Report on a special investigation of the Center for Behavioral Health for the period January 1, 2011 through May 21, 2013

Report on a special investigation of the Center for Behavioral Health for the period January 1, 2011 through May 21, 2013

La Vil·la romana dels Hospitals (El Morell, Tarragona) : un assentament de la via De Italia in Hispanias

Es tracta d’una obra fruit d’un conveni de col·laboració signat l’any 2004 entre la URV, l’ICAC i Repsol YPF, i resultat d’un projecte de recerca de l’ICAC inclòs en la línia de recerca Arqueologia del paisatge, poblament i territori, que ha comptat amb el cofinançament de Repsol YPF i la col·laboració de Codex. Aquesta obra se centra en les excavacions arqueològiques efectuades en una vil·la romana situada entre la via Tarraco-Ilerda i la llera del riu Francolí, a l’actual terme municipal del Morell. És un assentament datat entre els segles II aC i V dC que reflecteix els patrons d’ocupació romana a l’àrea central de l’ager Tarraconensis i complementa, a partir d’una exhaustiva anàlisi, les dades històriques que, fins a l’actualitat, oferien les vil·les de Centcelles a Constantí o de Paret Delgada a la Selva del Camp. L’estudi parteix de les excavacions que l’empresa Codex hi va efectuar l’any 1996 arran d’una actuació d’urgència motivada per la construcció d’una nova planta industrial de l’aleshores Repsol Química SA. L’obra és fruit de l’estudi de la documentació, fins ara inèdita, elaborada per l’empresa Codex i que ha estat cedida per a aquest projecte de recerca. La publicació ha estat coordinada per Josep M. Macias Solé i Joan J. Menchon Bes i els textos són obra del Dr. Domènec Campillo, M. Milagros Cuesta i Laura Devenat (Laboratori de Paleopatologia i Paleoantropologia, Museu d’Arqueologia de Catalunya), Montserrat García Noguera (Codex – Arqueologia i Patrimoni), Miguel Á. González Pérez (Grup de Recerca d’Arqueologia Clàssica, Protohistòrica i Egípcia, Universitat de Barcelona), Josep M. Macias Solé (ICAC), Joan J. Menchon Bes (Museu d’Història de Tarragona), Joan S. Mestres i Torres (Laboratori de Datació per Radiocarboni, Universitat de Barcelona), Rosario Navarro Sáez (Universitat de Barcelona), Josep M. Palet Martínez (ICAC) i Jordi Principal Ponce (Museu d’Arqueologia de Catalunya). Amb la nova col·lecció Hic et nunc l’ICAC assumeix el compromís de difondre regularment la documentació arqueològica bàsica generada des del camp universitari o empresarial, entenent que la publicació d’aspectes més concrets és imprescindible per a l’elaboració de síntesis més globalitzadores.

Report on a special investigation of the band program of the Monticello Community School District for the period January 1, 2009 through December 31, 2013

Report on a special investigation of the band program of the Monticello Community School District for the period January 1, 2009 through December 31, 2013

Effects of Special Aggregate on Bridge Deck Overlay Frictional Properties, HR-205, 1986

The Iowa DOT has been using the "Iowa Method" thin bonded low-slump dense Portland Cement Concrete (PCC) bridge deck overlay for rehabilitation of delaminated decks since 1963. In time, continued use of studded tires will wear away the transverse grooved texture. The objective of this research was to evaluate the benefit of incorporating a hard durable aggregate into a dense PCC overlay to provide frictional property longevity. The project included three overlays on I-35 near Ankeny. The texture and friction properties of two overlays, one constructed with crushed granite and the other with crushed quartzite coarse aggregate, were compared to an overlay constructed with locally available crushed limestone. There were no construction problems resulting from the use of crushed granite or quartzite. There was no significant frictional property benefit from the crushed granite or crushed quartzite through six years.

Awareness of HIV Testing Guidelines Is Low among Swiss Emergency Doctors: A Survey of Five Teaching Hospitals in French-Speaking Switzerland.

BACKGROUND: In Switzerland, 30% of HIV-infected individuals are diagnosed late. To optimize HIV testing, the Swiss Federal Office of Public Health (FOPH) updated 'Provider Induced Counseling and Testing' (PICT) recommendations in 2010. These permit doctors to test patients if HIV infection is suspected, without explicit consent or pre-test counseling; patients should nonetheless be informed that testing will be performed. We examined awareness of these updated recommendations among emergency department (ED) doctors. METHODS: We conducted a questionnaire-based survey among 167 ED doctors at five teaching hospitals in French-Speaking Switzerland between 1(st) May and 31(st) July 2011. For 25 clinical scenarios, participants had to state whether HIV testing was indicated or whether patient consent or pre-test counseling was required. We asked how many HIV tests participants had requested in the previous month, and whether they were aware of the FOPH testing recommendations. RESULTS: 144/167 doctors (88%) returned the questionnaire. Median postgraduate experience was 6.5 years (interquartile range [IQR] 3; 12). Mean percentage of correct answers was 59 ± 11%, senior doctors scoring higher (P=0.001). Lowest-scoring questions pertained to acute HIV infection and scenarios where patient consent was not required. Median number of test requests was 1 (IQR 0-2, range 0-10). Only 26/144 (18%) of participants were aware of the updated FOPH recommendations. Those aware had higher scores (P=0.001) but did not perform more HIV tests. CONCLUSIONS: Swiss ED doctors are not aware of the national HIV testing recommendations and rarely perform HIV tests. Improved recommendation dissemination and adherence is required if ED doctors are to contribute to earlier HIV diagnoses.

Special investigation of the City of Garwin for the period January 1, 2001 through April 30, 2014

Special investigation of the City of Garwin for the period January 1, 2001 through April 30, 2014

Report on a special investigation of the Shenandoah Community School District for the period July 1, 2012 through September 30, 2014

Report on a special investigation of the Shenandoah Community School District for the period July 1, 2012 through September 30, 2014

Special Report on Alkali-Aggregate Reactivity in Iowa, MLR-80-03, 1980

The purpose of this investigation was to obtain information relative to the alkali-silica reaction in Iowa aggregates. Of particular concern were those aggregates in southwestern Iowa thought to be potentially alkali reactive. Further, should those aggregates have proven to be alkali-reactive, at what cement alkali content could these aggregates be considered to be deleteriously reactive? If the aggregates were proven to be reactive, what types of effects might show up in a structure in which an alkali-silica reaction has occurred? Also, what environmental conditions would cause the reaction? Finally, based on the information obtained from the investigation, would it be possible to raise the cement alkali content specifications? Would the Iowa DOT eliminate the alkali content limits altogether except for cement used with reactive aggregate in the same manner as AASHTO or ASTM? Also, would there be any other side effects that might occur as the result of using high alkali-cement?

Report on a special investigation of the City of Moorland for the period January 1, 2008 through October 31, 2013

Report on a special investigation of the City of Moorland for the period January 1, 2008 through October 31, 2013

Report on a special investigation of the West Des Moines Community School District - Western Hills Elementary School for the period May 22, 2012 through March 31, 2015

Report on a special investigation of the West Des Moines Community School District - Western Hills Elementary School for the period May 22, 2012 through March 31, 2015

Lack of extended venous thromboembolism prophylaxis in high-risk patients undergoing major orthopaedic or major cancer surgery. Electronic Assessment of VTE Prophylaxis in High-Risk Surgical Patients at Discharge from Swiss Hospitals (ESSENTIAL).

Extended pharmacological venous thromboembolism (VTE) prophylaxis beyond discharge is recommended for patients undergoing high-risk surgery. We prospectively investigated prophylaxis in 1,046 consecutive patients undergoing major orthopaedic (70%) or major cancer surgery (30%) in 14 Swiss hospitals. Appropriate in-hospital prophylaxis was used in 1,003 (96%) patients. At discharge, 638 (61%) patients received prescription for extended pharmacological prophylaxis: 564 (77%) after orthopaedic surgery, and 74 (23%) after cancer surgery (p < 0.001). Patients with knee replacement (94%), hip replacement (81%), major trauma (80%), and curative arthroscopy (73%) had the highest prescription rates for extended VTE prophylaxis; the lowest rates were found in patients undergoing major surgery for thoracic (7%), gastrointestinal (19%), and hepatobiliary (33%) cancer. The median duration of prescribed extended prophylaxis was longer in patients with orthopaedic surgery (32 days, interquartile range 14-40 days) than in patients with cancer surgery (23 days, interquartile range 11-30 days; p<0.001). Among the 278 patients with an extended prophylaxis order after hip replacement, knee replacement, or hip fracture surgery, 120 (43%) received a prescription for at least 35 days, and among the 74 patients with an extended prophylaxis order after major cancer surgery, 20 (27%) received a prescription for at least 28 days. In conclusion, approximately one quarter of the patients with major orthopaedic surgery and more than three quarters of the patients with major cancer surgery did not receive prescription for extended VTE prophylaxis. Future effort should focus on the improvement of extended VTE prophylaxis, particularly in patients undergoing major cancer surgery.

Special investigation of the University of Iowa Health Care, Department of Orthopaedics and Rehabilitation, for the period July 1, 1999 through December 31, 2014

Special investigation of the University of Iowa Health Care, Department of Orthopaedics and Rehabilitation, for the period July 1, 1999 through December 31, 2014

Libraries of state welfare institutions, 1930.

State institutions, such as hospitals, penal and correctional institutions and training schools for children have had libraries starting in about 1905. In 1925 the supervisory librarian position became vacant and was not filled. This report states that Iowa is in danger of losing her reputation as a progressive library state.

Report on a special investigation of the University of Northern Iowa, College of Education – Curriculum and Instruction Department for the period January 1, 2012 through October 31, 2014

Report on a special investigation of the University of Northern Iowa, College of Education – Curriculum and Instruction Department for the period January 1, 2012 through October 31, 2014

Collaborative quality improvement to manage pain in acute care hospitals.

Objective. Collaborative quality improvement programs have been successfully used to manage chronic diseases in adults and acute lung complications in premature infants. Their effectiveness to improve pain management in acute care hospitals is currently unknown. The purpose of this study was to determine whether a collaborative quality improvement program implemented at hospital level could improve pain management and overall pain relief. Design.To assess the effectiveness of the program, we performed a before-after trial comparing patient's self-reported pain management and experience before and after program implementation. We included all adult patients hospitalized for more than 24 hours and discharged either to their home or to a nursing facility, between March 1, 2001 and March 31, 2001 (before program implementation) and between September 15, 2005 and October 15, 2005 (after program implementation). Setting.A teaching hospital of 2,096 beds in Geneva, Switzerland. Patients.All adult patients hospitalized for more than 24 hours and discharged between 1 to 31 March 2001 (before program) and 15 September to 15 October 2005 (after program implementation). Interventions.Implementation of a collaborative quality improvement program using multifaceted interventions (staff education, opinion leaders, patient education, audit, and feedback) to improve pain management at hospital level. Outcome Measures.Patient-reported pain experience, pain management, and overall hospital experience based on the Picker Patient Experience questionnaire, perceived health (SF-36 Health survey). Results.After implementation of the program only 2.3% of the patients reported having no pain relief during their hospital stay (vs 4.5% in 2001, P = 0.05). Among nonsurgical patients, improvements were observed for pain assessment (42.3% vs 27.9% of the patients had pain intensity measured with a visual analog scale, P = 0.012), pain management (staff did everything they could to help in 78.9% vs 67.9% of cases P = 0.003), and pain relief (70.4% vs 57.3% of patients reported full pain relief P = 0.008). In surgical patients, pain assessment also improved (53.7.3% vs 37.6%) as well as pain treatment. More patients received treatments to relieve pain regularly or intermittently after program implementation (95.1% vs 91.9% P = 0.046). Conclusion.Implementation of a collaborative quality improvement program at hospital level improved both pain management and pain relief in patients. Further studies are needed to determine the overall cost-effectiveness of such programs.