially be eligible for either modality, we modeled life year gained, the quality-adjusted life years (QALYs) and healthcare costs for a cohort of 1000 IRRT patients and a cohort of 1000 CRRT patients. We used a 1-year, 5-year and a lifetime horizon. A Markov model with two health states for AKI survivors was designed: dialysis dependence and dialysis independence. We applied Weibull regression from published estimates to fit survival curves for CRRT and IRRT patients and to fit the proportion of dialysis dependence among CRRT and IRRT survivors. We then applied a risk ratio reported in a large retrospective cohort study to the fitted CRRT estimates in order to determine the proportion of dialysis dependence for IRRT survivors. We conducted sensitivity analyses based on a range of differences for daily implementation cost between CRRT and IRRT (base case: CRRT day $632 more expensive than IRRT day; range from $200 to $1000) and a range of risk ratios for dialysis dependence for CRRT as compared with IRRT (from 0.65 to 0.95; base case: 0.80). RESULTS: Continuous renal replacement therapy was associated with a marginally greater gain in QALY as compared with IRRT (1.093 versus 1.078). Despite higher upfront costs for CRRT in the ICU ($4046 for CRRT versus $1423 for IRRT in average), the 5-year total cost including the cost of dialysis dependence was lower for CRRT ($37 780 for CRRT versus $39 448 for IRRT on average). The base case incremental cost-effectiveness analysis showed that CRRT dominated IRRT. This dominance was confirmed by extensive sensitivity analysis. CONCLUSIONS: Initial CRRT is cost-effective compared with initial IRRT by reducing the rate of long-term dialysis dependence among critically ill AKI survivors.

Audit report on the Chariton Valley Planning & Development Council of Governments in Centerville, Iowa for the years ended June 30, 2011, 2010, 2009 and 2008

Audit report on the Chariton Valley Planning & Development Council of Governments in Centerville, Iowa for the years ended June 30, 2011, 2010, 2009 and 2008

Adverse effects of high dose carnitine supplementation of total parenteral nutrition on protein and fat oxidation in the critically ill.

The aim of the present study was to investigate the effects of continuous and acute L-carnitine supplementation of total parenteral nutrition (TPN) on protein and fat oxidation in severe catabolism. A critically ill and severely malnourished male patient received TPN (non protein energy = 41 kcal/kg/day, provided equally as fat and glucose) over 38 days, without L-carnitine for 23 days and with carnitine supplements (15 mg/kg/day) for the following 15 days. Subsequently, he was given carnitine-free enteral nutrition for 60 more days. A four-hour infusion of 100 mg L-carnitine was given on day 11 of each TPN period. Indirect calorimetry was carried out after 11 days of either carnitine-free or supplemented TPN and at the initiation of enteral nutrition. Additional measurements were performed 4 hours and 24 hours after the acute infusions of carnitine. The rate of protein oxidation and the respiratory quotient were found to be higher, and the rate of fat oxidation to be lower, with carnitine-supplemented TPN, than with either carnitine-free TPN or enteral nutrition. Acute infusion of carnitine resulted in an increased rate of protein oxidation and a reduced rate of fat oxidation on both TPN-regimens. These unfavourable effects on protein metabolism may be due to an impairment of fat oxidation by excess amounts of carnitine.

Criminal and Juvenile Justice Planning Advisory Council Progress on the Long-range Justice System Plan, January 2010

Iowa Code Section 216A.135 requires the Criminal and Juvenile Justice Planning Advisory Council (CJJPAC) to submit a long-range plan for Iowa's justice system to the Governor and General Assembly every five years. The Criminal and Juvenile Justice Advisory Council directed that the 2005 plan be developed with input from the public. A public hearing was held in September 2004, utilizing the Iowa Communications Network at five sites across Iowa. Using the information gained, the Council developed new goals and strategies and modified others from the 2000 plan. The 2005 Long Range Goals for Iowa’s Criminal and Juvenile Justice Systems, organized as follows, are meant to facilitate analyses and directions for justice system issues and concerns in Iowa.

Audit report on the City of Council Bluffs, Iowa for the year ended June 30, 2012

Audit report on the City of Council Bluffs, Iowa for the year ended June 30, 2012

Audit report on the Council Bluffs Airport Authority for the year ended June 30, 2012

Audit report on the Council Bluffs Airport Authority for the year ended June 30, 2012

Iowa Autism Council; Priories Moving Iowa Forward, 2012

Department of Education should continue data collection regarding quality educational services for ASD students in Iowa. The council requires adequate data to continue to make sound recommendations on system improvements for Iowa students.