The role of presidential advisory systems in US foreign policy-making : the case of the National Security Council and Vietnam, 1953-1961

Doctoral dissertation, University of Joensuu

Audit report on the Perry Municipal Waterworks, Perry, Iowa for the year ended June 30, 2013

Audit report on the Perry Municipal Waterworks, Perry, Iowa for the year ended June 30, 2013

Prognostication in comatose survivors of cardiac arrest: An advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine.

OBJECTIVES: To review and update the evidence on predictors of poor outcome (death, persistent vegetative state or severe neurological disability) in adult comatose survivors of cardiac arrest, either treated or not treated with controlled temperature, to identify knowledge gaps and to suggest a reliable prognostication strategy. METHODS: GRADE-based systematic review followed by expert consensus achieved using Web-based Delphi methodology, conference calls and face-to-face meetings. Predictors based on clinical examination, electrophysiology, biomarkers and imaging were included. RESULTS AND CONCLUSIONS: Evidence from a total of 73 studies was reviewed. The quality of evidence was low or very low for almost all studies. In patients who are comatose with absent or extensor motor response at ?72h from arrest, either treated or not treated with controlled temperature, bilateral absence of either pupillary and corneal reflexes or N20 wave of short-latency somatosensory evoked potentials were identified as the most robust predictors. Early status myoclonus, elevated values of neuron specific enolase at 48-72h from arrest, unreactive malignant EEG patterns after rewarming, and presence of diffuse signs of postanoxic injury on either computed tomography or magnetic resonance imaging were identified as useful but less robust predictors. Prolonged observation and repeated assessments should be considered when results of initial assessment are inconclusive. Although no specific combination of predictors is sufficiently supported by available evidence, a multimodal prognostication approach is recommended in all patients.

Citizen participation and the Lisbon Treaty : A legal perspective

How to "bring the [European] Union closer to its citizens" is a vexed and vital problem of European integration. Article 11 TEU on participatory democracy, recently introduced by the Lisbon Treaty, is meant to be part of the solution. The EU Economic and Social Committee has gone so far as to define this provision "a milestone on the road to a people's Europe that is real and feasible". This appears to be an overly optimistic assessment - partly because art. 11 relies heavily on the involvement of civil society organisations, which political science literature suggests is conceptually and/or practically irrelevant to citizen involvement; partly because it largely formalizes participatory practices that have been in existence for years without cognizable effects on citizen participation; and partly because even its most innovative element - the European citizens' initiative (ECI) - does not bring significant changes to the Union's constitutional arrangements in terms of redistributing decision-making power. In addition to that, secondary legislation places significant hurdles on the submission of ECIs and might prevent or delay their becoming a standard democratic practice. This is not to say that art. 11 TEU has no potential at all. Its insertion in the Treaty might provide impetus to rethink and develop past participatory practices, such as horizontal civil dialogue. Moreover, the effects of "popular input" in the form of ECIs on EU institutional dynamics is as yet unknown - and perhaps not negligible, to judge from the keen interest that the European Parliament and other bodies have demonstrated in "appropriating" it as a political asset. Finally, art. 11 raises the stakes of the Union's democratic challenge and might pressure EU institutions to make full use of its potential. Or, if eventually proved inadequate, art. 11 might constitute a constitutional experiment on the way to meaningful forms of direct democracy at EU level.

Examination report on the City of Remsen, Iowa and the Remsen Municipal Utilities for the period July 1, 2012 through June 30, 2013

Examination report on the City of Remsen, Iowa and the Remsen Municipal Utilities for the period July 1, 2012 through June 30, 2013

Report on the Iowa School for the Deaf, Council Bluffs, Iowa for the year ended June 30, 2013

Report on the Iowa School for the Deaf, Council Bluffs, Iowa for the year ended June 30, 2013

Audit report on the Iowa Egg Council for the years ended June 30, 2013 and 2012

Audit report on the Iowa Egg Council for the years ended June 30, 2013 and 2012

Examination report on the Villisca Municipal Power Plant in Villisca, Iowa for the period January 1, 2013 through December 31, 2013

Examination report on the Villisca Municipal Power Plant in Villisca, Iowa for the period January 1, 2013 through December 31, 2013

Audit report on the Perry Municipal Waterworks, Perry, Iowa for the year ended June 30, 2014

Audit report on the Perry Municipal Waterworks, Perry, Iowa for the year ended June 30, 2014

Déficit en la provisión local de servicios públicos y tipologia municipal

Este trabajo analiza el déficit en la provisión de servicios públicos locales en España, especialmente en su relación con el tamaño de los municipios y con el número de núcleos de población que forman cada municipio, una variable largamente olvidada. El análisis empírico muestra que ambas variables son relevantes. Los resultados se revelan de interés en las discusiones relativas a la consolidación municipal como instrumento para eliminar el déficit de provisión de servicios

The costs of disorders of the brain in Switzerland: an update from the European Brain Council Study for 2010.

BACKGROUND: In 2005, findings of the first "cost of disorders of the brain in Europe" study of the European Brain Council (EBC) showed that these costs cause a substantial economic burden to the Swiss society. In 2010 an improved update with a broader range of disorders has been analysed. This report shows the new findings for Switzerland and discusses changes. METHODS: Data are derived from the EBC 2010 census study that estimates 12-month prevalence of 12 groups of disorders of the brain and calculates costs (direct health-care costs, direct non-medical costs and indirect costs) by combining top-down and bottom up cost approaches using existing data. RESULTS: The most frequent disorder was headache (2.3 million). Anxiety disorders were found in 1 million persons and sleep disorders in 700,000 persons. Annual costs for all assessed disorders total to 14.5 billion Euro corresponding to about 1,900 EUR per inhabitant per year. Mood, psychotic disorders and dementias (appr. 2 billion EUR each) were most costly. Costs per person were highest for neurological/neurosurgery-relevant disorders, e.g. neuromuscular disorders, brain tumour and multiple sclerosis (38,000 to 24,000 EUR). CONCLUSION: The estimates of the EBC 2010 study for Switzerland provide a basis for health care planning. Increase in size and costs compared to 2005 are mostly due to the inclusion of new disorders (e.g., sleep disorders), or the re-definition of others (e.g., headache) and to an increase in younger cohorts. We suggest coordinated research and preventive measures coordinated between governmental bodies, private health-care and pharmaceutical companies.

Indian Creek Channel: the evolution & significance of an historic public works administration flood control facility, Council Bluffs, Iowa, 2010

Plagued for nearly a century by the perennial flooding of Indian Creek, the City begins construction on a massive channelization project designed to confine the creek to its banks. Funded largely through a grant from the recently established Public Works Administration (PWA), the Indian Creek Channel, upon its completion two years later, would become the largest PWA undertaking in the State of Iowa. Though it did not completely end flooding in Council Bluffs, construction of the Indian Creek Channel did substantially reduce both the number and severity of the city's subsequent floods. It also profoundly impacted the residential and commercial development of Council Bluffs, as well as the city's sanitary conditions. The effects of the Indian Creek channelization, both practical and historical, are still realized today. In 2009, plans for a City road and bridge construction project at the intersection of North Broadway Street and Kanesville Boulevard proposed to replace a 221-foot-long segment of the Indian Creek Channel with a concrete box culvert. In compliance with the National Historic Preservation Act, a cultural resources study was conducted at the proposed construction site, the findings of which concluded that the historic character of the Indian Creek Channel would be compromised by the impending construction. As a means of mitigating these damages, an agreement was reached among the City, the Iowa State Historic Preservation Office, and the Federal Highway Administration that resulted in detailed research and documentation of the historical significance of the Indian Creek Channel. The findings of that study are summarized in this publication.

Agreed-upon procedures report on the City of Remsen, Iowa and the Remsen Municipal Utilities for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Remsen, Iowa and the Remsen Municipal Utilities for the period July 1, 2013 through June 30, 2014