907 resultados para single-case research design


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According to 23 CFR § 450.214(a), “The State shall develop a long-range statewide transportation plan, with a minimum 20-year forecast period at the time of adoption, that provides for the development and implementation of the multimodal transportation system for the State.” The state transportation plan (Plan) is a document that will address this requirement and serve as a transportation investment guide between now and 2040. Iowa’s most recent plan was developed by the Iowa Department of Transportation and adopted in 1997 through a planning process called Iowa in Motion. Much of Iowa in Motion has been implemented and this Plan, "Iowa in Motion – Planning Ahead," will build on the success of its predecessor. The Plan projects the demand for transportation infrastructure and services to 2040 based on consideration of social and economic changes likely to occur during this time. Iowa’s economy and the need to meet the challenges of the future will continue to place pressure on the transportation system. With this in mind, the Plan will provide direction for each transportation mode, and will support a renewed emphasis on efficient investment and prudent, responsible management of our existing transportation system. In recent years, the Iowa DOT has branded this philosophy as stewardship. As Iowa changes and the transportation system evolves, one constant will be that the safe and efficient movement of Iowans and our products is essential for stable growth in Iowa’s economy. Iowa’s extensive multimodal and multijurisdictional transportation system is a critical component of economic development and job creation throughout the state.

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An adequate air void system is imperative to produce concrete with freeze-thaw durability in a wet freeze environment such as found in Iowa. Specifications rely on a percentage of air obtained in the plastic state by the pressure meter. Actual, in place air contents, of some concrete pavements in Iowa, have been found with reduced air content due to a number of factors such as excessive vibration and inadequate mixing. Determining hardened air void parameters is a time consuming process involving potential for human error. The RapidAir 457 air void analyzer is an automated device used to determine hardened air void parameters. The device is used in Europe and has been shown to quickly produce accurate and repeatable hardened air results. This research investigates how well the RapidAir 457 results correlate to plastic air content and the image analysis air technique. The repeatability and operator variation were also investigated, as well as, the impact of aggregate porosity and selection of threshold value on hardened air results.

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The Missouri River Flood Recovery newsletter is published by the Iowa Homeland Security and Emergency Management Division in cooperation with members of the Missouri River Recovery Coordination Task Force.

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The Missouri River Flood Recovery newsletter is published by the Iowa Homeland Security and Emergency Management Division in cooperation with members of the Missouri River Recovery Coordination Task Force.

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The Missouri River Flood Recovery newsletter is published by the Iowa Homeland Security and Emergency Management Division in cooperation with members of the Missouri River Recovery Coordination Task Force.

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The Missouri River Flood Recovery newsletter is published by the Iowa Homeland Security and Emergency Management Division in cooperation with members of the Missouri River Recovery Coordination Task Force.

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The Missouri River Flood Recovery newsletter is published by the Iowa Homeland Security and Emergency Management Division in cooperation with members of the Missouri River Recovery Coordination Task Force.

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The development of new rail systems in the first part of the 21st century is the result of a wide range of trends that are making it increasingly difficult to maintain regional mobility using the two dominant intercity travel modes, auto and air. These trends include the changing character of the economic structure of industry. The character of the North American industrial structure is moving rapidly from a manufacturing base to a service based economy. This is increasing the need for business travel while the increase in disposable income due to higher salaries has promoted increased social and tourist travel. Another trend is the change in the regulatory environment. The trend towards deregulation has dramatically reduced the willingness of the airlines to operate from smaller airports and the level of service has fallen due to the creation of hub and spoke systems. While new air technology such as regional jets may mitigate this trend to some degree in medium-size airports, smaller airports will continue to lose out. Finally, increasing environmental concerns have reduced the ability of the automobile to meet intercity travel needs because of increased suburban congestion and limited highway capacity in big cities. Against this background the rail mode offers new options due to first, the existing rail rights-of-way offering direct access into major cities that, in most cases, have significant capacity available and, second, a revolution in vehicle technology that makes new rail rolling stock faster and less expensive to purchase and operate. This study is designed to evaluate the potential for rail service making an important contribution to maintaining regional mobility over the next 30 to 50 years in Iowa. The study evaluates the potential for rail service on three key routes across Iowa and assesses the impact of new train technology in reducing costs and improving rail service. The study also considers the potential for developing the system on an incremental basis. The service analysis and recommendations do not involve current Amtrak intercity service. That service is presumed to continue on its current route and schedule. The study builds from data and analyses that have been generated for the Midwest Rail Initiative (MWRI) Study. For example, the zone system and operating and capital unit cost assumptions are derived from the MWRI study. The MWRI represents a cooperative effort between nine Midwest states, Amtrak and the Federal Railroad Administration (FRA) contracting with Transportation Economics & Management Systems, Inc. to evaluate the potential for a regional rail system. The 1 The map represents the system including the decision on the Iowa route derived from the current study. Iowa Rail Route Alternatives Analysis TEMS 1-2 system is to offer modern, frequent, higher speed train service to the region, with Chicago as the connecting hub. Exhibit 1-1 illustrates the size of the system, and how the Iowa route fits in to the whole.

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Evidence-based (EBP) aims for a new distribution of power centered on scientific evidence rather than clinical expertise. The present article describes the operational process of EBP by describing the implementation stages of this type of practise. This stage presentation is essential given that there are many conceptions end models of EBP and that some nurses have a limited knowledge of its rules ans implications. Given that number and formulation of the stages varies by author, the process presented here attempts to integrate the different stages reviewed.

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Amplified Fragment Length Polymorphisms (AFLPs) are a cheap and efficient protocol for generating large sets of genetic markers. This technique has become increasingly used during the last decade in various fields of biology, including population genomics, phylogeography, and genome mapping. Here, we present RawGeno, an R library dedicated to the automated scoring of AFLPs (i.e., the coding of electropherogram signals into ready-to-use datasets). Our program includes a complete suite of tools for binning, editing, visualizing, and exporting results obtained from AFLP experiments. RawGeno can either be used with command lines and program analysis routines or through a user-friendly graphical user interface. We describe the whole RawGeno pipeline along with recommendations for (a) setting the analysis of electropherograms in combination with PeakScanner, a program freely distributed by Applied Biosystems; (b) performing quality checks; (c) defining bins and proceeding to scoring; (d) filtering nonoptimal bins; and (e) exporting results in different formats.

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Introduction.- Retinoids are effective and widely used for the treatment of severe acne. Their use can be, however, associated with numerous side effects. For example, some rare cases of premature epiphyseal closure were reported.Observation.- A sixteen-year-old soccer player consulted for bilateral progressive anterior knee pain, since two months, evoking a femoro-patellar origin. After physiotherapy, the pain decreases on the right but remained on the left. The history taking brought out the use of isotretinoin for more than 6 months (0.5 mg/kg). Magnetic resonance imaging (MRI) findings showed an irregularity of the growth plate and an important metaphyso-epiphyseal oedema, more marked on the left. The diagnosis of retinoid induced premature ephysieal closure was retained. The treatment was stopped, with a resolution of symptoms within two months. The control MRI of the left knee present persisting small sequelar thumbprint-like growth plate lesion. Eighteen months later, neither limb-length discrepancy nor static disorder was noticed.Discussion.- Premature epiphyseal closure is a rare complication of retinoid treatment of acne. Retinoids induce an invasion of the growth plate by osteoclasts and a decrease in proteoglycans synthesis. The knee seems the most involved joint. The clinical presentation is aspecific, sometimes lightly symptomatic. A careful pharmacological history and an appropriate imaging are necessary. MRI is now the gold standard. It shows an irregularity of the growth plate with an oedema on both sides. In chronic phase, a thumbprint-like image may persist. The symptoms resolution arises in few weeks after the treatment interruption. A single case of static disorder was reported until now. The small size of the growth plate interruptions, insufficient to lead to a growth disorder if the medicament is stopped early enough, explains probably it. This complication being rare, a radiological follow-up of the young patients treated by retinoids is not proposed.

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BACKGROUND: Little is known about how to most effectively deliver relevant information to patients scheduled for endoscopy. METHODS: To assess the effects of combined written and oral information, compared with oral information alone on the quality of information before endoscopy and the level of anxiety. We designed a prospective study in two Swiss teaching hospitals which enrolled consecutive patients scheduled for endoscopy over a three-month period. Patients were randomized either to receiving, along with the appointment notice, an explanatory leaflet about the upcoming examination, or to oral information delivered by each patient's doctor. Evaluation of quality of information was rated on scales between 0 (none received) and 5 (excellent). The analysis of outcome variables was performed on the basis of intention to treat-analysis. Multivariate analysis of predictors of information scores was performed by linear regression analysis. RESULTS: Of 718 eligible patients 577 (80%) returned their questionnaire. Patients who received written leaflets (N = 278) rated the quality of information they received higher than those informed verbally (N = 299), for all 8 quality-of-information items. Differences were significant regarding information about the risks of the procedure (3.24 versus 2.26, p < 0.001), how to prepare for the procedure (3.56 versus 3.23, p = 0.036), what to expect after the procedure (2.99 versus 2.59, p < 0.001), and the 8 quality-of-information items (3.35 versus 3.02, p = 0.002). The two groups reported similar levels of anxiety before procedure (p = 0.66), pain during procedure (p = 0.20), tolerability throughout the procedure (p = 0.76), problems after the procedure (p = 0.22), and overall rating of the procedure between poor and excellent (p = 0.82). CONCLUSION: Written information led to more favourable assessments of the quality of information and had no impact on patient anxiety nor on the overall assessment of the endoscopy. Because structured and comprehensive written information is perceived as beneficial by patients, gastroenterologists should clearly explain to their patients the risks, benefits and alternatives of endoscopic procedures. Trial registration: Current Controlled trial number: ISRCTN34382782.

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Oculofaciocardiodental (OFCD) and Lenz microphthalmia syndromes form part of a spectrum of X-linked microphthalmia disorders characterized by ocular, dental, cardiac and skeletal anomalies and mental retardation. The two syndromes are allelic, caused by mutations in the BCL-6 corepressor gene (BCOR). To extend the series of phenotypes associated with pathogenic mutations in BCOR, we sequenced the BCOR gene in patients with (1) OFCD syndrome, (2) putative X-linked ('Lenz') microphthalmia syndrome, (3) isolated ocular defects and (4) laterality phenotypes. We present a new cohort of females with OFCD syndrome and null mutations in BCOR, supporting the hypothesis that BCOR is the sole molecular cause of this syndrome. We identify for the first time mosaic BCOR mutations in two females with OFCD syndrome and one apparently asymptomatic female. We present a female diagnosed with isolated ocular defects and identify minor features of OFCD syndrome, suggesting that OFCD syndrome may be mild and underdiagnosed. We have sequenced a cohort of males diagnosed with putative X-linked microphthalmia and found a mutation, p.P85L, in a single case, suggesting that BCOR mutations are not a major cause of X-linked microphthalmia in males. The absence of BCOR mutations in a panel of patients with non-specific laterality defects suggests that mutations in BCOR are not a major cause of isolated heart and laterality defects. Phenotypic analysis of OFCD and Lenz microphthalmia syndromes shows that in addition to the standard diagnostic criteria of congenital cataract, microphthalmia and radiculomegaly, patients should be examined for skeletal defects, particularly radioulnar synostosis, and cardiac/laterality defects.

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In most highway asset management exercises, real estate used in alignments is considered to be an asset class that does not depreciate. Although the treatment of right of way assets as non-depreciable real property may be appropriate as an accounting exercise, the fact is that the real estate contained in transportation corridors can in fact lose value from a traffic service point of view. Such facilities become functionally obsolete in that they no longer serve the purpose that was intended when they were planned, designed, and built. This report is intended to begin a discussion of the topic of how highway alignments ought be valued as assets as opposed to how they generally are valued, at either book value or replacement value, given it can be shown that some highway alignments do in fact depreciate in value.

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This document describes planned investments in Iowa’s multimodal transportation system including aviation, transit, railroads, trails, and highways. A large part of funding available for highway programming comes from the federal government. Accurately estimating future federal funding levels is dependent on having a multiyear federal transportation authorization bill in place and having a sustainable and solvent federal Highway Trust Fund. The most recent federal authorization, Moving Ahead for Progress in the 21st Century (MAP-21), will expire September 30, 2014. At the same time that MAP-21 expires and absent Congressional action, the federal Highway Trust Fund will no longer be able provide funding at current levels resulting in up to a 90 percent reduction in federal highway funding for federal fiscal year 2015. These two issues provide funding uncertainty with this program in fiscal years 2015 and beyond.