Iowa Department of Veterans Affairs Performance Plan, FY 2009

Agency Performance Plan, Iowa Department of Veterans Affairs

Iowa Public Employees’ Retirement System Performance Plan, FY 2009

Agency Performance Plan, Iowa Public Employees’ Retirement System

Iowa Lottery Authority Performance Plan, FY 2009

Agency Performance Plan, Iowa Lottery Authority

Public Employment Relations Board Performance Plan, FY 2009

Agency Performance Plan, Public Employment Relations Board

Iowa College Student Aid Commission Strategic Plan 2006-2009

This report outlines the strategic plan for Iowa College Student Aid Commissions including,goals and mission.

2008 Affirmative Action in Iowa Annual Review

In with accordance 19B.5 of the Code of Iowa, this item has submitted the fiscal year 2008 Affirmative Action in Iowa report. The report details the progress we have made to balance our workforce in FY 2008. Just as importantly, the plan describes steps to put into practice our continued commitment to increasing diversity in the state’ workforce and details our response to the challenges we face as a result of increased talent competition. The State's renewed emphases on recruitments. along with greater oversight of state agency hiring practices, are key strategies that we must aggressively employ in competing for talent and balancing our workforce.

Iowa Vocational Rehabilitation Services Strategic Plan, 2007-2010

This report outlines the strategic plan for Iowa Vocational Rehabilitation Services, goals and mission.

Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008.

OBJECTIVE: To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock," published in 2004. DESIGN: Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. This process was conducted independently of any industry funding. METHODS: We used the GRADE system to guide assessment of quality of evidence from high (A) to very low (D) and to determine the strength of recommendations. A strong recommendation indicates that an intervention's desirable effects clearly outweigh its undesirable effects (risk, burden, cost), or clearly do not. Weak recommendations indicate that the tradeoff between desirable and undesirable effects is less clear. The grade of strong or weak is considered of greater clinical importance than a difference in letter level of quality of evidence. In areas without complete agreement, a formal process of resolution was developed and applied. Recommendations are grouped into those directly targeting severe sepsis, recommendations targeting general care of the critically ill patient that are considered high priority in severe sepsis, and pediatric considerations. RESULTS: Key recommendations, listed by category, include: early goal-directed resuscitation of the septic patient during the first 6 hrs after recognition (1C); blood cultures prior to antibiotic therapy (1C); imaging studies performed promptly to confirm potential source of infection (1C); administration of broad-spectrum antibiotic therapy within 1 hr of diagnosis of septic shock (1B) and severe sepsis without septic shock (1D); reassessment of antibiotic therapy with microbiology and clinical data to narrow coverage, when appropriate (1C); a usual 7-10 days of antibiotic therapy guided by clinical response (1D); source control with attention to the balance of risks and benefits of the chosen method (1C); administration of either crystalloid or colloid fluid resuscitation (1B); fluid challenge to restore mean circulating filling pressure (1C); reduction in rate of fluid administration with rising filing pressures and no improvement in tissue perfusion (1D); vasopressor preference for norepinephrine or dopamine to maintain an initial target of mean arterial pressure > or = 65 mm Hg (1C); dobutamine inotropic therapy when cardiac output remains low despite fluid resuscitation and combined inotropic/vasopressor therapy (1C); stress-dose steroid therapy given only in septic shock after blood pressure is identified to be poorly responsive to fluid and vasopressor therapy (2C); recombinant activated protein C in patients with severe sepsis and clinical assessment of high risk for death (2B except 2C for post-operative patients). In the absence of tissue hypoperfusion, coronary artery disease, or acute hemorrhage, target a hemoglobin of 7-9 g/dL (1B); a low tidal volume (1B) and limitation of inspiratory plateau pressure strategy (1C) for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS); application of at least a minimal amount of positive end-expiratory pressure in acute lung injury (1C); head of bed elevation in mechanically ventilated patients unless contraindicated (1B); avoiding routine use of pulmonary artery catheters in ALI/ARDS (1A); to decrease days of mechanical ventilation and ICU length of stay, a conservative fluid strategy for patients with established ALI/ARDS who are not in shock (1C); protocols for weaning and sedation/analgesia (1B); using either intermittent bolus sedation or continuous infusion sedation with daily interruptions or lightening (1B); avoidance of neuromuscular blockers, if at all possible (1B); institution of glycemic control (1B) targeting a blood glucose < 150 mg/dL after initial stabilization ( 2C ); equivalency of continuous veno-veno hemofiltration or intermittent hemodialysis (2B); prophylaxis for deep vein thrombosis (1A); use of stress ulcer prophylaxis to prevent upper GI bleeding using H2 blockers (1A) or proton pump inhibitors (1B); and consideration of limitation of support where appropriate (1D). Recommendations specific to pediatric severe sepsis include: greater use of physical examination therapeutic end points (2C); dopamine as the first drug of choice for hypotension (2C); steroids only in children with suspected or proven adrenal insufficiency (2C); a recommendation against the use of recombinant activated protein C in children (1B). CONCLUSION: There was strong agreement among a large cohort of international experts regarding many level 1 recommendations for the best current care of patients with severe sepsis. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improved outcomes for this important group of critically ill patients.

2009 State of Iowa Employee Benefits Handbook, October 2008

Examples of the information available include: • Links to health and dental plans • Health plan comparisons • Health and Dependent Care Flexible Spending Account information • Deferred Compensation information • Life and Long Term Disability insurance information • Link to Employee Assistance Program (EAP) Web site • Link to Employee Discount Program • Link to Wellness Web site which includes information about - Smoking Cessation Program - Prescription Drug information - Wellness activities

Accions transversals del CME contra l'odi i la discriminació (2008-2013)

1.El Pla de govern 2004-2007, va incloure per primera vegada polítiques específiques per a les persones LGTB. Es va crear el Pla interdepartamental per a la no discriminació de las persones LGTB 2006-2014, que crea el Consell Nacional para persones LGTB del Departament d’Acció Social i Ciutadania i detalla “accions de govern” que afecten al Departament d’Interior. A nivell municipal: creació de diferents consells LGTB.Creació el 2007 de la figura del Fiscal interlocutor en delictes amb component de discriminació per orientació sexual. Coincidència durant 2008 de diferents esdevenimentsLGTB: Conferencia internacional de policies gais-les en Barcelona, Eurogames, Creuers internacionals, mostra internacional de cinema, Gaycircus, Loveball, Circuit-festival, etc.

Charting Our Own Course: Today’s Challenges, Tomorrow’s Opportunities, December 2008

The Office of Energy Independence presents Iowa’s second annual energy independence plan, which highlights accomplishments achieved thus far and makes recommendations for the coming year. This plan shows that Iowa has made significant progress in building the foundation for reaching energy independence in just the past year. Continued investment and further efforts will enable Iowa to push toward even greater advances, while creating new jobs and diversifying local economies. With those aims in mind, the state has been investing extensively in the new energy economy. One important example is the Iowa Power Fund, an annual appropriation from the Iowa General Assembly administered by the Office of Energy Independence. In less than one year, the Office has received more than 160 project applications totaling more than $308 million in requests. The projects approved thus far will help advance Iowa’s wind and solar industries, foster new energy efficiency practices, and develop the bio fuels industry for a more economically and environmentally sustainable future. Iowa’s position as a leader in the new energy economy is dependent on the success of the Power Fund, and on the success of this plan. This plan clearly states that Iowa must boldly pursue a strong position in the emerging energy economy worldwide.

Hidrocarburos de petróleo en áreas marino costeras del Perú. 2004

Se han evaluado los hidrocarburos aromáticos en agua y en sedimento marino. En sedimentos de fondo como indicador del deterioro o estado de contaminación, se ha empleado el contenido de compuestos aromáticos.

Iowa Influenza Surveillance Network Final Report 2007-2008

The Iowa Influenza Surveillance Network (IISN) was formally established in 2004, though surveillance has been conducted at the Iowa Department of Public Health (IDPH) for more than ten years. The IISN is comprised of four primary surveillance systems- sentinel health care providers, hospital-based, laboratory-based, and school-based. Sentinel health care providers are part of the U.S. Influenza Sentinel Provider Surveillance System. All systems, except certain sentinel sites, report October-March. Schools and long-term care facilities report data weekly into a Web-based reporting system. Schools report the number of students absent due to illness and the total enrolled. Long-term care facilities report cases of influenza and vaccination status of each case. Both passively report outbreaks of illness, including influenza, to IDPH.

Biomasa desovante de la anchoveta del stock norte centro en el invierno 2004

El crucero BIC Olaya y SNP2 0408-09 tuvo el objetivo de estimar la biomasa desovante de la anchoveta (Engraulis ringens) del stock norte centro (4 a 15°S) durante el invierno 2004. Se utilizó el método de producción de huevos (MPH). El total estimado fue de 4,2 millones de toneladas.