Electronic Construction Collaboration - Phase 1, 2009

Bridge construction projects are becoming increasingly complex as the demand for context-sensitive solutions, aesthetic designs, and accelerated bridge construction becomes more prevalent. In addition, the Iowa Department of Transportation (Iowa DOT) is entering a phase of design and construction of large border bridges, such as the I-80 (let 2008 for $56 million) and US 34 bridges over the Missouri River and I-74 over the Mississippi River. Compared to typical construction projects, these bridges generate more contractor Requests for Information (RFIs), Value Engineering (VE) proposals, Requests for Changes (RFCs), and shop drawings. Management of these submittals is a significant challenge for Resident Construction Engineers (RCEs) and other Iowa DOT staff. In addition, some submittals require cross-departmental and project consultant reviews. Commercially available software exists for managing submittals and project collaboration teams; in-house solutions may also be possible. Implementation is intended to speed construction submittal review time, reduce incidence of delay claims, and free up Iowa DOT staff from project management administrative tasks. Researchers from Iowa State University working with the Iowa DOT conducted a multi-pronged approach to indentify a web-based collaboration solution for Iowa DOT bridge projects. An investigation was launched to determine the functional needs of the Iowa DOT. Commercially available software programs were also evaluated to find what functionality is currently available. A Request for Proposals (RFP) was written to select a commercial web-based collaboration solution for pilot testing. In the second phase of research, a solution will be selected and implemented on two pilot projects. Lessons learned from these pilot projects will assist the Iowa DOT in developing and implementing a long-term solution to improve the management of Iowa DOT bridge projects.

Transposition of great arteries and single coronary artery: a new surgical technique for the arterial switch operation.

A single coronary artery can complicate the surgical technique of arterial switch operations, impairing early and late outcomes. We propose a new surgical approach, successfully applied in a 2.1 kg neonate, aimed at reducing the risk of early and late compression and/or distortion of the newly constructed coronary artery system.

2016 Annual Report, Iowa Collaboration for Youth Development, February 1, 2016

The 2016 Annual Report includes our primary issue and goal, data that demonstrate the state’s current position, activities and accomplishments in the area of youth development completed by the ICYD Council in 2015; emerging activities being implemented in 2016; and recommended actions that will help Iowa achieve the ICYD goal – Increasing Iowa’s Graduation Rate to 95% by 2020. With the understanding that several issues (e.g. substance abuse, family, employment, teen pregnancy, and mental health) prevent many youth from graduating from high school, the ICYD Council agencies address these issues as individual agencies and work together as a team by making the best use of existing resources to maximize efficiency in state government in order to create substantial and lasting positive changes for Iowa’s youth.

Le tombeau de Charles Baudelaire / ouvrage publié avec la collaboration de Stéphane Mallarmé, Michel Abadie, Emile Blémont, Viviane de Brocélyande,... [et al.]. précédé d'une Etude sur les textes de "Les fleurs du mal" / commentaire et variantes, par le prince Alexandre Ourousof. et suivi d'Oeuvres posthumes interdites ou inédites de Charles Baudelaire / recueillies par les soins de MM. le vicomte Ch. Spoelberch de Lovenjoul, prince Alexandre Ourousof, Louis de St-Jacques et vicomte Aug. Gilbert de Voisin ; frontispice de Félicien Rops

Comprend : Etude sur les textes de "Les fleurs du mal" / commentaire et variantes, par le prince Alexandre Ourousof ; Oeuvres posthumes interdites ou inédites de Charles Baudelaire / recueillies par les soins de MM. le vicomte Ch. Spoelberch de Lovenjoul, prince Alexandre Ourousof, Louis de St-Jacques et vicomte Aug. Gilbert de Voisin

Long diagnostic delay in Crohn's disease is associated with complicated disease course and increased operation rate

Background: We have recently shown that the median diagnostic delay to establish Crohn's disease (CD) diagnosis in the Swiss IBD Cohort (SIBDC) was 9 months. Seventy five percent of all CD patients were diagnosed within 24 months. The clinical impact of a long diagnostic delay on the natural history of CD is unknown. Aim: To compare the frequency and type of CD-related complications in the patient groups with long diagnostic delay (>24 months) vs. the ones diagnosed within 24 months. Methods: Retrospective analysis of data from the SIBDCS, comprising a large sample of CD patients followed in hospitals and private practices across Switzerland. Results: Two hundred CD patients (121 female, mean age 44.9 ± 15.0 years, 38% smokers, 71% ever treated with immunomodulators and 35% with anti-TNF) with long diagnostic delay were compared to 697 CD patients (358 female, mean age 39.1 ± 14.9 years, 33% smokers, 74% ever treated with immunomodulators and 33% with anti-TNF) diagnosed within 24 months. No differences in the outcomes were observed between the two patient groups within year one after CD diagnosis. Among those diagnosed 2-5 years ago, CD patients with long diagnostic delay (n = 45) presented more frequently with internal fistulas (11.1% vs. 3.1%, p = 0.03) and bowel stenoses (28.9% vs. 15.7%, p = 0.05), and they more frequently underwent CD-related operations (15.6% vs. 5.0%, p = 0.02) compared to the patients diagnosed within 24 months (n = 159). Among those diagnosed 6-10 years ago, CD patients with long diagnostic delay (n = 48) presented more frequently with extraintestinal manifestations (60.4% vs. 34.6%, p = 0.001) than those diagnosed within 24 months (n = 182). For the patients diagnosed 11-15 years ago, no differences in outcomes were found between the long diagnostic delay group (n = 106) and the one diagnosed within 24 months (n = 32). Among those diagnosed >= 16 years ago, the group with long diagnostic delay (n = 71) more frequently underwent CD-related operations (63.4% vs. 46.5%, p = 0.01) compared to the group diagnosed with CD within 24 months (n = 241). Conclusions: A long diagnostic delay in CD patients is associated with a more complicated disease course and higher number of CD-related operations in the years following the diagnosis. Our results indicate that efforts should be undertaken to shorten the diagnostic delay in CD patients in order to reduce the risk for progression towards a complicated disease phenotype.

Senate File 2239 Section 30 AGENCY COLLABORATION AND REPORT

Section 30 of Senate File 2239 mandates “the Department on Aging, Department of Human Services, Department of Inspections and Appeals, Department of Public Health, and the Office of the Attorney General shall collaborate and provide written recommendations on strengthening Iowa’s elder abuse prevention, detection, and intervention efforts.

Médecine interne et gériatrie en soins aigus: mariage de raison [General internal medicine and geriatrics in the acute care setting: opportunities for collaboration]

The health care system faces a difficult challenge as a result of the demographic evolution. The acute hospital is especially challenged by the steady increase of the elderly population. The collaboration between internal medicine and geriatrics in this setting could prove useful to facilitate the adaptation of the acute care setting and greatly enhance education of the health care professionals. Internists and geriatricians can benefit from each other skills and competencies to develop together new models of acute care that would better match the elderly population needs.