Basic life support teaching in the second year predraduate medical curriculum: quality of acquisition after 6 months

Purpose of the study: Basic life support (BLS) and automated externaldefibrillation (AED) represent important skills to be acquired duringpregraduate medical training. Since 3 years, our medical school hasintroduced a BLS-AED course (with certification) for all second yearmedical students. Few reports about quality and persistence over timeof BLS-AED learning are available to date in the medical literature.Comprehensive evaluation of students' acquired skills was performedat the end of the 2008 academic year, 6 month after certification.Materials and methods: The students (N = 142) were evaluated duringa 9 minutes «objective structured clinical examination» (OSCE) station.Out of a standardized scenario, they had to recognize a cardiac arrestsituation and start a resuscitation process. Their performance wererecorded on a PC using an Ambuman(TM) mannequin and the AmbuCPR software kit(TM) during a minimum of 8 cycles (30 compressions:2 ventilations each). BLS parameters were systematically checked. Nostudent-rater interactions were allowed during the whole evaluation.Results: Response of the victim was checked by 99% of the students(N = 140), 96% (N = 136) called for an ambulance and/or an AED. Openthe airway and check breathing were done by 96% (N = 137), 92% (N =132) gave 2 rescue breaths. Pulse was checked by 95% (N=135), 100%(N = 142) begun chest compression, 96% (N = 136) within 1 minute.Chest compression rate was 101 ± 18 per minute (mean ± SD), depthcompression 43 ± 8 mm, 97% (N = 138) respected a compressionventilationratio of 30:2.Conclusions: Quality of BLS skills acquisition is maintained during a6-month period after a BLS-AED certification. Main targets of 2005 AHAguidelines were well respected. This analysis represents one of thelargest evaluations of specific BLS teaching efficiency reported. Furtherfollow-up is needed to control the persistence of these skills during alonger time period and noteworthy at the end of the pregraduatemedical curriculum.

Centres du sein: caprice ou nécessité [Breast Centers: whim or necessity?].

In order to prevent disparities in the management of breast cancer having a direct impact on the prognosis of patients, to promote early detection and optimal treatment while considering the quality of life of patients, Breast Centers are being set up in Switzerland on the basis of existing models in Europe. The centers provide also follow-up of patients and are submitted to certification criteria established by the Swiss Society of Senology and the Swiss Cancer League. These criteria include in particular the expertise of specialists based on a sufficient volume of activity and training, compliance with recommendations of clinical practice, integration of supportive care and timeliness of care. The certification process is voluntary. A database enables the regular assessment of the provided care and of the compliance with standards. The aim and the modalities of the creation of the Breast Centers are discussed.

Study of the Regulatory Issues Affecting Truck Freight Movement in the Midwest, RB29-013, 2014

This project investigated regulatory issues that may affect or limit freight movement in Iowa and other Midwest states: Illinois, Kansas, Minnesota, Missouri, Nebraska, South Dakota, and Wisconsin. Current state regulations for the following are reviewed and summarized: - Vehicle dimensions - Vehicle weights - Speed limits - Weight compliance enforcement - Fees and taxes - Driver qualifications - Medical certification - Hours of service - Oversize-overweight permits

State Plan for Library Program under Library Services and Construction Act, as amended, 1966

This document includes the general provisions and regulations of the Iowa Sate Traveling Library under the Library Services and Construction Act. It also includes information of appropriations of funds available for expenditure, authority of local agencies to administer and state agency to supervise local administration and certification.

Propuesta de implementación del cultivo del manzano (Malus domestica) en la Vall d'Alinyà : análisis de viabilidad ambiental-económica y certificación de créditos voluntarios de carbono

El presente proyecto tiene por objetivo realizar una propuesta de cultivo de manzano (Malus domestica) en la Vall d’Alinyà para el desarrollo de un producto agroalimentario que contribuya a la revitalización de esta área rural y a la mitigación del calentamiento global. Para ello, se pretende proporcionar una metodología para calcular, con mayor precisión, el comportamiento de los cultivos como sumidero de carbono a partir del balance neto de gases con efecto invernadero (GEI) del sistema. Con tal de obtener las emisiones de GEI generadas por los cultivos se desarrolla un análisis del ciclo de vida (ACV), y para obtener la fijación de los cultivos, se realiza un análisis de su capacidad de absorción de dióxido de carbono en la biomasa de la plantación. Además, mediante el uso de sistemas de información geográfica (SIG), se determinaron los terrenos potenciales para el cultivo del manzano en la zona de estudio. Posteriormente, se verifica la certificación de créditos en el mercado de carbono voluntario y se analiza la viabilidad económica del proyecto, obteniendo así un producto (la manzana) con valor ambiental añadido. Como conclusión se obtuvo una viabilidad positiva de la verificación de créditos, puesto que el balance neto de carbono fue positivo, absorbiéndose 234,54 t CO2 en todo el territorio potencialmente cultivable (16,92 ha) y durante 15 años de actividad agrícola. Al mismo tiempo, la propuesta resultó viable económicamente, generándose unos beneficios ligados a la venta de producción frutícola y de los créditos de carbono de 79.484 € durante los 15 años de actividad productiva.

Rastreabilidade de subprodutos de origem animal em dietas com levedura e trigo para frangos

O objetivo deste trabalho foi rastrear a inclussão de farinhas de origem animal em rações para frango de corte com ou sem levedura de cana-de-açúcar e farelo de trigo, por meio da análise do músculo peitoral das aves pelas técnicas dos isótopos estáveis de carbono e nitrogênio. Foram utilizados 210 pintos machos (Cobb), com um dia de idade, distribuídos aleatoriamente em sete tratamentos de 30 aves cada, tendo sido um tratamento controle (dieta vegetal) e seis com inclusão de farinha de carne e ossos bovina ou farinha de vísceras de aves na dieta, com ou sem levedura de cana-de-açúcar e farelo de trigo. Aos 42 dias de idade, foram abatidas quatro aves, por tratamento, escolhidas ao acaso, cujo músculo peitoral foi retirado para análise da razão isotópica. Os resultados obtidos foram submetidos à análise multivariada. Os tratamentos experimentais diferiram do tratamento controle, e foi identificada a inclusão de farinha de origem animal, pelas técnicas dos isótopos estáveis, mesmo com inclusão de levedura ou farelo de trigo na dieta.

Molecular characterization of grapevine from Santa Catarina, Brazil, using microsatellite markers

The objective of this work was to characterize the grape germplasm in Santa Catarina, Brazil, using microsatellite DNA markers (simple sequence repeats - SSR). The DNA samples were collected from leaves and shoots of accessions of public and private collections from the counties Urussanga, Nova Trento, Rodeio, São Joaquim, Campos Novos, Videira, and Água Doce. Ten SSR loci (VVS2, VVMD5, VVMD7, VVMD27, VrZAG62, VrZAG79, VVMD25, VVMD28, VVMD31, and VVMD32) were analysed by capillary electrophoresis. Molecular profiling was conducted for 190 grapevines (European, American, and hybrids), and 67 genotypes were obtained. The data were compared with each other and with those from the literature and from online databases, in order to identify varieties and discover cases of synonymy and homonymy. Forty molecular profiles corresponded to known varieties, while 27 genotypes were described for the first time. The existence of typical germplasm composed mainly of American and hybrid varieties is an important finding for local viticulture. Applications of the results rely on quality control and certification at the nursery level. Increasing precision in the characterization of grapevine genotypes may help breeding programs.

Potato cultivar identification using molecular markers

The objective of this work was to evaluate a set of microsatellite markers for varietal identification and characterization of the most widespread potato cultivars in Brazil. The DNA from 14 potato cultivars was genotyped using microsatellite markers and the alleles were scored in silver-stained polyacrylamide gel. Twenty-four microsatellite markers were evaluated, and only one locus was monomorphic. Based on band patterns, a set of two microsatellites that were able to identify and differentiate all examined cultivars was obtained.

Embankment Quality and Assessment of Moisture Control Implementation, TR-677, 2016

A specification for contractor moisture quality control (QC) in roadway embankment construction has been in use for approximately 10 years in Iowa on about 190 projects. The use of this QC specification and the development of the soils certification program for the Iowa Department of Transportation (DOT) originated from Iowa Highway Research Board (IHRB) embankment quality research projects. Since this research, the Iowa DOT has applied compaction with moisture control on most embankment work under pavements. This study set out to independently evaluate the actual quality of compaction using the current specifications. Results show that Proctor tests conducted by Iowa State University (ISU) using representative material obtained from each test section where field testing was conducted had optimum moisture contents and maximum dry densities that are different from what was selected by the Iowa DOT for QC/quality assurance (QA) testing. Comparisons between the measured and selected values showed a standard error of 2.9 lb/ft3 for maximum dry density and 2.1% for optimum moisture content. The difference in optimum moisture content was as high as 4% and the difference in maximum dry density was as high as 6.5 lb/ft3 . The difference at most test locations, however, were within the allowable variation suggested in AASHTO T 99 for test results between different laboratories. The ISU testing results showed higher rates of data outside of the target limits specified based on the available contractor QC data for cohesive materials. Also, during construction observations, wet fill materials were often observed. Several test points indicated that materials were placed and accepted at wet of the target moisture contents. The statistical analysis results indicate that the results obtained from this study showed improvements over results from previous embankment quality research projects (TR-401 Phases I through III and TR-492) in terms of the percentage of data that fell within the specification limits. Although there was evidence of improvement, QC/QA results are not consistently meeting the target limits/values. Recommendations are provided in this report for Iowa DOT consideration with three proposed options for improvements to the current specifications. Option 1 provides enhancements to current specifications in terms of material-dependent control limits, training, sampling, and process control. Option 2 addresses development of alternative specifications that incorporate dynamic cone penetrometer or light weight deflectometer testing into QC/QA. Option 3 addresses incorporating calibrated intelligent compaction measurements into QC/QA.

Accreditation of forensic pathology service: a priviledge or a nightmare?

Forensic experts play a major role in the legal process as they offer professional expert opinion and evidence within the criminal justice system adjudicating on the innocence or alleged guilt of an accused person. In this respect medico-legal examination is an essential part of the investigation process, determining in a scientific way, the cause(s) and manner of unexpected and/or unnatural death or bringing clinical evidence in case of physical, psychological or sexual abuse in living people. From a legal perspective, these types of investigation must meet international standards i-e it should be independent, effective and prompt. Ideally the investigations should be conducted by board certified experts in forensic medicine, endowed with a solid experience in this field, without any hierarchical relationship with the prosecuting authorities and having access to appropriate facilities in order to provide forensic reports of high quality. In this respect, there is a need for any private or public national or international authority including non-governmental organisations seeking experts qualified in forensic medicine,to have at disposal a list of specialists working in accordance with high standards of professional performance within forensic pathology services that have been successfully submitted to an official accreditation/certification process using valid and acceptable criteria. To reach this goal the National Association of Medical examiners (NAME) has elaborated an accreditation/certification check-list which should be served as decision-making support to assist inspectors appointed to evaluate applicants. In the same spirit than NAME Accreditation Standards, ECLM board decided to set up an ad hoc working group with the mission to elaborate an accreditation/certification procedure similar to the NAME's one but taking into account the realities of forensic medicine practices in Europe and restricted to post-mortem investigations. This accreditation process applies to services and not to individual practitioners by emphasizing policies and procedures rather than professional performance. In addition the standards to be complied with should be considered as the minimum standards needed to get the recognition of performing and reliable forensic pathology service.

Secure Dynamic MANET On-demand (SEDYMO) Routing Protocol

This paper describes the state of the art of secure ad hoc routing protocols and presents SEDYMO, a mechanism to secure a dynamic multihop ad hoc routing protocol. The proposed solution defeats internal and external attacks usinga trustworthiness model based on a distributed certification authority. Digital signatures and hash chains are used to ensure the correctness of the protocol. The protocol is compared with other alternatives in terms of security strength, energy efficiency and time delay. Both computational and transmission costs are considered and it is shown that the secure protocol overhead is not a critical factor compared to the high network interface cost.

Building Environmental Management System for Laboratory Products Manufacturing Company according ISO 14001-standard

Tutkielman tavoitteena on rakentaa toimiva ympäristöjärjestelmä Thermo Fisher Scientific Oy:lle. Tutkimuksen tarkoituksena on myös löytää kahdelle täysin erilaiselle toiminnalle yhtenäinen ympäristöjärjestelmä, jonka avulla pystytään ottamaan huomioon molempien toimipaikkojen hieman erilaiset vaatimukset. Lisäksi tavoitteena on muodostaa ympäristöjärjestelmälle oma organisaatio, jonka avulla ympäristöjärjestelmän integrointi yrityksen prosesseihin voidaan suorittaa sujuvasti. Aluksi tutkimusongelmaa lähestytään teoreettisesta näkökulmasta,jossa tarkastellaan ympäristöjärjestelmän historiaa, rakennetta, etuja sekä ISO 14001–standardin rakennetta ja sen etenemistä ympäristöjärjestelmän rakentamisen yhteydessä aina kolmannen osapuolen sertifiointiin asti. Empiria osa alkaa alustavalla ympäristökatselmuksella, jossa selvitetään ympäristöasioiden hoidon nykytaso ja luodaan pohja koko ympäristöjärjestelmän luomiselle, jonka vankimpana perustana on ympäristöpolitiikka. Johdon hyväksymä ympäristöpolitiikka varmistaa johdon sitoutumisen järjestelmään. Ympäristöjärjestelmän toimintarakenteen muodostaminen kahdelle erilaiselle toiminnalle onnistui tutkimuksessa kiitettävästi. Se miten ympäristöjärjestelmä toimii todellisuudessa, tullaan näkemään käytännön kokemuksien yhteydessä.

Toimintajärjestelmän rakentaminen laatu-, ympäristö- sekä työterveys- ja työturvallisuusstandardien vaatimusten mukaisesti

Diplomityön kohdeyritys on Lassila & Tikanoja Oyj:n (L&T) Vantaan jätehuolto -yksikkö.Yrityksen yhtenäiset toimintatavat ovat edellytyksenä toiminnan tehostamiselle,jatkuvalle kehittämiselle ja hallitulle laajentumiselle. Yrityksen toimintajärjestelmä (johtamisjärjestelmä) muodostuu laadun (ISO 9001), ympäristön (ISO 14001) sekä työterveyden ja työturvallisuuden (OHSAS 18001) hallintajärjestelmistä. Integroitu toimintajärjestelmä muodostaa yritykselle tehokkaan ja kokonaisvaltaisen kehittämisen työvälineen.Diplomityön tavoitteena on luoda teoreettinen perusta L&T:n Vantaan jätehuolto -yksikön sertifiointi -projektille. Diplomityön teoriasisältö muodostuu seuraavien asiakokonaisuuksien käsittelystä: kohdeyrityksen liiketoiminta-alan tunnuspiirteet, standardien sisältövaatimukset, toimintajärjestelmä yrityksen johtamisvälineenä sekä suorituskyvyn mittaaminen ja analysointi. Diplomityö kokoaa selkeät esitiedolliset lähtökohdat yksikön sertifiointi -projektille.Diplomityön muodostama teoreettinen perusta saavuttaa varsin onnistuneesti sille asetetut tavoitteet. Diplomityön määrittelemien lähtökohtien pohjalta rakentui yksikön varsinainen toimintajärjestelmä. Diplomityö tulee toimimaanhyvänä tukimateriaalina työn kohdeyritykselle jatkossakin; työstä on helppo tarkastaa ja kerrata toimintajärjestelmään liittyviä asiakokonaisuuksia.

Effective corporate governance : experimental evidence on international auditors'judgments and the contribution of financial accounting education

1 Summary This dissertation deals with two major aspects of corporate governance that grew in importance during the last years: the internal audit function and financial accounting education. In three essays, I contribute to research on these topics which are embedded in the broader corporate governance literature. The first two essays consist of experimental investigations of internal auditors' judgments. They deal with two research issues for which accounting research lacks evidence: The effectiveness of internal controls and the potentially conflicting role of the internal audit function between management and the audit committee. The findings of the first two essays contribute to the literature on internal auditors' judgment and the role of the internal audit function as a major cornerstone of corporate governance. The third essay theoretically examines a broader issue but also relates to the overall research question of this dissertation: What contributes to effective corporate governance? This last essay takes the perspective that the root for quality corporate governance is appropriate financial accounting education. r develop a public interest approach to accounting education that contributes to the literature on adequate accounting education with respect to corporate governance and accounting harmonization. The increasing importance of both the internal audit function and accounting education for corporate governance can be explained by the same recent fundamental changes that still affect accounting research and practice. First, the Sarbanes-Oxley Act of 2002 (SOX, 2002) and the 8th EU Directive (EU, 2006) have led to a bigger role for the internal audit function in corporate governance. Their implications regarding the implementation of audit committees and their oversight over internal controls are extensive. As a consequence, the internal audit function has become increasingly important for corporate governance and serves a new master (i.e. the audit committee) within the company in addition to management. Second, the SOX (2002) and the 8th EU Directive introduced additional internal control mechanisms that are expected to contribute to the reliability of financial information. As a consequence, the internal audit function is expected to contribute to a greater extent to the reliability of financial statements. Therefore, effective internal control mechanisms that strengthen objective judgments and independence become important. This is especially true when external- auditors rely on the work of internal auditors in the context of the International Standard on Auditing (ISA) 610 and the equivalent US Statement on Auditing Standards (SAS) 65 (see IFAC, 2009 and AICPA, 1990). Third, the harmonization of international reporting standards is increasingly promoted by means of a principles-based approach. It is the leading approach since a study of the SEC (2003) that was required by the SOX (2002) in section 108(d) was in favor of this approach. As a result, the Financial Accounting Standards Board (FASB) and the International Accounting Standards Board (IASB) commit themselves to the development of compatible accounting standards based on a principles-based approach. Moreover, since the Norwalk Agreement of 2002, the two standard setters have developed exposure drafts for a common conceptual framework that will be the basis for accounting harmonization. The new .framework will be in favor of fair value measurement and accounting for real-world economic phenomena. These changes in terms of standard setting lead to a trend towards more professional judgment in the accounting process. They affect internal and external auditors, accountants, and managers in general. As a consequence, a new competency set for preparers and users of financial statements is required. The basil for this new competency set is adequate accounting education (Schipper, 2003). These three issues which affect corporate governance are the initial point of this dissertation and constitute its motivation. Two broad questions motivated a scientific examination in three essays: 1) What are major aspects to be examined regarding the new role of the internal audit function? 2) How should major changes in standard setting affect financial accounting education? The first question became apparent due to two published literature reviews by Gramling et al. (2004) and Cohen, Krishnamoorthy & Wright (2004). These studies raise various questions for future research that are still relevant and which motivate the first two essays of my dissertation. In the first essay, I focus on the role of the internal audit function as one cornerstone of corporate governance and its potentially conflicting role of serving both management and the audit committee (IIA, 2003). In an experimental study, I provide evidence on the challenges for internal auditors in their role as servant for two masters -the audit committee and management -and how this influences internal auditors' judgment (Gramling et al. 2004; Cohen, Krishnamoorthy & Wright, 2004). I ask if there is an expectation gap between what internal auditors should provide for corporate governance in theory compared to what internal auditors are able to provide in practice. In particular, I focus on the effect of serving two masters on the internal auditor's independence. I argue that independence is hardly achievable if the internal audit function serves two masters with conflicting priorities. The second essay provides evidence on the effectiveness of accountability as an internal control mechanism. In general, internal control mechanisms based on accountability were enforced by the SOX (2002) and the 8th EU Directive. Subsequently, many companies introduced sub-certification processes that should contribute to an objective judgment process. Thus, these mechanisms are important to strengthen the reliability of financial statements. Based on a need for evidence on the effectiveness of internal control mechanisms (Brennan & Solomon, 2008; Gramling et al. 2004; Cohen, Krishnamoorthy & Wright, 2004; Solomon & Trotman, 2003), I designed an experiment to examine the joint effect of accountability and obedience pressure in an internal audit setting. I argue that obedience pressure potentially can lead to a negative influence on accountants' objectivity (e.g. DeZoort & Lord, 1997) whereas accountability can mitigate this negative effect. My second main research question - How should major changes in standard setting affect financial accounting education? - is investigated in the third essay. It is motivated by the observation during my PhD that many conferences deal with the topic of accounting education but very little is published about what needs to be done. Moreover, the Endings in the first two essays of this thesis and their literature review suggest that financial accounting education can contribute significantly to quality corporate governance as argued elsewhere (Schipper, 2003; Boyce, 2004; Ghoshal, 2005). In the third essay of this thesis, I therefore focus on approaches to financial accounting education that account for the changes in standard setting and also contribute to corporate governance and accounting harmonization. I argue that the competency set that is required in practice changes due to major changes in standard setting. As the major contribution of the third article, I develop a public interest approach for financial accounting education. The major findings of this dissertation can be summarized as follows. The first essay provides evidence to an important research question raised by Gramling et al. (2004, p. 240): "If the audit committee and management have different visions for the corporate governance role of the IAF, which vision will dominate?" According to the results of the first essay, internal auditors do follow the priorities of either management or the audit committee based on the guidance provided by the Chief Audit executive. The study's results question whether the independence of the internal audit function is actually achievable. My findings contribute to research on internal auditors' judgment and the internal audit function's independence in the broader frame of corporate governance. The results are also important for practice because independence is a major justification for a positive contribution of the internal audit function to corporate governance. The major findings of the second essay indicate that the duty to sign work results - a means of holding people accountable -mitigates the negative effect of obedience pressure on reliability. Hence, I found evidence that control .mechanisms relying on certifications may enhance the reliability of financial information. These findings contribute to the literature on the effectiveness of internal control mechanisms. They are also important in the light of sub-certification processes that resulted from the Sarbanes-Oxley Act and the 8th EU Directive. The third essay contributes to the literature by developing a measurement framework that accounts for the consequences of major trends in standard setting. Moreovér, it shows how these trends affect the required .competency set of people dealing with accounting issues. Based on this work, my main contribution is the development of a public interest approach for the design of adequate financial accounting curricula. 2 Serving two masters: Experimental evidence on the independence of internal auditors Abstract Twenty nine internal auditors participated in a study that examines the independence of internal auditors in their potentially competing roles of serving two masters: the audit committee and management. Our main hypothesis suggests that internal auditors' independence is not achievable in an institutional setting in which internal auditors are accountable to two different parties with potentially differing priorities. We test our hypothesis in an experiment in which the treatment consisted of two different instructions of the Chief audit executive; one stressing the priority of management (cost reduction) and one stressing the priority of the audit committee (effectiveness). Internal auditors had to evaluate internal controls and their inherent costs of different processes which varied in their degree of task complexity. Our main results indicate that internal auditors' evaluation of the processes is significantly different when task complexity is high. Our findings suggest that internal auditors do follow the priorities of either management or the audit committee depending on the instructions of a superior internal auditor. The study's results question whether the independence of the internal audit function is actually achievable. With our findings, we contribute to research on internal auditors' judgment and the internal audit function's independence in the frame of corporate governance.