Evaluation of the compliance with recommended procedures in newborns exposed to HBsAg-positive mothers: a multicenter collaborative study.

BACKGROUND: Maternal-infant transmission of hepatitis B virus (HBV) during birth carries a high risk for chronic HBV infection in infants with frequent subsequent development of chronic disease. This can be efficiently prevented by early immunization of exposed newborns. The purpose of this study was to determine the compliance with official recommendations for prevention of perinatal HBV transmission in hepatitis B surface antigen (HBsAg) exposed infants. METHODS: Records of pregnant women at 4 sites in Switzerland, admitted for delivery in 2005 and 2006, were screened for maternal HBsAg testing. In HBsAg-exposed infants, recommended procedures (postnatal active and passive immunization, completion of immunization series, and serological success control) were checked. RESULTS: Of 27,131 women tested for HBsAg, 194 (0.73%) were positive with 196 exposed neonates. Of these neonates, 143 (73%) were enrolled and 141 (99%) received simultaneous active and passive HBV immunization within 24 hours of birth. After discharge, the HBV immunization series was completed in 83%. Only 38% of children were tested for anti-HBs afterwards and protective antibody values (>100 U/L) were documented in 27% of the study cohort. No chronically infected child was identified. Analysis of hospital discharge letters revealed significant quality problems. CONCLUSIONS: Intensified efforts are needed to improve the currently suboptimal medical care in HBsAg-exposed infants. We propose standardized discharge letters, as well as reminders to primary care physicians with precise instructions on the need to complete the immunization series in HBsAg-exposed infants and to evaluate success by determination of anti-HBs antibodies after the last dose.

Modeling Merging Behavior at Lane Drops, InTrans Projects 13-466 and 06-277, 2015

In work-zone configurations where lane drops are present, merging of traffic at the taper presents an operational concern. In addition, as flow through the work zone is reduced, the relative traffic safety of the work zone is also reduced. Improving work-zone flow-through merge points depends on the behavior of individual drivers. By better understanding driver behavior, traffic control plans, work zone policies, and countermeasures can be better targeted to reinforce desirable lane closure merging behavior, leading to both improved safety and work-zone capacity. The researchers collected data for two work-zone scenarios that included lane drops with one scenario on the Interstate and the other on an urban arterial roadway. The researchers then modeled and calibrated these scenarios in VISSIM using real-world speeds, travel times, queue lengths, and merging behaviors (percentage of vehicles merging upstream and near the merge point). Once built and calibrated, the researchers modeled strategies for various countermeasures in the two work zones. The models were then used to test and evaluate how various merging strategies affect safety and operations at the merge areas in these two work zones.

Orchestration signals in the classroom: managing the jigsaw collaborative learning flow

The orchestration of collaborative learning processes in face-to-facephysical settings, such as classrooms, requires teachers to coordinate students indicating them who belong to each group, which collaboration areas areassigned to each group, and how they should distribute the resources or roles within the group. In this paper we present an Orchestration Signal system,composed of wearable Personal Signal devices and an Orchestration Signal manager. Teachers can configure color signals in the manager so that they are transmitted to the wearable devices to indicate different orchestration aspects.In particular, the paper describes how the system has been used to carry out a Jigsaw collaborative learning flow in a classroom where students received signals indicating which documents they should read, in which group they were and in which area of the classroom they were expected to collaborate. The evaluation results show that the proposed system facilitates a dynamic, visual and flexible orchestration.

Remote collaborative multi-user informal learning experiences: design and evaluation

This paper presents a customizable system used to develop a collaborative multi-user problem solving game. It addresses the increasing demand for appealing informal learning experiences in museum-like settings. The system facilitates remote collaboration by allowing groups of learners tocommunicate through a videoconferencing system and by allowing them to simultaneously interact through a shared multi-touch interactive surface. A user study with 20 user groups indicates that the game facilitates collaboration between local and remote groups of learners. The videoconference and multitouch surface acted as communication channels, attracted students’ interest, facilitated engagement, and promoted inter- and intra-group collaboration—favoring intra-group collaboration. Our findings suggest that augmentingvideoconferencing systems with a shared multitouch space offers newpossibilities and scenarios for remote collaborative environments and collaborative learning.

Collaborative quality improvement to manage pain in acute care hospitals.

Objective. Collaborative quality improvement programs have been successfully used to manage chronic diseases in adults and acute lung complications in premature infants. Their effectiveness to improve pain management in acute care hospitals is currently unknown. The purpose of this study was to determine whether a collaborative quality improvement program implemented at hospital level could improve pain management and overall pain relief. Design.To assess the effectiveness of the program, we performed a before-after trial comparing patient's self-reported pain management and experience before and after program implementation. We included all adult patients hospitalized for more than 24 hours and discharged either to their home or to a nursing facility, between March 1, 2001 and March 31, 2001 (before program implementation) and between September 15, 2005 and October 15, 2005 (after program implementation). Setting.A teaching hospital of 2,096 beds in Geneva, Switzerland. Patients.All adult patients hospitalized for more than 24 hours and discharged between 1 to 31 March 2001 (before program) and 15 September to 15 October 2005 (after program implementation). Interventions.Implementation of a collaborative quality improvement program using multifaceted interventions (staff education, opinion leaders, patient education, audit, and feedback) to improve pain management at hospital level. Outcome Measures.Patient-reported pain experience, pain management, and overall hospital experience based on the Picker Patient Experience questionnaire, perceived health (SF-36 Health survey). Results.After implementation of the program only 2.3% of the patients reported having no pain relief during their hospital stay (vs 4.5% in 2001, P = 0.05). Among nonsurgical patients, improvements were observed for pain assessment (42.3% vs 27.9% of the patients had pain intensity measured with a visual analog scale, P = 0.012), pain management (staff did everything they could to help in 78.9% vs 67.9% of cases P = 0.003), and pain relief (70.4% vs 57.3% of patients reported full pain relief P = 0.008). In surgical patients, pain assessment also improved (53.7.3% vs 37.6%) as well as pain treatment. More patients received treatments to relieve pain regularly or intermittently after program implementation (95.1% vs 91.9% P = 0.046). Conclusion.Implementation of a collaborative quality improvement program at hospital level improved both pain management and pain relief in patients. Further studies are needed to determine the overall cost-effectiveness of such programs.

Laboratory Investigation of Grouted Coupler Connection Details for ABC Bridge Projects, RB07-013, 2015

With an ever increasing desire to utilize accelerated bridge construction (ABC) techniques, it is becoming critical that bridge designers and contractors have confidence in typical details. The Keg Creek Bridge on US 6 in Iowa was a recent ABC example that utilized connection details that had been utilized elsewhere. The connection details used between the drilled shaft and pier column and between the pier column and the pier cap were details needing evaluation. These connection details utilized grouted couplers that have been tested by others with mixed results—some indicating quality performance and others indicating questionable performance. There was a need to test these couplers to gain an understanding of their performance in likely Iowa details and to understand how their performance might be impacted by different construction processes. The objective of the work was to perform laboratory testing and evaluation of the grouted coupler connection details utilized on precast concrete elements for the Keg Creek Bridge. The Bridge Engineering Center (BEC), with the assistance of the Iowa Department of Transportation (DOT) Office of Bridges and Structures, developed specimens representative of the Keg Creek Bridge connections for testing under static and fatigue loads in the structures laboratory. The specimens were also evaluated for their ability to resist the intrusion of water and chlorides. Evaluation of their performance was made through comparisons with design assumptions and previous research, as well as the physical performance of the coupled connections.

Iowa Strategy for Homeland Security and Emergency Management 2015-2017, October 1, 2014

Address sustainability in all efforts. Sustainability should be at the core of all levels of homeland security and emergency management effort in Iowa. Capabilities need to be built for the long term, and without a sustainability plan in place, projects can quickly deplete uncertain levels of funding. Utilize an all-hazards methodology. Developing capabilities that are effective during a variety of disaster and emergency scenarios represents sound planning and resource management. Enhance capabilities through joint planning, training and exercise. Effective capabilities developed through coordinated planning efforts and an ongoing joint training and exercising program to ensure substantiate of prepared response. Utilize a collaborative approach to build capability. We will utilize whatever partnerships are necessary to build capability in the most effective manner possible. Regional partnerships have been, and will continue to be, in the forefront of the State of Iowa’s efforts to build and enhance capability. Enhance statewide capabilities. Whenever possible, we will identify and augment existing resources to provide statewide capability during a disaster or terrorist attack. Awareness, outreach and education. Open communication is critical to the success of any initiative. All projects implemented will have awareness, education and outreach components to ensure that all stakeholders are informed as to their responsibilities, capabilities and access. Information sharing and a common operating picture. The timely exchange of critical/actionable information is imperative to the success of every operation. The identification of a common operating picture allows decision makers to make informed decisions based on a unified understanding of the events around them.

Key cognitive and collaborative aptitudes in ambulance people

The aim of our study was to identify and document some key cognitive aptitudes used by ambulance people in emergency situations. Better knowing such aptitudes is necessary for a school of ambulance people in order to improve the selection and education of students. The idea was to better consider real work activity requirements and characteristics, and to develop and implement genuine educational content and selection tools. We followed the work activity of ambulance professionals involved in real emergency situations. Some interventions were filmed and post-analyzed. We completed and validated our analysis by means of interviews with ambulance personnel. We selected some video sequences and used them as a support for the interviews. We identified and documented many different key aptitudes like orientation and spatial sense, the capacity to perform complex cognitive tasks and delicate manipulations in the context of divided attention, as well as diverse aptitudes relevant in collaborative work.

Corridor Management Pilot Projects, 2004

Managing existing and newly constructed highway corridors has recently become a significant concern in many states, including Iowa. As urban land and land on the urban fringe develops, there is pressure to add features such as commercial driveways, at-grade public road intersections, and traffic signals to arterial highway routes that should primarily serve high-speed traffic. This diminishes the speed and traffic capacity of such roadways and can also cause significant safety issues. if mobility and safety are diminished, the value of the highway investment is diminished. Since a major highway corridor improvement may cost tens of millions of dollars or more, corridor management is as critical to preserving that investment as is more "hard side" management practices such as pavement or bridge management. Corridor management is a process that applies access management principles to highway corridors in an attempt to balance the competing needs of traffic service, safety, and support for land development. This project helped to identify routes that should be given high priority for corridor management. The pilot study in the form of two corridor management case studies provides an analytical process that can be replicated along the other Iowa commuting corridors using commonly available transportation and land use data resources. It also offers a general set of guidelines for the Iowa Department of Transportation to use in the development of its own comprehensive corridor management program.

Application Summary Awarded Projects – 2007, December 2008

Summary of Applications that are awarded projects through the state of Iowa. Produced by Agriculture and Land Stewardship.

Application Summary Awarded Projects – 2008, August 2009

Summary of Applications that are awarded projects through the state of Iowa. Produced by Agriculture and Land Stewardship.

Application Summary Awarded Projects – 2009, June 2010

Summary of Applications that are awarded projects through the state of Iowa. Produced by Agriculture and Land Stewardship.