Use of Longitudinal Subdrains in the 3R Program, Final Report, HR-509, 1981

Construction of the interstate highway system began in 1956. This U.S. network of highway consists of more than 41,000 miles with 790 miles in Iowa. There have been many benefits of the controlled access roadway, but probably the most significant is the improved safety for the motorist. In Iowa, we have always endeavored to utilize quality locally available materials in our construction using the most economical or cost effective methods. Obviously when the effort is to build a cost effective system, there will be some portions of the network that will not perform as well as expected. In the design of our interstate, the main consideration for base construction under the pavement was structural capacity. The material was dense graded with the aim of supporting the pavement and distributing the load as it is transferred to the underlying grade. The drainage characteristic of the base was apparently not given adequate consideration. On jointed portland cement concrete (pcc) pavement, the water that is trapped immediately beneath the pavement causes severe problems. The traffic causes rapid movement of the water resulting in the hydraulic pressures or "pumping" (movement and redeposit of base fine material) resulting in faulting between individual slabs. Recognizing the need for maintaining this large national highway network, the Federal Highway Administration has initiated a funding program for resurfacing, restoration and rehabilitation (3R). Many miles of the system are more than 20 years old and in need of major maintenance. This new 3R Program necessitated a complete inventory of the Iowa interstate system to establish priorities and to identify those sections in need of immediate remedial treatments.

Iowa area command operation plan number 1 : military support of civil defense, 1975

Contains information on Iowa Area Command Operation Plan 1, Military Support of Civil Defense, Iowa Area Command, consisting of the basic plan and Annexes "A" through "N", is furnished for information, guidance and necessary actions of Commanders concerned.

Are You Prepared? A Guide to Emergency Preparedness, October 24, 2013

Being prepared means making an emergency plan, building an emergency kit and being aware of the hazards that can impact you. Whether you are at home or at work, emergencies like tornadoes, flooding or winter storms can occur quickly and without warning. We can’t prevent emergencies, but we can prepare for them.

Crisis Kit for Teacher and Administrators, January 17, 2012

Whether it’s tornadoes, flooding, winter storms or an act of terrorism, emergencies can occur quickly and without warning. Although we cannot prevent emergencies, we can prepare for them. Teachers and administrators need to take special care as they are responsible for the students in their care. Putting together and having on hand a crisis kit can be invaluable in times of emergency.

Sharing and Learning= Changing. A real story at the Institute of Public Security of Catalonia

The Institute has professionals with extensive experience in training, specifically with experience in the field of police and emergencies training. Moreover, it also has very talented people. But above all, our institution has public professionals with a desire to serve, who love security and emergency responders and want to provide them with the best knowledge to make them every day better professionals. In the quest for continuous training improvement, its during 2009 when e-learning begins to have a presence at the Institute. Virtual training methodology becomes a facilitator for the training of various professionals, avoiding geographical displacement and easing the class schedule.

Optimization of Snow Drifting Mitigation and Control Methods for Iowa Conditions Part II, TR-626, 2015

Blowing and drifting of snow is a major concern for transportation efficiency and road safety in regions where their development is common. One common way to mitigate snow drift on roadways is to install plastic snow fences. Correct design of snow fences is critical for road safety and maintaining the roads open during winter in the US Midwest and other states affected by large snow events during the winter season and to maintain costs related to accumulation of snow on the roads and repair of roads to minimum levels. Of critical importance for road safety is the protection against snow drifting in regions with narrow rights of way, where standard fences cannot be deployed at the recommended distance from the road. Designing snow fences requires sound engineering judgment and a thorough evaluation of the potential for snow blowing and drifting at the construction site. The evaluation includes site-specific design parameters typically obtained with semi-empirical relations characterizing the local transport conditions. Among the critical parameters involved in fence design and assessment of their post-construction efficiency is the quantification of the snow accumulation at fence sites. The present study proposes a joint experimental and numerical approach to monitor snow deposits around snow fences, quantitatively estimate snow deposits in the field, asses the efficiency and improve the design of snow fences. Snow deposit profiles were mapped using GPS based real-time kinematic surveys (RTK) conducted at the monitored field site during and after snow storms. The monitored site allowed testing different snow fence designs under close to identical conditions over four winter seasons. The study also discusses the detailed monitoring system and analysis of weather forecast and meteorological conditions at the monitored sites. A main goal of the present study was to assess the performance of lightweight plastic snow fences with a lower porosity than the typical 50% porosity used in standard designs of such fences. The field data collected during the first winter was used to identify the best design for snow fences with a porosity of 50%. Flow fields obtained from numerical simulations showed that the fence design that worked the best during the first winter induced the formation of an elongated area of small velocity magnitude close to the ground. This information was used to identify other candidates for optimum design of fences with a lower porosity. Two of the designs with a fence porosity of 30% that were found to perform well based on results of numerical simulations were tested in the field during the second winter along with the best performing design for fences with a porosity of 50%. Field data showed that the length of the snow deposit away from the fence was reduced by about 30% for the two proposed lower-porosity (30%) fence designs compared to the best design identified for fences with a porosity of 50%. Moreover, one of the lower-porosity designs tested in the field showed no significant snow deposition within the bottom gap region beneath the fence. Thus, a major outcome of this study is to recommend using plastic snow fences with a porosity of 30%. It is expected that this lower-porosity design will continue to work well for even more severe snow events or for successive snow events occurring during the same winter. The approach advocated in the present study allowed making general recommendations for optimizing the design of lower-porosity plastic snow fences. This approach can be extended to improve the design of other types of snow fences. Some preliminary work for living snow fences is also discussed. Another major contribution of this study is to propose, develop protocols and test a novel technique based on close range photogrammetry (CRP) to quantify the snow deposits trapped snow fences. As image data can be acquired continuously, the time evolution of the volume of snow retained by a snow fence during a storm or during a whole winter season can, in principle, be obtained. Moreover, CRP is a non-intrusive method that eliminates the need to perform man-made measurements during the storms, which are difficult and sometimes dangerous to perform. Presently, there is lots of empiricism in the design of snow fences due to lack of data on fence storage capacity on how snow deposits change with the fence design and snow storm characteristics and in the estimation of the main parameters used by the state DOTs to design snow fences at a given site. The availability of such information from CRP measurements should provide critical data for the evaluation of the performance of a certain snow fence design that is tested by the IDOT. As part of the present study, the novel CRP method is tested at several sites. The present study also discusses some attempts and preliminary work to determine the snow relocation coefficient which is one of the main variables that has to be estimated by IDOT engineers when using the standard snow fence design software (Snow Drift Profiler, Tabler, 2006). Our analysis showed that standard empirical formulas did not produce reasonable values when applied at the Iowa test sites monitored as part of the present study and that simple methods to estimate this variable are not reliable. The present study makes recommendations for the development of a new methodology based on Large Scale Particle Image Velocimetry that can directly measure the snow drift fluxes and the amount of snow relocated by the fence.

Médecine d'urgence [Emergency medicine: updates 2013].

New evidences published this year are susceptible to change the management of several medical emergencies. Combined antiplatelet therapy might be beneficial for the management of TIA or minor stroke and rapid blood pressure lowering might improve the outcome in patients with intracerebral hemorrhage. A restrictive red cell transfusion strategy is indicated in case of upper digestive bleeding and coagulation factors concentrates are superior to fresh frozen plasma for urgent warfarin reversal. Prolonged systemic steroid therapy is not warranted in case of acute exacerbation of BPCO, and iterative physiotherapy is not beneficial after acute whiplash. Finally, family presence during cardiopulmonary resuscitation may reduce post-traumatic stress disorder among relatives.

Conflictivitat comunicativa en episodis d'emergència: aproximació a la cobertura informativa i la gestió institucional de l'esfondrament d'un túnel del metro al barri del Carmel de Barcelona

En aquesta investigació s’estudien els processos de producció de la informacióper part dels mitjans de comunicació i la gestió comunicativa institucional en episodis d’emergència. En concret, s’analitzen les negociacions entre els actors, les fonts informatives i el respecte deontològic en la divulgacióde les notícies. Per tal de conèixer específicament aquesta conflictivitat,s’ha escollit per a l’estudi de cas l’esfondrament d’un túnel del metro albarri del Carmel de Barcelona el gener de 2005. Per a realitzar aquesta investigació,s’ha utilitzat una perspectiva teòrica multidisciplinària. S’han pres en consideració els postulats teòrics de la sociologia, a partir del diàleg queestableixen diferents autors (Beck, Giddens, Lash i Luhmann) entre el conceptede modernitat i el nou paradigma que Beck (1998) denomina la societat del risc. També s’han tingut en compte els camps de la teoria i la sociologia de la comunicació i, més específicament, el marc teòric del periodisme i de les relacions públiques.

Transverse Cracking of Asphalt Pavements, HR-1040, Summary Report, 1982

This report summarizes the analysis of transverse cracking in asphalt pavement by a five state study team from Iowa, Kansas, Nebraska, North Dakota, and Oklahoma. The study was initiated under the sponsorship of the Federal Highway Administration and four evaluation conferences were held during the course of the study. Each state conducted a crack inventory on their asphalt pavement. An effort was made to correlate this inventory with numerous factors that were considered to be pertinent to the cracking problem. One state did indicate that there was a correlation between transverse cracking severity and the subsurface geology. The other states were unable to identify any significant factors as being the primary contributors. The analysis of the problem was divided into, (1) mix design, (2) maintenance, and (3) 3R rehabilitation. Many potential factors to be considered were identified under each of these three study divisions. There were many conclusions as to good and bad practices. One major conclusions was that a more effective crack maintenance program with early sealing was essential. Some new practices were suggested as potentially more cost effective in design, construction and maintenance. The interchange of methods and procedures by individual states yielded benefits in that other states selected practices that would be an improvement to their program.

Servei Municipal d'emergències

Es presenta un sistema de gestió d'emergències dins d'un àmbit municipal on es pretén donar una resposta eficaç a les emergències que es puguin donar en un determinat municipi com, en el nostre cas, Barcelona.

Proyecto para la identificación de necesidades formativas y posterior implementación de acción docente en la Unidad de Salud y Socorros de Cruz Roja Pamplona

Proyecto orientado a identificar aspectos mejorables desde el punto de vista formativo en la labor desarrollada por el voluntariado dedicado a la emergencia extra-hospitalaria.

Gastrointestinal disease following heart transplantation.

With advances in heart transplantation, a growing number of recipients are at risk of developing gastrointestinal disease. We reviewed our experience with gastrointestinal disease in 92 patients undergoing 93 heart transplants. All had follow-up, with the median time 4.8 years (range 0.5-9.6 years). During the period of the study we progressively adopted a policy of low immunosuppression aiming toward monotherapy with cyclosporine. Nineteen patients (20.6%) developed 28 diseases related to the gastrointestinal tract. Thirteen patients required 18 surgical interventions, five as emergencies: closure of a duodenal ulcer, five cholecystectomies (one with biliary tract drainage), a sigmoid resection for a diverticulitis with a colovesical fistula, a colostomy followed by a colostomy takedown for an iatrogenic colon perforation, appendectomy, two anorectal procedures, and six abdominal wall herniorrhaphies. At the onset of gastrointestinal disease, 8 patients were on standard triple-drug immunosuppression, all of them within 6 months of transplantation; 13 were on double-drug immunosuppression; and 7 were on cyclosporine alone. All the patients with perforations/fistulas were on steroids. Among the 11 infectious or potentially infectious diseases, 10 were on triple- or double-drug immunosuppression. One death, a patient who was on triple-drug immunosuppression, had a postmortem diagnosis of necrotic and hemorrhagic pancreatitis. Except for an incisional hernia following a laparoscopic cholecystectomy, there was no morbidity and, importantly, no septic complications. We concluded that a low immunosuppression policy is likely to be responsible for the low morbidity and mortality of posttransplant gastrointestinal disease, with a lower incidence of viscous perforation/fistula and infectious gastrointestinal disease.

Prevention and management of potential adverse events during transapical aortic valve replacement.

BACKGROUND AND AIM OF THE STUDY: Transapical transcatheter aortic valve replacement (TAVR) is a new minimally invasive technique with a known risk of unexpected intra-procedural complications. Nevertheless, the clinical results are good and the limited amount of procedural adverse events confirms the usefulness of a synergistic surgical/anesthesiological management in case of unexpected emergencies. METHODS: A review was made of the authors' four-year database and other available literature to identify major and minor intra-procedural complications occurring during transapical TAVR procedures. All implants were performed under general anesthesia with a balloon-expandable Edwards Sapien stent-valve, and followed international guidelines on indications and techniques. RESULTS: Procedural success rates ranged between 94% and 100%. Life-threatening apical bleeding occurred very rarely (0-5%), and its incidence decreased after the first series of implants. Stent-valve embolization was also rare, with a global incidence ranging from 0-2%, with evidence of improvement after the learning curve. Rates of valve malpositioning ranged from 0% to < 3%, whereas the risk of coronary obstruction ranged from 0% to 3.5%. Aortic root rupture and dissection were dramatic events reported in 0-2% of transapical cases. Stent-valve malfunction was rarely reported (1-2%), whereas the valve-in-valve bailout procedure for malpositioning, malfunctioning or severe paravalvular leak was reported in about 1.0-3.5% of cases. Sudden hemodynamic management and bailout procedures such as valve-in-valve rescue or cannulation for cardiopulmonary bypass were more effective when planned during the preoperative phase. CONCLUSION: Despite attempts to avoid pitfalls, complications during transapical aortic valve procedures still occur. Preoperative strategic planning, including hemodynamic status management, alternative cannulation sites and bailout procedures, are highly recommended, particularly during the learning curve of this technique.

A methodology to estimate the potential to move inpatient to one day surgery.

BACKGROUND: The proportion of surgery performed as a day case varies greatly between countries. Low rates suggest a large growth potential in many countries. Measuring the potential development of one day surgery should be grounded on a comprehensive list of eligible procedures, based on a priori criteria, independent of local practices. We propose an algorithmic method, using only routinely available hospital data to identify surgical hospitalizations that could have been performed as one day treatment. METHODS: Moving inpatient surgery to one day surgery was considered feasible if at least one surgical intervention was eligible for one day surgery and if none of the following criteria were present: intervention or affection requiring an inpatient stay, patient transferred or died, and length of stay greater than four days. The eligibility of a procedure to be treated as a day case was mainly established on three a priori criteria: surgical access (endoscopic or not), the invasiveness of the procedure and the size of the operated organ. Few overrides of these criteria occurred when procedures were associated with risk of immediate complications, slow physiological recovery or pain treatment requiring hospital infrastructure. The algorithm was applied to a random sample of one million inpatient US stays and more than 600 thousand Swiss inpatient stays, in the year 2002. RESULTS: The validity of our method was demonstrated by the few discrepancies between the a priori criteria based list of eligible procedures, and a state list used for reimbursement purposes, the low proportion of hospitalizations eligible for one day care found in the US sample (4.9 versus 19.4% in the Swiss sample), and the distribution of the elective procedures found eligible in Swiss hospitals, well supported by the literature. There were large variations of the proportion of candidates for one day surgery among elective surgical hospitalizations between Swiss hospitals (3 to 45.3%). CONCLUSION: The proposed approach allows the monitoring of the proportion of inpatient stay candidates for one day surgery. It could be used for infrastructure planning, resources negotiation and the surveillance of appropriate resource utilization.