Report on the Iowa Department of Administrative Services for the year ended June 30, 2006

Report on the Iowa Department of Administrative Services for the year ended June 30, 2006

Blood pressure treatment in acute ischemic stroke: a review of studies and recommendations.

PURPOSE OF REVIEW: Elevated blood pressure (BP) is frequent in patients with acute ischemic stroke. Pathophysiological data support its usefulness to maintain adequate perfusion of the ischemic penumba. This review article aims to summarize the available evidence from clinical studies that examined the prognostic role of BP during the acute phase of ischemic stroke and intervention studies that assessed the efficacy of active BP alteration. RECENT FINDINGS: We found 34 observational studies (33,470 patients), with results being inconsistent among the studies; most studies reported a negative association between increased levels of BP and clinical outcome, whereas a few studies showed clinical improvement with higher BP levels, clinical deterioration with decreased BP, or no association at all. Similarly, the conclusions drawn by the 18 intervention studies included in this review (1637 patients) were also heterogeneous. Very recent clinical data suggest a possible beneficial effect of early treatment with some antihypertensives on late clinical outcome. SUMMARY: Observational and interventional studies of management of acute poststroke hypertension yield conflicting results. We discuss different explanations that may account for this and discuss the current guidelines and pathophysiological considerations for the management of acute poststroke hypertension.

Iowa Department of Administrative Services Customer Council Archives, 2003

Archive of meeting agendas and minutes for 2003 for the DAS-General Services Enterprise Customer Council.

Iowa Department of Administrative Services Customer Council Archives, 2004

Archive of meeting agendas and minutes for 2004 for the DAS-General Services Enterprise Customer Council.

Iowa Department of Administrative Services Customer Council Archives, 2005

Archive of meeting agendas and minutes for 2005 for the DAS-General Services Enterprise Customer Council.

Iowa Department of Administrative Services Customer Council Archives: Human Services, 2004

Archive of meeting agendas and minutes for 2004 for the DAS-Human Resources Enterprise Customer Council.

Iowa Department of Administrative Services Customer Council Archives: Human Services,2005

Archive of meeting agendas and minutes for 2005 for the DAS-Human Resources Enterprise Customer Council.

Iowa Department of Administrative Services Customer Council Archives: State Accounting, 2004

Archive of meeting agendas and minutes for 2004 for the DAS-I/3 Customer Council.

Iowa Department of Administrative Services Customer Council Archives: State Accounting, 2005

Archive of meeting agendas and minutes for 2005 for the DAS-I/3 Customer Council.

Report on the review of selected general and application controls over the State University of Iowa (University of Iowa) PeopleSoft General Ledger system for the period June 4, 2007 through July 27, 2007

Report on the review of selected general and application controls over the State University of Iowa (University of Iowa) PeopleSoft General Ledger system for the period June 4, 2007 through July 27, 2007

Revue des arthroplasties totales de la hanche et du genou infectées--à propos de 28 cas [Review of infected total arthroplasties of the hip and knee--apropos of 28 cases]

This study is a long-term analysis of a group of patients with infected arthroplasties of the hip or the knee. We identified 28 patients with an infected arthroplasty (22 hips, 6 knees) documented by bacterial culture or on direct examination. At the time of diagnosis and on follow-up (a mean of 46 months after treatment) we evaluated the clinical picture, the radiological appearances of the articulation and the biological parameters. 19/28 patients showed a typical clinical picture, whereas in 9 others the picture was more doubtful. The treatments were 14 two-stage replacements of the arthroplasties, 7 simple resections, 5 conservative treatments and 2 one-stage replacements. On follow-up, 25 patients were considered as cured of their infection and 3 as failures. From a functional viewpoint, 9 patients showed no limitation, whereas 19 were limited in the daily activity. Half of the patients had no pain. Radiology showed that 20/26 evaluated patients had no signs of recurrence. Paraclinical examinations are important in the diagnosis of persistent low grade infections, particularly the demonstration of bacteria by pre-surgical sampling (fine needle aspiration, culture from draining sinuses). In spite of the cure of infection, the functional and painful sequellae are often considerable. As a result of our experience, we recommend a two-stage surgical procedure. Only when the general condition of the patient is poor, or when the infection is not under control, would we envisage an alternative procedure (arthrodesis, girdelstone, conservative).

Review of Targeted Small Business (TSB) procurement activities for the period July 1, 2007 through September 30, 2007

Review of Targeted Small Business (TSB) procurement activities for the period July 1, 2007 through September 30, 2007

Department of Administrative Services Strategic Plan, 2008-2011

This report outlines the strategic plan for Department of Administrative Services, including, motto, goals and mission.

Audit report on Wave 2 of the Phase II Strategic Sourcing Initiative implemented by the Department of Administrative Services

Audit report on Wave 2 of the Phase II Strategic Sourcing Initiative implemented by the Department of Administrative Services

Review of the literature on reference pricing

This paper reviews the literature on reference pricing (RP) in pharmaceutical markets. The RP strategy for cost containment of expenditure on drugs is analyzed as part of the procurement mechanism. We review the existing literature and the state-of-the-art regarding RP by focusing on its economic effects. In particular, we consider: (1) the institutional context and problem-related factors which appear to underline the need to implement an RP strategy; i.e., its nature, characteristics and the sort of health care problems commonly addressed; (2) how RP operates in practice; that is, how third party-payers (the insurers/buyers) have established the RP systems existing on the international scene (i.e., information methods, monitoring procedures and legislative provisions); (3)the range of effects resulting from particular RP strategies (including effects on choice of appropriate pharmaceuticals, insurer savings, total drug expenditures, prices of referenced and non-referenced products and dynamic efficiency; (4) the market failures which an RP policy is supposed to address and the main advantages and drawbacks which emerge from an analysis of its effects. Results suggest that RP systems achieve better their postulated goals (1) if cost inflation in pharmaceuticals is due to high prices rather than to the excess of prescription rates, (2) when the larger is the existing difference in prices among equivalent drugs, and (3) more important is the actual market for generics.