998 resultados para Alicante (Valencian Community : Province)


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Iowa has a statewide system of 15 community colleges. These public, postsecondary, two-year institutions are organized as comprehensive community colleges. Each college serves a multi-county merged area which may vary in size from four to twelve counties; all of Iowa's 99 counties are included in one of these merged areas.

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Annual Report, Agency Performance Plan

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Contextual effects on child health have been investigated extensively in previous research. However, few studies have considered the interplay between community characteristics and individual-level variables. This study examines the influence of community education and family socioeconomic characteristics on child health (as measured by height and weight-for-age Z-scores), as well as their interactions. We adapted the Commission on Social Determinants of Health (CSDH) framework to the context of child health. Using data from the 2010 Colombian Demographic and Health Survey (DHS), weighted multilevel models are fitted since the data are not self-weighting. The results show a positive impact of the level of education of other women in the community on child health, even after controlling for individual and family socioeconomic characteristics. Different pathways through which community education can substitute for the effect of family characteristics on child nutrition are found. The interaction terms highlight the importance of community education as a moderator of the impact of the mother’s own education and autonomy, on child health. In addition, the results reveal differences between height and weight-for-age indicators in their responsiveness to individual and contextual factors. Our findings suggest that community intervention programmes may have differential effects on child health. Therefore, their identification can contribute to a better targeting of child care policies.

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IMPORTANCE: The clinical benefit of adding a macrolide to a β-lactam for empirical treatment of moderately severe community-acquired pneumonia remains controversial. OBJECTIVE: To test noninferiority of a β-lactam alone compared with a β-lactam and macrolide combination in moderately severe community-acquired pneumonia. DESIGN, SETTING, AND PARTICIPANTS: Open-label, multicenter, noninferiority, randomized trial conducted from January 13, 2009, through January 31, 2013, in 580 immunocompetent adult patients hospitalized in 6 acute care hospitals in Switzerland for moderately severe community-acquired pneumonia. Follow-up extended to 90 days. Outcome assessors were masked to treatment allocation. INTERVENTIONS: Patients were treated with a β-lactam and a macrolide (combination arm) or with a β-lactam alone (monotherapy arm). Legionella pneumophila infection was systematically searched and treated by addition of a macrolide to the monotherapy arm. MAIN OUTCOMES AND MEASURES: Proportion of patients not reaching clinical stability (heart rate <100/min, systolic blood pressure >90 mm Hg, temperature <38.0°C, respiratory rate <24/min, and oxygen saturation >90% on room air) at day 7. RESULTS: After 7 days of treatment, 120 of 291 patients (41.2%) in the monotherapy arm vs 97 of 289 (33.6%) in the combination arm had not reached clinical stability (7.6% difference, P = .07). The upper limit of the 1-sided 90% CI was 13.0%, exceeding the predefined noninferiority boundary of 8%. Patients infected with atypical pathogens (hazard ratio [HR], 0.33; 95% CI, 0.13-0.85) or with Pneumonia Severity Index (PSI) category IV pneumonia (HR, 0.81; 95% CI, 0.59-1.10) were less likely to reach clinical stability with monotherapy, whereas patients not infected with atypical pathogens (HR, 0.99; 95% CI, 0.80-1.22) or with PSI category I to III pneumonia (HR, 1.06; 95% CI, 0.82-1.36) had equivalent outcomes in the 2 arms. There were more 30-day readmissions in the monotherapy arm (7.9% vs 3.1%, P = .01). Mortality, intensive care unit admission, complications, length of stay, and recurrence of pneumonia within 90 days did not differ between the 2 arms. CONCLUSIONS AND RELEVANCE: We did not find noninferiority of β-lactam monotherapy in patients hospitalized for moderately severe community-acquired pneumonia. Patients infected with atypical pathogens or with PSI category IV pneumonia had delayed clinical stability with monotherapy. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00818610.

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Yearbook for Economic Development

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The major objective of this problem identification document is the determination of the relative severity of traffic safety problems in each of the 99 counties. The National Highway Traffic Safety Administration and the Iowa Governor's Traffic Safety Bureau are committed to the reduction of death and injury on the nation's roads. As part of its duty in administering federal traffic safety funds in the State of Iowa, the Governor's Traffic Safety Bureau conducts a comprehensive Problem Identification update each year.

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Sexism in Education brochure produced by the Iowa Commission on the Status of Women

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In the Cape Caribou River allochthon (CCRA), metaigneous and gneissic units occur as a shallowly plunging synform in the hanging wall of the Grand Lake thrust system (GLTS), a Grenvillian structure that forms the boundary between the Mealy Mountains and Groswater Bay terranes. The layered rocks of the CCRA are cut by a stockwork of monzonite dykes related to the Dome Mountain suite and by metadiabase-amphibolite dykes that probably form part of the ca. 1380 Ma Mealy swarm. The mafic dykes appear to postdate much of the development of subhorizontal metamorphic layering within the lower parts of the CCRA. The uppermost (least metamorphosed) units of the CCRA, the North West River anorthosite-metagabbro and the Dome Mountain monzonite suite, have been dated at 1625 +/- 6 and 1626 +/- 2 Ma, respectively. An amphibolite unit that concordantly underlies the anorthosite-metagabbro and is intruded discordantly by monzonite dykes has given metamorphic ages of 1660 +/- 3 and 1631 +/- 2 Ma. Granitoid gneisses that form the lowest level of the CCRA have given a migmatization age of 1622 +/- 6 Ma. The effects of Grenvillian metamorphism become apparent in the lower levels of the allochthon where gneisses, amphibolite, and mafic dykes have given new generation zircon ages of 1008 +/- 2, 1012 +/- 3, and 1011 +/- 3 Ma, respectively. A posttectonic pegmatite has also given zircon and monazite ages of 1016(-3)(+7) and 1013 +/- 3 Ma, respectively. Although these results indicate new growth of Grenvillian zircon, this process was generally not accompanied by penetrative deformation or melting. Thus, the formation of gneissic fabrics and the overall layered nature of the lower CCRA are a result primarily of Labradorian (1660-1620 Ma) tectonism and intrusion, and probably reflect early movement on an ancestral GLTS. Grenvillian heating and metamorphism (up to granulite facies) was strongly concentrated towards the base of the CCRA and probably occurred during northwestward thrusting of the allochthon over the Groswater Bay terrane.

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Community College Audit Report

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Community College Audit Report

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Community College Audit Report

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Community School District Audit Report - Reaudit

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Community School District Audit Report

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Community School District Audit Report, Reaudit