991 resultados para Programs for improvement


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On June 24, 2010, the Rebuild Iowa Office (RIO) held a discussion-based tabletop exercise for the purpose of creating a framework to support disaster recovery coordination within the State of Iowa. The purpose of this report is to provide an overview of the tabletop exercise, summarize and analyze exercise results, identify strengths which should be maintained and built upon, identify areas for further improvement, and support development of recommendations and corrective actions.

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While the morphological and electrophysiological changes underlying diabetic peripheral neuropathy (DPN) are relatively well described, the involved molecular mechanisms remain poorly understood. In this study, we investigated whether phenotypic changes associated with early DPN are correlated with transcriptional alterations in the neuronal (dorsal root ganglia [DRG]) or the glial (endoneurium) compartments of the peripheral nerve. We used Ins2(Akita/+) mice to study transcriptional changes underlying the onset of DPN in type 1 diabetes mellitus (DM). Weight, blood glucose and motor nerve conduction velocity (MNCV) were measured in Ins2(Akita/+) and control mice during the first three months of life in order to determine the onset of DPN. Based on this phenotypic characterization, we performed gene expression profiling using sciatic nerve endoneurium and DRG isolated from pre-symptomatic and early symptomatic Ins2(Akita/+) mice and sex-matched littermate controls. Our phenotypic analysis of Ins2(Akita/+) mice revealed that DPN, as measured by reduced MNCV, is detectable in affected animals already one week after the onset of hyperglycemia. Surprisingly, the onset of DPN was not associated with any major persistent changes in gene expression profiles in either sciatic nerve endoneurium or DRG. Our data thus demonstrated that the transcriptional programs in both endoneurial and neuronal compartments of the peripheral nerve are relatively resistant to the onset of hyperglycemia and hypoinsulinemia suggesting that either minor transcriptional alterations or changes on the proteomic level are responsible for the functional deficits associated with the onset of DPN in type 1 DM.

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Audit report on the Iowa Water Pollution Control Works Financing Program and the Iowa Drinking Water Facilities Financing Program, joint programs of the Iowa Finance Authority and the Iowa Department of Natural Resources, for the year ended June 30, 2010

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Planning for trails can be a confusing process. A tremendous level of coordination is needed simply to plan and construct trails. Once trails are in place, they present communities with a variety of economic development opportunities. This handbook outlines a variety of ways in which governments, businesses, chambers of commerce, tourism promoters, and individual citizens can help their communities develop and implement trail-based economic development programs.

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A systematic method to improve the quality (Q) factor of RF integrated inductors is presented in this paper. The proposed method is based on the layout optimization to minimize the series resistance of the inductor coil, taking into account both ohmic losses, due to conduction currents, and magnetically induced losses, due to eddy currents. The technique is particularly useful when applied to inductors in which the fabrication process includes integration substrate removal. However, it is also applicable to inductors on low-loss substrates. The method optimizes the width of the metal strip for each turn of the inductor coil, leading to a variable strip-width layout. The optimization procedure has been successfully applied to the design of square spiral inductors in a silicon-based multichip-module technology, complemented with silicon micromachining postprocessing. The obtained experimental results corroborate the validity of the proposed method. A Q factor of about 17 have been obtained for a 35-nH inductor at 1.5 GHz, with Q values higher than 40 predicted for a 20-nH inductor working at 3.5 GHz. The latter is up to a 60% better than the best results for a single strip-width inductor working at the same frequency.

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The Iowa Transportation Improvement Program (Program) is published to inform Iowans of planned investments in our state’s transportation system. The Iowa Transportation Commission (Commission) and Iowa Department of Transportation (Iowa DOT) are committed to programming those investments in a fiscally responsible manner. This document reflects Iowa’s multimodal transportation system by the inclusion of investments in aviation, transit, railroads, trails, and highways. A major component of this program is the highway section that documents programmed investments on the primary highway system for the next five years. A large part of funding available for highway programming comes from the federal government. Accurately estimating future federal funding levels is dependent on having a current enacted multi-year federal transportation authorization. The most recent authorization, Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU), expired September 30, 2009, and to date it has been extended seven times because a new authorization has not yet been enacted. The current extension will expire September 30, 2011. This leads to significant uncertainty in federal funding; however, it is becoming evident that, in Federal Fiscal Year 2012 and beyond, federal funding revenue will likely be reduced by 25 percent from current levels in order to match revenue that flows into the Highway Trust Fund. This Program reflects this anticipated reduction in federal funding. While Iowa law does not require the adoption of a Program when federal transportation funding is being reauthorized, the Commission believes it is important to adopt a Program in order to continue on-going planning and project development efforts so that Iowa will be well positioned when a new authorization is adopted. However, it is important to recognize that, absent a federal authorization bill, there is significant uncertainty in the forecast of federal revenues. The Commission and the Iowa DOT will continue to monitor federal revenues and will adjust future investments as needed to maintain a fiscally responsible Program. For 2012-2016, approximately $2.3 billion is forecast to be available for highway right of way and construction. In developing the highway section of the Program, the Commission’s primary investment objective remains stewardship (i.e. safety, maintenance and preservation) of Iowa’s existing highway system. Over $1.3 billion is programmed in FY2012 through FY2016 for preservation of Iowa’s existing highway system and for enhanced highway safety features. The highway section also includes significant interstate investments on I-29 in Sioux City, I-29/80/480 in Council Bluffs, and I-74 in Bettendorf/Davenport. The FY2016 programming for construction on I-74 in Bettendorf/Davenport is the first of several years of significant investments that will be monitored for available funding. Approximately $200 million of the investments on these three major urban interstate projects address preservation needs. In total, approximately $1.5 billion is programmed for highway preservation activities for 2012- 2016. Another highway programming objective is maintaining the scheduled completion of capacity and economic development projects. Projects that were previously scheduled to be completed within the previous Program continue on their current schedule. However, due to the reduction of projected federal revenues, the Commission has delayed by one year the initiation of construction of all multi-year non-Interstate capacity and economic development projects that cannot be completed within this Program. These projects are U.S. 20 in Woodbury County, U.S. 30 in Benton County, U.S. 61 in Louisa County, and Iowa 100 in Linn County. The Iowa DOT and Commission appreciate the public’s involvement in the state’s transportation planning process. Comments received personally, by letter or through participation in the Commission’s regular meetings or public input meetings held around the state each year, are invaluable in providing guidance for the future of Iowa’s transportation system. It should be noted that this document is a planning guide. It does not represent a binding commitment or obligation of the Commission or Iowa DOT, and is subject to change.

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Audit report on Mid-Iowa School Improvement Consortium, Carlisle, Iowa for the year ended June 30, 2010

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Soil penetration resistance (PR) and the tensile strength of aggregates (TS) are commonly used to characterize the physical and structural conditions of agricultural soils. This study aimed to assess the functionality of a dynamometry apparatus by linear speed and position control automation of its mobile base to measure PR and TS. The proposed equipment was used for PR measurement in undisturbed samples of a clayey "Nitossolo Vermelho eutroférrico" (Kandiudalfic Eutrudox) under rubber trees sampled in two positions (within and between rows). These samples were also used to measure the volumetric soil water content and bulk density, and determine the soil resistance to penetration curve (SRPC). The TS was measured in a sandy loam "Latossolo Vermelho distrófico" (LVd) - Typic Haplustox - and in a very clayey "Nitossolo Vermelho distroférrico" (NVdf) - Typic Paleudalf - under different uses: LVd under "annual crops" and "native forest", NVdf under "annual crops" and "eucalyptus plantation" (> 30 years old). To measure TS, different strain rates were applied using two dynamometry testing devices: a reference machine (0.03 mm s-1), which has been widely used in other studies, and the proposed equipment (1.55 mm s-1). The determination coefficient values of the SRPC were high (R² > 0.9), regardless of the sampling position. Mean TS values in LVd and NVdf obtained with the proposed equipment did not differ (p > 0.05) from those of the reference testing apparatus, regardless of land use and soil type. Results indicate that PR and TS can be measured faster and accurately by the proposed procedure.

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The historically-reactive approach to identifying safety problems and mitigating them involves selecting black spots or hot spots by ranking locations based on crash frequency and severity. The approach focuses mainly on the corridor level without taking the exposure rate (vehicle miles traveled) and socio-demographics information of the study area, which are very important in the transportation planning process, into consideration. A larger study analysis unit at the Transportation Analysis Zone (TAZ) level or the network planning level should be used to address the needs of development of the community in the future and incorporate safety into the long-range transportation planning process. In this study, existing planning tools (such as the PLANSAFE models presented in NCHRP Report 546) were evaluated for forecasting safety in small and medium-sized communities, particularly as related to changes in socio-demographics characteristics, traffic demand, road network, and countermeasures. The research also evaluated the applicability of the Empirical Bayes (EB) method to network-level analysis. In addition, application of the United States Road Assessment Program (usRAP) protocols at the local urban road network level was investigated. This research evaluated the applicability of these three methods for the City of Ames, Iowa. The outcome of this research is a systematic process and framework for considering road safety issues explicitly in the small and medium-sized community transportation planning process and for quantifying the safety impacts of new developments and policy programs. More specifically, quantitative safety may be incorporated into the planning process, through effective visualization and increased awareness of safety issues (usRAP), the identification of high-risk locations with potential for improvement, (usRAP maps and EB), countermeasures for high-risk locations (EB before and after study and PLANSAFE), and socio-economic and demographic induced changes at the planning-level (PLANSAFE).

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We obtain the next-to-next-to-leading-logarithmic renormalization-group improvement of the spectrum of hydrogenlike atoms with massless fermions by using potential NRQED. These results can also be applied to the computation of the muonic hydrogen spectrum where we are able to reproduce some known double logarithms at O(m¿s6). We compare with other formalisms dealing with logarithmic resummation available in the literature.

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OBJECTIVE: The objective of this study was to analyse the use of lights and siren (L&S) during transport to the hospital by the prehospital severity status of the patient and the time saved by the time of day of the mission. METHODS: We searched the Public Health Services data of a Swiss state from 1 January 2010 to 31 December 2010. All primary patient transports within the state were included (24 718). The data collected were on the use of L&S, patient demographics, the time and duration of transport, the type of mission (trauma vs. nontrauma) and the severity of the condition according to the National Advisory Committee for Aeronautics (NACA) score assigned by the paramedics and/or emergency physician. We excluded 212 transports because of missing data. RESULTS: A total of 24 506 ambulance transports met the inclusion criteria. L&S were used 4066 times, or in 16.6% of all missions. Of these, 40% were graded NACA less than 4. Overall, the mean total transport time to return to the hospital was 11.09 min (confidence interval 10.84-11.34) with L&S and 12.84 min (confidence interval 12.72-12.96) without. The difference was 1.75 min (105 s; P<0.001). For night-time runs alone, the mean time saved using L&S was 0.17 min (10.2 s; P=0.27). CONCLUSION: At present, the use of L&S seems questionable given the severity status or NACA score of transported patients. Our results should prompt the implementation of more specific regulations for L&S use during transport to the hospital, taking into consideration certain physiological criteria of the victim as well as time of day of transport.

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Audit report on the Iowa Water Pollution Control Works Financing Program and the Iowa Drinking Water Facilities Financing Program, joint programs of the Iowa Finance Authority and the Iowa Department of Natural Resources for the year ended June 30, 2011

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The frequent lack of microbiological documentation of infection by blood cultures (BC) has a major impact on clinical management of febrile neutropenic patients, especially in cases of unexplained persistent fever. We assessed the diagnostic utility of the LightCycler SeptiFast test (SF), a multiplex blood PCR, in febrile neutropenia. Blood for BC and SF was drawn at the onset of fever and every 3 days of persistent fever. SF results were compared with those of BC, clinical documentation of infection, and standard clinical, radiological, and microbiological criteria for invasive fungal infections (IFI). A total of 141 febrile neutropenic episodes in 86 hematological patients were studied: 44 (31%) microbiologically and 49 (35%) clinically documented infections and 48 (34%) unexplained fevers. At the onset of fever, BC detected 44 microorganisms in 35/141 (25%) episodes. Together, BC and SF identified 78 microorganisms in 61/141 (43%) episodes (P = 0.002 versus BC or SF alone): 12 were detected by BC and SF, 32 by BC only, and 34 by SF only. In 19/52 (37%) episodes of persistent fever, SF detected 28 new microorganisms (7 Gram-positive bacterial species, 15 Gram-negative bacterial species, and 6 fungal species [89% with a clinically documented site of infection]) whereas BC detected only 4 pathogens (8%) (P = 0.001). While BC did not detect fungi, SF identified 5 Candida spp. and 1 Aspergillus sp. in 5/7 probable or possible cases of IFI. Using SeptiFast PCR combined with blood cultures improves microbiological documentation in febrile neutropenia, especially when fever persists and invasive fungal infection is suspected. Technical adjustments may enhance the efficiency of this new molecular tool in this specific setting.

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On June 24, 2010, the Rebuild Iowa Office (RIO) held a discussion-based tabletop exercise for the purpose of creating a framework to support disaster recovery coordination within the State of Iowa. The exercise design team was composed of RIO and Iowa Homeland Security and Emergency Management Division (HSEMD) staff. Initial planning for the Iowa Disaster Recovery Tabletop Exercise began in February 2010, in response to recommendations by the Rebuild Iowa Advisory Commission and the Rebuild Iowa Coordinating Council. Both of these groups were organized in direct response to the 2008 Iowa disasters to help establish a path for Iowa’s recovery and monitor progress toward meeting established goals. Recommendations included formalizing the responsibilities of the RIO as they relate to 2008 disasters, capturing lessons learned, and determining what a recovery model should look like for Iowa’s future disasters.