Investigation of Warm-Mix Asphalt for Iowa Roadways, TR-635, 2013

Phase II of this study further evaluated the performance of plant-produced warm-mix asphalt (WMA) mixes by conducting additional mixture performance tests at a broader range of temperatures, adding additional pavements to the study, comparing virgin and recovered binder properties, performing pavement condition surveys, and comparing survey data with the Mechanistic Empirical Pavement Design Guide (MEPDG) forecast for pavement damage over 20 years of service life. Further objectives detailing curing behavior, quality assurance testing, and hybrid technologies were as follows: * Compare the predicted and observed field performance of existing WMA trials produced in the previous Phase I study to that of hot-mix asphalt (HMA) control sections to determine if Phase I conclusions are translating to the field; * Identify any curing effect (and timing of the effect) of WMA mixtures and binders in the field; * Determine how the field-compacted mixture properties and recovered binder properties of WMA compare to those of HMA over time for technologies common to Iowa; * Identify the protocols for WMA sample preparation for volumetric and performance testing that best simulate field conditions. The findings of this study indicate that WMA additives do show statistical differences in mixture properties in some of the mixes tested. These differences will not always be statistically different from mixture to mixture. Multiple factors, such as WMA additive type, amount of recycled asphalt material, construction conditions, and mixture variability all play a role in determining the extent of which WMA and HMA mixes differ. Other significant findings of this study include effects of curing, aging in recovered binders from HMA and WMA cores, and the influence of recycled asphalt shingles (RAS) used with WMA. These findings will be of interest to owner agencies and contractors utilizing WMA technologies.

Direct Effect of Birth Weight on Childhood Blood Pressure: a Causal Mediation Analysis

Background: Numerous studies have shown a negative association between birth weight (BW) and blood pressure (BP) later in life. To estimate the direct effect of BW on BP, it is conventional to condition on current weight (CW). However, such conditioning can induce collider stratification bias in the estimate of the direct effect. Objective: To bound the potential bias due to U, an unmeasured common cause of CW and BP, on the estimate of the (controlled) direct effect of BW on BP. Methods: Data from a school based study in Switzerland were used (N = 4,005; 2,010 B/1,995 G; mean age: 12.3 yr [range: 10.1-14.9]). Measured common causes of BW-BP (SES, smoking, body weight, and hypertension status of the mother) and CW-BP (breastfeeding and child's physical activity and diet) were identified with DAGs. Linear regression models were fitted to estimate the association between BW and BP. Sensitivity analyses were conducted to assess the potential effect of U on the association between BW and BP. U was assumed 1) to be a binary variable that affected BP by the same magnitude in low BWand in normal BW children and 2) to have a different prevalence in low BW children and in normal BW children for a given CW. Results: A small negative association was observed between BW and BP [beta: -0.3 mmHg/kg (95% CI: -0.9 to 0.3)]. The association was strengthened upon conditioning for CW [beta: -1.5 mmHg/kg (95% CI: -2.1 to -0.9)]. Upon further conditioning on common causes of BW-BP and CW-BP, the association did not change substantially [beta: -1.4 mmHg/kg (95% CI: -2.0 to -0.8)]. The negative association could be explained by U only if U was strongly associated with BP and if there was a large difference in the prevalence of U between low BWand normal BW children. Conclusion: The observed negative association between BW and BP upon adjustment for CW was not easily explained by an unmeasured common cause of CWand BP.

Mechanical ventilation in the newborn; a simplified approach. Part 2: High-frequency ventilation.

High frequency oscillatory ventilation (HFOV) is becoming an increasingly popular intervention in the neonatal intensive care unit. This article will attempt to explain the principles of HFOV. It is inherently more difficult to become skilled in this technique than in other forms of mechanical ventilation, so caution is warranted.

¿La sobreeducacion de los padres afecta al rendimiento academico de sus hijos?

El objetivo del trabajo consiste en analizar si el desajuste educativo de los progenitores afecta a los resultados educativos de los hijos. Para ello, se utilizan los microdatos de PISA-2009 para España, dado que facilita información detallada sobre el rendimiento educativo de los estudiantes, sus características personales y la de su entorno escolar y familiar lo que la hace idónea para llevar a cabo el estudio planteado. Los resultados obtenidos muestran que los estudiantes con progenitores sobreeducados tienen una penalización en su rendimiento académico en las tres materias analizadas, siendo ésta más intensa para los estudiantes con peores resultados educativos.

Shorter time since inflammatory bowel disease diagnosis in children is associated with lower mental health in parents.

AIM: This study assessed the mental health of parents of children with inflammatory bowel disease (IBD), compared their mental health with age-matched and gender-matched references and examined parental and child predictors for mental health problems. METHODS: A total of 125 mothers and 106 fathers of 125 children with active and inactive IBD from the Swiss IBD multicentre cohort study were included. Parental mental health was assessed by the Symptom Checklist 27 and child behaviour problems by the Strengths and Difficulties Questionnaire. Child medical data were extracted from hospital records. RESULTS: While the mothers reported lower mental health, the fathers' mental health was similar, or even better, than in age-matched and gender-matched community controls. In both parents, shorter time since the child's diagnosis was associated with poorer mental health. In addition, the presence of their own IBD diagnosis and child behaviour problems predicted maternal mental health problems. CONCLUSIONS: Parents of children with IBD may need professional support when their child is diagnosed, to mitigate distress. This, in turn, may help the child to adjust better to IBD. Particular attention should be paid to mothers who have their own IBD diagnosis and whose children display behaviour problems.

Determinants of maternal sex steroids during the first half of pregnancy.

OBJECTIVE: To examine the associations of maternal and child characteristics with early pregnancy maternal concentrations of testosterone, androstenedione, progesterone, 17-hydroxyprogesterone, and estradiol (E2). METHODS: We analyzed these hormones among 1,343 women with singleton pregnancies who donated serum samples to the Finnish Maternity Cohort from 1986 to 2006 during the first half of pregnancy (median 11 weeks). The associations of maternal and child characteristics with hormone concentrations were investigated by correlation and multivariable regression. RESULTS: Women older than age 30 years had lower androgen and E2 but higher progesterone concentrations than women younger than that age. Multiparous women had 14% lower testosterone, 11% lower androstenedione and 17-hydroxyprogesterone, 9% lower progesterone, and 16% lower E2 concentrations compared with nulliparous women (all P<.05). Smoking mothers had 11%, 18%, and 8% higher testosterone, androstenedione, and 17-hydroxyprogesterone levels, respectively, but 10% lower progesterone compared with nonsmoking women (all P<.05). E2 concentrations were 9% higher (P<.05) among women with a female fetus compared with those with a male fetus. CONCLUSION: Parity, smoking, and, to a lesser extent, maternal age and child sex are associated with sex steroid levels during the first half of a singleton pregnancy. The effects of smoking on the maternal hormonal environment and the possible long-term deleterious consequences on the fetus deserve further evaluation. LEVEL OF EVIDENCE: II.

2001 Iowa Termination of Pregnancy Report, March 3 2003

The total number of pregnancy terminations decreased from 7,602 in 2000 to 6,845 in 2001. This represents a 10% decrease. Induced termination decreased from 6,059 to 5,722 (a 6% decrease) and spontaneous termination decreased from 1,541 to 1,119 (a 27% decrease). Pregnancy terminations by maternal and child health regions (MCH) • The fertility rate for the state as a whole increased from 62.3 per 1,000 to 62.6 per 1,000, from 2000 to 2001. In 2000, 15 MCH regions had a higher rate than the statewide fertility rate, while in 2001, the number of MCH regions with a higher rate than the statewide fertility rate dropped to 12. Region 7 continued to have the highest fertility rate and region 12 continued to have the lowest rate. • The pregnancy rate decreased from 74.6 per 1,000 to 74.1 per 1,000. Region 16 continued to have the lowest pregnancy rate. However, region 23 had the highest pregnancy rate in 2001, compared to region 7 in 2000. • The induced termination rate decreased 0.6 per 1,000 and down to 9.4 per 1,000 in 2001. Compared to 2000 reports, two fewer regions had a higher rate than the statewide induced termination rate in 2001 (8 regions in 2000 vs. 6 regions in 2001). • The spontaneous termination rate for the state dropped to 1.8 per 1,000 from 2.5 per 1,000. The number of regions with a higher spontaneous termination rate decreased from 9 to 7. Region 14 had the highest rate, and region 20 had the lowest. • The statewide induced termination ratio increased from 145.7 per 1,000 to 149.6 per 1,000. Region 12 had the highest ratio for both years, and region 22 had the lowest ratio. • The statewide spontaneous termination ratio decreased from 39.7 per 1,000 to 29.3 per 1,000. One less region was higher, compared to 2000 data (9 regions in 2000 vs. 8 regions in 2001). In summary, the geographic distribution of the 2001 data showed a pattern similar to that seen in 2000. Generally, the frequency for both induced and spontaneous terminations decreased by month of occurrence, gestational age, marital status, and education level and mother’s age

Experiencias vividas por niños y niñas con cáncer a través de la musicoterapia: un proyecto de acción- participación

Justificación: este trabajo muestra una mirada más profunda acerca de cómo viven los niños y niñasla experiencia de vivir con el Cáncer, enfermedad que representa la primera causa de mortalidadentre los 5-14 años, en Cataluña.El profesional de Enfermería es clave en indagar y reflexionar acerca de la experiencia, y endesarrollar el papel que juega la intervención enfermera denominada Musicoterapia comoherramienta de expresión y comunicación, para descubrir que hay detrás de su realidad.Indagar en este contexto puede contribuir a mejorar la calidad de vida del colectivo infantil inmersoen la patología.Objetivo: conocer cómo viven la experiencia oncológica los niños y niñas, utilizando comoherramienta de trabajo la Musicoterapia en el escenario del Hospital Materno-Infantil Vall d´Hebrónde Barcelona.Diseño: proyecto de Investigación Acción-Participativa (IAP), enmarcado en el paradigma cualitativo.Metodología: se llevó a cabo una búsqueda en bases de datos: Pubmed, CINAHL, Cuiden, Cuidatge,entre otras y diferentes fuentes de información. Los sujetos de estudio fueron 14 niños y niñas entre8 y 12 años de edad ingresados en la planta de Oncología durante al menos 8 semanas. Para larecogida de datos se utilizaron las siguientes estrategias: entrevistas semiestructuradas, notas decampo y grupos de discusión.En cuanto al análisis mencionar que se siguió un riguroso trabajo para asignar unidades de significadoa la información obtenida.Consideraciones finales: Este proyecto ha permitido avanzar hacia el conocimiento enfermero yprofundizar en el cuidado holístico de los niños.

Conocimiento del método anticonceptivo de lactancia y amenorrea (MELA) en gestantes residentes en Logroño

El rol de la mujer ha evolucionado a ser el de una madre y trabajadora a la vez, originandocambios en las expectativas a la hora de tener descendencia, retrasando la edad de tener hijosy decidiendo crear núcleos pequeños 1, 2. Uno de los paradigmas enfermeros que se tiene encuenta en estas situaciones es el del autocuidado, por lo que como profesional en el campo dela planificación familiar, una de las labores es ofrecer información sobre los métodosanticonceptivos, adaptándolos a cada persona y en cada momento, según la situacióneconómica, social, física o emocional. De esta forma se podrían evitar los embarazos nodeseados y los maltratos infantiles. Uno de los métodos anticonceptivos naturales, que estáintegrado en la planificación familiar, es el método anticonceptivo lactancia-amenorrea. Éstees un método está basado en la fertilidad de la mujer cuando está realizando lactanciamaterna exclusiva.En este trabajo se propone investigar cuál es el grado de conocimiento que tienen las futurasmadres en la actualidad sobre este método anticonceptivo, ya que esto nos servirá de guíapara ofrecer la información necesaria, pudiendo reforzar los puntos débiles que se puedandetectar con éste estudio. Se propone un estudio multicéntrico, cuantitativo, observacional,descriptivo de corte transversal. Se administrará un cuestionario autoadministrado diseñado ad hoc, en una muestra de 148 gestantes durante el tercer trimestre (semana 32-38 de gestación), residentes en Logroño.

Performance Evaluation of Concrete Pavement Granular Subbase - Pavement Surface Condition Evaluation, TR-554, 2008

This research project covered a wide range of activities that allowed researchers to understand the relationship between stability, pavement distress, and recycled portland cement concrete (RPCC) subbase aggregate materials. Detailed laboratory and field tests, including pavement distress surveys, were conducted at 26 sites in Iowa. Findings show that specific gravities of RPCC are lower than those of crushed limestone. RPCC aggregate material varies from poorly or well-graded sand to gravel. A modified Micro-Deval test procedure showed that abrasion losses of virgin aggregate materials were within the maximum Micro-Deval abrasion loss of 30% recommended by ASTM D6028-06. Micro-Deval abrasion loss of RPCC aggregate materials, however, was much higher than that of virgin materials and exceeded 30% loss. Modulus of elasticity of RPCC subbase materials is high but variable. RPCC subbase layers normally have low permeability. The pavement surfaces for both virgin and RPCC subbase across Iowa were evaluated to fulfill the objectives of this study related to field evaluation. Visual distress surveys were conducted to gather the detailed current pavement condition information including the type, extent, and severity of the pavement distresses. The historical pavement condition information for the surveyed field sections was extracted from the Iowa DOT's Pavement Management Information System (PMIS). The current surface condition of existing field pavements with RPCC subbase was compared with the virgin aggregate subbase sections using two different approaches. The changes in pavement condition indices (PCI and IRI) with time for both types of pavements (subbases) were compared.

Outcome of severe unilateral cerebellar hypoplasia.

Aim: Complete or subtotal absence of one cerebellar hemisphere is exceptional; only single cases have been described. We aimed to assess the long-term outcome in children with severe unilateral cerebellar hypoplasia (UCH). Method: As part of a retrospective study we describe neuroimaging features, clinical findings, and cognitive outcomes of seven children with UCH (five males, two females; age at first magnetic resonance imaging [MRI]: median 1y 3mo, range 9d-8y 10mo; age at latest follow-up: median 6y 6mo, range 2y 3mo-14y 11mo). Results: One child had abnormalities on prenatal MRI at 21 weeks' gestation. The left cerebellar hemisphere was affected in five children, and the right hemisphere in two children. The vermis was involved in five children. The volume of the posterior fossa was variable. At the latest follow-up, neurological findings included truncal ataxia and muscular hypotonia in five children, limb ataxia in three patients, and head nodding in two patients. Three children had learning disability*, five had speech and language disorders, and one had a severe behavioural disorder. Interpretation: Severe UCH is a residual change after a disruptive prenatal cerebellar insult, most likely haemorrhagic. The outcome is variable, ranging from almost normal development to marked developmental impairment. Ataxia is a frequent but not a leading sign. It seems that involvement of the cerebellar vermis is often, but not consistently, associated with a poorer cognitive outcome, whereas an intact vermis is associated with normal outcome and no truncal ataxia.

Iowa’s Title V Block Grant Executive Summary, 2013

Title V of the Social Security Act is the longest-standing public health legislation in American history. Enacted in 1935, Title V is a federal-state partnership that promotes and improves maternal and child health (MCH). According to each state’s unique needs, Title V supports a spectrum of services, from infrastructure building services like quality assurance and policy development, to gap-filling direct health care services. Title V resources are directed towards MCH priority populations: pregnant women, mothers, infants, women of reproductive years, children and adolescents and children and youth with special health care needs.

Abuelos contemporáneos : ¿dónde está el límite?

En la sociedad actual están aconteciendo una serie de cambios en la estructura de lafamilia, en su ciclo y evolución, en los roles tradicionales, en la aparición de nuevosroles y en las relaciones intergeneracionales. Esta situación cambiante afecta al rol deabuelo y abuela y, en la actualidad, nadie cuestionará la importancia que estánadquiriendo los abuelos/as en las relaciones familiares, ya que el número de personasque llegan a ser abuelos/as aumenta, así como también crece el número de años quelos abuelos/as pueden compartir con sus nietos. Estos cambios han hecho que lafigura de los abuelos/as recupere su importancia dentro de la familia y adquiera unnotable protagonismo y una valiosa función social produciéndose una mayorintegración de los abuelos/as en la familia. En esta nueva situación social y familiarresulta especialmente importante el estudio de las características del rol de abuelo/aactual y de la relación y actividades que comparte con su nieto/a. Con estainvestigación se pretende examinar la relación abuelo nieto en la infancia, desde laperspectiva de los abuelos/as así como las repercuciones del cuidado de los nietos enla salud de éstos

Neuromotor development in children. Part 3: motor performance in 3- to 5-year-olds.

AIM: The aim of this cross-sectional study was to provide normative data (ordinal scores and timed performances) for gross and fine motor tasks in typically developing children between 3 and 5 years of age using the Zurich Neuromotor Assessment (ZNA). METHOD: Typically developing children (n=101; 48 males, 53 females) between 3 and 5 years of age were enrolled from day-care centres in the greater Zurich area and tested using a modified version of the ZNA; the tests were recorded digitally on video. Intraobserver reliability was assessed on the videos of 20 children by one examiner. Interobserver reliability was assessed by two examiners. Test-retest reliability was performed on an additional 20 children. The modelling approach summarized the data with a linear age effect and an additive term for sex, while incorporating informative missing data in the normative values. Normative data for adaptive motor tasks, pure motor tasks, and static and dynamic balance were calculated with centile curves (for timed performance) and expected ordinal scores (for ordinal scales). RESULTS: Interobserver, intraobserver, and test-retest reliability of tasks were moderate to good. Nearly all tasks showed significant age effects, whereas sex was significant only for stringing beads and hopping on one leg. INTERPRETATION: These results indicate that timed performance and ordinal scales of neuromotor tasks can be reliably measured in preschool children and are characterized by developmental change and high interindividual variability.

Ability of different adiposity indicators to identify children with elevated blood pressure.

OBJECTIVE: Body composition measured by dual-energy X-ray absorptiometry (DXA) is believed to be superior to crude measures such as BMI or waist circumference (WC) to assess health risks associated with adiposity in adults. We compared the ability of BMI, WC, waist-to-height ratio (WHtR), percentage body fat from skinfold thickness, and measures of total and central fat assessed by DXA to identify children with elevated blood pressure (BP). STUDY DESIGN: The QUALITY Study follows 630 Caucasian families (father, mother, and child originally aged 8-10 years). BP, height, weight, WC, and skinfold thickness were measured according to standardized protocols. Elevated BP was defined as systolic or diastolic BP at least 90th age, sex, and height-specific percentile. Total and central fat were determined with DXA. The area under the receiver operating characteristic (ROC) curve (AUC) statistic was computed from logistic models that adjusted for age, sex, height, Tanner stage, and physical activity. RESULTS: All adiposity indicators were highly correlated. WC and WHtR did not show superior ability over BMI to identify children with elevated SBP (P = 0.421 and 0.473). Measures of total and central fat from DXA did not show an improved ability over BMI or WC to identify children with elevated SBP (P = 0.325-0.662). CONCLUSION: Results support the use of BMI in clinical and public health settings, at least in this age group. As all indicators had a limited ability to identify children with elevated BP, results also support measurement of BP in all children of this age independent of a weight status.