Airborne exposures to monoethanolamine, glycol ethers, and benzyl alcohol during professional cleaning: a pilot study

A growing body of epidemiologic evidence suggests an association between exposure to cleaning products and respiratory dysfunction. Due to the lack of quantitative assessments of respiratory exposures to airborne irritants and sensitizers among professional cleaners, the culpable substances have yet to be identified.Purpose: Focusing on previously identified irritants, our aims were to determine (i) airborne concentrations of monoethanolamine (MEA), glycol ethers, and benzyl alcohol (BA) during different cleaning tasks performed by professional cleaning workers and assess their determinants; and (ii) air concentrations of formaldehyde, a known indoor air contaminant. METHODS: Personal air samples were collected in 12 cleaning companies, and analyzed by conventional methods. RESULTS: Nearly all air concentrations [MEA (n = 68), glycol ethers (n = 79), BA (n = 15), and formaldehyde (n = 45)] were far below (<1/10) of the corresponding Swiss occupational exposure limits (OEL), except for ethylene glycol mono-n-butyl ether (EGBE). For butoxypropanol and BA, no OELs exist. Although only detected once, EGBE air concentrations (n = 4) were high (49.48-58.72mg m(-3)), and close to the Swiss OEL (49mg m(-3)). When substances were not noted as present in safety data sheets of cleaning products used but were measured, air concentrations showed no presence of MEA, while the glycol ethers were often present, and formaldehyde was universally detected. Exposure to MEA was affected by its amount used (P = 0.036), and spraying (P = 0.000) and exposure to butoxypropanol was affected by spraying (P = 0.007) and cross-ventilation (P = 0.000). CONCLUSIONS: Professional cleaners were found to be exposed to multiple airborne irritants at low concentrations, thus these substances should be considered in investigations of respiratory dysfunctions in the cleaning industry; especially in specialized cleaning tasks such as intensive floor cleaning.

The nine-year sustained cost-containment impact of swiss pilot physicians-pharmacists quality circles.

BACKGROUND: Six pioneer physicians-pharmacists quality circles (PPQCs) located in the Swiss canton of Fribourg (administratively corresponding to a state in the US) were under the responsibility of 6 trained community pharmacists moderating the prescribing process of 24 general practitioners (GPs). PPQCs are based on a multifaceted collaborative process mediated by community pharmacists for improving compliance with clinical guidelines within GPs' prescribing practices. OBJECTIVE: To assess, over a 9-year period (1999-2007), the cost-containment impact of the PPQCs. METHODS: The key elements of PPQCs are a structured continuous quality improvement and education process; local networking; feedback of comparative and detailed data regarding costs, drug choice, and frequency of prescribed drugs; and structured independent literature review for interdisciplinary continuing education. The data are issued from the community pharmacy invoices to the health insurance companies. The study analyzed the cost-containment impact of the PPQCs in comparison with GPs working in similar conditions of care without particular collaboration with pharmacists, the percentage of generic prescriptions for specific cardiovascular drug classes, and the percentage of drug costs or units prescribed for specific cardiovascular drugs. RESULTS: For the 9-year period, there was a 42% decrease in the drug costs in the PPQC group as compared to the control group, representing a $225,000 (USD) savings per GP only in 2007. These results are explained by better compliance with clinical and pharmacovigilance guidelines, larger distribution of generic drugs, a more balanced attitude toward marketing strategies, and interdisciplinary continuing education on the rational use of drugs. CONCLUSIONS: The PPQC work process has yielded sustainable results, such as significant cost savings, higher penetration of generics and reflection on patient safety, and the place of "new" drugs in therapy. The PPQCs may also constitute a solid basis for implementing more comprehensive collaborative programs, such as medication reviews, adherence-enhancing interventions, or disease management approaches.

Development of Concepts for Pavement Management, MLR-79-04, 1979

Sufficient evidence was not discovered in this brief search to alter the general opinion that the Serviceability (Present Serviceability Index-PSI) - Performance Concepts developed by the AASHO Road Test provides the optimum engineering basis for pavement management. Use of these concepts in Iowa has the additional advantage in that we have a reasonable quantity of historical data over a period of time on the change in pavement condition as measured by PSI's. Some additional benefits would be the ability to better assess our needs with respect to those being recommended to Congress by AASHTO Committees. These concepts have been the basis used for developing policies on dimensions and weight of vehicles and highway needs which the AASHTO Transport Committees have recommended to the United States House Committee on Ways and Means. The first recommendation based on these concepts was made in the mid 1960's. Iowa's participation in the evaluation for this recommendation was under the direction of our present Director of Transportation, Mr. Raymond Kassel. PSI Indexes had to be derived from subjective surface ratings at that time. The most recent recommendation to Congress was made in November of 1977. Based on the rationale expressed above, a pilot study of the major part of the rural interstate system was conducted. The Objective of the study was to measure pavement performance through the use of the Present Serviceability Index (PSI) - Pavement Performance concepts as developed by the AASHO Road Test and to explore the usefulness of this type of data as a pavement management tool. Projects in the vicinity of the major urban centers were not included in this study due to the extra time that would be required to isolate accurate traffic data in these areas. Projects consisting of asphalt surface courses on crushed stone base sections were not included.

Embankment Quality Phase IV: Application to Unsuitable Soils, TR-492, 2007

The Quality Management Earthwork (QM-E) special provision was implemented on a pilot project to evaluate quality control (QC) and quality assurance (QA) testing in predominately unsuitable soils. Control limits implemented on this pilot project included the following: 95% relative compaction, moisture content not exceeding +/- 2% of optimum moisture content, soil strength not exceeding a dynamic cone penetrometer (DCP) index of 70 mm/blow, vertical uniformity not exceeding a variation in DCP index of 40 mm/blow, and lift thickness not exceeding depth determined through construction of control strips. Four-point moving averages were used to allow for some variability in the measured parameter values. Management of the QC/QA data proved to be one of the most challenging aspects of the pilot project. Implementing use of the G-RAD data collection system has considerable potential to reduce the time required to develop and maintain QC/QA records for projects using the QM-E special provision. In many cases, results of a single Proctor test were used to establish control limits that were used for several months without retesting. While the data collected for the pilot project indicated that the DCP index control limits could be set more tightly, there is not enough evidence to support making a change. In situ borings, sampling, and testing in natural unsuitable cut material and compacted fill material revealed that the compacted fill had similar strength characteristics to that of the natural cut material after less than three months from the start of construction.

Identification of Practices, Design, Construction, and Repair Using Trenchless Technology, TR-570, 2010

Trenchless technologies are methods used for the construction and rehabilitation of underground utility pipes. These methods are growing increasingly popular due to their versatility and their potential to lower project costs. However, the use of trenchless technologies in Iowa and their effects on surrounding soil and nearby structures has not been adequately documented. Surveys of and interviews with professionals working in trenchless-related industries in Iowa were conducted, and the results were analyzed and compared to survey results from the United States as a whole. The surveys focused on method familiarity, pavement distress observed, reliability of trenchless methods, and future improvements. Results indicate that the frequency of pavement distress or other trenchless-related issues are an ongoing problem in the industry. Inadequate soil information and quality control/quality assurance (QC/QA) are partially to blame. Fieldwork involving the observation of trenchless construction projects was undertaken with the purpose of documenting current practices and applications of trenchless technology in the United States and Iowa. Field tests were performed in which push-in pressure cells were used to measure the soil stresses induced by trenchless construction methods. A program of laboratory soil testing was carried out in conjunction with the field testing. Soil testing showed that the installations were made in sandy clay or well-graded sand with silt and gravel. Pipes were installed primarily using horizontal directional drilling with pipe diameters from 3 to 12 inches. Pressure cell monitoring was conducted during the following construction phases: pilot bore, pre-reaming, and combined pipe pulling and reaming. The greatest increase in lateral earth pressure was 5.6 psi and was detected 2.1 feet from the centerline of the bore during a pilot hole operation in sandy lean clay. Measurements from 1.0 to 2.5 psi were common. Comparisons were made between field measurements and analytical and finite element calculation methods.

Embankment Quality: Phase III, TR-401, 2002

This report describes test results from a full-scale embankment pilot study conducted in Iowa. The intent of the pilot project was to field test and refine the proposed soil classification system and construction specifications developed in Phase II of this research and to evaluate the feasibility of implementing a contractor quality control (QC) and Iowa DOT quality assurance (QA) program for earthwork grading in the future. One of the primary questions for Phase III is “Was embankment quality improved?” The project involved a “quality conscious” contractor, well-qualified and experienced Iowa Department of Transportation field personnel, a good QC consultant technician, and some of our best soils in the state. If the answer to the above question is “yes” for this project, it would unquestionably be “yes” for other projects as well. The answer is yes, the quality was improved, even for this project, as evidenced by dynamic cone penetrometer test data and the amount of disking required to reduce the moisture content to within acceptable control limits (approximately 29% of soils by volume required disking). Perhaps as important is that we know what quality we have. Increased QC/QA field testing, however, increases construction costs, as expected. The quality management-earthwork program resulted in an additional $0.03 per cubic meter, or 1.6%, of the total construction costs. Disking added about $0.04 per cubic meter, or 1.7%, to the total project costs. In our opinion this is a nominal cost increase to improve quality. It is envisioned that future contractor innovations have the potential for negating this increase. The Phase III results show that the new soil classification system and the proposed field test methods worked well during the Iowa Department of Transportation soils design phase and during the construction phase. Recommendations are provided for future implementation of the results of this study by city, county, and state agencies.

Development of LRFD Design Procedures for Bridge Piles in Iowa – Field Testing of Steel H-Piles in Clay, Sand, and Mixed Soils and Data Analysis (Volume II), TR-583, 2011

In response to the mandate on Load and Resistance Factor Design (LRFD) implementations by the Federal Highway Administration (FHWA) on all new bridge projects initiated after October 1, 2007, the Iowa Highway Research Board (IHRB) sponsored these research projects to develop regional LRFD recommendations. The LRFD development was performed using the Iowa Department of Transportation (DOT) Pile Load Test database (PILOT). To increase the data points for LRFD development, develop LRFD recommendations for dynamic methods, and validate the results of LRFD calibration, 10 full-scale field tests on the most commonly used steel H-piles (e.g., HP 10 x 42) were conducted throughout Iowa. Detailed in situ soil investigations were carried out, push-in pressure cells were installed, and laboratory soil tests were performed. Pile responses during driving, at the end of driving (EOD), and at re-strikes were monitored using the Pile Driving Analyzer (PDA), following with the CAse Pile Wave Analysis Program (CAPWAP) analysis. The hammer blow counts were recorded for Wave Equation Analysis Program (WEAP) and dynamic formulas. Static load tests (SLTs) were performed and the pile capacities were determined based on the Davisson’s criteria. The extensive experimental research studies generated important data for analytical and computational investigations. The SLT measured load-displacements were compared with the simulated results obtained using a model of the TZPILE program and using the modified borehole shear test method. Two analytical pile setup quantification methods, in terms of soil properties, were developed and validated. A new calibration procedure was developed to incorporate pile setup into LRFD.

Development of LRFD Procedures for Bridge Pile Foundations in Iowa Volume III: Recommended Resistance Factors with Consideration of Construction Control and Setup, TR-584, 2012

The Federal Highway Administration (FHWA) mandated utilizing the Load and Resistance Factor Design (LRFD) approach for all new bridges initiated in the United States after October 1, 2007. As a result, there has been a progressive move among state Departments of Transportation (DOTs) toward an increased use of the LRFD in geotechnical design practices. For the above reasons, the Iowa Highway Research Board (IHRB) sponsored three research projects: TR-573, TR-583 and TR-584. The research information is summarized in the project web site (http://srg.cce.iastate.edu/lrfd/). Two reports of total four volumes have been published. Report volume I by Roling et al. (2010) described the development of a user-friendly and electronic database (PILOT). Report volume II by Ng et al. (2011) summarized the 10 full-scale field tests conducted throughout Iowa and data analyses. This report presents the development of regionally calibrated LRFD resistance factors for bridge pile foundations in Iowa based on reliability theory, focusing on the strength limit states and incorporating the construction control aspects and soil setup into the design process. The calibration framework was selected to follow the guidelines provided by the American Association of State Highway and Transportation Officials (AASHTO), taking into consideration the current local practices. The resistance factors were developed for general and in-house static analysis methods used for the design of pile foundations as well as for dynamic analysis methods and dynamic formulas used for construction control. The following notable benefits to the bridge foundation design were attained in this project: 1) comprehensive design tables and charts were developed to facilitate the implementation of the LRFD approach, ensuring uniform reliability and consistency in the design and construction processes of bridge pile foundations; 2) the results showed a substantial gain in the factored capacity compared to the 2008 AASHTO-LRFD recommendations; and 3) contribution to the existing knowledge, thereby advancing the foundation design and construction practices in Iowa and the nation.

Implementation of a Pilot Continuous Monitoring System: Iowa Falls Arch Bridge, HR-1088, 2015

The goal of this work was to move structural health monitoring (SHM) one step closer to being ready for mainstream use by the Iowa Department of Transportation (DOT) Office of Bridges and Structures. To meet this goal, the objective of this project was to implement a pilot multi-sensor continuous monitoring system on the Iowa Falls Arch Bridge such that autonomous data analysis, storage, and retrieval can be demonstrated. The challenge with this work was to develop the open channels for communication, coordination, and cooperation of various Iowa DOT offices that could make use of the data. In a way, the end product was to be something akin to a control system that would allow for real-time evaluation of the operational condition of a monitored bridge. Development and finalization of general hardware and software components for a bridge SHM system were investigated and completed. This development and finalization was framed around the demonstration installation on the Iowa Falls Arch Bridge. The hardware system focused on using off-the-shelf sensors that could be read in either “fast” or “slow” modes depending on the desired monitoring metric. As hoped, the installed system operated with very few problems. In terms of communications—in part due to the anticipated installation on the I-74 bridge over the Mississippi River—a hardline digital subscriber line (DSL) internet connection and grid power were used. During operation, this system would transmit data to a central server location where the data would be processed and then archived for future retrieval and use. The pilot monitoring system was developed for general performance evaluation purposes (construction, structural, environmental, etc.) such that it could be easily adapted to the Iowa DOT’s bridges and other monitoring needs. The system was developed allowing easy access to near real-time data in a format usable to Iowa DOT engineers.

Laboratory Investigation of Grouted Coupler Connection Details for ABC Bridge Projects, RB07-013, 2015

With an ever increasing desire to utilize accelerated bridge construction (ABC) techniques, it is becoming critical that bridge designers and contractors have confidence in typical details. The Keg Creek Bridge on US 6 in Iowa was a recent ABC example that utilized connection details that had been utilized elsewhere. The connection details used between the drilled shaft and pier column and between the pier column and the pier cap were details needing evaluation. These connection details utilized grouted couplers that have been tested by others with mixed results—some indicating quality performance and others indicating questionable performance. There was a need to test these couplers to gain an understanding of their performance in likely Iowa details and to understand how their performance might be impacted by different construction processes. The objective of the work was to perform laboratory testing and evaluation of the grouted coupler connection details utilized on precast concrete elements for the Keg Creek Bridge. The Bridge Engineering Center (BEC), with the assistance of the Iowa Department of Transportation (DOT) Office of Bridges and Structures, developed specimens representative of the Keg Creek Bridge connections for testing under static and fatigue loads in the structures laboratory. The specimens were also evaluated for their ability to resist the intrusion of water and chlorides. Evaluation of their performance was made through comparisons with design assumptions and previous research, as well as the physical performance of the coupled connections.

Use of LIDAR-based Elevation Data for Highway Drainage Analysis: A Qualitative Assessment, 2003

US Geological Survey (USGS) based elevation data are the most commonly used data source for highway hydraulic analysis; however, due to the vertical accuracy of USGS-based elevation data, USGS data may be too “coarse” to adequately describe surface profiles of watershed areas or drainage patterns. Additionally hydraulic design requires delineation of much smaller drainage areas (watersheds) than other hydrologic applications, such as environmental, ecological, and water resource management. This research study investigated whether higher resolution LIDAR based surface models would provide better delineation of watersheds and drainage patterns as compared to surface models created from standard USGS-based elevation data. Differences in runoff values were the metric used to compare the data sets. The two data sets were compared for a pilot study area along the Iowa 1 corridor between Iowa City and Mount Vernon. Given the limited breadth of the analysis corridor, areas of particular emphasis were the location of drainage area boundaries and flow patterns parallel to and intersecting the road cross section. Traditional highway hydrology does not appear to be significantly impacted, or benefited, by the increased terrain detail that LIDAR provided for the study area. In fact, hydrologic outputs, such as streams and watersheds, may be too sensitive to the increased horizontal resolution and/or errors in the data set. However, a true comparison of LIDAR and USGS-based data sets of equal size and encompassing entire drainage areas could not be performed in this study. Differences may also result in areas with much steeper slopes or significant changes in terrain. LIDAR may provide possibly valuable detail in areas of modified terrain, such as roads. Better representations of channel and terrain detail in the vicinity of the roadway may be useful in modeling problem drainage areas and evaluating structural surety during and after significant storm events. Furthermore, LIDAR may be used to verify the intended/expected drainage patterns at newly constructed highways. LIDAR will likely provide the greatest benefit for highway projects in flood plains and areas with relatively flat terrain where slight changes in terrain may have a significant impact on drainage patterns.

Promotion of learning skills in the study of economics. pilot project in the subject area of

This communication is part of a larger teaching innovation project financed by the University ofBarcelona, whose objective is to develop and evaluate transversal competences of the UB, learningability and responsibility. The competence is divided into several sub-competencies being the ability toanalyze and synthesis the most intensely worked in the first year. The work presented here part fromthe results obtained in phase 1 and 2 previously implemented in other subjects (Mathematics andHistory) in the first year of the degree of Business Administration Degree. In these subjects’ previousexperiences there were deficiencies in the acquisition of learning skills by the students. The work inthe subject of Mathematics facilitated that students become aware of the deficit. The work on thesubject of History insisted on developing readings schemes and with the practical exercises wassought to go deeply in the development of this competence.The third phase presented here is developed in the framework of the second year degree, in the WorldEconomy subject. The objective of this phase is the development and evaluation of the same crosscompetence of the previous phases, from a practice that includes both, quantitative analysis andcritical reflection. Specifically the practice focuses on the study of the dynamic relationship betweeneconomic growth and the dynamics in the distribution of wealth. The activity design as well as theselection of materials to make it, has been directed to address gaps in the ability to analyze andsynthesize detected in the subjects of the first year in the previous phases of the project.The realization of the practical case is considered adequate methodology to improve the acquisition ofcompetence of the students, then it is also proposed how to evaluate the acquisition of suchcompetence. The practice is evaluated based on a rubric developed in the framework of the projectobjectives. Thus at the end of phase 3 we can analyze the process that have followed the students,detect where they have had major difficulties and identify those aspects of teaching that can help toimprove the acquisition of skills by the students. The interest of this phase resides in the possibility tovalue whether tracing of learning through competences, organized in a collaborative way, is a goodtool to develop the acquisition of these skills and facilitate their evaluation.

Effect of intradialytic resistance band exercise on physical function in patients on maintenance hemodialysis: a pilot study.

Although physical activity is recommended in patients on maintenance hemodialysis (MHD), randomized controlled trials testing the effects of exercise in this population have given conflicting results. In general, aerobic exercises mostly failed to produce improvements in physical function, whereas resistance exercises, although less studied, appeared to be more promising. The use of sophisticated materials such as leg press and free weights may preclude widespread application of resistance training in patients on MHD. Simple and cheap elastic bands may thus be an attractive alternative. We tested the feasibility of a supervised intradialytic resistance band exercise training program, and its effects on physical function, in patients on MHD. A total of 11 unselected adult patients on MHD from our center, aged 70 ± 10.7 (mean ± standard deviation) years, including 8 men and 3 women, accepted to follow the program under the supervision of qualified physiotherapists. Thirty-six exercise sessions of moderate intensity (twice a week, mean duration 40 minutes each, during 4.5 to 6 months), mainly involving leg muscles against an elastic resistance, were performed. The exercise program was well tolerated and all patients completed it. Statistically significant improvements were observed in the following tests: Tinetti test, 23.9 ± 3.9 points before versus 25.7 ± 3.5 points after the program (P = .022); the Timed Up and Go test, 12.1 ± 6.6 versus 10 ± 5.8 seconds (P = .0156). Improvements in the 6-minute walk distance and in the one-leg balance tests just failed to reach statistical significance. In this single-center pilot study, an intradialytic resistance band exercise program was feasible, well tolerated, and showed encouraging results on physical function.