Vital Statistics of Iowa in Brief, 2012

This publication is an historical recording of the most requested statistics on vital events and is a source of information that can be used in further analysis.

Vital Statistics of Iowa in Brief, 2013

This publication is an historical recording of the most requested statistics on vital events and is a source of information that can be used in further analysis.

Ethical issues in nutrition support of severely disabled elderly persons: a guide for health professionals.

Providing or withholding nutrition in severely disabled elderly persons is a challenging dilemma for families, health professionals, and institutions. Despite limited evidence that nutrition support improves functional status in vulnerable older persons, especially those suffering from dementia, the issue of nutrition support in this population is strongly debated. Nutrition might be considered a basic need that not only sustains life but provides comfort as well by patients and their families. Consequently, the decision to provide or withhold nutrition support during medical care is often complex and involves clinical, legal, and ethical considerations. This article proposes a guide for health professionals to appraise ethical issues related to nutrition support in severely disabled older persons. This guide is based on an 8-step process to identify the components of a situation, analyze conflicting values that result in the ethical dilemma, and eventually reach a consensus for the most relevant plan of care to implement in a specific clinical situation. A vignette is presented to illustrate the use of this guide when analyzing a clinical situation.

Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus SEMICYUC-SENPE: Oncohematological patient

Patients with cancer, irrespective of the stage of their disease, can require admission to the intensive care unit as a result of the complications of their underlying process or the surgical or pharmacological treatment provided. The cancer itself, as well as the critical status that can result from the complications of the disease, frequently lead to a high degree of hypermetabolism and inadequate energy intake, causing a high incidence of malnutrition in these patients. Moreover, cancer causes anomalous use of nutritional substrates and therefore the route of administration and proportion and intake of nutrients may differ in these patients from those in noncancer patients.

Issue review : Instructional support program funding inequities.

School districts may receive funding for the instructional support program subject to school board or voter approval. Program funding is based on a formula that includes a local funding provision, property tax and income surtax and a state aid component. When initially implemented, state aid was distributed through a formula designed to provide property tax equity and equalize the property tax burden between school districts. Since the initial year of the program, the state aid portion has not been fully funded and in fiscal year 2012, no state dollars were appropriated for the program. The result of underfunding the state-aid portion of the program has led to an inequity in the amount of funds school districts receive from the program. In fiscal year 2012, the portion of actual program funding for school districts ranged from a low of 52.6 percent to a high of 92.8 percent. This issue review examines the inequity in more detail.

Implantación de microcogeneración en el equipamiento municipal : "Centro de Historia de Zaragoza"

A raíz de la evolución del precio de la energía y de las medidas adoptadas a nivel mundial para el llamado “desarrollo sostenible”, la legislación europea ha liderado las correcciones a efectuar en los procesos protagonistas del consumo de recursos y de contaminación del medio ambiente. En la última década el proceso viene acelerándose para cumplir con los objetivos marcados, amparándose en unas ya consolidadas estadísticas sobre las repercusiones prácticas de cada una de las iniciativas proyectadas. Una de las tecnologías a emplear es la cogeneración, es decir, la producción simultánea de calor y electricidad. A diferencia de otras soluciones más ambiciosas, y por tanto con mayor incertidumbre en su aplicación práctica, la cogeneración es una respuesta ya madura y viable, directamente aplicable a industrias y con un claro apoyo institucional. El objetivo principal de este trabajo es demostrar mediante un estudio técnico – económico, la viabilidad de la solución planteada en este tipo de edificios, mediante la aportación de datos reales y contrastados. Así como establecer los parámetros e indicadores de medición que permitan elegir dicha tecnología como la solución óptima para el ahorro y eficiencia económica en su sector de aplicación. Entre las conclusiones más destacadas de este proyecto están los beneficios que aporta tanto al usuario del sistema como al conjunto de la sociedad, siendo este último aspecto fundamental en su financiación y subvención. Por otra parte, son instalaciones desconocidas en ciertos edificios por lo que este trabajo debe contribuir a su desarrollo y adopción por parte de las empresas de servicios energéticos.

Challenges and threats to implementing the fight against doping in sport

Prominent doping cases in certain sports have recently raised public awareness of doping and reinforced the perception that doping is widespread. Efforts to deal with doping in sport have intensified in recent years, yet the general public believes that the 'cheaters' are ahead of the testers. Therefore, there is an urgent need to change the antidoping strategy. For example, the increase in the number of individual drug tests conducted between 2005 and 2012 was approximately 90 000 and equivalent to an increase of about 50%, yet the number of adverse analytical findings remained broadly the same. There is also a strikingly different prevalence of doping substances and methods in sports such as a 0.03% prevalence of anabolic steroids in football compared to 0.4% in the overall WADA statistics. Future efforts in the fight against doping should therefore be more heavily based on preventative strategies such as education and on the analysis of data and forensic intelligence and also on the experiences of relevant stakeholders such as the national antidoping organisations, the laboratories, athletes or team physicians and related biomedical support staff. This strategy is essential to instigate the change needed to more effectively fight doping in sport.

Modelling ecological niches with support vector machines

1. The ecological niche is a fundamental biological concept. Modelling species' niches is central to numerous ecological applications, including predicting species invasions, identifying reservoirs for disease, nature reserve design and forecasting the effects of anthropogenic and natural climate change on species' ranges. 2. A computational analogue of Hutchinson's ecological niche concept (the multidimensional hyperspace of species' environmental requirements) is the support of the distribution of environments in which the species persist. Recently developed machine-learning algorithms can estimate the support of such high-dimensional distributions. We show how support vector machines can be used to map ecological niches using only observations of species presence to train distribution models for 106 species of woody plants and trees in a montane environment using up to nine environmental covariates. 3. We compared the accuracy of three methods that differ in their approaches to reducing model complexity. We tested models with independent observations of both species presence and species absence. We found that the simplest procedure, which uses all available variables and no pre-processing to reduce correlation, was best overall. Ecological niche models based on support vector machines are theoretically superior to models that rely on simulating pseudo-absence data and are comparable in empirical tests. 4. Synthesis and applications. Accurate species distribution models are crucial for effective environmental planning, management and conservation, and for unravelling the role of the environment in human health and welfare. Models based on distribution estimation rather than classification overcome theoretical and practical obstacles that pervade species distribution modelling. In particular, ecological niche models based on machine-learning algorithms for estimating the support of a statistical distribution provide a promising new approach to identifying species' potential distributions and to project changes in these distributions as a result of climate change, land use and landscape alteration.

Vital Statistics of Iowa in Brief, 2014

This publication is an historical recording of the most requested statistics on vital events and is a source of information that can be used in further analysis.