Unmet Needs SFY 2005 Final Report Version 2 10/26/2005

Despite the successes of the Senior Living Program and other efforts of the Iowa Aging Network, there continue to be documented unmet needs throughout the state, in part because of general fund budget reductions. These are needs identified for elderly Iowans that the community service networks are unable to meet. The sources for this data are interdisciplinary teams with the Case Management Program for the Frail Elderly (CMPFE) and service providers under contract with the Area Agencies on Aging.

Unmet Needs SFY 2006 Final Report, October 2006

Despite the successes of the Senior Living Program and other efforts of the Iowa Aging Network, there continue to be documented unmet needs throughout the state, in part because of general fund budget reductions. These are needs identified for elderly Iowans that the community service networks are unable to meet. The sources for this data are interdisciplinary teams with the Case Management Program for the Frail Elderly (CMPFE) and service providers under contract with the Area Agencies on Aging.

Unmet Needs SFY 2007 Final Report, October 2007

Despite the successes of the Senior Living Program and other efforts of the Iowa Aging Network, there continue to be documented unmet needs throughout the state, in part because of general fund budget reductions. These are needs identified for elderly Iowans that the community service networks are unable to meet. The sources for this data are interdisciplinary teams with the Case Management Program for the Frail Elderly (CMPFE) and service providers under contract with the Area Agencies on Aging.

Unmet Needs Report, July 2006-June 2007

Despite the successes of the Senior Living Program and other efforts of the Iowa Aging Network, there continue to be documented unmet needs throughout the state, in part because of general fund budget reductions. These are needs identified for elderly Iowans that the community service networks are unable to meet. The sources for this data are interdisciplinary teams with the Case Management Program for the Frail Elderly (CMPFE) and service providers under contract with the Area Agencies on Aging. June 2007 Unmet Needs Report May 2007 Unmet Needs Report April 2007 Unmet Needs Report March 2007 Unmet Needs Report February 2007 Unmet Needs Report January 2007 Unmet Needs Report December 2006 Unmet Needs Report November 2006 Unmet Needs Report October 2006 Unmet Needs Report September 2006 Unmet Needs Report August 2006 Unmet Needs Report July 2006 Unmet Needs Report

Do Spanish informal caregivers come to the rescue of dependent people with formal care unmet needs?

This paper analyses the effect of unmet formal care needs on informal caregiving hours in Spain using the two wavesof the Informal Support Survey (1994, 2004). Testing for double sample selection from formal care receipt and theemergence of unmet needs provides evidence that the omission of either variable would causes underestimation of thenumber of informal caregiving hours. After controlling for these two factors the number of hours of care increaseswith both the degree of dependency and unmet needs. More importantly, in the presence of unmet needs, the numberof informal caregiving hours increases when some formal care is received. This result refutes the substitution modeland supports complementarity or task specificity between both types of care. For a given combination of formal careand unmet needs, informal caregiving hours increased between 1994 and 2004. Finally, in the model for 2004, theselection term associated with the unmet needs equation is larger than that of the formal care equation, suggestingthat using the number of formal care recipients as a quality indicator may be confounding, if we do not complete thisinformation with other quality indicators.

Development of a control alternative for the citrus fruit borer, Ecdytolopha aurantiana (Lepidoptera, Tortricidae): from basic research to the grower

All research steps, developed from 1995 to 2000, to synthesize the sex pheromone of Ecdytolopha aurantiana (Lima, 1927) are described, in order to monitoring this pest that causes losses in the order of 50 million dollars per year to citriculture in the State of São Paulo. The basic researches conducted are described, including the development of an artificial diet for the insect, the study of its temperature and humidity requirements, behavioral studies, and synthesis of the male-attracting substance up to the formulation and distribution of the pheromone to the grower, by means of its commercialization. It is a case of success, at a cost of 50 thousand dollars, involving inter- and multidisciplinary researches, which can be adopted to other insect pests in the country.

Improving Transition Outcomes: CASE (Career And Self Awareness) Prototype: Basic Points

Basic Points about the CASE (Career And Self Awareness) prototype.

Stroke initial severity and outcome relative to insurance status in a universal health care system in Switzerland.

BACKGROUND:  Socioeconomic status is thought to have a significant influence on stroke incidence, risk factors and outcome. Its influence on acute stroke severity, stroke mechanisms, and acute recanalisation treatment is less known. METHODS:  Over a 4-year period, all ischaemic stroke patients admitted within 24 h were entered prospectively in a stroke registry. Data included insurance status, demographics, risk factors, time to hospital arrival, initial stroke severity (NIHSS), etiology, use of acute treatments, short-term outcome (modified Rankin Scale, mRS). Private insured patients (PI) were compared with basic insured patients (BI). RESULTS:  Of 1062 consecutive acute ischaemic stroke patients, 203 had PI and 859 had BI. They were 585 men and 477 women. Both populations were similar in age, cardiovascular risk factors and preventive medications. The onset to admission time, thrombolysis rate, and stroke etiology according to TOAST classification were not different between PI and BI. Mean NIHSS at admission was significantly higher for BI. Good outcome (mRS ≤ 2) at 7 days and 3 months was more frequent in PI than in BI. CONCLUSION:  We found better outcome and lesser stroke severity on admission in patients with higher socioeconomic status in an acute stroke population. The reason for milder strokes in patients with better socioeconomic status in a universal health care system needs to be explained.

Assessment of needs, health-related quality of life, and satisfaction with care in breast cancer patients to better target supportive care.

BACKGROUND: This study assessed whether breast cancer (BC) patients express similar levels of needs for equivalent severity of symptoms, functioning difficulties, or degrees of satisfaction with care aspects. BC patients who did (or not) report needs in spite of similar difficulties were identified among their sociodemographic or clinical characteristics. PATIENTS AND METHODS: Three hundred and eighty-four (73% response rate) BC patients recruited in ambulatory or surgery hospital services completed the European Organisation for Research and Treatment of Cancer Quality of Life questionnaire (EORTC QLQ)-C30 quality of life [health-related quality of life (HRQOL)], the EORTC IN-PATSAT32 (in-patient) or OUT-PATSAT35 (out-patient) satisfaction with care, and the supportive care needs survey short form 34-item (SCNS-SF34) measures. RESULTS: HRQOL or satisfaction with care scale scores explained 41%, 45%, 40% and 22% of variance in, respectively, psychological, physical/daily living needs, information/health system, and care/support needs (P < 0.001). BC patients' education level, having children, hospital service attendance, and anxiety/depression levels significantly predicted differences in psychological needs relative to corresponding difficulties (adjusted R(2) = 0.11). Medical history and anxiety/depression levels significantly predicted differences in information/health system needs relative to degrees of satisfaction with doctors, nurses, or radiotherapy technicians and general satisfaction (adjusted R(2) = 0.12). Unmet needs were most prevalent in the psychological domains across hospital services. CONCLUSIONS: Assessment of needs, HRQOL, and satisfaction with care highlights the subgroups of BC patients requiring better supportive care targeting.

Jackson County Sanitary Disposal Agency independent auditor's reports, basic financial statements and required supplementary information, schedule of findings, June 30, 2007

Audit report on the Jackson County Sanitary Disposal Agency for the year ended June 30, 2007

The size and burden of mental disorders and other disorders of the brain in Europe 2010.

Aims: To provide 12-month prevalence and disability burden estimates of a broad range of mental and neurological disorders in the European Union (EU) and to compare these findings to previous estimates. Referring to our previous 2005 review, improved up-to-date data for the enlarged EU on a broader range of disorders than previously covered are needed for basic, clinical and public health research and policy decisions and to inform about the estimated number of persons affected in the EU. Method: Stepwise multi-method approach, consisting of systematic literature reviews, reanalyses of existing data sets, national surveys and expert consultations. Studies and data from all member states of the European Union (EU-27) plus Switzerland, Iceland and Norway were included. Supplementary information about neurological disorders is provided, although methodological constraints prohibited the derivation of overall prevalence estimates for mental and neurological disorders. Disease burden was measured by disability adjusted life years (DALY). Results: Prevalence: It is estimated that each year 38.2% of the EU population suffers from a mental disorder. Adjusted for age and comorbidity, this corresponds to 164.8 million persons affected. Compared to 2005 (27.4%) this higher estimate is entirely due to the inclusion of 14 new disorders also covering childhood/adolescence as well as the elderly. The estimated higher number of persons affected (2011: 165 m vs. 2005: 82 m) is due to coverage of childhood and old age populations, new disorders and of new EU membership states. The most frequent disorders are anxiety disorders (14.0%), insomnia (7.0%), major depression (6.9%), somatoform (6.3%), alcohol and drug dependence (>4%), ADHD (5%) in the young, and dementia (1-30%, depending on age). Except for substance use disorders and mental retardation, there were no substantial cultural or country variations. Although many sources, including national health insurance programs, reveal increases in sick leave, early retirement and treatment rates due to mental disorders, rates in the community have not increased with a few exceptions (i.e. dementia). There were also no consistent indications of improvements with regard to low treatment rates, delayed treatment provision and grossly inadequate treatment. Disability: Disorders of the brain and mental disorders in particular, contribute 26.6% of the total all cause burden, thus a greater proportion as compared to other regions of the world. The rank order of the most disabling diseases differs markedly by gender and age group; overall, the four most disabling single conditions were: depression, dementias, alcohol use disorders and stroke. Conclusion: In every year over a third of the total EU population suffers from mental disorders. The true size of "disorders of the brain" including neurological disorders is even considerably larger. Disorders of the brain are the largest contributor to the all cause morbidity burden as measured by DALY in the EU. No indications for increasing overall rates of mental disorders were found nor of improved care and treatment since 2005; less than one third of all cases receive any treatment, suggesting a considerable level of unmet needs. We conclude that the true size and burden of disorders of the brain in the EU was significantly underestimated in the past.Concerted priority action is needed at all levels, including substantially increased funding for basic, clinical and public health research in order to identify better strategies for improved prevention and treatment for isorders of the brain as the core health challenge of the 21st century. (C) 2011 Published by Elsevier B.V.

Wireless E911 Emergency Communications Fund Iowa Homeland Security and Emergency Management Division of the Iowa Department of Public Defense independent auditor's reports, basic financial statements and supplementary information, June 30, 2007.

Audit report on the Wireless E911 Emergency Communication Fund of the Iowa Homeland Security and Emergency Management Division of the Iowa Department of Public Defense for the year ended June 30, 2007

Estudo exploratório sobre as atitudes e os comportamentos de alunos e professores do ensino secundário

A exploração exacerbada dos recursos naturais para a satisfação das necessidades humanas e para a manutenção de certos padrões de consumo e estilos de vida provocou a exaustão dos recursos da natureza, a degradação sócio ambiental e a perda de valores na relação homem natureza. O problema não é o consumo porque somos consumidores. O presente estudo teve como objetivo principal aferir e compreender o nível de conhecimento, os comportamentos pró e pós-consumo, a natureza e a extensão das oportunidades e ameaças, bem como pontos fortes e fracos que os alunos e professores da escola secundária selecionada apresentam em relação ao consumo e sustentabilidade e a promoção de ações conducentes à sustentabilidade ambiental. Para a sua realização utilizou-se um guião de entrevistas elaborado para servir de instrumento de gestão da entrevista semi estruturada dirigida a uma amostra de 18 participantes. Os resultados indicam que a maioria dos participantes apresenta um nível de conhecimento satisfatório sobre o consumo e a sustentabilidade, embora se tenha verificado algumas discrepâncias entre os discursos ambientalmente sustentáveis e as práticas de consumo diário. As dificuldades financeiras, os preços elevados e a iliteracia ambiental são as justificativas apresentadas. Constatou-se no grupo uma consciência e sensibilidade para a proteção ambiental, aliadas a uma forte recetividade às informações veiculadas ao longo do estudo, valores que devem ser valorizados e estimulados pela educação ambiental, que deve ser transversal a toda a sociedade, pois para a sustentabilidade do planeta é necessário que todos passem por uma alfabetização ecológica.

Radial measures of public services deficit for regional allocation of public funds

The goal of this paper is to present an optimal resource allocation model for the regional allocation of public service inputs. Theproposed solution leads to maximise the relative public service availability in regions located below the best availability frontier, subject to exogenous budget restrictions and equality ofaccess for equal need criteria (equity-based notion of regional needs). The construction of non-parametric deficit indicators is proposed for public service availability by a novel application of Data Envelopment Analysis (DEA) models, whose results offer advantages for the evaluation and improvement of decentralised public resource allocation systems. The method introduced in this paper has relevance as a resource allocation guide for the majority of services centrally funded by the public sector in a given country, such as health care, basic and higher education, citizen safety, justice, transportation, environmental protection, leisure, culture, housing and city planning, etc.