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, 2012.

Audit report on the Wireless E911 Emergency Communications Fund of the Iowa Homeland Security and Emergency Management Division of the Iowa Department of Public Defense for the year ended June 30, 2012

Waste Authority of Jackson County (formerly known as the Jackson County Sanitary Disposal Agency) independent auditor's reports, basic financial statements, required supplementary information, schedule of findings, June 30, 2012

Audit report on the Waste Authority of Jackson County (formerly known as the Jackson County Sanitary Disposal Agency) for the year ended June 30, 2012

Ringgold County Early Childhood Iowa Area independent auditor's reports, basic financial statements, schedule of findings, June 30, 2012

Audit report on the Ringgold County Early Childhood Iowa Area for the year ended June 30, 2012

City of Villisca independent auditor's reports, basic financial statements, supplementary and other information, schedule of findings, June 30

Audit report on the City of Villisca, Iowa for the year ended June 30, 2012

Iowa Maternal and Child Health Comprehensive Title V Assets and Needs Assessment, July 15, 2010

The Iowa Department of Public Health Bureau of Family Health and the Child Health Specialty Clinics embarked on a five-year needs assessment in March 2008 with a daylong strategic planning session involving key administrative and staff personnel from both agencies. As part of the strategic planning, the participants began preparation of a comprehensive assessment to identify the need in Iowa for: preventive and primary care services for pregnant women, mothers, and infants; preventive and primary care services for children; and services for children and youth with special health care needs.

Medical residents' feedback on needs and acquired skills following a short course on cross-cultural competence

Objectives The purpose of this study is to assess short and long term changes in knowledge, attitudes, and skills among medical residents following a short course on cultural competency and to explore their perspectives on the experience. Methods Eighteen medical residents went through a short training programme comprised of two seminars lasting 30' and 60' respectively over two days. Three months later, we conducted three focus groups, with 17 residents to explore their thoughts, perspectives and feedback about the course. To measure changes over time, we carried out a quantitative sequential survey before the seminars, three days after, and three months later using the Multicultural Assessment Questionnaire. Results Residents expressed a wide variety of perspectives on the main themes related to the content of the training - culture, trialogue, stereotypes, status, epidemiology, history and geopolitics - and related to its organization - relevance, volume, timing, target audience, training tools, and working material. Using the MAQ, we observed a higher global performance score (n=16) at three days (median=38) compared to results before the training (median=33) revealing a median difference of 5.5 points (z=2.4, p=0.015). This difference was still present at three months (∆=4.5, z=2.4, p=0.018), mainly due to knowledge acquisition (∆=3) rather than attitudes (∆=0) or skills (∆=1). Conclusions Cross-cultural competence training not only brings awareness of multicultural issues but also helps participants understand their own cultures, perception of others and preconceived ideas. Physicians' education should however also focus on improving implementation of acquired knowledge in cross-cultural competence.

Bridging basic science and clinical research - The EASL Monothematic Conference on Translational Research in Viral Hepatitis.

The EASL Monothematic Conference on Translational Research in Viral Hepatitis brought together a group of leading scientists and clinicians working on both, basic and clinical aspects of viral hepatitis, thereby building bridges from bench to bedside. This report recapitulates the presentations and discussions at the conference held in Lyon, France on November 29-30, 2013. In recent years, great advances have been made in the field of viral hepatitis, particularly in hepatitis C virus (HCV) infection. The identification of IL28B genetic polymorphisms as a major determinant for spontaneous and treatment-induced HCV clearance was a seminal discovery. Currently, hepatologists are at the doorstep of even greater advances, with the advent of a wealth of directly acting antivirals (DAAs) against HCV. Indeed, promising results have accumulated over the last months and few years, showing sustained virological response (SVR) rates of up to 100% with interferon-free DAA combination therapies. Thus, less than 25years after its identification, HCV infection may soon be curable in the vast majority of patients, highlighting the great success of HCV research over the last decades. However, viral hepatitis and its clinical complications such as liver cirrhosis and hepatocellular carcinoma (HCC) remain major global challenges. New therapeutic strategies to tackle hepatitis B virus (HBV) and hepatitis D virus (HDV) infection are needed, as current therapies have undeniable limitations. Nucleoside/nucleotide analogues (NUC) can efficiently control HBV replication and reduce or even reverse liver damage. However, these drugs have to be given for indefinite periods in most patients to maintain virological and biochemical responses. Although sustained responses off treatment can be achieved by treatment with (pegylated) interferon-α, only about 10-30% of patients effectively resolve chronic hepatitis B. It was the goal of this conference to review the progress made over the last years in chronic viral hepatitis research and to identify key questions that need to be addressed in order to close the gap between basic and clinical research and to develop novel preventive and treatment approaches for this most common cause of liver cirrhosis and HCC.

Le Resident Assessment Instrument-Home-Care (RAI-Domicile): ce que le médecin de premier recours doit savoir [The Resident Assessment Instrument Home care: what primary care physician needs to know].

Following the decision of the Swiss Association for Home Care Services to adopt the Resident Assessment Instrument (RAI), the RAI-Home Care is gradually implemented in all home care services in Switzerland. Based on a comprehensive geriatric assessment, the RAI not only allows to establish an individualized plan of care, but also generates quality indicators and a case-mix classification system that helps financing and planning resources. This article describes the five steps of the RAI-Home Care process and discusses the strengths, future and limitations of the RAI.

Disability in Iowa: Public Health Needs Assessment

According to the Centers for Disease Control and Prevention (CDC), the number of adults reporting a disability is expected to increase, along with the need for appropriate medical and public health services. People with disabilities (PWD) face many barriers to good heath, including having overall poorer health, less access toadequate health care, limited access to health insurance, skipping mediacl care because of cost, and engaging in risky health behaviors including smoking and physical inactivity. The goals of the Iowa public health needs assessment were to assess the burden of disability in Iowa counties including health risk factors such as chronic conditions, determine access to preventive health care, and determine the effect of socioeconomic conditions. The state level assessment was based on th 2009-2012 American Community Survey (ACS) and publiccally available Behavioral Risk FactorSurveillance System (BRFSS) 2011 survey. The 2001-2010 combined BRFSS data was used for county level assessment. The needs assessment led us to conclude that adult Iowans with idsabilities face several challenges compared to non-disabled adults. They are more likely to suffer from debilitating chronic conditions and social disparities. Counties with the higher levels of poverty were more likely to have PWD with higher levels of disability related disparities.

An Investigation of Signing Needs at Uncontrolled Local Road Intersections, HR-230, 1982

Iowa Counties have been experiencing significant tort claim liability due to the signing of local roads. One such problem is relative to the real or alleged need for signing at uncontrolled intersections of local roads. It has been assumed that the standard CROSS ROAD sign, which calls for a yellow diamond with a black cross, was sufficient to provide the necessary warning that a driver may be approaching an intersection which requires special precautionary driving attention. However, it is possible that this sign on a through highway might conflict with the legal status of the local county road. In light of this situation, it seemed worthwhile to know the extent to which uncontrolled local road intersections were perceived as a potential liability problem; the degree to which the standard CROSS ROAD sign communicated to the driver the message a county engineer wanted at these local road intersections; and whether there were any better signing alternatives available to communicate this hazard to the driver in this situation.

Programming of marginal zone B-cell fate by basic Kruppel-like factor (BKLF/KLF3).

Splenic marginal zone (MZ) B cells are a lineage distinct from follicular and peritoneal B1 B cells. They are located next to the marginal sinus where blood is released. Here they pick up antigens and shuttle the load onto follicular dendritic cells inside the follicle. On activation, MZ B cells rapidly differentiate into plasmablasts secreting antibodies, thereby mediating humoral immune responses against blood-borne type 2 T-independent antigens. As Krüppel-like factors are implicated in cell differentiation/function in various tissues, we studied the function of basic Krüppel-like factor (BKLF/KLF3) in B cells. Whereas B-cell development in the bone marrow of KLF3-transgenic mice was unaffected, MZ B-cell numbers in spleen were increased considerably. As revealed in chimeric mice, this occurred cell autonomously, increasing both MZ and peritoneal B1 B-cell subsets. Comparing KLF3-transgenic and nontransgenic follicular B cells by RNA-microarray revealed that KLF3 regulates a subset of genes that was similarly up-regulated/down-regulated on normal MZ B-cell differentiation. Indeed, KLF3 expression overcame the lack of MZ B cells caused by different genetic alterations, such as CD19-deficiency or blockade of B-cell activating factor-receptor signaling, indicating that KLF3 may complement alternative nuclear factor-κB signaling. Thus, KLF3 is a driving force toward MZ B-cell maturation.

City Of Mechanicsville Independent Auditor’s Reports Basic Financial Statements And Supplementary Information Schedule Of Findings June 30, 2008.

Annual audit report for Mechanicsville, Iowa.

Validation of the 34-item Supportive Care Needs Survey and 8-item Breast module French versions (SCNS-SF34-Fr and SCNS-BR8-Fr) in breast cancer patients.

This study aimed to assess the psychometric robustness of the French version of the Supportive Care Needs Survey and breast cancer (BC) module (SCNS-SF34-Fr and SCNS-BR8-Fr). Breast cancer patients were recruited in two hospitals (in Paris, France and Lausanne, Switzerland) either in ambulatory chemotherapy or radiotherapy, or surgery services. They were invited to complete the SCNS-SF34-Fr and SCNS-BR8-Fr as well as quality of life and patient satisfaction questionnaires. Three hundred and eighty-four (73% response rate) BC patients returned completed questionnaires. A five-factor model was confirmed for the SCNS-SF34-Fr with adequate goodness-of-fit indexes, although some items evidenced content redundancy, and a one-factor was identified for the SCNS-BR8-Fr. Internal consistency and test-retest estimates were satisfactory for most scales. The SCNS-SF34-Fr and SCNS-BR8-Fr scales demonstrated conceptual differences with the quality of life and satisfaction with care scales, highlighting the specific relevance of this assessment. Different levels of needs could be differentiated between groups of BC patients in terms of age and level of education (P < 0.001). The SCNS-SF34-Fr and SCNS-BR8-Fr present adequate psychometric properties despite some redundant items. These questionnaires allow for the crucial endeavour to design appropriate care services according to BC patients' characteristics.

Dynamic Pavement Deflection Measurements, Progress Report, HR-178, 1977

The Road Rater is a dynamic deflection measuring appa-ratus for flexible base pavements. The basic operating principle of the Road Rater is to impart a dynamic loading and measure the resultant movement of the pavement with velocity sensors. This data, when properly adjusted for temperature by use of a nomograph included in this report, can be used to determine pavement life expectancy and estimate overlay thickness required. Road Rater testing will be conducted in the spring, when pave-ments are in their weakest condition, until seasonal correction factors can be developed. The Road Rater does not have sufficient ram weight to effectively evaluate load carrying capacity of rigid pavements. All rigid pavements react similarly to Road Rater testing and generally deflect from 0.65 to 1.30 mils. Research will be continued to evaluate rigid pavements with the Road Rater, however. The Road Rater has proven to be a reliable, trouble free pavement evaluation machine. The deflection apparatus was originally front-mounted, but was rear-mounted during the winter of 1977-78. Since that time, van handling has greatly improved, and front suspension parts are no longer overstressed due to improper weight distribution. The Road Rater provides a fast, economical, nondestructive test method to evaluate flexible pavements. Road Rater test data can be used to predict pavement life, set priorities for asphaltic concrete resurfacing, and design asphaltic concrete overlays. Temperature and seasonal variations significantly affect Road Rater deflection readings and must be considered. A nomograph included in this report adjusts for temperature, but does not correct for seasonal effect. Road Rater testing will be conducted in the spring until seasonal correction factors can be developed. The Road Rater has not successfully evaluated rigid pavements, but research will continue in this area. 1. Recommendations for continuing Road Rater research, evaluation and application are as follows:A computer program should be established to reduce Road Rater raw data (Range and Sensor reading) to HR-178 Road Rater Dynamic Deflections For Determining Structural Rating Of Flexible Pavements mean deflection (mils) and/or structural rating. This computer printout would be similar to present friction testing printouts, and would greatly reduce Road Rater data reduction manpower needs and costs. 2. Seasonal variation study should continue to develop seasonal correction factors. Seasonal test roads will be studied concurrently with routine testing during 1979 to develop this relationship. All Road Rater testing will be conducted in the spring until the seasonal relationship is established. 3. An asphaltic concrete overlay design method should be established based on Road Rater de-flection readings. The AASHTO Interim Guide for Design of Pavement Structures 1972 will be used as a base document for this study. 4. AASHTO Structural numbers should be compared to Road Rater Structural Ratings during 1979 on asphaltic concrete overlay projects. This analysis will enable us to refine Road Rater evaluation of flexible pavements. Roads will be tested before resurfacing and several months