Iowa Department of Administrative Services Customer Council Archives, 2003

Archive of meeting agendas and minutes for 2003 for the DAS-General Services Enterprise Customer Council.

Iowa Department of Administrative Services Customer Council Archives, 2004

Archive of meeting agendas and minutes for 2004 for the DAS-General Services Enterprise Customer Council.

Iowa Department of Administrative Services Customer Council Archives, 2005

Archive of meeting agendas and minutes for 2005 for the DAS-General Services Enterprise Customer Council.

Iowa Department of Administrative Services Customer Council Archives: Human Services, 2004

Archive of meeting agendas and minutes for 2004 for the DAS-Human Resources Enterprise Customer Council.

Iowa Department of Administrative Services Customer Council Archives: Human Services,2005

Archive of meeting agendas and minutes for 2005 for the DAS-Human Resources Enterprise Customer Council.

Iowa Department of Administrative Services Customer Council Archives: State Accounting, 2004

Archive of meeting agendas and minutes for 2004 for the DAS-I/3 Customer Council.

Iowa Department of Administrative Services Customer Council Archives: State Accounting, 2005

Archive of meeting agendas and minutes for 2005 for the DAS-I/3 Customer Council.

Report on a special investigation of the Fifth and Eighth Judicial Districts Department of Correctional Services (Districts) for the period January 1, 2003 through June 30, 2006

Report on a special investigation of the Fifth and Eighth Judicial Districts Department of Correctional Services (Districts) for the period January 1, 2003 through June 30, 2006

Teaching cardiac auscultation to trainees in internal medicine and family practice: does it work?

BACKGROUND: The general proficiency in physical diagnostic skills seems to be declining in relation to the development of new technologies. The few studies that have examined this question have invariably used recordings of cardiac events obtained from patients. However, this type of evaluation may not correlate particularly well with bedside skills. Our objectives were 1) To compare the cardiac auscultatory skills of physicians in training with those of experienced cardiologists by using real patients to test bedside diagnostic skills. 2) To evaluate the impact of a five-month bedside cardiac auscultation training program. METHODS: 1) In an academic primary care center, 20 physicians (trainees in internal medicine and family practice) and two skilled academic cardiologists listened to 33 cardiac events in 13 patients directly at bedside and identified the cardiac events by completing an open questionnaire. Heart sounds, murmurs and diagnosis were determined beforehand by an independent skilled cardiologist and were validated by echocardiography. Thirteen primary cardiologic diagnoses were possible.2) Ten of the physicians agreed to participate in a course of 45-minute sessions once a week for 5 months. After the course they listened again to the same patients (pre/post-interventional study). RESULTS: 1) The experts were the most skillful, achieving 69% recognition of heart sounds and murmurs and correct diagnoses in 62% of cases. They also heard all of the diastolic murmurs. The residents heard only 40% of the extra heart sounds and made a correct diagnosis in 24% of cases. 2) After the weekly training sessions, their mean percentage for correct diagnosis was 35% [an increase of 66% (p < 0.05)]. CONCLUSIONS: The level of bedside diagnostic skills in this relatively small group of physicians in training is indeed low, but can be improved by a course focusing on realistic bedside teaching.

O Papel das Agências de Viagens e Turismo no Desenvolvimento do Turismo Emissor e Receptor

Devido a mudanças tecnológicas e da globalização, o turismo vem passando por grandes transformações, permitindo um maior acesso às informações e uma maior aproximação entre o consumidor e o mercado turístico. O papel das agências de viagens e turismo (AVT’s) é de fundamental importância para o desenvolvimento da actividade turística de um país. Face a isto, as AVT’s devem aderir ao novo cenário, procurando acompanhar a evolução, renovando e actualizando sempre os seus serviços. O presente estudo tem por objectivo avaliar o papel das AVT’s da ilha de São Vicente, no âmbito do turismo emissor e receptor. Foi realizado um estudo de caso, incluindo os doze representantes das AVT’s da ilha de S. Vicente, com excepção das empresas exclusivamente marítimas. Foi usado um guião de entrevistas para a obtenção de dados relacionados aos responsáveis dos serviços, a empresa, aos colaboradores internos, clientes, serviços oferecidos, sazonalidade e sua problemática, parceiros, as tecnologias de informação e as perspectivas futuras. As informações foram analisadas sob um enquadramento teórico e prático. Constatou-se que sete agências dedicam-se ao turismo emissor e receptor, três ao turismo emissor, e duas ao receptor. Foi possível observar que as AVT’s apresentam semelhanças na prestação de serviços e a maioria tem a preocupação de acompanhar as exigências actuais do turismo. Pode-se concluir que o turismo emissor e receptor estão bem representados pelas AVT’s de São Vicente. Technological changes and globalization has allowed big transformations in Tourism, greater access to information and a closer relationship between the consumer and tourist market. The role of the Travel and Tourism Agencies (TTA) has fundamental importance for the tourism development in a country, and they must adhere to the new environment, trying to follow the evolution, always renewing and updating their services. The present study aims to evaluate the role of TTA’s in São Vicente Island, in the field of inbound and outbound tourism. It was conducted a case study, including 12 representatives of TTA's in São Vicente, with exception of shipping companies. It was used a scripted interview to obtain data about the service delegate, the company, internal employees, customers, offered services, seasonality and its problems, partners, information technology and future prospects. Data were analyzed from a theoretical and practical view. It was found that seven agencies dedicated to inbound and outbound tourism, three to outbound and two to inbound. The TTA’s have similarities in service delivery and most have the concern to keep up with current demands of tourism. It can be concluded that inbound and outbound tourism are well represented by TTA’s in São Vicente.

Audit of Dormitory and Dining Services Revenue Bond Funds of Iowa State University of Science and Technology (Iowa State University) as of and for the year ended June 30, 2007

Audit of Dormitory and Dining Services Revenue Bond Funds of Iowa State University of Science and Technology (Iowa State University) as of and for the year ended June 30, 2007

Iowa Technology Governance Board Annual Report, January 2, 2008

This Technology Governance Board Annual Report provides information on the FY05 – FY09 Information Technology Personnel Spending; FY05 – FY09 Technology Equipment and Services Spending; and FY05 – FY09 Internal IT Expenditures with the Iowa Communications Network and Department of Administrative Services - Information Technology Enterprise. The report also contains a projection of technology cost savings. This report was produced in compliance with Iowa Code §8A.204(3a) and was submitted to the Governor, the Department of Management, and the General Assembly on January 2, 2008.

Diversity and regional inequalities: Assessing the outcomes of the Spanish 'System of Health Care Services'

The consolidation of a universal health system coupled with a process of regionaldevolution characterise the institutional reforms of the National Health System(NHS) in Spain in the last two decades. However, scarce empirical evidence hasbeen reported on the effects of both changes in health inputs, outputs andoutcomes, both at the country and at the regional level. This paper examinesthe empirical evidence on regional diversity, efficiency and inequality ofthese changes in the Spanish NHS using cross-correlation, panel data andexpenditure decomposition analysis. Results suggest that besides significantheterogeneity, once we take into account region-specific needs there is evidenceof efficiency improvements whilst inequalities in inputs and outcomes, althoughmore visible , do not appear to have increased in the last decade. Therefore,the devolution process in the Spanish Health System offers an interesting casefor the experimentation of health reforms related to regional diversity butcompatible with the nature of a public NHS, with no sizeable regionalinequalitiest.

Managing competition in professional services and the burden of inertia

Professional services require certain organizational patterns in order to avoid information asymmetries and external effects. These same patterns are used within production structures involving various degrees of monopoly. However, competitive restraints are justified today only when substantial external effects are clearly present, whereas information asymmetries hardly justify such restraints because reputational investments have become widespread in the economy and are relatively efficient in overcoming such asymmetries. As a consequence, innovation in the production of externalities can make competitive constraints unnecessary.

Locating emergency services with different priorities: The priority queuing covering location problem

Previous covering models for emergency service consider all the calls to be of the sameimportance and impose the same waiting time constraints independently of the service's priority.This type of constraint is clearly inappropriate in many contexts. For example, in urban medicalemergency services, calls that involve danger to human life deserve higher priority over calls formore routine incidents. A realistic model in such a context should allow prioritizing the calls forservice.In this paper a covering model which considers different priority levels is formulated andsolved. The model heritages its formulation from previous research on Maximum CoverageModels and incorporates results from Queuing Theory, in particular Priority Queuing. Theadditional complexity incorporated in the model justifies the use of a heuristic procedure.