Rebuild Iowa Advisory Commission (RIAC) 45-Day Report

The Rebuild Iowa Advisory Commission (RIAC) 45-Day Report offers the initial recommendations and priorities for Iowa's recovery from the devastating storms, flooding and tornadoes of 2008. The RIAC is a 15-member bipartisan commission appointed by Governor Chet Culver to lay out a blueprint to recovery.

Rebuild Iowa Advisory Commission (RIAC) 120-Day Report

The Rebuild Iowa Advisory Commission (RIAC) 120-Day Report offers the recommendations and priorities for Iowa's long-term recovery from the devastating storms, flooding and tornadoes of 2008. The RIAC is a 15-member bipartisan commission appointed by Governor Chet Culver to lay out a blueprint to recovery

Twenty-eight days and long term survival after severe sepsis and septic shock in adults

Résumé : Nous avons effectué une étude de cohorte examinant la survie de tous les patients qui ont présenté une sepsis sévère ou un choc septique aux soins intensifs de médecine et de chirurgie du CIIUV durant une période de 3 ans. Introduction: La sepsis sévère et le choc septique constituent la deuxième cause de mortalité dans les unités de soins intensifs non coronaires. La survie à long terme est mal connue. Nous avons comparé la survie à 28 jours de notre collectif avec les données de la littérature, examiné la survie à long terme des patients ayant survécus plus de 28 jours et identifié des paramètres prédictifs de la survie. Matériel et méthode : Nous avons classifié les patients ayant présenté un épisode septique rétrospectivement en sepsis sévère ou choc septique selon les critères de Bone (1). Les données cliniques et paracliniques ont été relevées au moment de l'épisode. Des courbes de survie uni- et multivariées ont été établies à 28 jours et à long terme chez ceux qui ont survécus plus de 28 jours, d'après les données de questionnaires envoyés aux médecins traitants. Résultats : Durant Ìa période de l'étude, 339 patients ont présenté un choc septique (169) ou une sepsis sévère (170). La mortalité à 28 jours a été de 33% (choc septique: 55%, sepsis sévère: 11.2%, p<10"5). Les données significativement associées à la mortalité à 28 jours dans l'analyse de régression multivariée selon Cox ont été le type d'épisode septique (choc septique vs. sepsis sévère, p=0.001), le «Acute Physiology Score» du score APACHE II (p=0.02) et le nombre de dysfonctions d'organes (plus de trois dysfunctions, p=0.04). 227 patients ont survécu plus de 28 jours et des données de suivi ont été obtenues chez 225. Le suivi moyen après 28 jours a été de 25.1 mois (5700 mois-patients). La mortalité globale de ces patients, extrapolée des courbes de Kaplan-Meyer, a été de l'ordre de 7% à 1 an et de 15% à 2 ans. Les données significativement associées à leur survie à long terme ont été les "chronic health points" du score APACHE II (p=0.02), l'âge (p=0.05) et le fait d'avoir subi une opération chirurgicale avant l'épisode septique (p=0.02). Conclusion : La mortalité à 28 jours de notre cohorte de patients s'est révélée comparable aux chiffres publiés. La survie à long terme des patients ayant survécu plus de 28 jours a été satisfaisante. Elle s'est révélée indépendante de la sévérité de l'épisode septique, mais dépendait plutôt des conditions de santé sous-jacentes.

Scenic Byways of Iowa, June 12, 2007

Bypass traffic and experience a “scenic” change of pace by traveling along Iowa’s scenic byways. Iowa’s eight state-designated and two nationally-designated scenic byways are a great way to experience Iowa’s natural beauty, history and culture. Stop to smell the wildflowers or listen to the songbirds, or follow an impulse to take a side trip to one of the many attractions and countryside hamlets. A camera is a must for these postcard-perfect vistas. You never know when you will encounter a bald eagle along the Mississippi River, rare plants and animals in the Loess Hills, or the exceptional architecture of unique barns, churches and other buildings along the routes. This brochure identifies each scenic byway route and the approximate mileage in terms of hard-surfaced and gravel roadways. Estimated driving time ranges from one and one-half hour to three and one-half hours, depending on your speed and the number of stops. These routes are offered for those of you who want to relax and stop often to enjoy the sights.

Evaluation par des médecins installés de l'efficacité antihypertensive de la débrisoquine, de la méthyldopa et du propranolol [Evaluation by practicing physicians of the antihypertensive efficacy of debrisoquin, methyldopa and propranolol]

The antihypertensive effect of debrisoquine (20 mg/day), methyldopa (100 mg/day) and propranolol (160 mg/day) was compared to that obtained with a placebo in a controlled trial carried out by a group of 14 internists. Forty-eight patients with uncomplicated essential hypertension were included. Mefruside (25 mg/day) was first given alone for 6 weeks ("open phase" of the trial) and to this diuretic was then added in double-blind fashion and randomized sequence a placebo or an active drug. Each of the 4 blind phases lasted 4 weeks. At the end of the "open phase", blood pressure in seated position averaged 168/111 +/- 19.6/13.5 mm Hg (mean +/- SD). A significant blood pressure decrease was observed after 4 weeks of treatment with the placebo as well as with the investigated compounds. With the placebo blood pressure was reduced to 158/102 +/- 19.6/13.5 mm Hg (p less than 0.001). The magnitude of the additional blood pressure decrease induced by the active drugs was relatively small and varied from 4 (debrisoquine) to 10 mm Hg (methyldopa, p less than 0.01) for the systolic and from 3 (debrisoquine, p less than 0.05) to 5 mm Hg (propranolol, p less than 0.05) for the diastolic. The percentage of patients with systolic pressure of less than or equal to 140 mm Hg and with diastolic pressure of less than 90 mm Hg during administration of either drug was not greater than 40 to 20% respectively. Propranolol appeared to be better tolerated than the other antihypertensive agents. These rather disappointing blood pressure results suggest that the efficacy of antihypertensive agents in private practice cannot be extrapolated from studies carried out in specialized hypertension clinics.

Grundriss innovativer Polizeiansätze. Eine kritische Begutachtung verschiedener Strategien und Tätigkeiten und deren Implementierung in der Schweiz in Theorie und Praxis.

This thesis contains three parts. The first one offers the theoretical basement, where the history of the police from their beginning in the early 19th century to this day is shown. The emphasis however is laid on the last 40 years, which gave birth to a multitude of innovations, such as community, problem-oriented, hot-spots or zero-tolerance policing. Those innovations are described in detail and are critically commented. At the end of this section, I present a scheme, where all the approaches are classified as strategic or methodic innovations, but united under a model called "modern policing". The fact that the innovations are not competitive but rather complementary is the most important finding of this examination. The second part of this work deals with a unique survey about the implementation of four innovations and eight problem- and community-oriented activities in 85 Swiss police forces. This explorative study shows that in the last 15 years the Swiss police forces have increasingly adopted innovative approaches. The most frequent innovation is community policing, which has been implemented all over the country. Due to the results, we can also assume that the implementation of the innovations is mostly substantial and profound. However, particularly in the area of problem-solving there is still a need for improvements. The third section consists of a scientific evaluation of a temporary special unit of the municipal police Zurich, which, during nine months, fought against public drug dealing and illegal prostitution in a particular neighborhood called Langstrasse. The effects of this hot-spot project were measured with police data, observations and several population surveys. In general, the special unit achieved a positive outcome and helped to defuse the hot-spot. Additionally, a survey conducted within the police department showed that the personal attitude towards the special unit differed widely between the policemen. We found significant differences between both police regions East and West, rank-and-file and higher ranking officers, different ages and the personal connection to the special unit. In fact, the higher the rank, the lower the age, and the closer the relationship, the more positive the officers were towards the unit.

Diabète et insuffisance rénate terminate. Evolution en huit ans dans le canton de Vaud [Diabetes and end stage renal disease. Eight year progression in the Canton de Vaud, Switzerland].

Diabetic nephropathy is the first cause of endstage renal disease. The demographic expansion, the increase in the incidence of diabetes and the prolonged survival rates explain the steep increase observed these last 30 years. In the United States, improved treatment has brought to a decline in the incidence of end-stage renal disease in the diabetic population since the mid nineties. We examined the change in prevalence of diabetics on dialysis from 2001 and 2009 in the Canton de Vaud, Switzerland. The prevalence of diabetics on dialysis increased from 18% to 31% in dialysis centers and increased from 1.1/1000 to 1.9/1000 in the diabetic population. These are strong indicators that efforts are needed to improve the renal outcome of patients with diabetic nephropathy.

Election Day Registration Guide, 2008

As of January 1, 2008, Iowa law allows you to register to vote on Election Day at the polling place for the precinct you currently live in. After showing proper identification you may register and vote at the precinct the same day. Please open file for more information.

Combined report on the eight Judicial District Departments of Correctional Services for the year ended June 30, 2008

Combined report on the eight Judicial District Departments of Correctional Services for the year ended June 30, 2008

Effect of weight loss on resting energy expenditure in obese prepubertal children.

To assess the effect of weight loss on resting metabolic rate (RMR), the energy expenditure of eight obese prepubertal children (age 9 +/- 1 years; weight 48.7 +/- 9.1 kg; BMI 25.3 +/- 3.9) and of 14 age-matched children of normal body weight (age 9 +/- 1 years; weight 28.8 +/- 5.6 kg; BMI 16.5 +/- 1.7) was measured by indirect calorimetry. The obese children were reinvestigated after a mean weight loss of 5.4 +/- 1.2 kg induced by a six-months mixed hypocaloric diet. Before slimming, the obese group showed a higher daily energy intake than the control group (10.40 +/- 3.45 MJ/day vs 7.97 +/- 2.02 MJ/day respectively; P less than 0.05) but a similar value was observed per unit fat-free mass (FFM) (0.315 +/- 0.032 MJ/kgFFM/day vs 0.329 +/- 0.041 MJ/kgFFM/day respectively). The average RMR of the obese children was greater than that of the control group (5217 +/- 531 kJ/day vs 4477 +/- 506 kJ/day) but similar after adjusting for FFM (4728 +/- 3102 kJ/day vs 4899 +/- 3102 kJ/day). Weight loss resulted in a reduction in RMR (5217 +/- 531 kJ/day vs 4874 +/- 820 kJ/day), each kg of weight loss being accompanied by a decrease of RMR of 64 kJ (15.3 kcal) per day. The changes in RMR induced by weight loss paralleled the changes in FFM. No difference was found in average RQ in obese children vs controls (0.85 +/- 0.03 vs 0.87 +/- 0.03 respectively) and in the obese children before and after weight loss (0.87 +/- 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Regulador de llum controlat per ordinador

RESUM El llum electric és un tipus d’energia amb la que s’il•lumina tot el món i s’utilitza tant per a il•luminar la nit com per a disposar de llum addicional durant el dia. L’energia es pren directament de la xarxa de subministrament elèctric i permet encendre tot tipus de focus i bombetes. Actualment la necessitat de controlar la intensitat lumínica de focus és de gran utilitat i es poden veure exemples en escenaris de teatres, concerts musicals, domòtica bàsica a vivendes, botigues, restaurants, etc. on s’incorporen aparells òptims per aquest control. Aspectes com la programació d’encesa, apagat i intensitat desitjada de focus a una hora convinguda facilita el fet de fer-ho manualment i disposar de més temps propi. L’objectiu principal d’aquest treball és dissenyar i construir un regulador de llum controlat per ordinador capac de regular la intensitat lumínica de 8 focus independentment l’un de l’altre. El control de regulació s’efectua mitjancant un programa informàtic compatible amb ordinadors que incorporin el sistema operatiu Windows i és programable en el temps permetent seleccionar la intensitat desitjada a diferents hores del dia seleccionat. Com a conclusions es pot destacar un estalvi energètic al regular la intensitat dels focus evitant així la permanent connexio a una tensió màxima de 230 VAC i la oportunitat de construir un regulador de llum amb els documents subministrats.

Role of high normal gamma-glutamyltransferase level in identifying heavy alcohol use in young men.

The objective of the current study was to determine the predictive value of high normal gamma-glutamyltransferase (GGT) level as an indication of heavy drinking in young men. In a sample of 577 men attending a one-day army recruitment process mandatory for all Swiss men at age 19 years, GGT level was evaluated as the dependent variable for each of eight dichotomous classifications of individuals on the basis of meeting cut-off criteria for five indexes of alcohol use, two indexes of alcohol-related problems, and one index of body mass. The sensitivity, specificity, and predictive values of GGT level in identifying subjects as either heavy drinkers or being overweight were determined. Compared with findings for their counterparts, GGT level was higher in subjects reporting consumption of more than 14 drinks per week (20.5 +/- 7.81 vs. 18.9 +/- 7.60, P <.05), in those reporting being drunk at least once during the past 30 days (20.3 +/- 7.80 vs. 18.3 +/- 7.43, P <.001), and in individuals with body mass indexes >or=25 kg/m(2) (25.8 +/- 10.84 vs. 18.3 +/- 6.59, P <.001). At a GGT level cut-off of 20 U/l, the sensitivity, specificity, and positive and negative predictive values of either being a heavy drinker or overweight were 48.2%, 70.2%, 67.7%, and 51.2%, respectively. Exclusion of subjects with body mass indexes of >or=25 kg/m(2) revealed similar results. High normal GGT level in young men is indicative of heavy alcohol use or being overweight; when present, subjects should be screened further for potential concomitant drinking problems.

Glomerular hyperfiltration and increased proximal sodium reabsorption in subjects with type 2 diabetes or impaired fasting glucose in a population of the African region.

BACKGROUND. Glomerular hyperfiltration (GHF) is a well-recognized early renal alteration in diabetic patients. As the prevalence of GHF is largely unknown in populations in the African region with respect to normal fasting glucose (NFG), impaired fasting glucose (IFG) and type 2 diabetes [diabetes mellitus (DM)], we conducted a cross-sectional study in the Seychelles islands among families including at least one member with hypertension. METHODS. The glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and proximal tubular sodium reabsorption were measured using inulin, p-aminohippurate (PAH) and endogenous lithium clearance, respectively. Twenty-four-hour urine was collected on the preceding day. RESULTS. Of the 363 participants (mean age 44.7 years), 6.6% had IFG, 9.9% had DM and 63.3% had hypertension. The prevalence of GHF, defined as a GFR >140 ml/min, was 17.2%, 29.2% and 52.8% in NFG, IFG and DM, respectively (P trend <0.001). Compared to NFG, the adjusted odds ratio for GHF was 1.99 [95% confidence interval (CI) 0.73-5.44] for IFG and 5.88 (2.39-14.45) for DM. Lithium clearance and fractional excretion of lithium were lower in DM and IFG than NFG (P < 0.001). CONCLUSION. In this population of African descent, subjects with impaired fasting glucose or type 2 diabetes had a high prevalence of GHF and enhanced proximal sodium reabsorption. These findings provide further insight on the elevated incidence of nephropathy reported among African diabetic individuals.