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Previous studies indicate adherence to pre-operative antibiotic prophylaxis guidelines has been inadequate. The purpose of this paper is to determine adherence rates to current perioperative antibiotic prophylaxis guidelines in gynecologic surgery at a tertiary care, academic institution. As a secondary outcome, improving guidelines after physician re-education were analyzed.

A retrospective chart review (2,463 patients) was completed. The authors determined if patients received perioperative antibiotic prophylaxis in accordance with current guidelines from the America College of Obstetricians and Gynecologists. Data were obtained before and after physician tutorials. Quality control was implemented by making guideline failures transparent. Statistical analysis used Fisher’s exact and agreement tests.

In total, 23 percent of patients received antibiotics not indicated across all procedures. This decreased to 9 percent after physician re-education and outcome transparency (p<0.0001). Laparoscopy was the procedure with the lowest guideline compliance prior to education. The compliance improved from 52 to 92 percent (p<0.0001) after re-education.

Gynecologic surgeons overuse antibiotics for surgical prophylaxis. Physician re-education and transparency were shown to enhance compliance.

Educational tutorials are an effective strategy for encouraging physicians to improve outcomes, which, in turn, allows the healthcare system a non-punitive way to monitor quality and mitigate cost.

The recent evolution of the provision of continued in‐service training in French companies is described and analysed. This evolution is placed in its legal, political and social context with emphasis being placed on the interaction between state action and managerial strategies. It is shown how an interplay of continued “social democratic” legislation and innovation in Human Resources Management policies has served to place training at the top of the economic and social agenda in France. Its role in contemporary French industrial relations is also considered.

This paper aims to propose a generative design method combined with meta-heuristic algorithm for automating and optimizing the floor layout of modular buildings using typical standardized module units, which are the room module, the corridor module and the stair module.

The integrated framework involves the generative design method and optimization for modular construction. The generative rules are provided by geometric relationships and functionalities of the module units. An evaluation function of the generated floor plans is also presented by the combination of project cost and cost penalties for the geometric features. The multi-population genetic algorithm (MPGA) method is provided for the optimization of the combination of costs.

The proposed MPGA method is demonstrated fast and efficient at discovering the globally optimal solution. The results indicate that when the unit price of modules is high, the transportation distance is long, or the land cost is high, the layout cost, which related to the symmetry, the compactness and the energy is tend to be lower, making the optimal layout economical.

This paper presented an integrated framework of generative floor layout and optimization for modular construction by using typical module units. It fulfills the need for automated layout generation with repetitive units and corresponding assessment during the early design stage.

The first aim of this study is to show the impact of global warming on temperature and precipitation changes in Algeria. The second objective is to exhibit the strategy planned by the country to mitigate these effects on water resources in the future.

This research assesses the expected changes in temperature, precipitation and SPEI index, over Algeria (16 weather stations), between two horizons (2030, 2050), by using an ensemble of 16 general circulation models under RCP2.6 and RCP8.5 scenarios.

More warming and drought will be experienced under RCP8.5 than RCP2.6 scenario. The highest warming is observed at the Southern stations. However, the lowest precipitation is projected in the western stations. The results of SPEI calculation indicate that the severity of drought spread progressively across time and space. The highest values were observed over 2050 with values varied between 0.15 and −2.08 under RCP2.6 scenario, and range from −0.73 to −2.63 under RCP8.5. These results indicate that Algeria is highly vulnerable to the impact of climate change on water resources, which stressed the need to develop a strategy against this situation.

This study is one of the first to simulate the future climate changes over 16 Algerian weather stations by using an average of 16 general circulation models data, under two RCP scenarios. This study shows the 2030 water development strategy to mitigate the effect of drought and water scarcity on different sectors.