984 resultados para Innovative service


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The strategic plan for bridge engineering issued by AASHTO in 2005 identified extending the service life and optimizing structural systems of bridges in the United States as two grand challenges in bridge engineering, with the objective of producing safer bridges that have a minimum service life of 75 years and reduced maintenance cost. Material deterioration was identified as one of the primary challenges to achieving the objective of extended life. In substructural applications (e.g., deep foundations), construction materials such as timber, steel, and concrete are subjected to deterioration due to environmental impacts. Using innovative and new materials for foundation applications makes the AASHTO objective of 75 years service life achievable. Ultra High Performance Concrete (UHPC) with compressive strength of 180 MPa (26,000 psi) and excellent durability has been used in superstructure applications but not in geotechnical and foundation applications. This study explores the use of precast, prestressed UHPC piles in future foundations of bridges and other structures. An H-shaped UHPC section, which is 10-in. (250-mm) deep with weight similar to that of an HP10×57 steel pile, was designed to improve constructability and reduce cost. In this project, instrumented UHPC piles were cast and laboratory and field tests were conducted. Laboratory tests were used to verify the moment-curvature response of UHPC pile section. In the field, two UHPC piles have been successfully driven in glacial till clay soil and load tested under vertical and lateral loads. This report provides a complete set of results for the field investigation conducted on UHPC H-shaped piles. Test results, durability, drivability, and other material advantages over normal concrete and steel indicate that UHPC piles are a viable alternative to achieve the goals of AASHTO strategic plan.

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Audit report on the Regional Utility Service Systems Commission for the year ended June 30, 2014

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L'hypophosphatémie sévère définie comme une phosphatémie plasmatique < 0.32 mmol/l (Norme : 0.8-1-4 mmol/l) est associé à une morbidité et mortalité accrues. Il s'agit d'un trouble électrolytique dont la prévalence a été évaluée entre 0.24-0.42 % dans une population d'un hôpital général. Un nombre considérable de maladies et de situations cliniques ont été identifiées comme étant associées à une hypophosphatémie. Méthodologie Etude rétrospective chez les patients du service de médecine interne du Centre Hospitalier Universitaire Vaudois (CHUV, Lausanne) au cours de la période 2008-2010 qui ont présenté au moins un épisode de hypophosphatémie sévère définie comme une phosphatémie ≤ 0.35 mmol/l. Nous avons obtenu les données sur l'âge, le sexe, et les taux plasmatiques de : calcium, albumine, créatinine, bicarbonate veineux, glucose et acide urique.Nous avons étudié la prévalence de l'hypophosphatémie sévère et les pathologies associées. Comparaisondans une analyse cas-contrôles des caractéristiques des patients avec hypophosphatémie sévère et ceux ayant des valeurs de phosphate plasmatiques normales(0.8-1.4 mmol/l). Résultats La prévalence des patients ayant présenté au moins une valeur de phosphatémie ≤0.35 mmol/l pendant l'hospitalisation est de 1.3% sur les trois années cumulées. Chez les 84 patients avec hypophosphatémie sévère, la majorité présente plusieurs causes concomitantes. Nous avons retrouvé les étiologies suivantes : dénutrition sévère, 59.5% ; dialyse, 34.5% ; diarrhées chroniques, 23.8% ; consommation chronique d'alcool, 21.4% ; syndrome de renutrition inappropriée (refeeding syndrome), 20.3% et hyperparathyroïdisme primaire, 4.8%. L'hypokaliémie, l'hypocalcémie et l'hypomagnésémie sont positivement et significativement associées à l'hypophosphatémie. Conclusion La prévalence est rare dans un service de médecine interne, mais reste très probablement sous- diagnostiquée. Les patients à risque de développer ce trouble électrolytique sont les patients souffrant de dénutrition avec son pendant le syndrome de renutritioninappropriée et la consommation chronique d'alcool, et les patients sous dialyse.

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OBJECTIVES: To determine 1) HIV testing practices in a 1400-bed university hospital where local HIV prevalence is 0.4% and 2) the effect on testing practices of national HIV testing guidelines, revised in March 2010, recommending Physician-Initiated Counselling and Testing (PICT). METHODS: Using 2 hospital databases, we determined the number of HIV tests performed by selected clinical services, and the number of patients tested as a percentage of the number seen per service ('testing rate'). To explore the effect of the revised national guidelines, we examined testing rates for two years pre- and two years post-PICT guideline publication. RESULTS: Combining the clinical services, 253,178 patients were seen and 9,183 tests were performed (of which 80 tested positive, 0.9%) in the four-year study period. The emergency department (ED) performed the second highest number of tests, but had the lowest testing rates (0.9-1.1%). Of inpatient services, neurology and psychiatry had higher testing rates than internal medicine (19.7% and 9.6% versus 8%, respectively). There was no significant increase in testing rates, either globally or in the majority of the clinical services examined, and no increase in new HIV diagnoses post-PICT recommendations. CONCLUSIONS: Using a simple two-database tool, we observe no global improvement in HIV testing rates in our hospital following new national guidelines but do identify services where testing practices merit improvement. This study may show the limit of PICT strategies based on physician risk assessment, compared to the opt-out approach.

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Audit report on the South Central Iowa Regional E-911 Service Board for the year ended June 30, 2005

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Audit report on the South Central Iowa Regional E-911 Service Board for the year ended June 30, 2004

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Audit report on the South Central Iowa Regional E-911 Service Board for the year ended June 30, 2015

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En aquest article s'aporten proves de l'impacte positiu que té l'aplicació de les tecnologies de la informació i la comunicació (TIC) en l'empresa turística catalana. La transcendència que en els darrers anys ha adquirit el mercat turístic català en el context europeu el converteix en un laboratori d'anàlisi idoni per al sector. Els resultats obtinguts posen de manifest que l'ús d'aquestes tecnologies s'acompanya d'un major grau d'internacionalització de l'empresa, el desenvolupament de canvis organitzatius i la implantació de noves estratègies competitives, cosa que dóna lloc a un model de negoci allunyat de les concepcions tradicionals del sector. A més, l'ús estratègic de les TIC afavoreix l'ús de mà d'obra més qualificada, un servei més personalitzat i una major proximitat a proveïdors i distribuïdors. Tanmateix, és en el procés d'innovació empresarial on l'impacte positiu de les TIC és percep més, atès que el seu ús ha contribuït a superar alguns dels obstacles existents, a interioritzar el procés en el si de l'empresa i a fer més partícips els mateixos treballadors, i això ha donat com a resultat una àmplia diversitat d'innovacions de tota mena (de producte, de procés i organitzatives). La participació en xarxes de cooperació, el fet de tenir treballadors amb un nivell educatiu elevat i l'aplicació intensiva de les TIC han estat elements indispensables en aquest procés innovador. Finalment, gràcies a l'ús de les TIC i el seu impacte en la innovació, però també al canvi organitzatiu dins l'empresa, s'han millorat els registres de productivitat, amb la qual cosa s'afavoreix una major competitivitat en un context canviant i de forta pressió de l'entorn.

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The Americans with Disabilities Act (ADA) and the Fair Housing Act (FHA) prohibit discrimination on the basis of disability and govern the use of service or emotional support animals in places where pets may not be permitted. However, courts have been struggling with how to define and treat animals that qualify for protection under each law. This has created confusion as to what rights and duties are owed disabled persons and the animals that live with or accompany them. This essay attempts to clarify these two federal laws with regard to service or emotional support animals and the differing parties‘ rights and interests. It also includes an overview of select state laws that govern assistance animals of all types and our recommendations for enhancing the Iowa Civil Rights Act.