Report on the Iowa Lottery Authority for the period July 1, 2002 through June 30, 2010

Report on the Iowa Lottery Authority for the period July 1, 2002 through June 30, 2010

Home Heating and Cooling, 2011

Every year, a typical family in the United States spends around half of its home energy budget on heating and cooling. In Iowa, that percentage can be higher, due to temperature extremes reached during the winter and summer months. Unfortunately, many of those dollars often are wasted, because conditioned air escapes through leaky ceilings, walls and foundations—or flows through inadequately insulated attics, exterior walls and basements. In addition, many heating systems and air conditioners aren’t properly maintained or are more than 10 years old and very inefficient, compared to models being sold today. As a result, it makes sense to analyze your home as a collection of systems that must work together in order to achieve peak energy savings. For example, you won’t get anywhere near the savings you’re expecting from a new furnace if your airhandling ducts are uninsulated and leak at every joint. The most energy-efficient central air-conditioning setup won’t perform to your expectations if your attic insulation is inadequate and can’t reduce solar heat gain to help keep your home cool. And planting the wrong types of trees or shrubs close to your home adversely can affect potential energy savings all year long.

Agreed upon procedures report on the Iowa Sheep and Wool Promotion Board for the period July 1, 2009 through June 30, 2011

Agreed upon procedures report on the Iowa Sheep and Wool Promotion Board for the period July 1, 2009 through June 30, 2011

Report on a review of selected application controls over the Iowa Department of Transportation’s Driver’s License System for the period May 2, 2011 through May 27, 2011

Report on a review of selected application controls over the Iowa Department of Transportation’s Driver’s License System for the period May 2, 2011 through May 27, 2011

Report on a special investigation of the Sunrise Sunset Daycare of the Southeast Warren Community School District for the period September 1, 2010 through September 26, 2011

Report on a special investigation of the Sunrise Sunset Daycare of the Southeast Warren Community School District for the period September 1, 2010 through September 26, 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

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

Outcome Prediction after Cardiac Arrest Treated with Hypothermia

Rationale: Clinical and electrophysiological prognostic markers of brain anoxia have been mostly evaluated in comatose survivors of out hospital cardiac arrest (OHCA) after standard resuscitation, but their predictive value in patients treated with mild induced hypothermia (IH) is unknown. The objective of this study was to identify a predictive score of independent clinical and electrophysiological variables in comatose OHCA survivors treated with IH, aiming at a maximal positive predictive value (PPV) and a high negative predictive value (NPV) for mortality. Methods: We prospectively studied consecutive adult comatose OHCA survivors from April 2006 to May 2009, treated with mild IH to 33-34_C for 24h at the intensive care unit of the Lausanne University Hospital, Switzerland. IH was applied using an external cooling method. As soon as subjects passively rewarmed (body temperature >35_C) they underwent EEG and SSEP recordings (off sedation), and were examined by experienced neurologists at least twice. Patients with status epilepticus were treated with AED for at least 24h. A multivariable logistic regression was performed to identify independent predictors of mortality at hospital discharge. These were used to formulate a predictive score. Results: 100 patients were studied; 61 died. Age, gender and OHCA etiology (cardiac vs. non-cardiac) did not differ among survivors and nonsurvivors. Cardiac arrest type (non-ventricular fibrillation vs. ventricular fibrillation), time to return of spontaneous circulation (ROSC) >25min, failure to recover all brainstem reflexes, extensor or no motor response to pain, myoclonus, presence of epileptiform discharges on EEG, EEG background unreactive to pain, and bilaterally absent N20 on SSEP, were all significantly associated with mortality. Absent N20 was the only variable showing no false positive results. Multivariable logistic regression identified four independent predictors (Table). These were used to construct the score, and its predictive values were calculated after a cut-off of 0-1 vs. 2-4 predictors. We found a PPV of 1.00 (95% CI: 0.93-1.00), a NPV of 0.81 (95% CI: 0.67-0.91) and an accuracy of 0.93 for mortality. Among 9 patients who were predicted to survive by the score but eventually died, only 1 had absent N20. Conclusions: Pending validation in a larger cohort, this simple score represents a promising tool to identify patients who will survive, and most subjects who will not, after OHCA and IH. Furthermore, while SSEP are 100% predictive of poor outcome but not available in most hospitals, this study identifies EEG background reactivity as an important predictor after OHCA. The score appears robust even without SSEP, suggesting that SSEP and other investigations (e.g., mismatch negativity, serum NSE) might be principally needed to enhance prognostication in the small subgroup of patients failing to improve despite a favorable score.

Report on a special investigation of the Starmont Community School District for the period July 1, 1993 through November 30, 2010

Report on a special investigation of the Starmont Community School District for the period July 1, 1993 through November 30, 2010

Report on a review of selected general and application controls over the Iowa Department of Human Services’ Medicaid Management Information System for the period April 4, 2011 through April 29, 2011

Report on a review of selected general and application controls over the Iowa Department of Human Services’ Medicaid Management Information System for the period April 4, 2011 through April 29, 2011

Agreed upon procedures report on the six Library Service Areas in the State of Iowa for the period July 1, 2010 through June 30, 2011

Agreed upon procedures report on the six Library Service Areas in the State of Iowa for the period July 1, 2010 through June 30, 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

Special investigation of the City of Scarville for the period January 1, 2006 through March 31, 2011

Special investigation of the City of Scarville for the period January 1, 2006 through March 31, 2011

Report on applying agreed-upon procedures of Kossuth Connections, Algona, Iowa, and the Iowa Commission on Volunteer Services within the Iowa Department of Economic Development, now known as the Iowa Economic Development Authority, for the period October 2010 through June 2011

Report on applying agreed-upon procedures of Kossuth Connections, Algona, Iowa, and the Iowa Commission on Volunteer Services within the Iowa Department of Economic Development, now known as the Iowa Economic Development Authority, for the period October 2010 through June 2011

Report on the Chariton Valley Planning & Development Council of Governments for the period July 1, 2007 through August 31, 2010

Report on the Chariton Valley Planning & Development Council of Governments for the period July 1, 2007 through August 31, 2010

Report on a special investigation of the City of Bloomfield Volunteer Fire Department for the period July 1, 2006 through June 30, 2010

Report on a special investigation of the City of Bloomfield Volunteer Fire Department for the period July 1, 2006 through June 30, 2010