Impacts on Safety of Left-Turn Treatment at High Speed Signalized Intersections, HR-347, 1994

Left-turning traffic is a major source of conflicts at intersections. Though an average of only 10% to 15% of all approach traffic turns left, these vehicles are involved in approximately 45% of all accidents. This report presents the results of research conducted to develop models which estimate approach accident rates at high speed signalized intersections. The objective of the research was to quantify the relationship between traffic and intersection characteristics, and accident potential of different left turn treatments. Geometric, turning movement counts, and traffic signal phasing data were collected at 100 intersections in Iowa using a questionnaire sent to municipalities. Not all questionnaires resulted in complete data and ultimately complete data were derived for 63 intersections providing a database of 248 approaches. Accident data for the same approaches were obtained from the Iowa Department of Transportation Accident Location and Analysis System (ALAS). Regression models were developed for two different dependent variables: 1) the ratio of the number of left turn accidents per approach to million left turning vehicles per approach, and 2) the ratio of accidents per approach to million traffic movements per approach. A number of regression models were developed for both dependent variables. One model using each dependent variable was developed for intersections with low, medium, and high left turning traffic volumes. As expected, the research indicates that protected left turn phasing has a lower accident potential than protected/permitted or permitted phasing. Left turn lanes and multiple lane approaches are beneficial for reducing accident rates, while raised medians increase the likelihood of accidents. Signals that are part of a signal system tend to have lower accident rates than isolated signals. The resulting regression models may be used to determine the likely impact of various left turn treatments on intersection accident rates. When designing an intersection approach, a traffic engineer may use the models to estimate the accident rate reduction as a result of improved lane configurations and left turn treatments. The safety benefits may then be compared to any costs associated with operational effects to the intersection (i.e., increased delay) to determine the benefits and costs of making intersection safety improvements.

Safety and functional outcome of thrombolysis in dissection-related ischemic stroke: a meta-analysis of individual patient data.

Background and Purpose-The safety and efficacy of thrombolysis in cervical artery dissection (CAD) are controversial. The aim of this meta-analysis was to pool all individual patient data and provide a valid estimate of safety and outcome of thrombolysis in CAD.Methods-We performed a systematic literature search on intravenous and intra-arterial thrombolysis in CAD. We calculated the rates of pooled symptomatic intracranial hemorrhage and mortality and indirectly compared them with matched controls from the Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register. We applied multivariate regression models to identify predictors of excellent (modified Rankin Scale=0 to 1) and favorable (modified Rankin Scale=0 to 2) outcome.Results-We obtained individual patient data of 180 patients from 14 retrospective series and 22 case reports. Patients were predominantly female (68%), with a mean +/- SD age of 46 +/- 11 years. Most patients presented with severe stroke (median National Institutes of Health Stroke Scale score=16). Treatment was intravenous thrombolysis in 67% and intra-arterial thrombolysis in 33%. Median follow-up was 3 months. The pooled symptomatic intracranial hemorrhage rate was 3.1% (95% CI, 1.3 to 7.2). Overall mortality was 8.1% (95% CI, 4.9 to 13.2), and 41.0% (95% CI, 31.4 to 51.4) had an excellent outcome. Stroke severity was a strong predictor of outcome. Overlapping confidence intervals of end points indicated no relevant differences with matched controls from the Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register.Conclusions-Safety and outcome of thrombolysis in patients with CAD-related stroke appear similar to those for stroke from all causes. Based on our findings, thrombolysis should not be withheld in patients with CAD. (Stroke. 2011;42:2515-2520.)

Snow Removal on Iowa's Secondary Roads, HR-267, 1984

Snow removal on the 90,000 mile Iowa secondary road system is a major concern of county engineers. Rural residents rely almost entirely on motor vehicles for travel. They have come to expect passable roads during all types of weather and as most county engineers know, the public is less tolerant of problems in snow removal than in any other highway department function. To avoid snow removal problems, maintenance personnel begin preparation before the winter maintenance season. The slide tape presentation, "Snow Removal on Iowa's Secondary Roads", was developed to assist in training and retraining maintenance personnel each year prior to winter. The program covers preparation for winter, snow and ice removal, and after storm care of equipment.

Test result-based sampling: an efficient design for estimating the accuracy of patient safety indicators.

OBJECTIVE: Accuracy studies of Patient Safety Indicators (PSIs) are critical but limited by the large samples required due to low occurrence of most events. We tested a sampling design based on test results (verification-biased sampling [VBS]) that minimizes the number of subjects to be verified. METHODS: We considered 3 real PSIs, whose rates were calculated using 3 years of discharge data from a university hospital and a hypothetical screen of very rare events. Sample size estimates, based on the expected sensitivity and precision, were compared across 4 study designs: random and VBS, with and without constraints on the size of the population to be screened. RESULTS: Over sensitivities ranging from 0.3 to 0.7 and PSI prevalence levels ranging from 0.02 to 0.2, the optimal VBS strategy makes it possible to reduce sample size by up to 60% in comparison with simple random sampling. For PSI prevalence levels below 1%, the minimal sample size required was still over 5000. CONCLUSIONS: Verification-biased sampling permits substantial savings in the required sample size for PSI validation studies. However, sample sizes still need to be very large for many of the rarer PSIs.

Drivers' Behavior at Railroad Grade Crossings: Before and After Safety Campaign, HR-335, 1992

In April 1991 the Iowa Department of Transportation, the CNW Transportation Company, the SOO Line, and local agencies and business in the Mason City/Clear Lake area initiated an Operation Lifesaver program to attempt to increase public awareness of safety issues and safe behavior at railroad-highway grade crossings. This document reports an initial study of data on traffic characteristics at a selected set of grade crossings in Cerro Gordo County taken before and after the safety program. Twenty-two crossings were studied. The 13 crossings at which collisions were reported for the five years prior to the study were included in the sample of sites. Two field observations were made at each study crossing before the Operation Lifesaver campaign was in full swing, and two observations were made after the conclusion of the main effort of the campaign. The summary of each data set is contained in a companion volume. The research shows that Operation Lifesaver altered drivers' behavior in the following ways: (1) reduced approach speeds and crossing speeds at crossings with low speed limits, (2) reduced the percent of drivers approaching the crossing at speeds in excess of the posted speed limit, and (3) increased alertness of drivers to railroad crossing hazards as evidenced by more drivers looking for a clear track. Thus, Operation Lifesaver enhanced safety in street and highway traffic operations in the vicinity of railroad-highway grade crossings.

Maintaining Iowa's Secondary Road Environment, HR-289, 1989

The Iowa counties have been successful in maintaining a good roadway environment on our 90,000 mile secondary road system. However, county highway personnel must remain vigilant in detecting, discovering and correcting potential problems if our roads are to remain so. This presentation was developed for those county personnel who work and travel on secondary roads. The presentation discusses things county personnel can look for during their daily operations which could possibly create a potential problem. If these situations are uncovered and corrected in a timely manner, our secondary road system will be maintained in an appropriate manner.

Efficacy and Safety of Certolizumab Pegol in an Unselected Crohn's Disease Population: 26 Week Data of the FACTS II Survey.

BACKGROUND: Certolizumab pegol (Cimzia, CZP) was approved for the treatment of Crohn's disease (CD) patients in 2007 in Switzerland as first country worldwide. This prospective phase IV study aimed to evaluate the efficacy and safety of CZP over 26 weeks in a multicenter cohort of practice-based patients. METHODS: Evaluation questionnaires at baseline, week 6 and 26 were completed by gastroenterologists in hospitals and private practices. RESULTS: Sixty patients (38F/22M) were included, 53% had complicated disease (stricturing or penetrating), 45% had undergone prior CD related surgery. All patients had prior exposure to systemic steroids, 96% to immunomodulators, 73% to infliximab, and 43% to adalimumab. A significant decrease of Harvey Bradshaw Index (HBI) was observed under CZP therapy (12.24.9 at week 0 vs 6.34.7 at week 6 and 6.75.3 at week 26, both P <0.001). Response and remission rates were 70% and 40% (week 6) and 67% and 36% respectively (week 26). The complete perianal fistula closure rate was 36% at week 6 and 55% at week 26. The frequency of adverse drug reactions attributed to CZP was 5%. CZP was continued in 88% of patients beyond week 6 and in 67% beyond week 26. CONCLUSIONS: In a population of CD patients with predominantly complicated disease behaviour, CZP proved to be effective in induction and maintenance of response and remission. This series provides the first evidence of CZP's effectiveness in perianal fistulizing CD in clinical practice.

Ralumac Latex Modified Asphalt, HR-2041, 1994

Some asphalt roadways tend to develop wheelpath ruts over time when exposed to heavy traffic. As the rutting increases in depth, the travel comfort and levels of safety decrease. A variety of remedies involving major or minor operations can be applied to eliminate ruts and renew the roadway surface. One of the simple remedies, called Ralumac microsurfacing, involves only a longitudinal band over the rut. For better coverage, ruts are filled initially and followed by a complete thin surface wearing cover over the roadway.

Evaluation of Experimental Data Obtained from Lightweight Aggregate Bridge Girders, HR-104, 1968

The use of lightweight aggregates in prestressed concrete is becoming more of a reality as our design criteria become more demanding. Bridge girders of greater lengths have been restricted from travel on many of our highways because the weight of the combined girders and transporting vehicle is excessive making hauls of any distance prohibitive. This, along with new safety recommendations, prompted the State of Iowa to investigate the use of lightweight aggregate bridge girders. A series of three projects was started to investigate the possibility of using lightweight aggregate in prestressed concrete. The object of this project is to study the effect which lightweight aggregate concrete has on the camber of bridge girders when used in a field situation.

Field Observation of Five Lightweight Aggregate Pretensioned Prestressed Bridge Beams, HR-104, 1969

The use of lightweight aggregates in pretensioned prestressed concrete beams is becoming more advantageous as our design criteria dictate longer span concrete bridges. Bridge beams of greater lengths have been restricted from travel on many of our highways because the weight of the combined beams and transporting vehicle was excessive, making hauls of any distance prohibitive. This, along with the fact that new safety requirements necessitate the use of longer spans in grade separation structures over major highways, prompted the State of Iowa to investigate the use of lightweight aggregate bridge beams. The objective of this project is the collection of field deflection measurements for five pretensioned prestressed lightweight aggregate concrete bridge beams fabricated by conventional plant processes; also the comparison of the actual cambers and deflections of the beams with that predicted from the design assumptions.

Sprinkle Treatment of Asphalt Surfaces, HR-199, 1984

Methods of improving highway safety are of major concern to everyone who is involved in the planning, development and construction of improvements of our vast highway network. Other major concerns are the conservation of our rapidly disappearing sources of energy and quality building materials. This research is devoted to further exploration of a process which will: 1. help preserve higher quality aggregates; and, 2. improve the frictional characteristics and surface texture of asphalt pavement surfaces. Sprinkle treatment of asphalt concrete pavement surfaces with a non-polishing aggregate, a procedure which was developed in Europe, is one method which has shown promise in accomplishing the above listed objectives. This research seeks to explore the feasibility and cost effectiveness of using standard asphalt mixtures of local, less expensive aggregates for surface courses followed by a surface sprinkle treatment of a hard, durable, non-polishing layer of precoated chips to produce a durable, non-skid pavement surface for safe highway travel. Three standard mixture types are being evaluated for aggregate retention characteristics and six sprinkle aggregates are being evaluated for durability, polishing and friction characteristics. In addition, measurements of the surface texture by the silicone putty method are being made. Another feature of this research is the evaluation of a rubberized asphalt material called Overflex MS as a crack filler. It has been reported that the material could be beneficial in reducing reflective cracking. The project was begun in July of 1978 and was completed in August. A review made in the spring of 1979 indicates very satisfactory performance. It was determined from slide photos taken after construction and again in the spring that aggregate retention was very good. However, many cracks had reflected indicating that the Overflex MS had not been effective. Follow up friction test results and texture analysis were also very good. The results of these tests are shown in Appendix A.

Evaluation of Gateway and Low-Cost Traffic-Calming Treatments for Major Routes in Small, Rural Communities, TR-523, 2007

Many rural communities have developed around highways or major county roads; as a result, the main street through small rural communities is often part of a high-speed rural highway. Highways and county roads are characterized by high speeds outside the city limits; they then transition into a reduced speed section through the rural community. Consequently, drivers passing through the community often enter at high speeds and maintain those speeds as they travel through the community. Traffic calming in small rural communities along major roadways is common in Europe, but the U.S. does not have experience with applying traffic-calming measures outside of major urban areas. The purpose of the project was to evaluate traffic-calming treatments on the major road through small Iowa communities using either single-measure low-cost or gateway treatments. The project was partially funded by the Iowa Highway Research Board (IHRB). The focus of the IHRB portion was to evaluate single-measure, low-cost, traffic-calming measures that are appropriate to major roads through small rural communities. Seven different low-cost traffic treatments were implemented and evaluated in five rural Iowa communities. The research evaluated the use of two gateway treatments in Union and Roland; five single-measure treatments (speed table, on-pavement “SLOW” markings, a driver speed feedback sign, tubular markers, and on-pavement entrance treatments) were evaluated in Gilbert, Slater, and Dexter.

The future of patient safety: Surgical trainees accept virtual reality as a new training tool.

BACKGROUND: The use of virtual reality (VR) has gained increasing interest to acquire laparoscopic skills outside the operating theatre and thus increasing patients' safety. The aim of this study was to evaluate trainees' acceptance of VR for assessment and training during a skills course and at their institution. METHODS: All 735 surgical trainees of the International Gastrointestinal Surgery Workshop 2006-2008, held in Davos, Switzerland, were given a minimum of 45 minutes for VR training during the course. Participants' opinion on VR was analyzed with a standardized questionnaire. RESULTS: Fivehundred-twenty-seven participants (72%) from 28 countries attended the VR sessions and answered the questionnaires. The possibility of using VR at the course was estimated as excellent or good in 68%, useful in 21%, reasonable in 9% and unsuitable or useless in 2%. If such VR simulators were available at their institution, most course participants would train at least one hour per week (46%), two or more hours (42%) and only 12% wouldn't use VR. Similarly, 63% of the participants would accept to operate on patients only after VR training and 55% to have VR as part of their assessment. CONCLUSION: Residents accept and appreciate VR simulation for surgical assessment and training. The majority of the trainees are motivated to regularly spend time for VR training if accessible.

Iowa Department of Public Safety Annual Report, FY2013

The Iowa Department of Public Safety (DPS) has a history of dedication and service to the citizens of Iowa and those who visit our state. Since it was first established in 1939, DPS has been the chief law enforcement agency in the State of Iowa. DPS is headquartered in Des Moines, Iowa in the Wallace State Office Building on the Capitol Complex, along with a statewide presence.

Iowa Department of Public Safety Annual Report, FY2012

The Iowa Department of Public Safety (DPS) has a history of dedication and service to the citizens of Iowa and those who visit our state. Since it was first established in 1939, DPS has been the chief law enforcement agency in the State of Iowa. DPS is headquartered in Des Moines, Iowa in the Wallace State Office Building on the Capitol Complex, along with a statewide presence.