Use of the Cognitive Performance Scale (CPS) to detect cognitive impairment in the acute care setting: concurrent and predictive validity.

The Cognitive Performance Scale (CPS) was initially designed to assess cognition in long term care residents. Subsequently, the CPS has also been used among in-home, post-acute, and acute care populations even though CPS' clinimetric performance has not been studied in these settings. This study aimed to determine CPS agreement with the Mini Mental Status Exam (MMSE) and its predictive validity for institutionalization and death in a cohort (N=401) of elderly medical inpatients aged 75 years and over. Medical, physical and mental status were assessed upon admission. The same day, the patient's nurse completed the CPS by interview. Follow-up data were gathered from the central billing system (nursing home stay) and proxies (death). Cognitive impairment was present in 92 (23%) patients according to CPS (score >or= 2). Agreement with MMSE was moderate (kappa 0.52, P<.001). Analysis of discordant results suggested that cognitive impairment was overestimated by the CPS in dependent patients with comorbidities and depressive symptoms, and underestimated in older ones. During follow-up, subjects with abnormal CPS had increased risks of death (adjusted hazard ratio (adjHR) 1.7, 95% CI 1.0-2.8, P=.035) and institutionalization (adjHR 2.7, 95% CI 1.3-5.3, P=.006), independent of demographic, health and functional status. Interestingly, subjects with abnormal CPS were at increased risk of death only if they also had abnormal MMSE. The CPS predicted death and institutionalization during follow-up, but correlated moderately well with the MMSE. Combining CPS and MMSE provided additional predictive information, suggesting that domains other than cognition are assessed by professionals when using the CPS in elderly medical inpatients.

Issue review : university revenue growth adjusted for inflation and enrollment change.

An examination of the historical revenues for Regents universities' general education budgets considering enrollment changes and inflation.

Iowa Community Colleges High School Enrollment Report, February 2006

Community Colleges of Iowa transmit fiscal year enrollment data to the Department of Education. All data included in this report, except where noted, are taken from the Management Information System (MIS) electronic data files and are confirmed by the community college.

Third Annual Iowa Community Colleges High School Enrollment Report, January 2007

Community Colleges of Iowa transmit fiscal year enrollment data to the Department of Education. All data included in this report, except where noted, are taken from the Management Information System (MIS) electronic data files and are confirmed by the community college.

Iowa Community Colleges High School Enrollment Report, July 2008

Community Colleges of Iowa transmit fiscal year enrollment data to the Department of Education. All data included in this report, except where noted, are taken from the Management Information System (MIS) electronic data files and are confirmed by the community college.

Second Annual Iowa Community Colleges High School Enrollment Report, February 2006

Community Colleges of Iowa transmit fiscal year enrollment data to the Department of Education. All data included in this report, except where noted, are taken from the Management Information System (MIS) electronic data files and are confirmed by the community college.

Joint Enrollment 2012

This report summarizes joint enrollment in Iowa's community colleges. Jointly enrolled students are high school students enrolled in community college credit coursework. This report contains fiscal year data for the state's 15 community colleges reported through the Community College Management Information System (MIS) and confirmed by each college.

Joint Enrollment 2008

This report summarizes joint enrollment in Iowa's community colleges. Jointly enrolled students are high school students enrolled in community college credit coursework. This report contains fiscal year data for the state's 15 community colleges reported through the Community College Management Information System (MIS) and confirmed by each college.

Joint Enrollment 2010

This report summarizes joint enrollment in Iowa's community colleges. Jointly enrolled students are high school students enrolled in community college credit coursework. This report contains fiscal year data for the state's 15 community colleges reported through the Community College Management Information System (MIS) and confirmed by each college.

Joint Enrollment 2013

This report summarizes joint enrollment in Iowa's community colleges. Jointly enrolled students are high school students enrolled in community college credit coursework. This report contains fiscal year data for the state's 15 community colleges reported through the Community College Management Information System (MIS) and confirmed by each college.

Joint Enrollment 2014

This report summarizes joint enrollment in Iowa's community colleges. Jointly enrolled students are high school students enrolled in community college credit coursework. This report contains fiscal year data for the state's 15 community colleges reported through the Community College Management Information System (MIS) and confirmed by each college.

Fall Enrollment Report, 2011

The Iowa Department of Education collects enrollment information from all 15 community colleges on the tenth business day of the fall semester. This report summarizes several key aspects of community college enrollment from fall 2012.

Fall Enrollment Report, 20123

The Iowa Department of Education collects enrollment information from all 15 community colleges on the tenth business day of the fall semester. This report summarizes several key aspects of community college enrollment from fall 2012.

Eighty-Sixth General Assembly Joint Rules Governing Lobbyists (House Concurrent Resolution 7) House Adopted 2-3-2015, Senate Adopted 2-4-2015, February 5, 2015

Eighty-Sixth General Assembly Joint Rules Governing Lobbyists (House Concurrent Resolution 7) House Adopted 2-3-2015, Senate Adopted 2-4-2015

Concurrent or sequential adjuvant letrozole and radiotherapy after conservative surgery for early-stage breast cancer (CO-HO-RT): a phase 2 randomised trial.

BACKGROUND: Letrozole radiosensitises breast cancer cells in vitro. In clinical settings, no data exist for the combination of letrozole and radiotherapy. We assessed concurrent and sequential radiotherapy and letrozole in the adjuvant setting. METHODS: This phase 2 randomised trial was undertaken in two centres in France and one in Switzerland between Jan 12, 2005, and Feb 21, 2007. 150 postmenopausal women with early-stage breast cancer were randomly assigned after conserving surgery to either concurrent radiotherapy and letrozole (n=75) or sequential radiotherapy and letrozole (n=75). Randomisation was open label with a minimisation technique, stratified by investigational centres, chemotherapy (yes vs no), radiation boost (yes vs no), and value of radiation-induced lymphocyte apoptosis (< or = 16% vs >16%). Whole breast was irradiated to a total dose of 50 Gy in 25 fractions over 5 weeks. In the case of supraclavicular and internal mammary node irradiation, the dose was 44-50 Gy. Letrozole was administered orally once daily at a dose of 2.5 mg for 5 years (beginning 3 weeks pre-radiotherapy in the concomitant group, and 3 weeks post-radiotherapy in the sequential group). The primary endpoint was the occurrence of acute (during and within 6 weeks of radiotherapy) and late (within 2 years) radiation-induced grade 2 or worse toxic effects of the skin. Analyses were by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00208273. FINDINGS: All patients were analysed apart from one in the concurrent group who withdrew consent before any treatment. During radiotherapy and within the first 12 weeks after radiotherapy, 31 patients in the concurrent group and 31 in the sequential group had any grade 2 or worse skin-related toxicity. The most common skin-related adverse event was dermatitis: four patients in the concurrent group and six in the sequential group had grade 3 acute skin dermatitis during radiotherapy. At a median follow-up of 26 months (range 3-40), two patients in each group had grade 2 or worse late effects (both radiation-induced subcutaneous fibrosis). INTERPRETATION: Letrozole can be safely delivered shortly after surgery and concomitantly with radiotherapy. Long-term follow-up is needed to investigate cardiac side-effects and cancer-specific outcomes. FUNDING: Novartis Oncology France.