Bruce Treadmill Test in Children : First Normal Values for Children from Western Europe : P67

Introduction: One of the main goals for exereise testing in children is evaluation of exercise capacity. There are many testing protocols, but the Bruce treadmill protocol is widely used among pediatrie cardiology centers. Thirty years ago, Cuming et al. were the first to establish normal values for children from North America (Canada) aged 4 to 18 years old. No data was ever published for children from Western Europe. Our study aimed to assess the validity of the normal values from Cuming et al. for children from Western Europe in the 21 st century. Methods: It is a retrospective cohort study in a tertiary care children's hospital. 144 children referred to our institution but finally diagnosed as having a normal heart underwent exercise stress testing using the Bruce protocol between 1999 and 2006. Data from 59 girls and 85 boys aged 6 to 18 were reviewed. Mean endurance time (ET) for each age category and gender was compared with the mean normal values fram Cumming et al by an unpaired t-test. Results: Mean ET increases with age until 15 years old in girls and then decreases. Mean endurance time increases continuouslY'from 6 to 18 years old in boys. The increase is more pronounced in boys than girls. In our study, a significant higher mean ET was found for boys in age categories 10 to 12, 13 to 15 and 16 to 18. No significant difference was found in any other groups. Conclusions: Some normal values from Cuming et al. established in 1978 for ET with the Bruce protocol are probably not appropriate any more today for children from Western Europe. Our study showed that mean ET is higher for boys from 10 to 18 years old. Despite common beliefs, cardiovascular conditioning doesn't seem yet reduced in children from Western Europe. New data for Bruce treadmill exercise. testing for healthy children, 4 to 18 years old, living in Western Europe are required. .

Pinpointing Suspect Triplicate Unconfined Compressive Strength Values in a Series of Soil-Additive Strength Determinations, HR-1, Progress Report, 1961

In recent years, various types of organic and inorganic materials have been investigated for use as soil stabilizing agents in the construction of highways and airports. Since the properties and environmental conditions of soils vary so greatly from place to place, a stabilizing agent that is suitable for one type of soil may not be satisfactory for another. As a result, it is often desirable to evaluate several stabilizing agents under varying treatment conditions before deciding on a specific one to be used with a given soil. In addition many research programs have been initiated which investigate the effects of these stabilizing agents upon soils.

Improving Traffic Safety Culture in Iowa, 2011

Vehicle crashes rank among the leading causes of death in the United States. In 2006, the AAA Foundation for Traffic Safety “made a long- term commitment to address the safety culture of the United States, as it relates to traffic safety, by launching a sustained research and educational outreach initiative.” An initiative to produce a culture of safety in Iowa includes the Iowa Comprehensive Highway Safety Plan (CHSP). The Iowa CHSP “engages diverse safety stakeholders and charts the course for the state, bringing to bear sound science and the power of shared community values to change the culture and achieve a standard of safer travel for our citizens.” Despite the state’s ongoing efforts toward highway safety, an average of 445 deaths and thousands of injuries occur on Iowa’s public roads each year. As such, a need exists to revisit the concept of safety culture from a diverse, multi-disciplinary perspective in an effort to improve traffic safety. This study summarizes the best practices and effective laws in improving safety culture in the United States and abroad. Additionally, this study solicited the opinions of experts in public health, education, law enforcement, public policy, social psychology, safety advocacy, and traffic safety engineering in a bid to assess the traffic safety culture initiatives in Iowa. Recommendations for improving traffic safety culture are offered in line with the top five Iowa CHSP safety policy strategies, which are young drivers, occupant protection, motorcycle safety, traffic safety enforcement and traffic safety improvement program, as well as the eight safety program strategies outlined in the CHSP. As a result of this study, eleven high-level goals were developed, each with specific actions to support its success. The goals are: improve emergency medical services response, toughen law enforcement and prosecution, increase safety belt use, reduce speeding-related crashes, reduce alcohol-related crashes, improve commercial vehicle safety, improve motorcycle safety, improve young driver education, improve older driver safety, strengthen teenage licensing process, and reduce distracted driving.

Reference values and factors associated with renal resistive index in a family-based population study.

Increased renal resistive index (RRI) has been recently associated with target organ damage and cardiovascular or renal outcomes in patients with hypertension and diabetes mellitus. However, reference values in the general population and information on familial aggregation are largely lacking. We determined the distribution of RRI, associated factors, and heritability in a population-based study. Families of European ancestry were randomly selected in 3 Swiss cities. Anthropometric parameters and cardiovascular risk factors were assessed. A renal Doppler ultrasound was performed, and RRI was measured in 3 segmental arteries of both kidneys. We used multilevel linear regression analysis to explore the factors associated with RRI, adjusting for center and family relationships. Sex-specific reference values for RRI were generated according to age. Heritability was estimated by variance components using the ASSOC program (SAGE software). Four hundred women (mean age±SD, 44.9±16.7 years) and 326 men (42.1±16.8 years) with normal renal ultrasound had mean RRI of 0.64±0.05 and 0.62±0.05, respectively (P<0.001). In multivariable analyses, RRI was positively associated with female sex, age, systolic blood pressure, and body mass index. We observed an inverse correlation with diastolic blood pressure and heart rate. Age had a nonlinear association with RRI. We found no independent association of RRI with diabetes mellitus, hypertension treatment, smoking, cholesterol levels, or estimated glomerular filtration rate. The adjusted heritability estimate was 42±8% (P<0.001). In a population-based sample with normal renal ultrasound, RRI normal values depend on sex, age, blood pressure, heart rate, and body mass index. The significant heritability of RRI suggests that genes influence this phenotype.

2012 Community Tree Management Plan, Alburnett, IA, June 24, 2013

This plan was developed to assist Alburnett with the management, budgeting and future planning of their urban forest. Across the state, forestry budgets continue to decrease with more and more of that money spent on tree removal. With the anticipated arrival of Emerald Ash Borer (EAB), an invasive pest that kills native ash trees, it is time to prepare for the increased costs of tree removal and replacement planting. With proper planning and management of the current canopy in Alburnett, these costs can be extended over years and public safety issues from dead and dying ash trees mitigated. Trees are an important component of Alburnett’s infrastructure and one of the greatest assets to the community. The benefits of trees are immense. Trees provide the community with improved air quality, stormwater runoff interception, energy conservation, lower traffic speeds, increased property values, reduced crime, improved mental health and create a desirable place to live, to name just a few benefits. It is essential that these benefits be maintained for the people of Alburnett and future generations through good urban forestry management. Good urban forestry management involves setting goals and developing management strategies to achieve these goals. An essential part of developing management strategies is a comprehensive public tree inventory. The inventory supplies information that will be used for maintenance, removal schedules, tree planting and budgeting. Basing actions on this information will help meet Alburnett’s urban forestry goals.

2012 Community Tree Management Plan, Avoca, IA, May 2, 2013

This plan was developed to assist Avoca with the management, budgeting and future planning of their urban forest. Across the state, forestry budgets continue to decrease with more and more of that money spent on tree removal. With the anticipated arrival of Emerald Ash Borer (EAB), an invasive pest that kills native ash trees, it is time to prepare for the increased costs of tree removal and replacement planting. With proper planning and management of the current canopy in Avoca, these costs can be extended over years and public safety issues from dead and dying ash trees mitigated. Trees are an important component of Avoca’s infrastructure and one of the greatest assets to the community. The benefits of trees are immense. Trees provide the community with improved air quality, stormwater runoff interception, energy conservation, lower traffic speeds, increased property values, reduced crime, improved mental health and create a desirable place to live, to name just a few benefits. It is essential that these benefits be maintained for the people of Avoca and future generations through good urban forestry management. Good urban forestry management involves setting goals and developing management strategies to achieve these goals. An essential part of developing management strategies is a comprehensive public tree inventory. The inventory supplies information that will be used for maintenance, removal schedules, tree planting and budgeting. Basing actions on this information will help meet Avoca’s urban forestry goals.

2012 Community Tree Management Plan, Belle Plaine, IA, June 24, 2013

This plan was developed to assist Belle Plaine with the management, budgeting and future planning of their urban forest. Across the state, forestry budgets continue to decrease with more and more of that money spent on tree removal. With the anticipated arrival of Emerald Ash Borer (EAB), an invasive pest that kills native ash trees, it is time to prepare for the increased costs of tree removal and replacement planting. With proper planning and management of the current canopy in Belle Plaine, these costs can be extended over years and public safety issues from dead and dying ash trees mitigated. Trees are an important component of Belle Plaine’s infrastructure and one of the greatest assets to the community. The benefits of trees are immense. Trees provide the community with improved air quality, stormwater runoff interception, energy conservation, lower traffic speeds, increased property values, reduced crime, improved mental health and create a desirable place to live, to name just a few benefits. It is essential that these benefits be maintained for the people of Belle Plaine and future generations through good urban forestry management. Good urban forestry management involves setting goals and developing management strategies to achieve these goals. An essential part of developing management strategies is a comprehensive public tree inventory. The inventory supplies information that will be used for maintenance, removal schedules, tree planting and budgeting. Basing actions on this information will help meet Belle Plaine’s urban forestry goals.

Reference values of fat-free and fat masses by bioelectrical impedance analysis in 3393 healthy subjects.

Determination of fat-free mass (FFM) and fat mass (FM) is of considerable interest in the evaluation of nutritional status. In recent years, bioelectrical impedance analysis (BIA) has emerged as a simple, reproducible method used for the evaluation of FFM and FM, but the lack of reference values reduces its utility to evaluate nutritional status. The aim of this study was to determine reference values for FFM, FM, and %FM by BIA in a white population of healthy subjects, to observe the changes in these values with age, and to develop percentile distributions for these parameters. Whole-body resistance of 1838 healthy white men and 1555 women, aged 15-64 y, was determined by using four skin electrodes on the right hand and foot. FFM and FM were calculated according to formulas validated for the subject groups and analyzed for age decades. This is the first study to present BIA-determined age- and sex-specific percentiles for FFM, FM, and %FM for healthy subjects, aged 15-64 y. Mean FM and %FM increased progressively in men and after age 45 y in women. The results suggest that any weight gain noted with age is due to a gain in FM. In conclusion, the data presented as percentiles can serve as reference to evaluate the normality of body composition of healthy and ill subject groups at a given age.

Country actions to meet UN commitments on non-communicable diseases: a stepwise approach.

Strong leadership from heads of state is needed to meet national commitments to the UN political declaration on non-communicable diseases (NCDs) and to achieve the goal of a 25% reduction in premature NCD mortality by 2025 (the 25 by 25 goal). A simple, phased, national response to the political declaration is suggested, with three key steps: planning, implementation, and accountability. Planning entails mobilisation of a multisectoral response to develop and support the national action plan, and to build human, financial, and regulatory capacity for change. Implementation of a few priority and feasible cost-effective interventions for the prevention and treatment of NCDs will achieve the 25 by 25 goal and will need only few additional financial resources. Accountability incorporates three dimensions: monitoring of progress, reviewing of progress, and appropriate responses to accelerate progress. A national NCD commission or equivalent, which is independent of government, is needed to ensure that all relevant stakeholders are held accountable for the UN commitments to NCDs.