State of Iowa Long-Term Economic Recovery Strategy Prepared for the Economic Development Administration, U.S. Department of Commerce, October 2010

The Rebuild Iowa Office (RIO) continues to coordinate the state‘s recovery effort from the storms, tornadoes and floods of 2008. Much has been accomplished since the Office‘s last quarterly report was issued in July 2010. State funding has been disbursed to help Iowans with unmet needs and housing. Local governments and entities are utilizing millions of federal dollars so thousands of disaster-impacted homeowners can be offered a buyout. More infrastructure projects are under construction and new neighborhoods are being built with mitigation efforts in mind. However, as Iowa continues to celebrate many successes along the road to recovery, it must also address the numerous challenges that are encountered along the path. Recovering from the state‘s largest disaster must be looked at as a marathon, not a sprint. Over the past three months, the RIO has especially remained focused on helping small business owners impacted by the 2008 disasters. Many disaster-affected businesses have reopened their doors, however their debt load continues to be overwhelming and many still struggle with the timeliness of the disbursement of funds. This report describes how programs and recent modifications are working to assist recovering businesses. This report contains updates on housing progress while outlining the complexities behind certain programs and the bottlenecks communities are facing due to strict federal guidelines for implementation. This following pages also describe how Iowa is implementing Smart Planning principles, publicizing flood awareness through outreach efforts and preparing a blueprint for the state to follow when future disasters occur. As always, the RIO recognizes and thanks the countless leaders and front-line workers from local, regional, state and federal government, businesses, non-profit organizations and private citizens that have provided input, support and leadership. Their dedication to Iowa‘s disaster recovery has made the plans and projects on the following pages possible.

What factors influence long-term antidepressant use in primary care? Findings from the Australian diamond cohort study.

BACKGROUND: Antidepressants are one of the most commonly prescribed drugs in primary care. The rise in use is mostly due to an increasing number of long-term users of antidepressants (LTU AD). Little is known about the factors driving increased long-term use. We examined the socio-demographic, clinical factors and health service use characteristics associated with LTU AD to extend our understanding of the factors that may be driving the increase in antidepressant use. METHODS: Cross-sectional analysis of 789 participants with probable depression (CES-D≥16) recruited from 30 randomly selected Australian general practices to take part in a ten-year cohort study about depression were surveyed about their antidepressant use. RESULTS: 165 (21.0%) participants reported <2 years of antidepressant use and 145 (18.4%) reported ≥2 years of antidepressant use. After adjusting for depression severity, LTU AD was associated with: single (OR 1.56, 95%CI 1.05-2.32) or recurrent episode of depression (3.44, 2.06-5.74); using SSRIs (3.85, 2.03-7.33), sedatives (2.04, 1.29-3.22), or antipsychotics (4.51, 1.67-12.17); functional limitations due to long-term illness (2.81, 1.55-5.08), poor/fair self-rated health (1.57, 1.14-2.15), inability to work (2.49, 1.37-4.53), benefits as main source of income (2.15, 1.33-3.49), GP visits longer than 20min (1.79, 1.17-2.73); rating GP visits as moderately to extremely helpful (2.71, 1.79-4.11), and more self-help practices (1.16, 1.09-1.23). LIMITATIONS: All measures were self-report. Sample may not be representative of culturally different or adolescent populations. Cross-sectional design raises possibility of "confounding by indication". CONCLUSIONS: Long-term antidepressant use is relatively common in primary care. It occurs within the context of complex mental, physical and social morbidities. Whilst most long-term use is associated with a history of recurrent depression there remains a significant opportunity for treatment re-evaluation and timely discontinuation.

Long-tailed trapping times and Lévy flights in a self-organized critical granular system

We present a continuous time random walk model for the scale-invariant transport found in a self-organized critical rice pile [K. Christensen et al., Phys. Rev. Lett. 77, 107 (1996)]. From our analytical results it is shown that the dynamics of the experiment can be explained in terms of Lvy flights for the grains and a long-tailed distribution of trapping times. Scaling relations for the exponents of these distributions are obtained. The predicted microscopic behavior is confirmed by means of a cellular automaton model.

Follow-up care amongst long-term childhood cancer survivors: a report from the Swiss Childhood Cancer Survivor Study.

In the Swiss Childhood Cancer Survivor Study, we aimed to assess the proportion of long-term survivors attending follow-up care, to characterise attendees and to describe the health professionals involved. We sent a questionnaire to 1252 patients, of whom 985 (79%) responded, aged in average 27 years (range 20-49). Overall, 183 (19%) reported regular, 405 (41%) irregular and 394 (40%) no follow-up. For 344, severity of late effects had been classified in a previous medical examination. Only 17% and 32% of survivors with moderate and severe late effects respectively had made regular visits a decade later. Female gender, after a shorter time since diagnosis, had radiotherapy, and having suffered a relapse predicted follow-up. In the past year, 8% had seen a general practitioner only, 10% a paediatric or adult oncologist and 16% other health specialists for a cancer related problem. These findings underline the necessity to implement tailored national follow-up programmes.

Étude exploratoire de la stabilité à long terme des indices standard du WISC-IV

Par le biais d'une procédure Test-Retest, la stabilité à long terme des indices standard du WISC-IV français a été évaluée. L'intervalle moyen entre les deux passations est de 2,33 ans. L'échantillon comprend 96 enfants « tout venant » âgés de huit à 12 ans. Les comparaisons entre les moyennes des deux passations ne montrent pas de différence significative pour indice de compréhension verbale (ICV), indice de raisonnement perceptif (IRP), indice de mémoire de travail (IMT), indice d'aptitude générale (IAG) et QIT. Au niveau interindividuel, les coefficients de corrélations témoignent d'une bonne stabilité à long terme pour ICV, IAG et QIT (allant de 0,81 à 0,82). Une analyse des différences de performances entre les deux passations indique une stabilité intra-individuelle satisfaisante pour IMT et IAG. Seul IAG présente donc une stabilité à long terme satisfaisante au niveau inter- et intra-individuel. By a Test-Retest procedure, this study explores the long-term stability of the French WISC-IV index scores. The average Test-Retest interval was 2.33 years. The sample consisted of 96 non-clinical children aged between 8 and 12 years. Mean difference between the two testings was not statistically significant for VCI, PRI, WMI, GAI and FSIQ. Test-Retest reliability correlations between the two assessments are high for VCI, GAI and FSIQ (ranging from .81 to .82). An analysis of the performance differences between two assessments indicates intra-individual stability for WMI and GAI. In sum, only GAI demonstrates reliable long-term stability at an inter-and intra-individual level.

Obesity in long-term survivors of childhood acute lymphoblastic leukemia

Rapport de synthèse : Le traitement des leucémies aiguës chez l'enfant représente un des succès de la médecine moderne avec des taux de guérison avoisinant les 80% ce qui implique la nécessité de suivre les effets secondaires à long terme des traitements chez cette population de patients. Récemment plusieurs études internationales ont relevé une prévalence plus importante de surpoids et d'obésité chez les enfants traités pour une leucémie aiguë. L'origine de ce processus reste incertaine :aux effets secondaires bien connus et décrits des traitements (stéroïdes et radiothérapie) semblent s'ajouter des facteurs génétiques, familiaux (age, BMI au diagnostic, BMI parents et fratrie), environnementaux. L'objectif de ce travail est d'estimer la prévalence et les facteurs de risque pour le surpoids et l'obésité chez les enfants traités et guéris d'une leucémie aiguë en Suisse romande et de comparer ces résultats à ceux d'études internationales. Pour répondre à ces questions nous avons inclus 54 patients (40 de Lausanne et 14 de Genève) traités pour une leucémie aiguë. Seuls les enfants à 5 ans de leur première rémission clinique, sans atteinte du système nerveux central, testiculaire ou médullaire et traités par chimiothérapie seule sont retenus. Leur poids, taille sont enregistrés durant les phases précises de traitement (au diagnostic, à la rémission, fin de consolidation, milieumaintenance et en fin de traitement) puis annuellement jusqu'à 12 ans post fin de traitement. Le BMI (kg/ml) et sa déviation standard BMI-SDS (spécifique pour Page et le sexe) pour les patients et leurs parents sont calculés selon les valeurs internationales (IOTF) respectivement BMI-SDS >1.645 (p<0.05) pour le surpoids et> 1.96 (p<0.025) pour l'obésité. Les résultats de ce travail confirment une prévalence double de surpoids (30% versus 17%) et quadruple d'obésité (18% versus 4%) au sein de la population d'enfants traités pour une leucémie aiguë comparées à la population suisse standard. Les facteurs de risque impliqués sont le BMI initial au diagnostic et le BMI maternel contrairement à Page, sexe, stéroïdes et au BMI paternel. Ces données confirment une prévalence significative d'enfants en surpoids/obèses au sein de cette population avec des résultats similaires à ceux retrouvés dans des études internationales récentes. Les facteurs de risque identifiés semblent plutôt liés à l'environnement familial qu'aux traitements. Ces constatations pourraient être le résultat d'interactions complexes entre "le background génétique", les facteurs environnementaux, les habitudes socioculturelles (activité physique, status nutritionnel) paramètres non évalués dans cette revue. Des études plus larges, prospectives sont nécessaires pour clarifier les rôles des différents facteurs de risque et de leurs interactions ;celles-ci devraient inclure des données génétiques (LEPR), taux de leptine, activité physique et le status nutritionnel. Enfin, l'identification des patients à risque est cruciale afin de prévenir les effets secondaires cardio-vasculaires, métaboliques bien connus liés au surpoids et à l'obésité.

Outcome evaluation of ankle osteoarthritis treatments: plantar pressure analysis during relatively long-distance walking.

Background : This study aimed to use plantar pressure analysis in relatively long-distance walking for objective outcome evaluation of ankle osteoarthritis treatments, i.e., ankle arthrodesis and total ankle replacement.Methods : Forty-seven subjects in four groups: three patient groups and controls, participated in the study. Each subject walked twice in 50-m trials. Plantar pressure under the pathological foot was measured using pressure insoles. Six parameters: initial contact time, terminal contact time, maximum force time, peak pressure time, maximum force and peak pressure were calculated and averaged over trials in ten regions of foot. The parameters in each region were compared between patient groups and controls and their effect size was estimated. Besides, the correlations between pressure parameters and clinical scales were calculated.Findings : We observed based on temporal parameters that patients postpone the heel-off event, when high force in forefoot and high ankle moment happens. Also based on maximum force and peak pressure, the patients apply smoothened maximum forces on the affected foot. In ten regions, some parameters showed improvements after total ankle replacement, some showed alteration of foot function after ankle arthrodesis and some others showed still abnormality after both surgical treatments. These parameters showed also significant correlation with clinical scales in at least two regions of foot.Interpretation : Plantar pressure parameters in relatively long-distance trials showed to be strong tools for outcome evaluation of ankle osteoarthritis treatments. (C) 2010 Elsevier Ltd. All rights reserved.

Long-range correlations in diffusive systems away from equilibrium

We study the dynamics of density fluctuations in purely diffusive systems away from equilibrium. Under some conditions the static density correlation function becomes long ranged. We then analyze this behavior in the framework of nonequilibrium fluctuating hydrodynamics.

Integrated random processes exhibiting long tails, finite moments, and power-law spectra

A dynamical model based on a continuous addition of colored shot noises is presented. The resulting process is colored and non-Gaussian. A general expression for the characteristic function of the process is obtained, which, after a scaling assumption, takes on a form that is the basis of the results derived in the rest of the paper. One of these is an expansion for the cumulants, which are all finite, subject to mild conditions on the functions defining the process. This is in contrast with the Lévy distribution¿which can be obtained from our model in certain limits¿which has no finite moments. The evaluation of the spectral density and the form of the probability density function in the tails of the distribution shows that the model exhibits a power-law spectrum and long tails in a natural way. A careful analysis of the characteristic function shows that it may be separated into a part representing a Lévy process together with another part representing the deviation of our model from the Lévy process. This

Exact long-time behavior of a network of oscillators under random fields

We present an exact solution for the order parameters that characterize the stationary behavior of a population of Kuramotos phase oscillators under random external fields [Y. Kuramoto, in International Symposium on Mathematical Problems in Theoretical Physics, Lecture Notes in Physics, Vol. 39 (Springer, Berlin, 1975), p. 420]. From these results it is possible to generate the phase diagram of models with an arbitrary distribution of random frequencies and random fields.

Long-Term Community Recovery Report, Parkersburg, Iowa, December 2008

At approximately 5pm on May 25, 2008, City of Parkersburger was struck by a powerful EF5 tornado, estimated to be three-quarters of a mile wide. As it moved across the southern half of the City, the tornado cased severe damage, destroying at least twenty businesses and over two hundred fifty homes along with city Hall and Aplington-Parkersburg High School. Numerous other homes, businesses and civic buildings were damaged. Approximately two weeks later, Beaver Creek was among the many Iowa streams to flood. While Parkersburg was not affected significantly by flooding, a number of properties were damaged, including Beaver Meadows Golf Course and a City park with athletic fields.