Supporting interdisciplinary case studies: development and implementation of a joint learning environment for students in forensic science and criminal law

Scientific reporting and communication is a challenging topic for which traditional study programs do not offer structured learning activities on a regular basis. This paper reports on the development and implementation of a web application and associated learning activities that intend to raise the awareness of reporting and communication issues among students in forensic science and law. The project covers interdisciplinary case studies based on a library of written reports about forensic examinations. Special features of the web framework, in particular a report annotation tool, support the design of various individual and group learning activities that focus on the development of knowledge and competence in dealing with reporting and communication challenges in the students' future areas of professional activity.

Medical residents' feedback on needs and acquired skills following a short course on cross-cultural competence

Objectives The purpose of this study is to assess short and long term changes in knowledge, attitudes, and skills among medical residents following a short course on cultural competency and to explore their perspectives on the experience. Methods Eighteen medical residents went through a short training programme comprised of two seminars lasting 30' and 60' respectively over two days. Three months later, we conducted three focus groups, with 17 residents to explore their thoughts, perspectives and feedback about the course. To measure changes over time, we carried out a quantitative sequential survey before the seminars, three days after, and three months later using the Multicultural Assessment Questionnaire. Results Residents expressed a wide variety of perspectives on the main themes related to the content of the training - culture, trialogue, stereotypes, status, epidemiology, history and geopolitics - and related to its organization - relevance, volume, timing, target audience, training tools, and working material. Using the MAQ, we observed a higher global performance score (n=16) at three days (median=38) compared to results before the training (median=33) revealing a median difference of 5.5 points (z=2.4, p=0.015). This difference was still present at three months (∆=4.5, z=2.4, p=0.018), mainly due to knowledge acquisition (∆=3) rather than attitudes (∆=0) or skills (∆=1). Conclusions Cross-cultural competence training not only brings awareness of multicultural issues but also helps participants understand their own cultures, perception of others and preconceived ideas. Physicians' education should however also focus on improving implementation of acquired knowledge in cross-cultural competence.

Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation for chronic low back pain.

OBJECTIVE: To assess the cost-utility of an exercise programme vs usual care after functional multidisciplinary rehabilitation in patients with chronic low back pain. DESIGN: Cost-utility analysis alongside a randomized controlled trial. SUBJECTS/PATIENTS: A total of 105 patients with chronic low back pain. METHODS: Chronic low back pain patients completing a 3-week functional multidisciplinary rehabilitation were randomized to either a 3-month exercise programme (n = 56) or usual care (n = 49). The exercise programme consisted of 24 training sessions during 12 weeks. At the end of functional multidisciplinary rehabilitation and at 1-year follow-up quality of life was measured with the SF-36 questionnaire, converted into utilities and transformed into quality--adjusted life years. Direct and indirect monthly costs were measured using cost diaries. The incremental cost-effectiveness ratio was calculated as the incremental cost of the exercise programme divided by the difference in quality-adjusted life years between both groups. RESULTS: Quality of life improved significantly at 1-year follow-up in both groups. Similarly, both groups significantly reduced total monthly costs over time. No significant difference was observed between groups. The incremental cost-effectiveness ratio was 79,270 euros. CONCLUSION: Adding an exercise programme after functional multidisciplinary rehabilitation compared with usual care does not offer significant long-term benefits in quality of life and direct and indirect costs.

A regional Industrial Symbiosis methodology and its implementation in Geneva, Switzerland

The Agenda 21 for the Geneva region is the results from a broad consultation process including all local actors. The article 12 stipulates that « the State facilitates possible synergies between economic activities in order to minimize their environmental impacts » thus opening the way for Industrial Ecology (IE) and Industrial Symbiosis (IS). An Advisory Board for Industrial Ecology and Industrial Symbiosis implementation was established in 2002 involving relevant government agencies. Regulatory and technical conditions for IS are studied in the Swiss context. Results reveal that the Swiss law on waste does not hinder by-product exchanges. Methodology and technical factors including geographic, qualitative, quantitative and economical aspects are detailed. The competition with waste operators in a highly developed recycling system is also tackled.The IS project develops an empirical and systematic method for detecting and implementing by-products synergies between industrial actors disseminated throughout the Geneva region. Database management tool for the treatment of input-output analysis data and GIS tools for detecting potentials industrial partners are constantly improved. Potential symbioses for 17 flows (including energy, water and material flows) are currently studied for implementation.

Dépistage néonatal systématique de la mucoviscidose en Suisse: dès janvier 2011 [Implementation of the neonatal cystic fibrosis screening program in Switzerland: beginning January 2011].

The diagnosis of cystic fibrosis (CF) is often delayed because of the nonspecificity of a wide variety of clinical symptoms at disease onset. Newborn screening for CF has been advocated to reduce delays in diagnosis, facilitating preventive care for early respiratory and nutritional involvement. According to American and European consensus and experience of existing programs, a Swiss Nationwide Cystic Fibrosis Newborn Screening Program started in January 2011. Screening strategy combines two steps: an immunoreactive trypsinogen assay and DNA mutation analysis in dried blood samples at day 4 (Guthrie cards).

Maturity of Concrete: Field Implementation, MLR-96-1, 1996

The result and experience of field implementation of the maturity method on 14 portland cement concrete (PCC) paving and patching projects during 1995 are summarized in this report. The procedure for developing reference PCC maturity-strength curve of concrete is discussed. Temperature measurement as well as effects of datum temperature, entrained air content and type of aggregate on maturity-strength relationship are examined. Some limitations of the maturity method are discussed. The available field experience and results indicate that the maturity method provides a simple approach to determine strength of concrete, and can be easily implemented in field paving and patching projects. The use of the maturity method may result in reduced project construction time.

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.

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.

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.

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."

The Arts (Music, Arts&Crafts and Drama) as a procedure for learning pre-school content: Grupo Edebé Project

There is nothing as amazing and fascinating as children learning process. Between 0 and 6 years old, a child brain develops in a waythat will never be repeated. At this age, children are eager to discover and they have great potential of active and affective life.Because of this, their learning capacity in this period is incalculable. (Jordan-Decarbo y Nelson, 2002; Wild, 1999).Pre-school Education is a unique and special stage, with self identity, which aims are:attending children as a whole,motivate them to learn,give them an affective and stable environment in which they can grow up and get to be balanced and confident people and inwhich they can relate to others, learn, enjoy and be happy.Arts, Music, Visual Arts and Drama (Gardner, 1994) can provide a framework of special, even unique, personal expression.With the aim of introducing qualitative improvements in the education of children and to ensure their emotional wellbeing, and havingnoticed that teachers had important needs and concerns as regards to diversity in their student groups, we developed a programbased on the detection of needs and concerns explained by professionals in education.This program of Grupo edebé, object of our research, is a multicultural, interdisciplinary and globalizing project the aims of which are:developing children's talent and personality,keeping their imagination and creativity and using these as a learning resource,promoting reasoning, favouring expression and communication,providing children with the tools to manage their emotions,and especially, introducing Arts as a procedure to increase learning.We wanted to start the research by studying the impact (Brice, 2003) that this last point had on the learning of five-year-old childrenschooled in multicultural environments.Therefore, the main goal of the research was the assessment of the implementation of a child education programme attending todiversity in a population of five-year-old children, specifically in the practice of procedures based on the use of Arts (music, arts andcrafts and theatre) as a vehicle or procedure for learning contents in Pre-school stage.Because children emotional welfare was a subject of our concern, and bearing in mind that the affective aspects are of vitalimportance for learning and child development (Parke and Gauvain, 2009), Grupo Edebé has also evaluated the starting, evolving andfinal impact in five-year-old children given that they finish Pre-school education at that age.