Psychodynamic interventions in cancer care II: a qualitative analysis of the therapists' reports.

BACKGROUND: To investigate the focus of psychodynamic-oriented interventions in cancer patients by means of a qualitative analysis of the therapists' reports. METHODS: One hundred thirty-five reports collected within a controlled psychotherapy trial were analyzed; the themes addressed during the intervention were classified in categories reflecting the focus of the intervention and correlated with sociodemographic and medical data and type of intervention. RESULTS: Twenty main themes were identified and classified in two categories: category 1 corresponded to interventions based on expression and support, and category 2 to interventions based on introspection, with subcategory 2.1 focusing on the patient's psychological functioning and subcategory 2.2 focusing on his way to engage and communicate in relationships. While the most frequently addressed theme was related to the diagnosis of cancer (N = 102/576; 22.6%), the majority of themes were related to other concerns (N = 446/576; 77.4%). Half of the interventions (50.4%) were classified in category 1, 27.4% in category 2.1, and 9.6% in category 2.2. Patients of category 1 entered less often brief psychotherapy (step 2 of the intervention) and more frequently suffered from advances disease. CONCLUSIONS: A wide variety of themes are addressed in psychodynamic interventions in the oncology setting, illustrating that cancer is not the only focus of therapy. Other themes reflect different psychological difficulties triggered by the disease. This study illustrates that cancer patients have different needs, which surpass the event of the disease. Early clarification and comprehension of the demand may therefore be beneficial to adjust the therapeutic approach. Copyright © 2013 John Wiley & Sons, Ltd.

Techniques for Estimating Flood-Frequency Discharges for Streams in Iowa, HR-395A, 2001

A statewide study was conducted to develop regression equations for estimating flood-frequency discharges for ungaged stream sites in Iowa. Thirty-eight selected basin characteristics were quantified and flood-frequency analyses were computed for 291 streamflow-gaging stations in Iowa and adjacent States. A generalized-skew-coefficient analysis was conducted to determine whether generalized skew coefficients could be improved for Iowa. Station skew coefficients were computed for 239 gaging stations in Iowa and adjacent States, and an isoline map of generalized-skew-coefficient values was developed for Iowa using variogram modeling and kriging methods. The skew map provided the lowest mean square error for the generalized-skew- coefficient analysis and was used to revise generalized skew coefficients for flood-frequency analyses for gaging stations in Iowa. Regional regression analysis, using generalized least-squares regression and data from 241 gaging stations, was used to develop equations for three hydrologic regions defined for the State. The regression equations can be used to estimate flood discharges that have recurrence intervals of 2, 5, 10, 25, 50, 100, 200, and 500 years for ungaged stream sites in Iowa. One-variable equations were developed for each of the three regions and multi-variable equations were developed for two of the regions. Two sets of equations are presented for two of the regions because one-variable equations are considered easy for users to apply and the predictive accuracies of multi-variable equations are greater. Standard error of prediction for the one-variable equations ranges from about 34 to 45 percent and for the multi-variable equations range from about 31 to 42 percent. A region-of-influence regression method was also investigated for estimating flood-frequency discharges for ungaged stream sites in Iowa. A comparison of regional and region-of-influence regression methods, based on ease of application and root mean square errors, determined the regional regression method to be the better estimation method for Iowa. Techniques for estimating flood-frequency discharges for streams in Iowa are presented for determining ( 1) regional regression estimates for ungaged sites on ungaged streams; (2) weighted estimates for gaged sites; and (3) weighted estimates for ungaged sites on gaged streams. The technique for determining regional regression estimates for ungaged sites on ungaged streams requires determining which of four possible examples applies to the location of the stream site and its basin. Illustrations for determining which example applies to an ungaged stream site and for applying both the one-variable and multi-variable regression equations are provided for the estimation techniques.

The link between land-use management and fluvial flood risk : a chaotic conception?

There is much policy interest in the possible linkages that might exist between land use and downstream fluvial flood risk. On the one hand, this position is sustained by observations from plot- and field-scale studies that suggest land management does affect runoff. On the other, upscaling these effects to show that land-management activities impact upon flood risk at larger catchment scales has proved to be elusive. This review considers the reasons for why this upscaling is problematic. We argue that, rather than it reflecting methodological challenges associated with the difficulties of modelling hydrological processes over very large areas and during extreme runoff events, it reflects the fact that any linkage between land management and flood risk cannot be generalized and taken out of its specific spatial (catchment) and temporal (flood event) context. We use Sayer's (1992) notion of a `chaotic conception' to describe the belief that there is a simple and general association between land management and downstream flood risk rather than the impacts of land management being spatially and temporally contingent in relation to the particular geographical location, time period and scale being considered. Our argument has important practical consequences because it implies that land-management activities to reduce downstream flood risk will be different to traditional flood-reduction interventions such as levees. The purpose of demonstration projects then needs careful consideration such that conclusions made for one project are not transferred uncritically to other scales of analysis or geographical locations.

Evaluation of Design Flood Frequency Methods for Iowa Streams, TR-533, 2009

The objective of this project was to assess the predictive accuracy of flood frequency estimation for small Iowa streams based on the Rational Method, the NRCS curve number approach, and the Iowa Runoff Chart. The evaluation was based on comparisons of flood frequency estimates at sites with sufficiently long streamgage records in the Midwest, and selected urban sites throughout the United States. The predictive accuracy and systematic biases (under- or over-estimation) of the approaches was evaluated based on forty-six Midwest sites and twenty-one urban sites. The sensitivity of several watershed characteristics such as soil properties, slope, and land use classification was also explored. Recommendations on needed changes or refinements for applications to Iowa streams are made.

Delaware County Solid Waste Disposal Commission, Independent Auditor's Reports, Financial Statement and Required Supplementary Information, Schedule of Findings, June 30, 2006

Other Audit Reports - 28E Organizations

Delaware County Solid Waste Disposal Commission, Independent Auditor's Reports, Financial Statement and Required Supplementary Information, Schedule of Findings, June 30, 2004

Other Audit Reports - 28E Organizations

Iowa Flood Mitigation Board Annual Report, 2014

The Iowa Flood Mitigation Program is created within Code of Iowa, Chapter 418. The Program seeks to provide funds for flood mitigation projects that otherwise would not be funded. The Flood Mitigation Board is responsible for the implementation Code of Iowa Chapter 418. The membership of the Board is comprised of four voting public members appointed by the Governor, five voting members representing state agencies, and four non-voting ex-officio members of the legislature.

IOWATER Program: Summary of Recent Reports

Summary of water quality data collected by volunteers as part of the IOWATER program.

Recommendations and Funding Options to Mitigate Flood Risk, November 2009

Iowa legislation required the state’s Water Resources Coordinating Council (WRCC) to submit policy and make recommendations that promote a watershed management approach to reduce the adverse impact of future flooding on this state’s residents, businesses, communities, and soil and water quality.

Application of ultrasound in bone surgery: two case reports

The present study describes some of the applications of ultrasound in bone surgery, based on the presentation of two clinical cases. The Piezosurgery® ultrasound device was used (Tecnología Mectron Medical, Carasco, Italy). In one case the instrument was used to harvest a chin bone graft for placement in a bone defect at level 1.2, while in the other case a bony window osteotomy was made in the external wall of the maxillary sinus, in the context of a sinus membrane lift procedure. The Piezosurgery® device produces specific ultrasound frequency modulation (25-29 kHz), and has been designed to secure increased precision in application to bone surgery. This instrument produces selective sectioning of the mineralized bone structures, and causes less intra- and postoperative bleeding. One of the advantages of the Piezosurgery® device is that it can be used for maxillary sinus lift procedures in dental implant placement. In this context it considerably lessens the risk of sinus mucosa laceration by preparing the bony window in the external wall of the upper maxilla, and can be used to complete the lifting maneuver. The use of ultrasound in application to hard tissues can be regarded as a slow technique compared with the conventional rotary instruments, since it requires special surgical skill and involves a certain learning curve.

Iowa Flood Mitigation Board Annual Report, 2015

The Iowa Flood Mitigation Program is created within Code of Iowa, Chapter 418. The Program seeks to provide funds for fl ood mitigation projects that otherwise would not be funded. The Flood Mitigation Board is responsible for the implementation of Code of Iowa Chapter 418. The membership of the Board is comprised of four voting public members appointed by the Governor, five voting members representing state agencies, four non-voting ex officio members of the legislature, and one non-voting ex officio member representing a state agency.

Air Formed Arch Culvert Construction: Crawford County, Construction Reports, HR-314, 1991

Iowa's secondary roads contain nearly 15,000 bridges which are less than 40 feet (12 m) in length. Many of these bridges were built several decades ago and need to be replaced. Box culvert construction has proven to be an adequate bridge replacement technique. Recently a new bridge replacement alternative, called the Air-0-Form method, has emerged which has several potential advantages over box culvert construction. This new technique uses inflated balloons as the interior form in the construction of an arch culvert. The objective of research project HR-314 was to construct an air formed arch culvert to determine the applicability of the Air-O-Form technique as a county bridge replacement alternative.

Do Objective Measures of Blood Alcohol Concentrations Make More Sense than Self-reports in Emergency Department Studies?

Purpose: Concerns about self-reports have led to calls for objective measures of blood alcohol concentration (BAC). The present study compared objective measures with self-reports. Methods: BAC from breath or blood samples were obtained from 272 randomly sampled injured patients who were admitted to a Swiss emergency department (ED). Self-reports were compared a) between those providing and refusing a BAC test, and b) to estimated peak BAC (EPBAC) values based on BACs using the Widmark formula. Results: Those providing BACs were significantly (P < 0.05) younger, more often male, and less often reported alcohol consumption before injury, but consumed higher quantities when drinking. Eighty-eight percent of those with BAC measures gave consistent reports (positive or negative). Significantly more patients reported consumption with negative BAC measures (N = 29) than vice versa (N = 3). Duration of consumption and times between injury and BAC measurement predicted EPBAC better than did the objective BAC measure. Conclusions: There is little evidence that patients who provide objective BAC measures deliberately conceal consumption. ED studies must rely on self-reports, eg, take the time period between injury and ED admission into account. Clearly, objective measures are of clinical relevance, eg, to provide optimal treatment in the ED. However, they may be less relevant to establishing effects in an epidemiologic sense, such as estimating risk relationships. In this respect, efforts to increase the validity and reliability of self-reports should be preferred over the collection of additional objective measures.