Vision suisse romande de la pratique infirmière avancée [Advanced nursing practice: vision in Switzerland].

To meet the challenges related to the development of health problems taking into account the development of knowledge, several innovations in care are being implemented. Among these, advanced nursing roles and increased interprofessional collaboration are considered as important features in Switzerland. Although the international literature provides benchmarks for advanced roles, it was considered essential to contextualize these in order to promote their application value in Switzerland. Thus, from 79 statements drawn from the literature, 172 participants involved in a two-sequential phases study only kept 29 statements because they considered they were relevant, important and applicable in daily practice. However, it is important to point out that statements which have not been selected at this stage to describe advanced practice cannot be considered irrelevant permanently. Indeed, given the emergence of advanced practice in western Switzerland, it is possible that a statement judged not so relevant at this moment of the development of advanced practice, will be considered as such later on. The master's program in nursing embedded at the University of Lausanne and the University of Applied Sciences Western Switzerland was also examined in the light of these statements. It was concluded that all the objectives of the program are aligned with the competencies statements that were kept.

Iowa Board of Nursing Annual Report FY 10 (7/1/09 - 6/30/10)

The Iowa Bord of Nursing Annual Report includes information on legislation, rule changes and statistics related to all aspects of board business: licensing, education, continuing education, enforcement, administrative changes, financial report, general nursing demographics.

Iowa Board of Nursing Annual Report FY 11 (7/1/10 - 6/30/11)

The Iowa Bord of Nursing Annual Report includes information on legislation, rule changes and statistics related to all aspects of board business: licensing, education, continuing education, enforcement, administrative changes, financial report, general nursing demographics.

Polypharmacy as predictor of drug cost, length of hospital stay and mortality rate in nursing homes : a retrospective analysis of pharmacy medication records

Background and objectives: Polypharmacy (PP) is a typical con-sequence of multiple chronic conditions in elderly patients. PP is commonly defined as the use of multiple concurrent drug therapies although a standard definition is not used. The aims of this study were to assess the PP rate among nursing home (NH) residents using the data of the pharmacy medication records and to investigate the threshold level of PP as predictor of drug cost, length of hospital stay and mortality rate

Les règles n'ont plus la cote: une question de contraception ou de choix [To bleed or not--a new dogma or a real choice in contraception?]

On en parle ! Il est question de la suppression des règles par l'administration de contraceptifs oestro-progestatifs (pilule, patch ou anneau vaginal) en cycles longs (cycles prolongés ; cycles étendus ; extended cycles) entraînant des périodes d'aménorrhée, rythmées par des intervalles libres de sept jours sans administration hormonale. L'indication à ce mode de prescription est presque unanimement reconnue pour le traitement des pathologies bénéficiant de la suppression des règles et des fluctuations hormonales inhérentes à l'activité ovarienne. Ce traitement suscite cependant également de l'intérêt pour une indication du type mode de vie. Les modalités thérapeutiques, les avantages et inconvénients sont examinés à la lumière de l'attente des femmes et de leur droit au choix éclairé et libre. Let's talk about it ! Suppression of menstruation, by extending the duration of contraceptives containing estro-progestins (oral contraception, patch or vaginal ring) to long cycles, is a new approach in the field of contraception. These extended cycles aim at obtaining prolonged amenorrhea, interrupted periodically by a free interval of 7 days without hormone intake and thus causing breakthrough bleeding. Pathologies, which are supposed to get some benefit from the suppression of menstruation and of hormone level variations related to ovarian activity, are widely recognized as an indication. Some interest is also coming up for so called life style indications. Treatment issues, advantages and disadvantages are examined in the light of women's expectations and right to access to informed consent and independent choice.

Mental Health Institute Task Force, December 2009

The Department shall staff a task force to be appointed by the governor consisting of knowledgeable citizen to perform an in-depth review of the four state mental health institutes, services provided, public benefits of the services provided, economic effects connected to the presence of the institutes that are realized by the communities in the areas served and the families of personnel and other public costs and benefits associated with the presence and availability of the four institutes. the review shall be coordinated with the proposal to be developed by the department under this section and shall submit a report providing findings and recommendations to the governor and general assembly on or before December, 15. 2009

Business Disaster Case Management Task Force, November 2010

During the 2010 session, the Iowa Legislature created per House File 2422 a Business Disaster Case Management Task Force. The purpose of the Task Force is to research disaster recovery case management assistance needed for businesses following a major disaster and to recommend steps for providing such assistance following disasters. The Task Force was duly constituted. Its recommendations are contained in this report. The Task Force focused on what the State of Iowa could do for itself without reliance on federal agencies or programs. It concluded that the hallmarks of any business disaster assistance must be speed of delivery and simplicity in execution. In addition, monies used to assist business recovery should be free of as many restraints on use as possible, relying on the affected businesses to judge for themselves how best to deploy capital resources.

Agreed upon procedures report on the Lee County Narcotics Task Force for the period July 1, 2010 through May 31, 2012

Agreed upon procedures report on the Lee County Narcotics Task Force for the period July 1, 2010 through May 31, 2012

Task 4: Testing Iowa Portland Cement Concrete Mixtures for the AASHTO Mechanistic-Empirical Pavement Design Procedure, May 2008

The present research project was designed to identify the typical Iowa material input values that are required by the Mechanistic-Empirical Pavement Design Guide (MEPDG) for the Level 3 concrete pavement design. It was also designed to investigate the existing equations that might be used to predict Iowa pavement concrete for the Level 2 pavement design. In this project, over 20,000 data were collected from the Iowa Department of Transportation (DOT) and other sources. These data, most of which were concrete compressive strength, slump, air content, and unit weight data, were synthesized and their statistical parameters (such as the mean values and standard variations) were analyzed. Based on the analyses, the typical input values of Iowa pavement concrete, such as 28-day compressive strength (f’c), splitting tensile strength (fsp), elastic modulus (Ec), and modulus of rupture (MOR), were evaluated. The study indicates that the 28-day MOR of Iowa concrete is 646 + 51 psi, very close to the MEPDG default value (650 psi). The 28-day Ec of Iowa concrete (based only on two available data of the Iowa Curling and Warping project) is 4.82 + 0.28x106 psi, which is quite different from the MEPDG default value (3.93 x106 psi); therefore, the researchers recommend re-evaluating after more Iowa test data become available. The drying shrinkage (εc) of a typical Iowa concrete (C-3WR-C20 mix) was tested at Concrete Technology Laboratory (CTL). The test results show that the ultimate shrinkage of the concrete is about 454 microstrain and the time for the concrete to reach 50% of ultimate shrinkage is at 32 days; both of these values are very close to the MEPDG default values. The comparison of the Iowa test data and the MEPDG default values, as well as the recommendations on the input values to be used in MEPDG for Iowa PCC pavement design, are summarized in Table 20 of this report. The available equations for predicting the above-mentioned concrete properties were also assembled. The validity of these equations for Iowa concrete materials was examined. Multiple-parameters nonlinear regression analyses, along with the artificial neural network (ANN) method, were employed to investigate the relationships among Iowa concrete material properties and to modify the existing equations so as to be suitable for Iowa concrete materials. However, due to lack of necessary data sets, the relationships between Iowa concrete properties were established based on the limited data from CP Tech Center’s projects and ISU classes only. The researchers suggest that the resulting relationships be used by Iowa pavement design engineers as references only. The present study furthermore indicates that appropriately documenting concrete properties, including flexural strength, elastic modulus, and information on concrete mix design, is essential for updating the typical Iowa material input values and providing rational prediction equations for concrete pavement design in the future.

Task 6: Material Thermal Input for Iowa Materials, May 2008

The present research project was designed to determine thermal properties, such as coefficient of thermal expansion (CTE) and thermal conductivity, of Iowa concrete pavement materials. These properties are required as input values by the Mechanistic-Empirical Pavement Design Guide (MEPDG). In this project, a literature review was conducted to determine the factors that affect thermal properties of concrete and the existing prediction equations for CTE and thermal conductivity of concrete. CTE tests were performed on various lab and field samples of portland cement concrete (PCC) at the Iowa Department of Transportation and Iowa State University. The variations due to the test procedure, the equipment used, and the consistency of field batch materials were evaluated. The test results showed that the CTE variations due to test procedure and batch consistency were less than 5%, and the variation due to the different equipment was less than 15%. Concrete CTE values were significantly affected by different types of coarse aggregate. The CTE values of Iowa concrete made with limestone+graval, quartzite, dolomite, limestone+dolomite, and limestone were 7.27, 6.86, 6.68, 5.83, and 5.69 microstrain/oF (13.08, 12.35, 12.03, 10.50, and 10.25 microstrain/oC), respectively, which were all higher than the default value of 5.50 microstrain/oF in the MEPDG program. The thermal conductivity of a typical Iowa PCC mix and an asphalt cement concrete (ACC) mix (both with limestone as coarse aggregate) were tested at Concrete Technology Laboratory in Skokie, Illinois. The thermal conductivity was 0.77 Btu/hr•ft•oF (1.33 W/m•K) for PCC and 1.21 Btu/hr•ft•oF (2.09 W/m•K) for ACC, which are different from the default values (1.25 Btu/hr•ft•oF or 2.16 W/m•K for PCC and 0.67 Btu/hr•ft•oF or 1.16 W/m•K for ACC) in the MEPDG program. The investigations onto the CTE of ACC and the effects of concrete materials (such as cementitious material and aggregate types) and mix proportions on concrete thermal conductivity are recommended to be considered in future studies.

EFNS guidelines on cognitive rehabilitation: report of an EFNS task force.

Disorders of language, spatial perception, attention, memory, calculation and praxis are a frequent consequence of acquired brain damage [in particular, stroke and traumatic brain injury (TBI)] and a major determinant of disability. The rehabilitation of aphasia and, more recently, of other cognitive disorders is an important area of neurological rehabilitation. We report here a review of the available evidence about effectiveness of cognitive rehabilitation. Given the limited number and generally low quality of randomized clinical trials (RCTs) in this area of therapeutic intervention, the Task Force considered, besides the available Cochrane reviews, evidence of lower classes which was critically analysed until a consensus was reached. In particular, we considered evidence from small group or single cases studies including an appropriate statistical evaluation of effect sizes. The general conclusion is that there is evidence to award a grade A, B or C recommendation to some forms of cognitive rehabilitation in patients with neuropsychological deficits in the post-acute stage after a focal brain lesion (stroke, TBI). These include aphasia therapy, rehabilitation of unilateral spatial neglect (ULN), attentional training in the post-acute stage after TBI, the use of electronic memory aids in memory disorders, and the treatment of apraxia with compensatory strategies. There is clearly a need for adequately designed studies in this area, which should take into account specific problems such as patient heterogeneity and treatment standardization.

Concrete Overlay Field Application Program Iowa Task Report US 18 Concrete Overlay Construction Under Traffic, May 2012

The National Concrete Pavement Technology Center, Iowa Department of Transportation, and Federal Highway Administration set out to demonstrate and document the design and construction of portland cement concrete (PCC) overlays on two-lane roadways while maintaining two-way traffic. An 18.82 mile project was selected for 2011 construction in northeast Iowa on US 18 between Fredericksburg and West Union. This report documents planning, design, and construction of the project and lessons learned. The work included the addition of subdrains, full-depth patching, bridge approach replacement, and drainage structural repair and cleaning prior to overlay construction. The paving involved surface preparation by milling to grade and the placement of a 4.5 inch PCC overlay and 4 foot of widening to the existing pavement. In addition, the report makes recommendations on ways to improve the process for future concrete overlays.

Nursing Facility Accountability Measure Work group Membership List, March 19, 2009

Recognize facilities that provide quality of life and appropriate access to medical assistance program beneficiaries in a cost-effective manner. Each measure is intended to represent nursing facility characteristics in each of the four domains.