966 resultados para Road related injuries
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Iowa's public road system of 112,000 miles is one of the largest and the best in the nation. It represents a considerable financial investment of taxpayer revenues over the years. And, it requires a sustained investment to preserve an economical level of transport service into the future. In 1982, a Governor's Blue Ribbon Transportation Task Force evaluated the effectiveness of Iowa's entire transportation system. Four important Task Force recommendations dealt with public road administrative issues in Iowa. These issues were related to: 1. design criteria and levels of maintenance 2. consistency in the use of standards among jurisdictions 3. consolidation of maintenance operations at one jurisdictional level and 4. jurisdictional authority for roads. The issues formed the background for Research Project HR-265.
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A. Costanza, K. Weber, S. Gandy, C. Bouras, P. R. Hof, P. Giannakopoulos and A. Canuto (2011) Neuropathology and Applied Neurobiology37, 570-584 Contact sport-related chronic traumatic encephalopathy in the elderly: clinical expression and structural substrates Professional boxers and other contact sport athletes are exposed to repetitive brain trauma that may affect motor functions, cognitive performance, emotional regulation and social awareness. The term of chronic traumatic encephalopathy (CTE) was recently introduced to regroup a wide spectrum of symptoms such as cerebellar, pyramidal and extrapyramidal syndromes, impairments in orientation, memory, language, attention, information processing and frontal executive functions, as well as personality changes and behavioural and psychiatric symptoms. Magnetic resonance imaging usually reveals hippocampal and vermis atrophy, a cavum septum pellucidum, signs of diffuse axonal injury, pituitary gland atrophy, dilated perivascular spaces and periventricular white matter disease. Given the partial overlapping of the clinical expression, epidemiology and pathogenesis of CTE and Alzheimer's disease (AD), as well as the close association between traumatic brain injuries (TBIs) and neurofibrillary tangle formation, a mixed pathology promoted by pathogenetic cascades resulting in either CTE or AD has been postulated. Molecular studies suggested that TBIs increase the neurotoxicity of the TAR DNA-binding protein 43 (TDP-43) that is a key pathological marker of ubiquitin-positive forms of frontotemporal dementia (FTLD-TDP) associated or not with motor neurone disease/amyotrophic lateral sclerosis (ALS). Similar patterns of immunoreactivity for TDP-43 in CTE, FTLD-TDP and ALS as well as epidemiological correlations support the presence of common pathogenetic mechanisms. The present review provides a critical update of the evolution of the concept of CTE with reference to its neuropathological definition together with an in-depth discussion of the differential diagnosis between this entity, AD and frontotemporal dementia.
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Capacity is affected by construction type and its intensity on adjacent open traffic lanes. The effect on capacity is a function of vehicles moving in and out of the closed lanes of the work zone, and the presence of heavy construction vehicles. Construction activity and its intensity, however, are not commonly considered in estimating capacity of a highway lane. The main purpose of this project was to attempt to quantify the effects of construction type and intensity (e.g. maintenance, rehabilitation, reconstruction, and milling) on work zone capacity. The objective of this project is to quantify the effects of construction type and its intensity on work zone capacity and to develop guidelines for MoDOT to estimate the specific operation type and intensity that will improve the traffic flow by reducing the traffic flow and queue length commonly associated with work zones. Despite the effort put into field data collection, the data collected did not show a full speed-flow chart therefore extracting a reliable capacity value was difficult. A statistical comparison between the capacity values found in this study using either methodologies indicates that there is an effect of construction activity on the values work zone capacity. It was found that the heavy construction activity reduces the capacity. It is very beneficial to conduct similar studies on the capacity of work zone with different lane closure barriers, which is also directly related to the type of work zone being short-term or long-term work zones. Also, the effect of different geometric and environmental characteristics of the roadway should be considered in future studies.
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From August 91 to December 94, 20 external fixators were used for severely injured patients (avg. ISS 25.2). The fractures were essentially open book with or without lateral compression and vertical lesions. The indication for fixation was treatment of shock and stabilization in 8 cases, stabilization alone in 9 cases, and in 3 cases as complementary fixation after internal fixation of posterior lesions. The fixation of the pelvis was effective on the amount of blood loss. One acetabulum fracture required surgery, two patients had internal fixation for loss of reduction and two others for late pubic and posterior pain. The clinical results are good; they are more related to the severity of the initial lesion than to the mode of fixation or the quality of the reduction. No superficial sepsis or osteitis was observed in relation to the pins.
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Road dust is caused by wind entraining fine material from the roadway surface and the main source of Iowa road dust is attrition of carbonate rock used as aggregate. The mechanisms of dust suppression can be considered as two processes: increasing particle size of the surface fines by agglomeration and inhibiting degradation of the coarse material. Agglomeration may occur by capillary tension in the pore water, surfactants that increase bonding between clay particles, and cements that bind the mineral matter together. Hygroscopic dust suppressants such as calcium chloride have short durations of effectiveness because capillary tension is the primary agglomeration mechanism. Somewhat more permanent methods of agglomeration result from chemicals that cement smaller particles into a mat or larger particles. The cements include lignosulfonates, resins, and asphalt products. The duration of the cements depend on their solubility and the climate. The only dust palliative that decreases aggregate degradation is shredded shingles that act as cushions between aggregate particles. It is likely that synthetic polymers also provide some protection against coarse aggregate attrition. Calcium chloride and lignosulfonates are widely used in Iowa. Both palliatives have a useful duration of about 6 months. Calcium chloride is effective with surface soils of moderate fine content and plasticity whereas lignin works best with materials that have high fine content and high plasticity indices. Bentonite appears to be effective for up to two years and works well with surface materials having low fines and plasticity and works well with limestone aggregate. Selection of appropriate dust suppressants should be based on characterization of the road surface material. Estimation of dosage rates for potential palliatives can be based on data from this report, from technical reports, information from reliable vendors, or laboratory screening tests. The selection should include economic analysis of construction and maintenance costs. The effectiveness of the treatment should be evaluated by any of the field performance measuring techniques discussed in this report. Novel dust control agents that need research for potential application in Iowa include; acidulated soybean oil (soapstock), soybean oil, ground up asphalt shingles, and foamed asphalt. New laboratory evaluation protocols to screen additives for potential effectiveness and determine dosage are needed. A modification of ASTM D 560 to estimate the freeze-thaw and wet-dry durability of Portland cement stabilized soils would be a starting point for improved laboratory testing of dust palliatives.
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U.S. Highway 61 between Muscatine and Davenport, Iowa, is a four-lane divided section of road approximately 21 miles in length. This section was found to be among the top 5% of Iowa roadways for single-vehicle run-off-road, impaired driver, unbelted driver, and speed-related crashes for the period of 2001 through 2005. A road safety audit of this corridor was deemed appropriate by the Iowa Department of Transportation’s Office of Traffic and Safety. Staff and officials from the Iowa Department of Transportation (Iowa DOT), Iowa State Patrol, Governor’s Traffic Safety Bureau, Federal Highway Administration, Center for Transportation Research and Education, and several local law enforcement and transportation agencies met to review crash data and discuss potential safety improvements to US 61. This report outlines the findings and recommendations of the road safety audit team to address the safety concerns on this US 61 corridor and explains several selected mitigation strategies.
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The objective of this research project was to evaluate the construction and service performance of ammonium phosphate/fly ash (APFA) treated base courses of crushed fines and/or unprocessed sand. Specific test results related to construction of the test sections were included in the 1987 construction report by Iowa State University. The performance of the experimental sections is dealt with in this final report. This 1986 project demonstrated that in all cases the control sections utilizing a Type B base experienced dramatically less cracking in the surface than the APFA treated base sections. The cost per mix and subsequent surface maintenance costs for the APFA base sections, especially those having a substantial amount of limestone, were higher than the Type B base control sections. This type of construction may prove to be economical only when petroleum product costs escalate.
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Between 1976 and 1991, we observed lesions of the small bowel or colon in 39 patients having sustained blunt abdominal trauma. 70% of the patients presented with concomitant injuries. Except for 3 cases, all the patients presented with abdominal pain on admission. All the patients were operated on. The delay between admission and operation varied between a few minutes and 48 hours. Indication was hemoperitoneum, peritonitis or progressive abdominal pain. Overall morbidity is high, often related to associated disease. 4 patients died (mortality 10%), including 2 patients with isolated intestinal trauma who were operated on after 20 and 36 hours. Due to the lack of specific laboratory or X-ray test, we suggest a high index of suspicion for bowel lesions in blunt abdominal trauma, especially in unconscious patients. Close observation is mandatory. Indication for laparotomy must not be delayed if any doubt exists regarding the integrity of hollow viscus.
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Introduction Occupational therapists could play an important role in facilitating driving cessation for ageing drivers. This, however, requires an easy-to-learn, standardised on-road evaluation method. This study therefore investigates whether use of P-drive' could be reliably taught to occupational therapists via a short half-day training session. Method Using the English 26-item version of P-drive, two occupational therapists evaluated the driving ability of 24 home-dwelling drivers aged 70 years or over on a standardised on-road route. Experienced driving instructors' on-road, subjective evaluations were then compared with P-drive scores. Results Following a short half-day training session, P-drive was shown to have almost perfect between-rater reliability (ICC2,1=0.950, 95% CI 0.889 to 0.978). Reliability was stable across sessions including the training phase even if occupational therapists seemed to become slightly less severe in their ratings with experience. P-drive's score was related to the driving instructors' subjective evaluations of driving skills in a non-linear manner (R-2=0.445, p=0.021). Conclusion P-drive is a reliable instrument that can easily be taught to occupational therapists and implemented as a way of standardising the on-road driving test.
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Tutkielman tavoitteena oli selvittää Roosanauha kampanjan tuotteiden ostoon liittyvää aikeen muodostumista kuluttajilla. Lisäksi tavoitteena oli selvittää onko aikeen muodostumisessa eroja uuden pinkin värin tai lahjoitus ominaisuuden osalta. Tutkimus toteutettiin sähköisenä kyselynä, jota analysoitiin tilastollisin menetelmin, lähinnä korrelaatioiden avulla. Tutkimus ei saavuttanut toivottua päämääräänsä lähinnä huonoksi jääneen vastausten kokonaismäärän vuoksi.Joitakin suuntaa antavia tuloksia pystyttiin kuitenkin tunnistamaan. Tuloksissa oli viitteitä lahjoitusominaisuuden tärkeydestä kuluttajille sekä vaaleanpunaiseen väriin positiivisesti asennoitumisesta. Kampanjan jatkoa ajatellen markkinoijien on syytä huomata tuloksissa ilmennyt värin tärkeä rooli sekä lahjoitusominaisuudelle painottunut sosiaalisten normien vahvuus.
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Objective: To analyze the characteristics of trauma patients with renal lesions treated at a university hospital in Curitiba. Methods: We conducted a retrospective, cross-sectional study guided by review of medical records of trauma victims who underwent surgical treatment. The variables analyzed were age, gender, mechanism of injury, degree of kidney damage, conduct individualized according to the degree of renal injury, associated injuries, complications and deaths. We classified lesions according to the American Association of Trauma Surgery (TSAA). Results: We analyzed 794 records and found renal lesions in 33 patients, with mean age 29.8 years, most (87.8%) being male. Penetrating trauma accounted for 84.8% of cases. The most common renal injuries were grade II (33.3%), followed by grade I (18.1%), III, IV and V. Nephrectomy treated 45.4% of injuries, 73.3% being total nephrectomy, and 45.4% by nephrorraphy. In 9% treatment was non-surgical. Only 12.1% of patients had isolated renal lesions. Complications ensued in 15.1% and mortality was 6.06%. Conclusion: The surgical approach was preferred due to penetrating trauma mechanism. We achieved low rates of complications and deaths, and neither case could be directly related to kidney damage, and there were patients with multiple lesions. In this sample, we could not observe a direct relationship between kidney damage and complications, deaths or the type of conduct employed.
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Porin seudulle laadittiin liikenneturvallisuussuunnitelma Harjavallan, Huittisen, Kokemäen, Luvian, Merikarvian, Nakkilan, Pomarkun, Porin ja Ulvilan kuntien alueelle. Suunnitelmat laadittiin kuntien ja Varsinais-Suomen ELY-keskuksen yhteistyönä. Suunnitelma sisältää turvallisuuden parantamisen lisäksi kestävien liikkumismuotojen edistämistä. Seudun liikenneturvallisuuden ja liikkumisen ongelmia kartoitettiin kaikille kuntalaisille suunnatuilla kyselyillä, onnettomuusanalyysillä sekä maastokäynneillä. Onnettomuusanalyysin perusteella seudun liikenneturvallisuuden tila Porin seudulla on koko maan keskiarvoa heikompi. Vuosittain kuolee noin 10 henkilöä ja loukkaantuu noin 220 henkilöä. Seudulla tapahtuneista onnettomuuksista aiheutuu kustannuksia vuosittain keskimäärin noin 90 miljoonaa euroa, josta kuntien osuus on vuosittain noin 16 miljoonaa euroa. Kyselyn vastauksista ilmeni, että vastaajia huolestutti muun muassa jalankulku- ja pyöräväylien kunto ja esteettömyys sekä talvikunnossapidon taso. Autoilun olosuhteissa tyytymättömyyttä aiheutti teiden kunto ja kunnossapidon taso sekä kouluympäristöjen liikennejärjestelyt. Kyselyyn vastanneista 64 %:lla työ- tai koulumatkan pituus on korkeintaan 5 kilometriä, joten kävelyn ja pyöräilyn edistämisellä seudulla on hyvät edellytykset. Ongelma-analyysin sekä valtakunnallisten tavoitteiden pohjalta seudulle määritettiin liikenneturvallisuustavoitteet. Pitkän aikavälin liikenneturvallisuusvisioksi seudulle asetettiin, että kenenkään ei tarvitse kuolla tai loukkaantua vakavasti liikenteessä ja liikkuminen on vastuullista ja se koetaan turvalliseksi. Määrällisenä tavoitteena on, että nykyisestä 10 keskimäärin vuodessa kuolleesta seudulla kuolisi liikenteessä enintään 6 henkilöä (40 henkilöä / miljoona asukasta) vuonna 2014 ja enintään 3 henkilöä (24 henkilöä / miljoona asukasta) vuonna 2020. Loukkaantuneiden määrän tavoitteena on, että nykyisestä 218 henkilöstä vähennystä olisi 25 % (korkeintaan 163 henkilöä) vuoteen 2020 mennessä. Nuorten onnettomuusriskiä halutaan pienentää 25 % vuoteen 2020 mennessä siten, että heidän riskinsä lähenee muun väestön onnettomuusriskin tasoa. Liikenneympäristön parantamisehdotukset tehtiin noin 300 kohteeseen seudulla. Toimenpiteiden toteuttaminen vaiheistettiin kolmeen ohjeelliseen kiireellisyysluokkaan. Suunnitelmatyön aikana kuntien liikenneturvallisuustyötä aktivoitiin ja perustettiin uudet ryhmät niihin kuntiin, joista ryhmät puuttuivat. Hallintokuntatilaisuuksissa ideoitiin ja käsiteltiin eri liikkujaryhmille sopivia toimintamuotoja liikenneturvallisuuden ja kestävän liikkumisen edistämiseksi. Lisäksi muodostettiin seudullinen liikenneturvallisuusryhmä, joka seuraa ja koordinoi liikenneturvallisuustyötä tulevaisuudessa.
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Dental injuries are common and the incidence of maxillofacial injuries has increased over the recent decades in Finland. Accidental injuries are the global leading cause of death among children over the age of one year and among adults under the age of 40 globally. Significant resources and costs are needed for the treatment of these patients. The prevention is the most economical way to reduce trauma rates and costs. For the prevention it is crucial to know the prevalences, incidences and risk factors related to injuries. To improve the quality of treatment, it is essential to explore the causes, trauma mechanisms and management of trauma. The above mentioned was the aim of this thesis. With a large epidemiological cohort study (5737 participants) it was possible to estimate lifetime prevalence of and risk factors for dental trauma in general population (Study I). The prevalence of dental fractures was 43% and the prevalence of dental luxations and avulsions was 14%. Male gender, a history of previous non-dental injuries, mental distress, overweight and high alcohol consumption were positively associated with the occurrence of dental injuries Study II was conducted to explore the differences in type and multiplicity of mandibular fractures in three different countries (Canada, Finland and Kuwait). This retrospective study showed that the differences in mandibular fracture multiplicity and location are based on different etiologies and demographic patterns. This data can be exploited for planning of measures to prevent traumatic facial fractures. The etiology, management and outcome of 63 pediatric skull base fracture (Study III) and 20 pediatric frontobasal fracture patients (Study IV) were explored. These retrospective studies showed that, both skull base fracture and frontobasa fracture are rare injuries in childhood and although intracranial injuries and morbidity are frequent, permanent neurological or neuropsychological deficits are infrequent. A systematic algorithm (Study V) for computer tomography (CT) image review was aimed at clinicians and radiologists to improve the assessment of patients with complex upper midface and cranial base trauma. The cohort study was cross sectional and data was collected in the Turku and Oulu University Hospitals. A novel image-reviewing algorithm was created to enhance the specificity of CT for the diagnosis of frontobasal fractures. The study showed that an image-viewing algorithm standardizes the frontobasal trauma detection procedure and leads to better control and assessment. The purpose of the retrospective subcranial craniotomy study (VI) was to review the types of frontobasal fractures and their management, complications and outcome when the fracture is approached subcranially. The subcranial approach appears to be successful and have a reasonably low complication rate. It may be recommended as the technique of choice in multiple and the most complicated frontal base fractures where the endoscopic endonasal approach is not feasible.
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Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014
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The aim of this thesis is to study whether the use of biomethane as a transportation fuel is reasonable from climate change perspective. In order to identify potentials and challenges for the reduction of greenhouse gas (GHG) emissions, this dissertation focuses on GHG emission comparisons, on feasibility studies and on the effects of various calculation methodologies. The GHG emissions calculations are carried out by using life cycle assessment (LCA) methodologies. The aim of these LCA studies is to figure out the key parameters affecting the GHG emission saving potential of biomethane production and use and to give recommendations related to methodological choices. The feasibility studies are also carried out from the life cycle perspective by dividing the biomethane production chain for various operators along the life cycle of biomethane in order to recognize economic bottlenecks. Biomethane use in the transportation sector leads to GHG emission reductions compared to fossil transportation fuels in most cases. In addition, electricity and heat production from landfill gas, biogas or biomethane leads to GHG reductions as well. Electricity production for electric vehicles is also a potential route to direct biogas or biomethane energy to transportation sector. However, various factors along the life cycle of biomethane affect the GHG reduction potentials. Furthermore, the methodological selections have significant effects on the results. From economic perspective, there are factors related to different operators along the life cycle of biomethane, which are not encouraging biomethane use in the transportation sector. To minimize the greenhouse gas emissions from the life cycle of biomethane, waste feedstock should be preferred. In addition, energy consumption, methane leakages, digestate utilization and the current use of feedstock or biogas are also key factors. To increase the use of biomethane in the transportation sector, political steering is needed to improve the feasibility for the operators. From methodological perspective, it is important to recognize the aim of the life cycle assessment study. The life cycle assessment studies can be divided into two categories: 1.) To produce average GHG information of biomethane to evaluate the acceptability of biomethane use compared to fossil transportation fuels. 2.) To produce GHG information of biomethane related to actual decision-making situations. This helps to figure out the actual GHG emission changes in cases when feedstock, biogas or biomethane are already in other use. For example directing biogas from electricity production to transportation use does not necessarily lead to additional GHG emission reductions. The use of biomethane seems to have a lot of potential for the reduction of greenhouse gas emissions as a transportation fuel. However, there are various aspects related to production processes, to the current use of feedstock or biogas and to the feasibility that have to be taken into account.