Iowa Department of Elder Affairs Legislative Update, January 20, 2006, Vol. 2, no. 2

Iowa Department of Elder Affairs provides a brief summation of a Departmental program or other important Departmental information in each Legislative Update. The Legislative Update is produced for informational and educational purposes only.

Iowa Department of Elder Affairs Legislative Update, March 20, 2006, Vol. 2, no. 10

Iowa Department of Elder Affairs provides a brief summation of a Departmental program or other important Departmental information in each Legislative Update. The Legislative Update is produced for informational and educational purposes only.

Challenging the "inoffensiveness" of regular cannabis use by its associations with other current risky substance use--a census of 20-year-old Swiss men.

3,537 men enrolling in 2007 for mandatory army recruitment procedures were assessed for the co-occurrence of risky licit substance use among risky cannabis users. Risky cannabis use was defined as at least twice weekly; risky alcohol use as 6+ drinks more than once/monthly, or more than 20 drinks per week; and risky tobacco use as daily smoking. Ninety-five percent of all risky cannabis users reported other risky use. They began using cannabis earlier than did non-risky users, but age of onset was unrelated to other risky substance use. A pressing public health issue among cannabis users stems from risky licit substance use warranting preventive efforts within this age group.

Iowa Lottery Action, March 20-April 2, Vol. 13, no. 6

Iowa Lottery newsletter for retailers

Executive Order Number Sixty Five, May 20, 1988

Establish the Iowa Geographic Information Council.

Executive Order Number Sixty Six, May 20, 1988

Establish the Iowa Geographic Information Council.

Monitoring of the Launched Girder Bridge over the Iowa River on US 20, March 2004

The objective of the study presented in this report was to document the launch of the Iowa River Bridge and to monitor and evaluate the structural performance of the bridge superstructure and substructure during the launch. The Iowa Department of Transportation used an incremental launching method, which is relatively unique for steel I-girder bridges, to construct the Iowa River Bridge over an environmentally sensitive river valley in central Iowa. The bridge was designed as two separate roadways consisting of four steel plate girders each that are approximately 11 ft deep and span approximately 301 ft each over five spans. The concrete bridge deck was not placed until after both roadways had been launched. One of the most significant monitoring and evaluation observations related to the superstructure was that the bottom flange (and associated web region) was subjected to extremely large stresses during the crossing of launch rollers. Regarding the substructure performance, the column stresses did not exceed reasonable design limits during the daylong launches. The scope of the study did not allow adequate quantification of the measured applied launch forces at the piers. Future proposed esearch should provide an opportunity to address this. The overall experimental performance of the bridge during the launch was compared with the predicted design performance. In general, the substructure design, girder contact stress, and total launching force assumptions correlated well with the experimental results. The design assumptions for total axial force in crossframe members, on the other hand, differed from the experimental results by as much as 300%.

¶ LE VOYAGE et || expedition de Charles le quint em- || pereur en Africque cõtre la || ville de Argiere. || ¶ La description de larmee & voyage de || Lempereur en Africque contre la || ville de Argiere / enuoyee a || mõsieur de Langest / tra- || duicte de latin en || françois. || ¶ Mil. D. xlii [1542] || ¶ On les vend a Paris en la rue sainct Ia- || ques a lenseigne des troys Brochetz / par Be- || noist de Gourmont. In-8 de 20 f. non chiffr. de 25 lignes à la page, sign. A-E par 4, mar. br., riches entrelacs et rinceaux en mosaïque de mar. vert, citron et rouge, doublé de mar. bleu, feuillages à petits fers, dos orné, gardes de moire bleue, tr. dor., dans un étui de mar. v. (Lortic.)

Charles Quint, roi d'Espagne et empereur d'Allemagne, d'abord archiduc d'Autriche. Le Voyage et Expedition de Charles le quint en Africque contre la ville de Argiere (1542)

Clinical management of immunocompetent hospitalized patients with community-acquired pneumonia.

Background: Clinical practices and guidelines may differ regarding the management of inpatients with community-acquired pneumonia (CAP). Methods: The management of 152 consecutive CAP inpatients (70+/-17 years) admitted to a teaching hospital was analyzed retrospectively and compared with published data and an evidence-based guideline developed at our institution. Results: Of the patients studied, 64% had a high prognostic score index (PSI), 14% were admitted to the ICU, and 4.6% died. Initially, patients received either a one-drug (47%) or a two-drug (53%) antibiotic regimen. None of the 20 PSI parameters, and neither the PSI nor admission to the ICU, was associated with the initial antibiotic regimen. Agreement between current practice and our guideline was low (kappa=0.16). Following the recommendations would have led to a decrease of 51% in the initial two-drug regimen. The duration of i.v. antibiotherapy was higher in patients following the two-drug regimen (142+/-150 vs. 102+/-60 h, P<0.05). Chest physiotherapy (CP) and bronchodilatators (BD) were prescribed in 72% and 54% of cases, respectively (median duration 10 days). Conclusions: The variations observed in the clinical management of CAP inpatients were not in agreement with published guidelines. The overuse of a two-drug regimen, CP, and BD necessitates the development and implementation of evidence-based guidelines proposing detailed steps for the management of CAP inpatients.

Fulgentius, Mythologie, phisica expositio super XII libros eneidorum (16), expositio sermonum ad Calcidium (20 v°). - Pauli et Senece epistole (22 v°). - Xenia M. Valerii Martialis (23). - Honorius, philosophia mundi (26 v°). - Prologus quorumdam juridicorum tractatuum (54 v°). - Ex Ausonio (55). -

Cordeliers.

Pääjohtaja K.-A. Fagerholm 20/12 1967

Kirje

The hematology laboratory in blood doping (bd): 2014 update on the athlete biological passport (APB)

Introduction: Blood doping (BD) is the use of Erythropoietic Stimulating Agents (ESAs) and/or transfusion to increase aerobic performance in athletes. Direct toxicologic techniques are insufficient to unmask sophisticated doping protocols. The Hematological module of the ABP (World Anti-Doping Agency), associates decision support technology and expert assessment to indirectly detect BD hematological effects. Methods: The ABP module is based on blood parameters, under strict pre-analytical and analytical rules for collection, storage and transport at 2-12°C, internal and external QC. Accuracy, reproducibility and interlaboratory harmonization fulfill forensic standard. Blood samples are collected in competition and out-ofcompetition. Primary parameters for longitudinal monitoring are: - hemoglobin (HGB); - reticulocyte percentage (RET); - OFF score, indicator of suppressed erythropoiesis, calculated as [HGB(g/L) * 60-√RET%]. Statistical calculation predicts individual expected limits by probabilistic inference. Secondary parameters are RBC, HCT, MCHC-MCH-MCV-RDW-IFR. ABP profiles flagged as atypical are review by experts in hematology, pharmacology, sports medicine or physiology, and classified as: - normal - suspect (to target) - likely due to BD - likely due to pathology. Results: Thousands of athletes worldwide are currently monitored. Since 2010, at least 35 athletes have been sanctioned and others are prosecuted on the sole basis of abnormal ABP, with a 240% increase of positivity to direct tests for ESA, thanks to improved targeting of suspicious athletes (WADA data). Specific doping scenarios have been identified by the Experts (Table and Figure). Figure. Typical HGB and RET profiles in two highly suspicious athletes. A. Sample 2: simultaneous increases in HGB and RET (likely ESA stimulation) in a male. B. Samples 3, 6 and 7: "OFF" picture, with high HGB and low RET in a female. Sample 10: normal HGB and increased RET (ESA or blood withdrawal). Conclusions: ABP is a powerful tool for indirect doping detection, based on the recognition of specific, unphysiological changes triggered by blood doping. The effect of factors of heterogeneity, such as sex and altitude, must also be considered. Schumacher YO, et al. Drug Test Anal 2012, 4:846-853. Sottas PE, et al. Clin Chem 2011, 57:969-976.