Letter regarding a review of payments made by the Secretary of State’s Office to Jim Gibbons, former Deputy Director, from May 24, 2012 through December 31, 2012

Letter regarding a review of payments made by the Secretary of State’s Office to Jim Gibbons, former Deputy Director, from May 24, 2012 through December 31, 2012

Examination of the Iowa Medical Assistance Disproportionate Share Hospital Payments Program and the accompanying schedule identified as Schedule 1 for the Iowa Department of Human Services for the year ended June 30, 2011

Examination of the Iowa Medical Assistance Disproportionate Share Hospital Payments Program and the accompanying schedule identified as Schedule 1 for the Iowa Department of Human Services for the year ended June 30, 2011

Issue review : IPERS retirement dividend payments.

The Iowa Public Employees' Retirement System, or IPERS, does not apply a traditional cost-of-living adjustment for retirement benefits. A retiree's monthly benefit payment is determined by a formula at the time of retirement and the amount does not change. Instead of adjusting the monthly benefit for inflation, the General Assembly creates two separate once-a-year payments for retirees, the November dividend for pre-1990 retirees and the favorable experience dividend, or FED for 1990 and later retirees. Available funding for the FED is estimated to be depleted within the next three years.

The ADVANCE trial: clarifying the role of perindopril/indapamide fixed-dose combination in the reduction of cardiovascular and renal events in patients with diabetes mellitus.

Patients with type 2 diabetes mellitus exhibit a marked increase in cardiovascular and renal risk. A number of interventional trials have shown that these patients benefit greatly from aggressive BP lowering, especially when the drug regimen comprises an inhibitor of the renin-angiotensin system. The results of the placebo-controlled ADVANCE (Action in Diabetes and Vascular disease: PreterAx and DiamicroN MR Controlled Evaluation) trial, conducted in patients with type 2 diabetes, are exemplary in this respect. The systematic use of a fixed-dose combination containing the ACE inhibitor perindopril and the diuretic indapamide afforded substantial protection against cardiovascular mortality and myocardial infarction, while providing important renoprotection, reducing the development of micro- and macroalbuminuria, and allowing regression of nephropathy. The beneficial effects were obtained regardless of baseline BP and whether or not the patients were receiving antihypertensive therapy.

Pediatric advance care planning: a systematic review.

BACKGROUND AND OBJECTIVES: Advance care planning (ACP) is increasingly regarded as the gold standard in the care of patients with life-limiting illnesses. Research has focused on adults, but ACP is also being practiced in pediatrics. We conducted a systematic review on empirical literature on pediatric ACP (pACP) to assess current practices, effects, and perspectives of pACP. METHODS: We searched PubMed, BELIT, and PSYCinfo for empirical literature on pACP, published January 1991 through January 2012. Titles, abstracts, and full texts were screened by 3 independent reviewers for studies that met the predefined criteria. The evidence level of the studies was assessed. Relevant study outcomes were retrieved according to predefined questions. RESULTS: We included 5 qualitative and 8 quantitative studies. Only 3 pACP programs were identified, all from the United States. Two of them were informed by adult programs. Major pACP features are discussions between families and care providers, as well as advance directives. A chaplain and other providers may be involved if required. Programs vary in how well they are evaluated; only 1 was studied by using a randomized controlled trial. Preliminary data suggest that pACP can successfully be implemented and is perceived as helpful. It may be emotionally relieving and facilitate communication and decision-making. Major challenges are negative reactions from emergency services, schools, and the community. CONCLUSIONS: There are few systematic pACP programs worldwide and none in Europe. Future research should investigate the needs of all stakeholders. In particular, the perspective of professionals has so far been neglected.

Report on a review of certain Unemployment Insurance payments made by Iowa Workforce Development during the period January 1, 2012 through January 13, 2015

Report on a review of certain Unemployment Insurance payments made by Iowa Workforce Development during the period January 1, 2012 through January 13, 2015

Pediatric advance care planning from the perspective of health care professionals: a qualitative interview study.

BACKGROUND: Pediatric advance care planning differs from the adult setting in several aspects, including patients' diagnoses, minor age, and questionable capacity to consent. So far, research has largely neglected the professionals' perspective. AIM: We aimed to investigate the attitudes and needs of health care professionals with regard to pediatric advance care planning. DESIGN: This is a qualitative interview study with experts in pediatric end-of-life care. A qualitative content analysis was performed. SETTING/PARTICIPANTS: We conducted 17 semi-structured interviews with health care professionals caring for severely ill children/adolescents, from different professions, care settings, and institutions. RESULTS: Perceived problems with pediatric advance care planning relate to professionals' discomfort and uncertainty regarding end-of-life decisions and advance directives. Conflicts may arise between physicians and non-medical care providers because both avoid taking responsibility for treatment limitations according to a minor's advance directive. Nevertheless, pediatric advance care planning is perceived as helpful by providing an action plan for everyone and ensuring that patient/parent wishes are respected. Important requirements for pediatric advance care planning were identified as follows: repeated discussions and shared decision-making with the family, a qualified facilitator who ensures continuity throughout the whole process, multi-professional conferences, as well as professional education on advance care planning. CONCLUSION: Despite a perceived need for pediatric advance care planning, several barriers to its implementation were identified. The results remain to be verified in a larger cohort of health care professionals. Future research should focus on developing and testing strategies for overcoming the existing barriers.

Palaeolithic Populations and Waves of Advance

The wave-of-advance model has been previously applied to Neolithic human range expansions, yielding good agreement to the speeds inferred from archaeological data. Here, we apply it for the first time to Palaeolithic human expansions by using reproduction and mobility parameters appropriate to hunter-gatherers (instead of the corresponding values for preindustrial farmers). The order of magnitude of the predicted speed is in agreement with that implied by the AMS radiocarbon dating of the lateglacial human recolonization of northern Europe (14.2–12.5 kyr BP). We argue that this makes it implausible for climate change to have limited the speed of the recolonization front. It is pointed out that a similar value for the speed can be tentatively inferred from the archaeological data on the expansion of modern humans into the Levant and Europe (42–36 kyr BP)

Mobile Banking and Mobile Payments: Changing Banking Services in Finland

The purpose of this thesis is to examine how mobile banking and mobile payments services will change the banking sector in Finland, and what role non-bank companies from the IT and telecom industries will play in this process. The thesis consists of a literature review and a qualitative study. The literature review forms a comprehensive overview of mobile banking and mobile payments services. The qualitative research was conducted as a descriptive study, focusing on the views of bank and non-bank players. The results show that banks have a significant advantage over their IT and telecom rivals in regards to their service offering, financial buffer, and status as trustworthy institutions. The banks’ embrace of mobile financial services will change the Finnish banking sector into one, with a light branch network focused on sales power, and a heavy emphasis on new mobile devices providing service power regardless of time and place.

Using Network Analysis to Understand and Advance Falls Prevention Services and Programs

The purpose of this study was to understand referral linkages that exist among falls prevention agencies in a southern Ontario region using network analysis theory. This was a single case study which included fifteen individual interviews. The data was analyzed through the constant comparative approach. Ten themes emerged and are classified into internal and external factors. Themes associated with internal factors are: 1) health professionals initiating services; 2) communication strategies; 3) formal partnerships; 4) trust; 5) program awareness; and 6) referral policies. Themes associated with external factors are: 1) client characteristics; 2) primary and community care collaboration; 3) networking; and 4) funding. Recommendations to improve the referral pathway are: 1) electronic database; 2) electronic referral forms; 3) educating office staff; and 4) education days. This study outlined the benefit of using network analysis to understand referral pathways and the importance of implementing strategies that will improve falls prevention referral pathways.

10th Anniversary - Niagara Advance

A 10th Anniversary advertisement in the Niagara Advance, 10 July 1985. The official 10 year anniversary is July 9th, 1985. There is a short message thanking residents and businesses in the area for their support. Wine tour hours are also listed.

Letter to S.D. Woodruff in order to give Mr. Woodruff and idea of how fast the interest payments are made to the company

Letter (incomplete) to S.D. Woodruff in order to give Mr. Woodruff an idea of how fast the interest payments are made to the company. The letter is slightly water damaged. The text is affected, but legible. The signature is missing. Feb. 8, 1883.

Note with calculations regarding payments for gas and other items

Note (1 page, handwritten) with calculations regarding payments for gas and other items.