Reforming the Iowa Civil Justice System, January 30, 2012

Executive Summary I. Survey The Task Force conducted a wide-ranging survey of more than 9,000 licensed Iowa attorneys and judges to obtain their input on a variety of civil justice system topics. The survey results helped inform the Task Force of problem areas in Iowa’s civil justice system. II. Two-Tier Justice System The Task Force recommends a pilot program based on a two-tier civil justice system. A two-tier system would streamline litigation processes—including rules of evidence and discovery disclosures—and reduce litigation costs of certain cases falling below a threshold dollar value. III. One Judge/One Case and Date Certain for Trial Some jurisdictions in Iowa have adopted one judge/one case and date certain for trial in certain cases. The assignment of one judge to each case for the life of the matter and the establishment of dates certain for civil trials could enhance Iowans’ access to the courts, improve judicial management, promote consistency and adherence to deadlines, and reduce discovery excesses. IV. Discovery Processes Reforms addressing inefficient discovery processes will reduce delays in and costs of litigation. Such measures include adopting an aspirational purpose for discovery rules to “secure the just, speedy, and inexpensive determination of every action,” holding discovery proportional to the size and nature of the case, requiring initial disclosures, limiting the number of expert witnesses, and enforcing existing rules. V. Expert Witness Fees The Task Force acknowledges the probable need to revisit the statutory additional daily compensation limit for expert witness fees. Leaving the compensation level to the discretion of the trial court is one potential solution. VI. Jurors Additions to the standard juror questionnaire would provide a better understanding of the potential jurors’ backgrounds and suitability for jury service. The Task Force encourages adoption of more modern juror educational materials and video. Rehabilitation of prospective jurors who express an unwillingness or inability to be fair should include a presumption of dismissal. VII. Video and Teleconferencing Options When court resources are constrained both by limited numbers of personnel and budget cuts, it is logical to look to video and teleconferencing technology to streamline the court process and reduce costs. The judicial branch should embrace technological developments in ways that will not compromise the fairness, dignity, solemnity, and decorum of judicial proceedings. VIII. Court-Annexed Alternative Dispute Resolution(ADR) Litigants and practitioners in Iowa are generally satisfied with the current use of private, voluntary ADR for civil cases. There is concern, however, that maintaining the status quo may have steep future costs. Court-annexed ADR is an important aspect of any justice system reform effort, and the Task Force perceives benefits and detriments to reforming this aspect of the Iowa civil justice system. IX. Relaxed Requirement of Findings of Fact and Conclusions of Law A rule authorizing parties to waive findings of fact and conclusions of law could expedite resolution of nonjury civil cases. X. Business (Specialty) Courts Specialty business courts have achieved widespread support across the country. In addition, specialty courts provide excellent vehicles for implementing or piloting other court innovations that may be useful in a broader court system context. A business specialty court should be and could be piloted in Iowa within the existing court system framework of the Iowa Judicial Branch. Appendix included as a separate document, is 176 pages.

Peripheral dual-energy X-ray absorptiometry in the management of osteoporosis: the 2007 ISCD Official Positions.

Peripheral assessment of bone density using photon absorptiometry techniques has been available for over 40 yr. The initial use of radio-isotopes as the photon source has been replaced by the use of X-ray technology. A wide variety of models of single- or dual-energy X-ray measurement tools have been made available for purchase, although not all are still commercially available. The Official Positions of the International Society for Clinical Densitometry (ISCD) have been developed following a systematic review of the literature by an ISCD task force and a subsequent Position Development Conference. These cover the technological diversity among peripheral dual-energy X-ray absorptiometry (pDXA) devices; define whether pDXA can be used for fracture risk assessment and/or to diagnose osteoporosis; examine whether pDXA can be used to initiate treatment and/or monitor treatment; provide recommendations for pDXA reporting; and review quality assurance and quality control necessary for effective use of pDXA.

Mental Health Institute Task Force, December 2009

The Department shall staff a task force to be appointed by the governor consisting of knowledgeable citizen to perform an in-depth review of the four state mental health institutes, services provided, public benefits of the services provided, economic effects connected to the presence of the institutes that are realized by the communities in the areas served and the families of personnel and other public costs and benefits associated with the presence and availability of the four institutes. the review shall be coordinated with the proposal to be developed by the department under this section and shall submit a report providing findings and recommendations to the governor and general assembly on or before December, 15. 2009

Business Disaster Case Management Task Force, November 2010

During the 2010 session, the Iowa Legislature created per House File 2422 a Business Disaster Case Management Task Force. The purpose of the Task Force is to research disaster recovery case management assistance needed for businesses following a major disaster and to recommend steps for providing such assistance following disasters. The Task Force was duly constituted. Its recommendations are contained in this report. The Task Force focused on what the State of Iowa could do for itself without reliance on federal agencies or programs. It concluded that the hallmarks of any business disaster assistance must be speed of delivery and simplicity in execution. In addition, monies used to assist business recovery should be free of as many restraints on use as possible, relying on the affected businesses to judge for themselves how best to deploy capital resources.

Report on a review of selected application controls over the Iowa State University of Science and Technology Facilities Planning and Management - Facilities Administrative Management Information System for the period of April 18, 2011 through May 16, 2011

Report on a review of selected application controls over the Iowa State University of Science and Technology Facilities Planning and Management - Facilities Administrative Management Information System for the period of April 18, 2011 through May 16, 2011

Agreed upon procedures report on the Lee County Narcotics Task Force for the period July 1, 2010 through May 31, 2012

Agreed upon procedures report on the Lee County Narcotics Task Force for the period July 1, 2010 through May 31, 2012

Report of Recommendations to Iowa State University of Science and Technology, Ames, Iowa, for the year ended June 30, 2011

Report on Iowa State University of Science and Technology, Ames, Iowa, for the year ended June 30, 2011

Indicators of therapeutic effect in FIT-06, a Phase II trial of a DNA vaccine, GTU(®)-Multi-HIVB, in untreated HIV-1 infected subjects.

BACKGROUND: Combination highly active antiretroviral therapy (HAART) has significantly decreased HIV-1 related morbidity and mortality globally transforming HIV into a controllable condition. HAART has a number of limitations though, including limited access in resource constrained countries, which have driven the search for simpler, affordable HIV-1 treatment modalities. Therapeutic HIV-1 vaccines aim to provide immunological support to slow disease progression and decrease transmission. We evaluated the safety, immunogenicity and clinical effect of a novel recombinant plasmid DNA therapeutic HIV-1 vaccine, GTU(®)-multi-HIVB, containing 6 different genes derived from an HIV-1 subtype B isolate. METHODS: 63 untreated, healthy, HIV-1 infected, adults between 18 and 40 years were enrolled in a single-blinded, placebo-controlled Phase II trial in South Africa. Subjects were HIV-1 subtype C infected, had never received antiretrovirals, with CD4 ≥ 350 cells/mm(3) and pHIV-RNA ≥ 50 copies/mL at screening. Subjects were allocated to vaccine or placebo groups in a 2:1 ratio either administered intradermally (ID) (0.5mg/dose) or intramuscularly (IM) (1mg/dose) at 0, 4 and 12 weeks boosted at 76 and 80 weeks with 1mg/dose (ID) and 2mg/dose (IM), respectively. Safety was assessed by adverse event monitoring and immunogenicity by HIV-1-specific CD4+ and CD8+ T-cells using intracellular cytokine staining (ICS), pHIV-RNA and CD4 counts. RESULTS: Vaccine was safe and well tolerated with no vaccine related serious adverse events. Significant declines in log pHIV-RNA (p=0.012) and increases in CD4+ T cell counts (p=0.066) were observed in the vaccine group compared to placebo, more pronounced after IM administration and in some HLA haplotypes (B*5703) maintained for 17 months after the final immunisation. CONCLUSIONS: The GTU(®)-multi-HIVB plasmid recombinant DNA therapeutic HIV-1 vaccine is safe, well tolerated and favourably affects pHIV-RNA and CD4 counts in untreated HIV-1 infected individuals after IM administration in subjects with HLA B*57, B*8101 and B*5801 haplotypes.

Field Data Acquisition Technologies for Iowa Transportation Agencies, HR-366 August 1994

This report describes the results of the research project investigating the use of advanced field data acquisition technologies for lowa transponation agencies. The objectives of the research project were to (1) research and evaluate current data acquisition technologies for field data collection, manipulation, and reporting; (2) identify the current field data collection approach and the interest level in applying current technologies within Iowa transportation agencies; and (3) summarize findings, prioritize technology needs, and provide recommendations regarding suitable applications for future development. A steering committee consisting oretate, city, and county transportation officials provided guidance during this project. Technologies considered in this study included (1) data storage (bar coding, radio frequency identification, touch buttons, magnetic stripes, and video logging); (2) data recognition (voice recognition and optical character recognition); (3) field referencing systems (global positioning systems [GPS] and geographic information systems [GIs]); (4) data transmission (radio frequency data communications and electronic data interchange); and (5) portable computers (pen-based computers). The literature review revealed that many of these technologies could have useful applications in the transponation industry. A survey was developed to explain current data collection methods and identify the interest in using advanced field data collection technologies. Surveys were sent out to county and city engineers and state representatives responsible for certain programs (e.g., maintenance management and construction management). Results showed that almost all field data are collected using manual approaches and are hand-carried to the office where they are either entered into a computer or manually stored. A lack of standardization was apparent for the type of software applications used by each agency--even the types of forms used to manually collect data differed by agency. Furthermore, interest in using advanced field data collection technologies depended upon the technology, program (e.g.. pavement or sign management), and agency type (e.g., state, city, or county). The state and larger cities and counties seemed to be interested in using several of the technologies, whereas smaller agencies appeared to have very little interest in using advanced techniques to capture data. A more thorough analysis of the survey results is provided in the report. Recommendations are made to enhance the use of advanced field data acquisition technologies in Iowa transportation agencies: (1) Appoint a statewide task group to coordinate the effort to automate field data collection and reporting within the Iowa transportation agencies. Subgroups representing the cities, counties, and state should be formed with oversight provided by the statewide task group. (2) Educate employees so that they become familiar with the various field data acquisition technologies.

The oxygen concentrator : an appropriate technology for treating hypoxaemic children in developing countries

RÉSUMÉ L'Organisation Mondiale de la Santé (OMS) recommande d'administrer l'oxygène par concentrateurs dans les pays en voie de développement (PVD), les cylindres posant des problèmes logistiques et financiers trop importants. Cette technologie a été proposée aux enfants d'un hôpital sénégalais (Ndioum) qui présentaient les critères d'oxygénation de l'OMS. Les bénéfices cliniques et financiers ont été majeurs. En revanche, les connaissances des soignants sur les diverses techniques d'administration d'oxygène ainsi que les prestations du service de maintenance étaient insuffisantes. L'implantation de concentrateurs doit être encouragée dans les PVD, mais doit respecter une stratégie englobant enseignement, maintenance et suivi de l'opération. Diverses actions correctrices ont été entreprises à Ndioum où plusieurs concentrateurs fonctionnent désormais régulièrement. Summary: The World Health Organisation (WHO) recommends supplying oxygen in developing countries by concentra¬tors because cylinders pose considerable logistic and financial problems. This technology was employed to treat children in a hospital in Ndioum, Senegal, who met the WHO oxygenation criteria. There were clear clinical and financial benefits, but neither the nurses' knowledge of the various techniques of oxygen supply nor the maintenance service were satisfactory. The use of concentra¬tors should be encouraged in developing countries. A strategy including technical training, maintenance and monitoring should be adopted. Corrective actions were undertaken in Ndioum, and several concentrators are now being used on a regular basis.

EFNS guidelines on cognitive rehabilitation: report of an EFNS task force.

Disorders of language, spatial perception, attention, memory, calculation and praxis are a frequent consequence of acquired brain damage [in particular, stroke and traumatic brain injury (TBI)] and a major determinant of disability. The rehabilitation of aphasia and, more recently, of other cognitive disorders is an important area of neurological rehabilitation. We report here a review of the available evidence about effectiveness of cognitive rehabilitation. Given the limited number and generally low quality of randomized clinical trials (RCTs) in this area of therapeutic intervention, the Task Force considered, besides the available Cochrane reviews, evidence of lower classes which was critically analysed until a consensus was reached. In particular, we considered evidence from small group or single cases studies including an appropriate statistical evaluation of effect sizes. The general conclusion is that there is evidence to award a grade A, B or C recommendation to some forms of cognitive rehabilitation in patients with neuropsychological deficits in the post-acute stage after a focal brain lesion (stroke, TBI). These include aphasia therapy, rehabilitation of unilateral spatial neglect (ULN), attentional training in the post-acute stage after TBI, the use of electronic memory aids in memory disorders, and the treatment of apraxia with compensatory strategies. There is clearly a need for adequately designed studies in this area, which should take into account specific problems such as patient heterogeneity and treatment standardization.

Defining the level of evidence for technology adoption in the localized prostate cancer pathway.

New technologies in prostate cancer are attempting to change the current prostate cancer pathway by aiming to reduce harms while maintaining the benefits associated with screening, diagnosis, and treatment. In this article, we discuss the optimal evaluation that new technologies should undergo to provide level 1 evidence typically required to change the practice. With this in mind, we focus on feasible and pragmatic trials that could be delivered in a timely fashion by many centers while retaining primary outcomes that focus on clinically meaningful outcomes.