In-Pavement Pedestrian Flasher Evaluation: Cedar Rapids, Iowa, 2004

Numerous strategies have been experimented with nationwide in an attempt to reduce the overall number of pedestrian-vehicle crashes, especially in instances where improper crossing or failure to yield was the proximate cause of the crash. Some of these measures include overhead signs, flashing warning beacons, advanced crossing signs, more visible pavement markings, in-street “Yield to Pedestrian” signs, and more recently, in-pavement flashing lights. Pedestrian safety has been a key issue for the City of Cedar Rapids, Iowa, in particular at non-controlled intersections and mid-block crossings. In 2002, the city council gave preliminary approval to implement a pedestrian-actuated overhead flasher system in conjunction with an in-pavement flasher system at the intersection of 1st Avenue NE and 4th Street NE in the downtown central business district. This location is uncontrolled and has several elements that can create conflicts between pedestrians, vehicles, and trains that service local industry. This report summarizes the results from a small-scale study completed by CTRE to evaluate the effectiveness of the in-pavement flasher system installed in downtown Cedar Rapids. The installation of in-pavement flashing warning lights at the pedestrian crosswalk at this site has had a net positive effect on the safety characteristics of the location. The results of this study show a marked improvement in motorist compliance with the state law requiring that motorists yield to pedestrians in the crosswalk. The pedestrian and motorist surveys show that both groups felt the in-pavement flashing lights have increased motorist awareness, especially at night. The data indicate the in-pavement flashing warning lights improved the motorists' response to pedestrians in the area, and that the system could be operational throughout summer and winter conditions.

Road Safety Audit for the US 61/Harrison Street and West Locust Street Intersection in Davenport-Scott County, Iowa, 2008

On the October 7 and 8, 2008, a road safety audit was conducted for the intersection of US 61/Harrison Street and West Locust Street in Davenport, Iowa. US 61/Harrison Street is a one-way street and a principal arterial route through Davenport, with three southbound lanes. Locust Street is a four-lane, two-way minor arterial running across the city from west to east. The last major improvement at this intersection was implemented approximately 20 years ago. The Iowa Department of Transportation requested a safety audit of this intersection in response to a high incidence of crashes at the location over the past several years, in view of the fact that no major improvements are anticipated for this intersection in the immediate future. The road safety audit team discussed current conditions at the intersection and reviewed the last seven years of crash data. The team also made daytime and nighttime field visits to the intersection to examine field conditions and observe traffic flow and crossing guard operations with younger pedestrians. After discussing key issues, the road safety audit team drew conclusions and suggested possible enforcement, engineering, public information, and educational strategies for mitigation.

Health consultation : Allied Products Corporation Targeted Brownfields Assessment 13th Avenue and E Street, Charles City, Floyd County, Iowa (2005)

The Iowa Department of Natural Resources (IDNR) has requested the Iowa Department of Public Health (IDPH) Hazardous Waste Site Health Assessment Program to evaluate environmental data collected at former farm equipment manufacturing facility located in Charles City, Iowa. The site, most recently operated by Allied Products Corporation, is a 70-acre site located at 13th Street and E Street in Charles City, Iowa (Figure 1). The site is undergoing a Targeted Brownfields Assessment conducted by the Contaminated Sites Section of the IDNR. This health consultation addresses potential health risks to people from future exposure to the soil within the property boundary, and any health impacts resulting from contaminated groundwater beneath the site property. The information in this health consultation was current at the time of writing. Data that emerges later could alter this document’s conclusions and recommendations.

Road Safety Audit for James Avenue NW and 250th Street NW, from the North Corporate Limits of Tiffin to I-380, in Johnson County, Iowa, 2010

To address safety concerns on James Avenue NW and 250th Street NW, from the North Corporate Limits (NCL) of Tiffin, north and east to I-380 (at North Liberty), the Johnson County engineer requested a road safety audit (RSA). The audit was conducted on September 1, 2010, through a program supported by the Office of Traffic and Safety at the Iowa Department of Transportation (DOT). This road is a seal-coated roadway, about 25-ft wide, but with only about 0-1 ft of earth shoulders. According to 2006 Iowa DOT estimates, traffic volume is about 820 vehicles per day, north from Tiffin to a commercial entrance on 250th Street, then increasing to 2,990 vehicles per day to the on-ramp of Interstate 380 (I-380). Local traffic uses this road as a short-cut to Cedar Rapids, North Liberty, and the I-380/I-80 interchange (to avoid congestion on IA 965). This report outlines the findings and recommendations of the road safety audit team for addressing the safety concerns on this roadway.

Health consultation : Former Chamberlain Manufacturing Site 550 Esther Street Waterloo, Black Hawk County, Iowa (2012)

The United States Environmental Protection Agency (EPA) has requested the Iowa Department of Public Health (IDPH) to evaluate the health impacts associated with exposure to contaminants of concern that have been found at the former Chamberlain Manufacturing Site. The EPA has been involved in the investigation and remediation of the Former Chamberlain Manufacturing Site since 2005. As part of these investigative activities, on-site soil sampling and both on-and off-site groundwater sampling has been completed. In addition, sub-slab soil gas, indoor air, and ambient air sampling at properties located near the Former Chamberlain Manufacturing Site has been completed. This health consultation addresses potential health risks to the public from exposure to the soil, groundwater and potential vapors within homes or buildings at or near the Former Chamberlain Manufacturing Site. The information in this health consultation was current at the time of writing. Data that emerges later could alter this document’s conclusions and recommendations.

Health consultation : Buchanan Bulk Oil -- Ma & Pa Stores West 6th Avenue and South F Street, Oskaloosa, Mahaska County, Iowa (2006)

The Iowa Department of Natural Resources (IDNR) has requested the Iowa Department of Public Health (IDPH) Hazardous Waste Site Health Assessment Program to evaluate the potential health impacts of the future development at the Buchanan Bulk Oil – Ma & Pa Stores site. A Targeted Brownfields Assessment was completed by the IDNR at this site to measure existing on-site contaminants. Assistance was sought from the IDPH to determine potential health risks if the site was developed for residential use. This health consultation addresses potential health risks to people from exposure to the contaminants found in the soil and groundwater within the property boundary. The information in this health consultation was current at the time of writing. Data that emerges later could alter this document’s conclusions and recommendations.

Health consultation : Iowa City former manufactured gas plant site, 505 Burlington Street, Iowa City, Johnson County, Iowa EPA facility ID: IAD984591172 (2006)

The United States Environmental Protection Agency (EPA) has requested the Iowa Department of Public Health (IDPH) Hazardous Waste Site Health Assessment Program to evaluate the health impacts of the proposed remedial strategy to be implemented at the Iowa City Former Manufactured Gas Plant Site (FMGP). The proposed remedial strategy to be implemented incorporates the following: 1) access restrictions through the continued operation of the Iowa-Illinois Manor and restriction on any future water well installation through continued implementation of a local environmental covenant; 2) previous site decommissioning activities that have restricted access to site contaminants; and 3) continued monitoring of the groundwater to ensure that contaminant levels in groundwater remain the same or are declining in concentration. This health consultation addresses potential health risks to people from exposure to the soil and vapors within the property. The information in this health consultation was current at the time of writing. Data that emerges later could alter this document’s conclusions and recommendations.

Differential diagnosis of leukocoria and strabismus, first presenting signs of retinoblastoma.

Leukocoria in infants is always a danger signal as retinoblastoma, a malignant retinal tumor, is responsible for half of the cases in this age group. More common signs should also be considered suspicious until proved otherwise, such as strabismus, the second most frequent sign of retinoblastoma. Less frequent manifestations are inflammatory conditions resistant to treatment, hypopyon, orbital cellulitis, hyphema or heterochromia. Other causal pathologies, including persistent hyperplastic primary vitreous (PHPV), Coats' disease, ocular toxocariasis or retinopathy of prematurity, may also manifest the same warning signs and require specialized differential diagnosis. Members of the immediate family circle are most likely to notice the first signs, the general practitioner, pediatrician or general ophthalmologist the first to be consulted. On their attitude will depend the final outcome of this vision and life-threatening disease. Early diagnosis is vital.

Health consultation : Rolfe aboveground storage tank petroleum bulk plant targeted brownfields assessment, Railroad Street and 300th Avenue, Rolfe, Pocahontas County, Iowa (2005)

The Iowa Department of Natural Resources (IDNR) has requested the Iowa Department of Public Health (IDPH) Hazardous Waste Site Health Assessment Program evaluate future health impacts of exposures at a former aboveground storage tank site located in Rolfe, Iowa. The former aboveground storage tank site is located to the southwest of the intersection of Railroad Street and 300th Avenue in Rolfe, Iowa. This site is undergoing a Targeted Brownfields Assessment conducted by the Contaminated Sites Section of the IDNR. This health consultation addresses potential health risks to people from future exposure to the soil within the property boundary, and any health impacts resulting from contaminated groundwater beneath the site property. The information in this health consultation was current at the time of writing. Data that emerges later could alter this document’s conclusions and recommendations.

Contemporary engagements within corridors of the past: temporal elasticity, graffiti, and the materiality of St. Rock Street, Barcelona

In a medieval Barcelonan side-street, urine, rubbish, and a bewildering array of graphic imagery splatters the narrowing walls between two major thoroughfares. A contemporary conflict between residents, unknown artists and others is played out using banners, bottles, stickers, posters, stencils, spray paint, and bodily substances. In this shadowed liminality, local and global debates are superimposed upon substructures constructed from disease, prostitution, and the Saint of the Plague. The continuing urban struggle constitutes temporal statements of dirt and purity, violence and humour, dominance and resistance, death and salvation. Like the renovated facades masking the crumbling remains of structures long neglected, the government’s literal whitewashing of the art is a temporal cover-up of a discursive symptom stretching from deeply embedded preconditions. However, from his niche in the angular bend of the alley bearing his name, the statue of St. Rock remains unblinkingly staring, raised above the contestations expressed below.

Interobserver agreement and validity of bedside 'positive signs' for functional weakness, sensory and gait disorders in conversion disorder: a pilot study.

BACKGROUND: Conversion disorder (CD) is no longer a diagnosis of exclusion. The new DSM-V criteria highlight the importance of 'positive signs' on neurological examination. Only few signs have been validated, and little is known about their reliability. OBJECTIVE: The aim was to examine the clinical value of bedside positive signs in the diagnosis of CD presenting with weakness, gait or sensory symptoms by assessing their specificity, sensitivity and their inter-rater reliability. PATIENTS AND METHODS: Standardised video recorded neurological examinations were performed in 20 consecutive patients with CD and 20 'organic' controls. Ten previously validated sensory and motor signs were grouped in a scale. Thirteen additional motor/sensory 'positive signs', 14 gait patterns and 1 general sign were assessed in a pilot validation study. In addition, two blinded independent neurologists rated the video recordings to assess the inter-rater reliability (Cohen's κ) of each sign. RESULTS: A score of ≥4/14 on the sensory motor scale showed a 100% specificity (CI 85 to 100) and a 95% sensitivity (CI 85 to 100). Among the additional tested signs, 10 were significantly more frequent in CD than controls. The interobserver agreement was acceptable for 23/38 signs (2 excellent, 10 good, 11 moderate). CONCLUSIONS: Our study confirms that six bedside 'positive signs' are highly specific for CD with good-excellent inter-rater reliability; we propose to consider them as 'highly reliable signs'. In addition 13 signs could be considered as 'reliable signs' and six further signs as 'suggestive signs' while all others should be used with caution until further validation is available.

Visual signs and symptoms in patients with the visual variant of Alzheimer disease.

BACKGROUND: Prominent visual symptoms can present in the visual variant of Alzheimer's disease (VVAD). Ophthalmologists have a significant role to play in the early diagnosis of VVAD. METHODS: We retrospectively reviewed the files of ten consecutive patients diagnosed with VVAD. All patients had a full neuro-ophthalmologic examination, a formal neurological and neuro-psychological testing, and cerebral MRI to confirm diagnosis. In addition, functional neuroimaging was obtained in seven patients. RESULTS: The common primary symptom at presentation with all patients was difficulty with near vision (reading difficulty n = 8, "visual blur" in near vision n = 2), and difficulty writing (n = 3). Following assessment, impaired reading and writing skills were evident in 9/10 and 8/10 patients respectively. Median distance visual acuity was 20/25 and at near the median visual acuity was J6. Partial homonymous visual field defect was detected in 80 % (8/10) of the patients. Color vision was impaired in all patients when tested with Ishihara pseudoisochromatic plates, but simple color naming was normal in 8/9 tested patients. Simultanagnosia was present in 8/10 patients. Vision dysfunction corresponded with cerebral MRI findings where parieto-occipital cortical atrophy was observed in all patients. PET scan (5 patients) or SPECT (2 patients) revealed parieto-occipital dysfunction (hypometabolism or hypoperfusion) in all 7 tested patients CONCLUSIONS: Visual difficulties are prominent in VVAD. Dyslexia, incomplete homonymous hemianopia, preserved color identification with abnormal color vision on Ishihara, and simultanagnosia were all symptoms observed frequently in this patient series. Ophthalmologists should be aware of the possibility of neurodegenerative disorders such as VVAD in patients with unexplained visual complaints, in particular reading difficulties.