Safety & You, September 2014

Iowa State University Police Department annually prepares and distributes “Safety & You” to all students, faculty, staff, as well as potential students and employees. Campus crime, arrest and referral statistics include those reported to the ISU Police, designated campus officials (including, but not limited to, Department of Residence, Dean of Students Office, athletic coaches, and advisors to student organizations), Ames Police and the Story County Sheriff’s Office. The ISU Counseling and Thielen Student Health Centers are exempted by patient confidentiality laws from disclosing reported information. Iowa State University does not have a voluntary confidential procedure for reporting crimes to law enforcement

Lapatax: Safety profile of neoadjuvant lapatinib combined with docetaxel in Her 2/neu overexpressing breast cancer - EORTC protocol 10054

Objective: To assess the safety/tolerability of the combination lapatinib (L) and docetaxel (D) in patients with Her 2/neu overexpressing breast cancer (BC). This study is important as it will define how to deliver lapatinib with taxotere, a highly active drug in breast cancer. Patients and Methods: Female patients (pts) with locally advanced, inflammatory or large operable BC were treated with escalating doses of L from 1000 to 1250 mg/day, in combination with D given IV every 21 days at doses ranging from 75 to 100 mg/m2 for 4 cycles. At least 3 pts were treated at each dose level. The definition of dose limiting toxicity (DLT) is based on the toxicity assessed at cycle 1 as follows: any grade 3−4 non hematological toxicity, ANC < 0.5 G/L lasting for 7 days or more, febrile neutropenia or thrombocytopenia <25 G/L. GCSF was not permitted as primary prophylaxis. Core biopsies were mandatory at baseline and after cycle 4. Pharmcokinetic (PK) samples were collected on day 1 of cycles 1 and 2. Results: To date, 18 pts with a median age of 53 years (range 36−65) have been enrolled at 5 Dose Levels (DLs). The toxicity profile for 18 patients (68 documented cycles) is summarized below. At DL5 (1000/100), 2 pts had DLTs (neutropenia grade 4 _7 days and febrile neutropenia), and 3 additional pts were enrolled with primary prophylactic G-CSF. As expected, the safety profile improved and the dose escalation will continue with prophylactic G-CSF to investigate DL6 (1250/100). These findings are consistent with published Phase I data for this combination [1]. N= 18 patients n (%) Grade 1 Grade 2 Grade 3 Grade 4 neutropenia 1 (6) 3 (17) 13 (72) febrile neutropenia 2 (11) fatigue 8 (44) 7 (39) diarrhoea 9 (50) 3 (17) pain: joint/muscle/other 5 (28)/4 (22)/3 (17) 4 (22)/4 (22)/3 (17) 0/0/1 (6) constipation 2 (11) 3 (17) 1 (6) elevated transaminases SGPT/SGOT 7 (39)/5 (28) Conclusions: The main toxicity of the L + D combination is haematological and was reached at DL5 (1000/100), without primary GCSF. An additional DL6 with primary prophylactic GCSF is being investigated (1250/100). PK data will be presented at the meeting plus the recommended dose for phase II studies.

Safety and efficacy of chronic therapy with captopril in hypertensive patients: an update

Captopril, an orally active angiotensin-converting enzyme inhibitor, has been administered to 81 patients with different types of clinical hypertension. Most of the patients had previously uncontrollable high blood pressure. In order to achieve a satisfactory blood pressure control during long-term captopril therapy, a concomitant decrease in total body sodium was required in more than half of the patients. During our first two years of clinical experience with this new antihypertensive agent, side effects developed in 46.9 per cent of the patients and necessitated the withdrawal of the drug in 23.4 per cent of all patients. Only a few side effects such as hypotensive or syncopal episodes and cold extremities appeared to be due to the chronic blockade of the renin-angiotensin system. The most frequent and the most serious adverse reactions such as skin rash, altered taste, pancytopenia, and pemphigus foliaceus seemed to be specifically drug related. The incidence of cutaneous and taste problems was markedly higher in patients with impaired renal function in whom retention of captopril has been previously demonstrated. This suggests that the occurrence of adverse reactions to captopril could be lowered in the future by using smaller daily doses and by titrating them according to the renal function.

Utility accommodation policy of the Iowa State Highway Commission, 1970

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa State Highway Commission exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway.

Utility accommodation policy of the Iowa State Highway Commission, 1973

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa State Highway Commission exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway. (1973 revision to 1970 policy.)

Policy for Accommodating Utilities on State Highway Rights-of-Way, 1985

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa Department of Transportation exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway. (1985 revision to 1973 policy.)

Policy of the Iowa Department of Transportation Highway Division For Accommodating Utilities on Primary Road System, 1990

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa Department of Transportation exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway. (1990 revision to 1985 policy.)

Policy of the Iowa Department of Transportation Highway Division For Accommodating Utilities on the Primary Road System, 1992

This chapter covers initial placement, adjustment, improvement, relocation, replacement and maintenance of utility facilities in, on, above or below the right-of-way over of primary highways, including attachments to primary highway structures. It embodies the basic specifications and standards needed, to ensure the safety of the highway user and the integrity of the highway. (1992 revision to 1990 policy.)

Multidisciplinary Safety Team (MDST) Factors of Success, 2014

This project included a literature review and summary that focused on subjects related to team building, team/committee member motivational strategies, and tools for effective and efficient committee meetings. It also completed an online survey of multidisciplinary safety team (MDST) members that focused on methods to increase meeting attendance and the identification of factors that make MDSTs successful. The survey had a response rate of about 15 percent. Finally, three small MDST focus groups were held and the participants discussed information similar to that investigated by the online survey. The results of these three activities were similar and complementary. In general, the outcomes of all three tasks show that a well-designed agenda that has items relevant to the meeting attendees is very important. In addition, the literature, online survey, and focus group results identified other characteristics that define a good team or MDST. Some of these characteristics included effective and consistent leadership, members that are allowed to provide input and have an impact, members that are vested in the activities of the group, and a match between the interests of the members and the focus/mission/purpose of the meetings/group. Meetings that are scheduled well in advance of the meeting date, include time for networking, local safety activity discussions, hands-on activities/tasks, and/or some type of educational or informational presentation or activity also appeared to be the most desirable. Lastly, it was shown that MDSTs can thrive and be successful through various means, but the ability to focus on a specific safety issue when the group is first organized was suggested as a benefit that could be of assistance for long-term sustainability.

Safety and Mobility Impacts of Winter Weather --Phase 3, SPR RB01-012, 2014

Highway agencies spend millions of dollars to ensure safe and efficient winter travel. However, the effectiveness of winter-weather maintenance practices on safety and mobility are somewhat difficult to quantify. Safety and Mobility Impacts of Winter Weather - Phase 1 investigated opportunities for improving traffic safety on state-maintained roads in Iowa during winter-weather conditions. In Phase 2, three Iowa Department of Transportation (DOT) high-priority sites were evaluated and realistic maintenance and operations mitigation strategies were also identified. In this project, site prioritization techniques for identifying roadway segments with the potential for safety improvements related to winter-weather crashes, were developed through traditional naïve statistical methods by using raw crash data for seven winter seasons and previously developed metrics. Additionally, crash frequency models were developed using integrated crash data for four winter seasons, with the objective of identifying factors that affect crash frequency during winter seasons and screening roadway segments using the empirical Bayes technique. Based on these prioritization techniques, 11 sites were identified and analyzed in conjunction with input from Iowa DOT district maintenance managers and snowplow operators and the Iowa DOT Road Weather Information System (RWIS) coordinator.

Calibration of Highway Safety Manual Work Zone Crash Modification Factors, TPF-5(081), 2014

The Highway Safety Manual is the national safety manual that provides quantitative methods for analyzing highway safety. The HSM presents crash modification factors related to work zone characteristics such as work zone duration and length. These crash modification factors were based on high-impact work zones in California. Therefore there was a need to use work zone and safety data from the Midwest to calibrate these crash modification factors for use in the Midwest. Almost 11,000 Missouri freeway work zones were analyzed to derive a representative and stratified sample of 162 work zones. The 162 work zones was more than four times the number of work zones used in the HSM. This dataset was used for modeling and testing crash modification factors applicable to the Midwest. The dataset contained work zones ranging from 0.76 mile to 9.24 miles and with durations from 16 days to 590 days. A combined fatal/injury/non-injury model produced a R2 fit of 0.9079 and a prediction slope of 0.963. The resulting crash modification factors of 1.01 for duration and 0.58 for length were smaller than the values in the HSM. Two practical application examples illustrate the use of the crash modification factors for comparing alternate work zone setups.

An Assessment of Traffic Safety in Urban Deer Herd Management Zones in Iowa, 2010

Many states are striving to keep their deer population to a sustainable and controllable level while maximizing public safety. In Iowa, measures to control the deer population include annual deer hunts and special deer herd management plans in urban areas. While these plans may reduce the deer population, traffic safety in these areas has not been fully assessed. Using deer population data from the Iowa Department of Natural Resources and data on deer-vehicle crashes and deer carcass removals from the Iowa Department of Transportation, the authors examined the relationship between deer-vehicle collisions, deer density, and land use in three urban areas in Iowa that have deer management plans in place (Cedar Rapids, Dubuque, and Iowa City) over the period 2002 to 2007. First, a comparison of deer-vehicle crash counts and deer carcass removal counts was conducted at the county level. Further, the authors estimated econometric models to investigate the factors that influence the frequency and severity of deer-vehicle crashes in these zones. Overall, the number of deer carcasses removed on the primary roads in these counties was greater than the number of reported deervehicle crashes on those roads. These differences can be attributed to a number of reasons, including variability in data reporting and data collection practices. In addition, high rates of underreporting of crashes were found on major routes that carry high volumes of traffic. This study also showed that multiple factors affect deer-vehicle crashes and corresponding injury outcomes in urban management zones. The identified roadway and non-roadway factors could be useful for identifying locations on the transportation system that significantly impact deer species and safety and for determining appropriate countermeasures for mitigation. Efforts to reduce deer density adjacent to roads and developed land and to provide wider shoulders on undivided roads are recommended. Improving the consistency and accuracy of deer carcass and deer-vehicle collision data collection methods and practices is also desirable.

A Survey of Traffic Safety Culture Among Iowa Adults, TS-1101, 2012

Iowa’s traffic safety culture is influenced by laws and policies, enforcement methods, driver education, roadway engineering, and drivers’ behaviors. The Center for Social and Behavioral Research at the University of Northern Iowa was contracted by the Iowa Department of Transportation to conduct a general population survey of adult Iowans. Telephone interviews were conducted with 1,088 adult Iowans from October to December 2011. A dual-frame (cell phone and landline) sampling design was used. The interview covered a wide range of traffic safety topics (e.g., traffic safety policies, enforcement techniques, and distracted driving). Most Iowans said driving in Iowa is about as safe now as it was 5 years ago; however, one-fourth said driving in Iowa is less safe now. There are a number of driving-related behaviors many adult Iowans consider serious threats to traffic safety and never acceptable to do while driving. Yet, many Iowans report often seeing other drivers engaging in these behaviors and admit engaging in some themselves. For example, nearly 1 in 5 adult Iowa drivers said they have sent or read a text message or email while driving in the past 30 days despite this being prohibited since July of 2011. A slight majority said they support using cameras on highways, interstates, and city streets to automatically ticket drivers for speeding, with even stronger support for red light cameras. A comprehensive approach to traffic safety in Iowa is required to encourage protective factors that enhance traffic safety and reduce the impact of detrimental factors.

Analysis of Safety Benefits for Shielding of Bridge Piers, 2009

The highway system in the State of Iowa includes many grade separation structures constructed to provide maximum safety and mobility to road users on intersecting roadways. However, these structures can present possible safety concerns for traffic passing underneath due to close proximity of piers and abutments. Shielding of these potential hazards has been a design consideration for many years. This study examines historical crash experience in the State of Iowa to address the advisability of shielding bridge piers and abutments as well as other structure support elements considering the offset from the traveled way. A survey of nine Midwestern states showed that six states had bridge pier shielding practices consistent with those in Iowa. Data used for the analyses include crash data (2001 to 2007) from the Iowa Department of Transportation (Iowa DOT), the Iowa DOT’s Geographic Information Management System (GIMS) structure and roadway data (2006) obtained from the Office of Transportation Data, and shielding and offset data for the bridges of interest. Additionally, original crash reports and the Iowa DOT video log were also utilized as needed. Grade-separated structures over high-speed, multilane divided Interstate and primary highways were selected for analysis, including 566 bridges over roadways with a speed limit of at least 45 mph. Bridges that met the criteria for inclusion in the study were identified for further analysis using crash data. The study also included economic analysis for possible shielding improvement.