Review of the Sigourney Community School District for the period July 1, 2006 through February 29, 2008

Review of the Sigourney Community School District for the period July 1, 2006 through February 29, 2008

Special investigation of the City of Vinton Parks and Recreation Department for the period July 19, 2001 through August 30, 2007

Special investigation of the City of Vinton Parks and Recreation Department for the period July 19, 2001 through August 30, 2007

Special investigation of selected transactions at Perry High School for the period July 1, 2005 through November 30, 2007

Special investigation of selected transactions at Perry High School for the period July 1, 2005 through November 30, 2007

Report on a special investigation of the West Marshall Community School District for the period January 1, 2001 through June 30, 2007

Report on a special investigation of the West Marshall Community School District for the period January 1, 2001 through June 30, 2007

Report on a review of selected general and application controls over the Iowa State University of Science and Technology tuition and fees system for the period of April 11 through May 2, 2008

Report on a review of selected general and application controls over the Iowa State University of Science and Technology tuition and fees system for the period of April 11 through May 2, 2008

Report on a review of selected general and application controls over the University of Northern Iowa’s tuition and fees system for the period May 24, 2007 through July 3, 2007

Report on a review of selected general and application controls over the University of Northern Iowa’s tuition and fees system for the period May 24, 2007 through July 3, 2007

Report on a special investigation of the City of Durant for the period July 1, 2000 through May 6, 2008

Report on a special investigation of the City of Durant for the period July 1, 2000 through May 6, 2008

Effect of an I.V. bolus of phenylephrine or ephedrine on skin blood flow during spinal anesthesia

Effet d'un bolus intraveineux de phénylephrine ou d'éphedríne sur le flux sanguin cutané lors d'une anesthésie rachidienne Introduction : La phénylephrine et l'éphedrine sont des substances vaso-actives utilisées de routine pour corriger des épisodes d'hypotension artérielle induits par l'anesthésie intrarachidienne. L'influence de ces deux vasopresseurs sur le flux sanguin cutané (FSC) dans ce contexte n'a jusqu'à maintenant pas été décrite. Cette étude évalue l'effet d'une injection intraveineuse de 75 µg de phénylephrine ou de 7.5 mg d'éphedrine sur le FSC mesuré par Laser Doppler, dans les zones concernées parle bloc sympathiqué induit par l'anesthésie intrarachidienne (membres inférieurs) et dans les zones non concernées (membres supérieurs). Méthode :Après acceptation par le Comité d'Éthique, et obtention de leur accord écrit, 20 patients devant subir une intervention chirurgicale élective en décubitus dorsal sous anesthésie. intrarachidienne ont été inclus dans cette étude randomisée en double insu. Le FSC a été mesuré en continu par deux sondes fixées l'une à la cuisse (zone avec bloc sympathique) et l'autre sur l'avantbras (zone sans bloc sympathique). Les valeurs de FSC ont été enregistrées après l'anesthésie rachidienne (valeur contrôle), puis après l'injection i.v. dè phénylephrine (10 patients) ou d'éphedrine (10 patients) pour corriger une hypotension définie comme une chute de 20 mmHg de la pression artérielle systolique. Les variations de FSC exprimées en pourcentage de la valeur contrôle moyenne (+/- écart type) ont été analysées par le test t de Student. Résultats :Les données démographiques des patients et le niveau sensitif induit par l'anesthésie rachidienne sont similaires dans les deux groupes. Aux doses utilisées, seule l'éphedrine restaure la pression artérielle aux valeurs précédant l'anesthésie rachidienne. La phénylephrine augmente le FSC de l'avant-bras de 44% (+/- 79%) et de la cuisse de 34% (+/-24%), alors que l'éphedrine diminue le débit sanguin cutané de l'avant-bras de 16% (+/- 15%) et de la cuisse de 22% (+/-11%). Conclusion : L'injection intraveineuse de phénylephrine et d'éphedrine ont des effets opposés sur le flux sanguin cutané, et cette réponse n'est pas modifiée par le bloc sympathique.. Cette différence peut s'expliquer par la distribution des sous-types de récepteurs adrénergiques alpha et leur prédominance relative dans les veines et les artères de différents diamètres perfusant le tissu sous-cutané et la peau. L'éphedrine, èn raison de sa meilleure efficacité pour traiter les épisodes d'hypotension artérielle après anesthésie intrarachidienne devrait être préféré à la phénylephrine, leurs effets opposés sur le flux sanguin cutané n'étant pas pertinents en pratique clinique. SUMMARY Background: Phenylephrine or ephedrine is routinely used to correct hypotensive episodes fallowing spinal anaesthesia (SA). The influence of these two vasopressors on skin blood flow (SBF) has not yet been described. We have therefore evaluated the effects of an i.v. bolus of 75 µg phenylephrine or 7.5 mg of ephedrine on SBF measured by laser Doppler flowmetry during sympathetic blockade induced by SA. Methods: With Ethical Committee approval and written consent, 20 patients scheduled for elective procedures in supine position under SA were enrolled in this double-blind randomized study. SBF was measured continuously by two probes fixed at the thigh (area with sympathic blockade) and forearm level (area without sympathic blockade) respectively. SBF values were recorded after SA (control values) and then after a bolus administration of phenylephriné (n=10) or ephedrine (n=10) when systolic blood pressure decreased by 20 mmHg. Changes were expressed as percentage of control SBF values and analysed by Student's paired t-test. Results: Patient characteristics and dermatomal sensory levels were similar in both groups. Phenylephrine increases mean SBF at the forearm level by 44% (79%) [mean (SD)j and at the thigh by 34% (24%). Ephedrine decreases SBF at the forearm level by 16% (15%) and at the thigh by 22% (il%). Ephedrine bolus restores arterial blood pressure to pre-anaesthesia values, whereas phenylephrine does not. Conclusion: Administratión of phenylephrine and ephedrine has opposite effects on skin blood flow and sympathetic blockade does not modify this response. These findings could be explained by the distribution of the alpha-adrenoréceptor subtypes and their relative predominance among veins and arteries of different size perfusing the subcutaneous tissue and the skin. Ephedrine, due to its better efficacy to correct hypotensive episodes following SA, should be preferred, to phenylephrine, their opposite effects on SBF being not relevant for clinical practice.

Report on a special investigation of the City of Macedonia for the period June 26, 2006 through September 30, 2008

Report on a special investigation of the City of Macedonia for the period June 26, 2006 through September 30, 2008

Report on a special investigation of the City of Halbur for the period July 1, 1995 through June 30, 2008

Report on a special investigation of the City of Halbur for the period July 1, 1995 through June 30, 2008

Monitoramento Ambiental da Estrada São Domingos – Assomada, Ilha de Santiago, Cabo Verde, com Ênfase na Compartimentação Geomorfológica

Este trabalho tem por objetivo a aferição dos impactos ambientais ocorridos ao longo da estrada São Domingos-Assomada, na ilha de Santiago na República de Cabo Verde, África Ocidental no período de 2003 a 2009, com ênfase sobre os compartimentos geomorfológicos e seus materiais estruturadores, bem como estabelecer medidas de minimização dos referidos impactos. O estudo ainda procurou mostrar que o monitoramento ambiental das obras da rodovia tem uma série de vantagens porque pode identificar tendências nocivas sobre as variáveis ambientais e sociais antes que seja tarde demais para minimizar ou prevenir seus impactos. Ao longo da pesquisa foram destacadas as principais atividades que originaram impactos ambientais causados pelas obras tanto na fase de reabilitação como na fase de exploração da via. Buscou-se ainda mostrar que a crescente intervenção antrópica ao longo da estrada tem repercutido cada vez mais intensamente sobre a dinâmica do relevo e nos processos de erosão do solo associados às práticas inadequadas de uso da terra. Os impactos ambientais ocorridos durante a exploração da via resultaram, sobretudo, na degradação dos compartimentos geomorfológicos, por estes se constituírem no principal suporte das demais organizações espaciais. Metodologicamente este trabalho abrangeu uma pesquisa aplicada de cunho descritivo e exploratório visando melhor identificar as alterações nos sistemas ambientais, decorrentes da implantação da estrada e das atividades antrópicas realizadas no seu entorno. A fim de estimar a repercussão das intervenções junto à população imediatamente afetada foram aplicadas entrevistas voltadas à avaliação da percepção dos riscos ambientais. A coleta de dados geomorfológicos em campo foi realizada mediante a observação in loco das condições ambientais e sua posterior cartografação em gabinete. Os resultados dessas foram cotejados com o levantamento da literatura especializada a fim de permitir o enquadramento coerente do grau dos agravos ambientais analisados. Os resultados do estudo apontaram que a degradação dos compartimentos geomorfológicos e suas formações superficiais não ocorrem unicamente em função da estrada, mas também pelas práticas tradicionais de uso da terra. Ainda foi possível constatar que no caso da estrada São Domingos – Assomada, as obras de recuperação não levam em conta à dinâmica do relevo, ou seja, não consideram os parâmetros morfogenéticos. Dessa forma, tais obras essenciais de infra-estrutura acabam, muitas vezes, durando pouco tempo, desperdiçando recursos financeiros que são escassos nos países em desenvolvimento.

Report on the City of Hazleton for the period January 1, 2008 through November 30, 2008

Report on the City of Hazleton for the period January 1, 2008 through November 30, 2008

Report on a special investigation of the Fairfield Parks and Recreation Department (Parks and Recreation) for the period January 1, 2007 through April 8, 2008

Report on a special investigation of the Fairfield Parks and Recreation Department (Parks and Recreation) for the period January 1, 2007 through April 8, 2008

Special investigation of the Cedar Rapids Veterans Memorial Commission and Valor, Inc. (Valor) for the period January 1, 2006 through October 31, 2007

Special investigation of the Cedar Rapids Veterans Memorial Commission and Valor, Inc. (Valor) for the period January 1, 2006 through October 31, 2007

Report on a special investigation of the Assistant Director of the Camp Adventure program at the University of Northern Iowa for the period January 1, 2006 through March 31, 2008

Report on a special investigation of the Assistant Director of the Camp Adventure program at the University of Northern Iowa for the period January 1, 2006 through March 31, 2008