Time for change: a roadmap to guide the implementation of the World Anti-Doping Code 2015

A medical and scientific multidisciplinary consensus meeting was held from 29 to 30 November 2013 on Anti-Doping in Sport at the Home of FIFA in Zurich, Switzerland, to create a roadmap for the implementation of the 2015 World Anti-Doping Code. The consensus statement and accompanying papers set out the priorities for the antidoping community in research, science and medicine. The participants achieved consensus on a strategy for the implementation of the 2015 World Anti-Doping Code. Key components of this strategy include: (1) sport-specific risk assessment, (2) prevalence measurement, (3) sport-specific test distribution plans, (4) storage and reanalysis, (5) analytical challenges, (6) forensic intelligence, (7) psychological approach to optimise the most deterrent effect, (8) the Athlete Biological Passport (ABP) and confounding factors, (9) data management system (Anti-Doping Administration & Management System (ADAMS), (10) education, (11) research needs and necessary advances, (12) inadvertent doping and (13) management and ethics: biological data. True implementation of the 2015 World Anti-Doping Code will depend largely on the ability to align thinking around these core concepts and strategies. FIFA, jointly with all other engaged International Federations of sports (Ifs), the International Olympic Committee (IOC) and World Anti-Doping Agency (WADA), are ideally placed to lead transformational change with the unwavering support of the wider antidoping community. The outcome of the consensus meeting was the creation of the ad hoc Working Group charged with the responsibility of moving this agenda forward.

La tipicidad de las detenciones ilegales policiales. Revisión crítica de la aplicación jurisprudencial de los arts. 167 y 530 del Código Penal

Es difícil encontrar en el Código penal español una regulación tan deficiente y confusa de una serie de conductas delictivas tan relevantes para el funcionamiento del Estado de Derecho como es la relativa a las detenciones ilegales cometidas por funcionario público que se prevé en los arts. 167 y 530. Lejos de hallar criterios jurisprudenciales satisfactorios que reconduzcan, en la medida de lo posible, la situación se advierte que el caos se ha instalado en buena medida en las resoluciones de los tribunales. En este trabajo se describe la situación y se propone una revisión general de los criterios interpretativos de los tipos en cuestión con el fin de dotarlos de mayor coherencia y certeza en su aplicación.

Development and Implementation of an Expert System for Forecasting Fog on US Highway 30 in Cedar Rapids, Iowa, HR-357, 1996

Several accidents, some involving fatalities, have occurred on U.S. Highway 30 near the Archer Daniels Midland Company (ADM) Corn Sweeteners plant in Cedar Rapids, Iowa. A contributing factor to many of these accidents has been the large amounts of water (vapor and liquid) emitted from multiple sources at ADM's facility located along the south side of the highway. Weather and road closure data acquired from IDOT have been used to develop a database of meteorological conditions preceding and accompanying closure of Highway 30 in Cedar Rapids. An expert system and a FORTRAN program were developed as aids in decision making with regard to closure of Highway 30 near the plant. The computer programs were used for testing, evaluation, and final deployment. Reports indicate the decision tools have been successfully implemented and were judged to be helpful in forecasting road closures and in reducing costs and personnel time in monitoring the roadway.

L'experiència pilot desenvolupada a partir del projecte d'innovació "La gestió integrada de la qualitat, el medi ambient i la seguretat en la docència experimental dels estudis de grau de les Facultats de Belles Arts"

Es presenta un projecte d'innovació docent, la recerca desevolupada del qual va incorporar aspectes relacionats amb la seguretat i la sostenibilitat dels procediments realitzats als tallers i laboratoris de les Facultats de Belles Arts, aplicant criteris de gestió de qualitat. Els resultats d'aquestes investigacions tenen una extensió social en l'àmbit de les Belles Arts en general. El projecte d'innovació docent va aplicar criteris de gestió de qualitat. La recerca desenvolupada va incorporar aspectes relacionats amb la seguretat i la sostenibilitat dels procediments als tallers i laboratoris de les Facultats de Belles Arts. Els resultats d¿aquestes investigacions tenen una extensió social en l'àmbit de les Belles Arts en general. Amb aquest projecte es va redissenyar un model de procediment normalitzat de treball (PNT) que 11 tallers diferents de les Facultats de BBAA de Barcelona, Conca i València van utilitzar per a elaborar 14 PNT i 3 vídeos de suport. Aquests es van aplicar durant una experiència pilot (curs 2009-2010). El nombre de participants en l¿experiència va ser de 211 alumnes, 15 professors, 10 tècnics de taller, majoritàriament de BBAA de la Universitat de Barcelona. L'experiència pilot va demostrar satisfactòriament la viabilitat de l'aplicació del model de PNT adoptat i els beneficis, de la seva aplicació, orientats a la millora continuada de la qualitat docent i de la investigació. Per concloure el projecte es va elaborar el procediment general (PG) que determina les pautes per a redactar un PNT. Aquest PG va ser aprovat recentment per la CSSMA del Centre2 i es podrà aplicar en el futur en la Facultat de BBAA de Barcelona. Sobre l'experiència s'han realitzat les publicacions pertinents (un llibre i un DVD) i s'ha participat també en dos congressos.

Implementation of enhanced recovery after surgery (ERAS) in colorectal surgery is highly cost-effective

Objective: Enhanced Recovery After Surgery (ERAS) clinical pathways in¦colorectal surgery are known to reduce postoperative complications leading¦to shortened hospital stay. However, the implementation of such an ERAS¦pathway requires time and financial investment. This study evaluates whether¦the savings related to the reduction in the length of stay (LOS) outweigh the¦costs of implementing an ERAS pathway.¦Methods: An ERAS pathway was implemented in our institution for colorectal¦surgery. The first 50 consecutive patients subjected to this ERAS pathway¦(ERAS group) were compared to 50 consecutive patients that were operated one¦year before its introduction (control group). Primary LOS, readmission within¦30 days, and total costs based on costs per day were compared. The mean costs¦per day were: 3,263 CHF for intensive care, 1,152 CHF for intermediate care,¦and 728 CHF for basic care.¦Results: Primary LOS was shorter in the ERAS group than in the control¦group: median 7 (interquartile range 5-12·25) versus 10 (7-18) days (P =¦0·0025). The readmission within 30 postoperative days was similar in both¦groups (2 patients each). In the ERAS group, the added primary LOS was¦485 days (379 in basic care, 99 in intermediate care, 7 in intensive care) compared¦to 706 days in the control group (533 in basic care, 146 in intermediate care,¦27 in intensive care). The total costs were significantly lower for the 50 ERAS¦patients compared to the control group: 412,801 CHF versus 644,317 CHF (P <¦0·01). Investments required for the 50 first ERAS patients were approximately¦83,544 CHF, including 348 working hours as well a full-time ERAS dedicated¦nurse. The overall cost saving was approximately 2,959 CHF per patient.¦Conclusion: Implementation of an ERAS pathway significantly reduced LOS¦after colorectal surgery. The financial investment to introduce and maintain¦such a pathway is clearly inferior to the cost-saving of reduced hospital stay.

Implementation of Benchmark Project Recommendations for Iowa DOT Offices of Construction, Addendum to HR-381, 1996

This report describes the continuation of the development of performance measures for the Iowa Department of Transportation (DOT) Offices of Construction. Those offices are responsible for administering transportation construction projects for the Iowa DOT. Researchers worked closely with the Benchmark Steering Team which was formed during Phase I of this project and is composed of representatives of the Offices of Construction. The research team conducted a second survey of Offices of Construction personnel, interviewed numerous members of the Offices and continued to work to improve the eight key processes identified during Phase I of this research. The eight key processes include Inspection of Work, Resolution of Technical Issues, Documentation of Work Progress and Pay Quantities, Employee Training and Development, Continuous Feedback for Improved Contract Documents, Provide Safe Traffic Control, External/Public Communication, and Providing Pre-Letting Information. Three to four measurements were specified for each key process. Many of these measurements required opinion surveys of employees, contractors, and others. During Phase II, researchers concentrated on conducting surveys, interviewing respondents to improve future surveys, and facilitating Benchmark Steering Team monthly meetings. Much effort was placed on using the information collected during the first year's research to improve the effectiveness and efficiency of the Offices of Construction. The results from Process Improvement Teams that studied Traffic Control and Resolution of Technical Issues were used to improve operations.

Seguretat i sostenibilitat: elaboració d'un model de procediment normalitzat de treball (pnt) com a eina docent per a l'autoaprenentatge en els tallers de les Facultats Belles Arts

La implementació dels nous graus requereix la integració dels conceptes i metodologies relacionades amb la seguretat, la prevenció de riscos laborals i la protecció del medi ambient. En aquest context, un equip de professorat de les facultats de Belles Arts (UB, UPV, UCLM) ha desenvolupat un projecte d'innovació docent, una de les parts fonamentals del qual, ha estat la ideació i la creació d'un model de procediment normalitzat de treball (PNT) i la seva aplicació en experiències pilot realitzades en diverses pràctiques als tallers i laboratoris. El PNT s'ha mostrat com una eina bàsica per a l'autoaprenentatge, que, així mateix, garanteix l'adquisició de les competències transversals relacionades amb la seguretat i la sostenibilitat.

The Governor's Blue Ribbon Transportation Task Force: Implementation Report for Maximizing the Efficient Use of Iowa's Road Use Tax Fund, 1998

This report documents the Iowa Department of Transportation's accomplishments and ongoing efforts in response to 39 recommendations proposed by the Governor's Blue Ribbon Transportation Task Force at the end of 1995. Governor Terry Branstad challenged the Task Force to "maximize the benefits of each dollar spent from the Road Use Tax Fund."

Implementation of guidelines on delirium in a General Hospital: a before-after study of their impact on caregivers' knowledge and clinical skills

INTRODUCTION: Delirium is a highly prevalent disorder, with serious consequences for the hospitalised patient. Nevertheless, it remains under-diagnosed and under-treated. We developed evidence-based clinical practice guidelines (CPGs) focusing on prevention, screening, diagnosis, and treatment of delirium in a general hospital. This article presents the implementation process of these CPGs and a before-after study assessing their impact on healthcare professionals' knowledge and on clinical practice. METHODS: CPGs on delirium were first implemented in two wards (Neurology and Neurosurgery) of the Lausanne university hospital. Interactive one-hour educational sessions for small groups of nurses and physicians were organised. Participants received a summary of the guidelines and completed a multiple choice questionnaire, assessing putative changes in knowledge, before and three months after the educational session. Other indicators such as "diagnosis of delirium" reported in the discharge letters, and mean duration of patients' hospital stay before and after implementation were compared. RESULTS: Eighty percent of the nurses and physicians from the Neurology and Neurosurgery wards attended the educational sessions. Both nurses and physicians significantly improved their knowledge after the implementation (+9 percentage-points). Other indicators were not modified by the intervention. CONCLUSION: A single interactive intervention improved both nurses' and physicians' knowledge on delirium. Sustained and repeated interventions are probably needed to demonstrate changes in clinical practice.

County grant program for veterans : status report on the implementation of 2006 Iowa Acts, Chapter 1185, Section 34, 2007

This is an overview of the program that the General Assembly of Iowa appropriated $1 million for to the Iowa Department of Veterans Affairs with the intent to improve delivery services by the various County Commissions of Veterans Affairs to veterans in their respective counties.

Lihahygienialainsäädännön omavalvontasäädökset ja käytäntö Oy Snellman Ab:n teurastamossa ja leikkaamossa, osa I Osa 1 : Owncontrol directions in meat hygiene legislation and their practical implementation in the slaughterhouse and cutting plant of Snellman Ltd, part I

Summary: Owncontrol directions in meat hygiene legislation and their practical implementation in the slaughterhouse and cutting plant of Snellman Ltd, part I

Veterans counseling program : status report on the implementation of Iowa Code 35.12, Veterans Counseling & Outreach Program, 2008

This report gives an overview, background and progress on the implementation of the Veterans Counseling Program established pursuant to Iowa Code 35.12, as enacted by 2007 Iowa Acts, House FIle 817.