Sample records for access roads rehabilitation

  1. Road analysis: a tool for cost-effective rehabilitation measures for Finnish roads

    NASA Astrophysics Data System (ADS)

    Roimela, Petri; Salmenkaita, Seppo; Maijala, Pekka; Saarenketo, Timo

    2000-04-01

    Public funding for road network maintenance has decreased 30% during the last few years in Finland. Reduced resources, together with the current rehabilitation strategies, will in the long term result in increasing deterioration of the Finnish road network. For this reason road rehabilitation funding should be focused more specifically on those roads and road sections requiring measures and these measures should be optimized to ensure that only the specific problem structure will be repaired. Roadscanners Oy, in cooperation with the Finnish National Road Administration (Finnra), has developed a new and effective Road Analysis technique to survey the condition of roads and road networks. Road Analysis is based on the integrated analysis of the measured data collected from the road under survey. The basic survey methods used in Road Analysis include Ground Penetrating Data (GPR), falling weight deflectometer (FWD), roughness and rutting measurements, pavement distress mapping and GPS-positioning, as well as reference drilling based on preliminary GPR data analysis. The collected road survey data is processed, interpreted, analyzed and classified using Road Doctor software, specifically developed for this purpose. GPR measurements in road analysis are carried out using a 400 MHz ground-coupled antenna and a 1.0 GHz horn antenna. Horn antenna data is used to measure the thickness of the pavement and base course layers, as well as to evaluate their quality based on their dielectric properties. The 400 MHz ground-coupled data is used to estimate the thickness of the pavement structure and embankment. Ground-coupled antenna data is used for subgrade quality estimations and in evaluating the causes of subgrade- related frost defects. GPR data also provides important location information about special structures, such as steel reinforcements, cables and pipelines. Road Analysis includes a classification of the critical elements affecting the lifetime of the road: (1

  2. Road maintenance and rehabilitation : funding and allocation strategies

    DOT National Transportation Integrated Search

    1994-01-24

    With ageing road infrastructure and sustained traffic growth, the maintenance and rehabilitation of road and motorway networks require increased funding. Adequate allocation and distribution of available resources are therefore a key policy issue. Th...

  3. On the road again after traumatic brain injury: driver safety and behaviour following on-road assessment and rehabilitation.

    PubMed

    Ross, Pamela; Ponsford, Jennie L; Di Stefano, Marilyn; Charlton, Judith; Spitz, Gershon

    2016-01-01

    To examine pre- and post-injury self-reported driver behaviour and safety in individuals with traumatic brain injury (TBI) who returned to driving after occupational therapy driver assessment and on-road rehabilitation. A self-report questionnaire, administered at an average of 4.5 years after completing an on-road driver assessment, documenting pre- and post-injury crash rates, near-crashes, frequency of driving, distances driven, driving conditions avoided and navigation skills, was completed by 106 participants, who had either passed the initial driver assessment (pass group n = 74), or required driver rehabilitation, prior to subsequent assessments (rehabilitation group n = 32). No significant difference was found between pre- and post-injury crash rates. Compared to pre-injury, 36.8% of drivers reported limiting driving time, 40.6% drove more slowly, 41.5% reported greater difficulty with navigating and 20.0% reported more near-crashes. The rehabilitation group (with greater injury severity) was significantly more likely to drive less frequently, shorter distances, avoid: driving with passengers, busy traffic, night and freeway driving than the pass group. Many drivers with moderate/severe TBI who completed a driver assessment and rehabilitation program at least 3 months post-injury, reported modifying their driving behaviour, and did not report more crashes compared to pre-injury. On-road driver training and training in navigation may be important interventions in driver rehabilitation programs. Driver assessment and on-road retraining are important aspects of rehabilitation following traumatic brain injury. Many drivers with moderate/severe TBI, reported modifying their driving behaviour to compensate for ongoing impairment and continued to drive safely in the longer term. Navigational difficulties were commonly experienced following TBI, suggesting that training in navigation may be an important aspect of driver rehabilitation.

  4. Going-to-the-Sun Road rehabilitation plan/final environmental impact statement : Glacier National Park

    DOT National Transportation Integrated Search

    2003-04-01

    Glacier National Park is considering the rehabilitation of the 50-mile (80-kilometer) Going-to-the-Sun Road, a National Historic Landmark. Road rehabilitation is needed to correct structural deficiencies in the deteriorating roadway, improve safety, ...

  5. ROAD: domestic assistant and rehabilitation robot.

    PubMed

    Carrera, Isela; Moreno, Héctor A; Saltarén, Roque; Pérez, Carlos; Puglisi, Lisandro; Garcia, Cecilia

    2011-10-01

    This study introduces the concept design and analysis of a robotic system for the assistance and rehabilitation of disabled people. Based on the statistical data of the most common types of disabilities in Spain and other industrialized countries, the different tasks that the device must be able to perform have been determined. In this study, different robots for rehabilitation and assistance previously introduced have been reviewed. This survey is focused on those robots that assist with gait, balance and standing up. The structure of the ROAD robot presents various advantages over these robots, we discuss some of them. The performance of the proposed architecture is analyzed when it performs the sit to stand activity.

  6. A synthesis of postfire road treatments for BAER teams: methods, treatment effectiveness, and decisionmaking tools for rehabilitation

    Treesearch

    Randy B. Foltz; Peter R. Robichaud; Hakjun Rhee

    2008-01-01

    We synthesized post-fire road treatment information to assist BAER specialists in making road rehabilitation decisions. We developed a questionnaire; conducted 30 interviews of BAER team engineers and hydrologists; acquired and analyzed gray literature and other relevant publications; and reviewed road rehabilitation procedures and analysis tools. Post-fire road...

  7. The Priority of Road Rehabilitation in Karanganyar Regency Using IRI Estimation from Roadroid

    NASA Astrophysics Data System (ADS)

    Achmadi, F.; Suprapto, M.; Setyawan, A.

    2017-02-01

    The IRI (International Roughness Index) is a road roughness index commonly obtained from measured longitudinal road profiles. This is one of the functional performance a surface of road pavement. Therefore, needs to be done evaluation and monitoring periodically to getting priority of road rehabilitation right on target. The IRI standard has commonly been used worldwide for evaluating road system. The Roadroid is an application to measure road quality with a website to view road quality. It is designed for Android smartphones, so we can easily measure and monitor the road and also use the camera for GPS-tagged photo. By using the built-in vibration sensor in smartphones, it is possible to collect IRI value which can be an indicator road conditions. This study attempts to explain the priority of road rehabilitation in Karanganyar Regency. The location of the study focused on a collector street (primary, secondary and locally road). The result of IRI estimation will be combined with other aspects that influences; land use, policy, the connectivity of road and traffic average daily. Based on IRI estimation using Roadroid, the road conditions in Karanganyar Regency can be described 59,60% were good (IRI<4,5) 21,30% fair (4,512).

  8. The Alternative Road. The Rehabilitation of the Practical.

    ERIC Educational Resources Information Center

    Layton, David, Ed.

    The "alternative road" refers to a practically oriented curriculum, one which is more concerned with being able to do, rather than remembering. The book consists of an edited series of papers which were presented at a conference in England on the rehabilitation of the practical, at which a broad range of interests (academic,…

  9. 25 CFR 170.121 - What is a cultural access road?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is a cultural access road? 170.121 Section 170.121 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Use of Irr and Cultural Access Roads § 170...

  10. 25 CFR 170.127 - What terms apply to access roads?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What terms apply to access roads? 170.127 Section 170.127 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Irr Housing Access Roads § 170.127 What...

  11. 75 FR 20034 - Over-the-Road Bus Accessibility Program Grants: Corrections

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-16

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Over-the-Road Bus Accessibility... ``Over-the-Road Bus Accessibility Program Grants,'' extends the application deadline, and allows... comply with the terms and conditions of the Special Warranty for the Over-the-Road Bus Accessibility...

  12. Inequities in access to inpatient rehabilitation after stroke: an international scoping review.

    PubMed

    Lynch, Elizabeth A; Cadilhac, Dominique A; Luker, Julie A; Hillier, Susan L

    2017-12-01

    Background Inequities in accessing inpatient rehabilitation after stroke have been reported in many countries and impact on patient outcomes. Objective To explore variation in international recommendations regarding which patients should receive inpatient rehabilitation after stroke and to describe reported access to rehabilitation. Methods A scoping review was conducted to identify clinical guidelines with recommendations regarding which patients should access inpatient rehabilitation after stroke, and data regarding the proportion of patients accessing stroke rehabilitation. Four bibliographic databases and grey literature were searched. Results Twenty-eight documents were included. Selection criteria for post-acute inpatient rehabilitation were identified for 14 countries or regions and summary data on the proportion of patients receiving inpatient rehabilitation were identified for 14 countries. In Australia, New Zealand, and the United Kingdom, it is recommended that all patients with stroke symptoms should access rehabilitation, whereas guidelines from the United States, Canada, and Europe did not consistently recommend rehabilitation for people with severe stroke. Access to inpatient rehabilitation ranged from 13% in Sweden to 57% in Israel. Differences in availability of early supported discharge/home rehabilitation programs and variations in reporting methods may influence the ability to reliably compare access to rehabilitation between regions. Conclusion Recommendations regarding which patients with moderate and severe strokes should access ongoing rehabilitation are inconsistent. Clinical practice guidelines from different countries regarding post-stroke rehabilitation do not always reflect the evidence regarding the likely benefits to people with stroke. Inequity in access to rehabilitation after stroke is an international issue.

  13. 25 CFR 170.122 - Can a tribe close a cultural access road?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Can a tribe close a cultural access road? 170.122 Section... ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Use of Irr and Cultural Access Roads § 170.122 Can a tribe close a cultural access road? (a) A tribe with jurisdiction over a cultural...

  14. 25 CFR 170.122 - Can a tribe close a cultural access road?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Can a tribe close a cultural access road? 170.122 Section... ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Use of Irr and Cultural Access Roads § 170.122 Can a tribe close a cultural access road? (a) A tribe with jurisdiction over a cultural...

  15. The Evaluation of Screening Process and Local Bureaucracy in Determining the Priority of Urban Roads Maintenance and Rehabilitation

    NASA Astrophysics Data System (ADS)

    Hendhratmoyo, Andri; Syafi'i; Pungky Pramesti, Florentina

    2017-11-01

    Due to the limited budget of urban roads maintenance and rehabilitation, its prioritizationis inevitable. Many models have been developed to solve these problems. That is the reason why the purpose of this study was to evaluate the screening process in the decision making of the urban roads maintenance and rehabilitation priority. The prioritization that have to be taken into account on the effect of important criteria are road condition, traffic volume, budget processing and land use. 30 stakeholders were asked to fill in the questionnaires. The object of this case study are 188 urban roads sections at Ponorogo in order to examine the priorities. The researchers collected the data from Surface Distress Index (SDI), traffic volume, budget processing and land use of these road sections. Based on analysis, the weights of the criteria were: road condition (W1) = 0,411; traffic volume (W2) = 0,122; budget processing (W3) = 0,363 and land use (W4) = 0,105. The result of this study by the comparison of the index values of the alternatives priorities, Nyi Ageng Serang Street, was revealed to have the highest priority over the other streets regarding of maintenance and rehabilitation activities.

  16. A Landowner's Guide to Building Forest Access Roads

    Treesearch

    Richard L. Wiest

    1998-01-01

    This guide is designed for landowners in the northeastern United States who will use a tractor and ordinary earth moving equipment to build the simplest access roads on their property, or who will contract for these services. Logging roads on small woodland properties are usually constructed by the logging contractor, sawmill operator, or by a road contractor.

  17. Predatory Open Access in Rehabilitation.

    PubMed

    Manca, Andrea; Martinez, Gianluca; Cugusi, Lucia; Dragone, Daniele; Mercuro, Giuseppe; Deriu, Franca

    2017-05-01

    Increasingly scholars and researchers are being solicited by predatory open access journals seeking manuscript submissions and abusing the author-pays model by charging authors with publishing fees without any or proper peer review. Such questionable editorial practices are threatening the reputation and credibility of scholarly publishing. To date, no investigation has been conducted on this phenomenon in the field of rehabilitation. This study attempts to identify specific predatory journals operating in this field to quantify the phenomenon and its geographic distribution. Beall's List has been used to this end which, although not perfect, is a comprehensive and up-to-date report of predatory publishers. Of the 1113 publishers on the list, 59 journals were identified, for a total of 5610 published articles. The median number of articles published by each journal was 21, and the median amount of article processing charges was $499. Only 1 out of 59 journals was included in the Directory of Open Access Journals, whereas 7 (12%) were indexed by PubMed. Most of the publishers were based in India (36%) followed by the United States (25%) and Pakistan (5%), and 25% were without a verifiable address. The data indicate that the threat of predatory publishing in rehabilitation is real. Physiatrists, physiotherapists, researchers, and academics operating in this field are advised to use the tools available to recognize predatory practices before considering publishing in open access journals. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. 77 FR 73976 - Nez Perce-Clearwater National Forests; Idaho; Crooked River Valley Rehabilitation Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-12

    ... maintenance of the road. Proposed Action The proposed action is to rehabilitate the lower two miles of the... from the road, improve forest visitor safety, and provide easier maintenance of the road. The proposed... the effects to cultural resources, public access, and future road maintenance costs. Permits or...

  19. 4. View of Building 802 from the access road, facing ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. View of Building 802 from the access road, facing northwest. - Naval Air Station Fallon, 100-man Fallout Shelter, 800 Complex, off Carson Road near intersection of Pasture & Berney Roads, Fallon, Churchill County, NV

  20. 33 CFR 211.78 - Maintenance and conveyance of access roads.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Site Development and Use § 211.78 Maintenance and conveyance of access roads. The Government will not... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Maintenance and conveyance of access roads. 211.78 Section 211.78 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE...

  1. 77 FR 71865 - Over-the-Road Bus Accessibility Grant Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-04

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Over-the-Road Bus Accessibility Grant... selection of projects to be funded under Fiscal Year (FY) 2012 appropriations for the Over-the-Road Bus...-road buses to help finance the incremental capital and training costs of complying with DOT's over-the...

  2. 77 FR 5295 - Over-the-Road Bus Accessibility Program Announcement of Project Selections

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-02

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Over-the-Road Bus Accessibility...-Road Bus (OTRB) Accessibility Program, authorized by Section 3038 of the Transportation Equity Act for... of over-the-road buses to help finance the incremental capital and training costs of complying with...

  3. Cognitive-communication disorder following right hemisphere stroke: exploring rehabilitation access and outcomes.

    PubMed

    Hewetson, Ronelle; Cornwell, Petrea; Shum, David

    2017-07-01

    Rehabilitation positively influences return to activities and social roles in people with aphasia. The cognitive-communication disorder (CCD) found following a right hemisphere stroke has been less extensively researched with rehabilitation access and outcomes yet to be determined. To document rehabilitation access and outcomes for people with CCD post-stroke; and compare outcomes based on presence (viz CCD; aphasia) or absence of communication impairment. A retrospective chart audit was completed for patients with first onset unilateral stroke, with a hospital length of stay (LOS) of at least two days and a communication assessment by a speech pathologist. Data extracted included presence and severity of communication impairment, access to and LOS in a rehabilitation unit, and functional outcome measures recorded at rehabilitation discharge. The majority of the 115 patients who met inclusion criteria were living independently (n = 112, 97.4%) at the time of stroke. CCD (66%) was diagnosed with similar frequency to aphasia (68%). The presence of communication impairment did not result in significant differences in rehabilitation LOS and discharge destination when compared to hemispheric strokes without communication impairment. Severity of CCD was an independent predictor of functional gain by rehabilitation discharge. People with CCD require comparable access to rehabilitation as people with aphasia, and severity of CCD should be considered in determining rehabilitation LOS. A large number of people are discharged with ongoing CCD which warrants exploration of potential participation restrictions created by the communication impairment.

  4. 10. EASTERLY VIEW OF THE ACCESS ROAD TO THE DOWNSTREAM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. EASTERLY VIEW OF THE ACCESS ROAD TO THE DOWNSTREAM SIDE OF BIG DALTON DAM EXTENDING FROM THE FOOTBRIDGE TO THE GAGING STATION. BIG DALTON DAM IN BACKGROUND. - Big Dalton Dam, 2600 Big Dalton Canyon Road, Glendora, Los Angeles County, CA

  5. Access to pedestrian roads, daily activities, and physical performance of adolescents.

    PubMed

    Sjolie, A N

    2000-08-01

    A cross-sectional study using a questionnaire and physical tests was performed. To study how access to pedestrian roads and daily activities are related to low back strength, low back mobility, and hip mobility in adolescents. Although many authorities express concern about the passive lifestyle of adolescents, little is known about associations between daily activities and physical performance. This study compared 38 youths in a community lacking access to pedestrian roads with 50 youths in nearby area providing excellent access to pedestrian roads. A standardized questionnaire was used to obtain data about pedestrian roads, school journeys, and activities from the local authorities and the pupils. Low back strength was tested as static endurance strength, low back mobility by modified Schober techniques, and hip mobility by goniometer. For statistical analyses, a P value of 0.05 or less determined significance. In the area using school buses, the pupils had less low back extension, less hamstring flexibility, and less hip abduction, flexion, and extension than pupils in the area with pedestrian roads. Multivariate analyses showed no associations between walking or bicycling to school and anatomic function, but regular walking or bicycling to leisure-time activities associated positively with low back strength, low back extension, hip flexion, and extension. Distance by school bus associated negatively with hip abduction, hip flexion, hip extension, and hamstring flexibility (P<0.001). Time spent on television or computer associated negatively but insignificantly with low back strength, hamstring flexibility, hip abduction, and flexion (P<0.1). The results indicate that access to pedestrian roads and other lifestyle factors are associated with physical performance.

  6. The effect of agency budgets on minimizing greenhouse gas emissions from road rehabilitation policies

    NASA Astrophysics Data System (ADS)

    Reger, Darren; Madanat, Samer; Horvath, Arpad

    2015-11-01

    Transportation agencies are being urged to reduce their greenhouse gas (GHG) emissions. One possible solution within their scope is to alter their pavement management system to include environmental impacts. Managing pavement assets is important because poor road conditions lead to increased fuel consumption of vehicles. Rehabilitation activities improve pavement condition, but require materials and construction equipment, which produce GHG emissions as well. The agency’s role is to decide when to rehabilitate the road segments in the network. In previous work, we sought to minimize total societal costs (user and agency costs combined) subject to an emissions constraint for a road network, and demonstrated that there exists a range of potentially optimal solutions (a Pareto frontier) with tradeoffs between costs and GHG emissions. However, we did not account for the case where the available financial budget to the agency is binding. This letter considers an agency whose main goal is to reduce its carbon footprint while operating under a constrained financial budget. A Lagrangian dual solution methodology is applied, which selects the optimal timing and optimal action from a set of alternatives for each segment. This formulation quantifies GHG emission savings per additional dollar of agency budget spent, which can be used in a cap-and-trade system or to make budget decisions. We discuss the importance of communication between agencies and their legislature that sets the financial budgets to implement sustainable policies. We show that for a case study of Californian roads, it is optimal to apply frequent, thin overlays as opposed to the less frequent, thick overlays recommended in the literature if the objective is to minimize GHG emissions. A promising new technology, warm-mix asphalt, will have a negligible effect on reducing GHG emissions for road resurfacing under constrained budgets.

  7. 9. SOUTHERLY VIEW OF THE ACCESS ROAD TO THE DOWNSTREAM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. SOUTHERLY VIEW OF THE ACCESS ROAD TO THE DOWNSTREAM SIDE OF BIG DALTON DAM EXTENDING FROM THE DAM TO THE FOOTBRIDGE. VIEW FROM BIG DALTON DAM SHOWING THE TOE WEIR IN FOREGROUND AND FOOTBRIDGE IN BACKGROUND. - Big Dalton Dam, 2600 Big Dalton Canyon Road, Glendora, Los Angeles County, CA

  8. Evaluating the Influence of Road Lighting on Traffic Safety at Accesses Using An Artificial Neural Network.

    PubMed

    Xu, Yueru; Ye, Zhirui; Wang, Yuan; Wang, Chao; Sun, Cuicui

    2018-05-18

    This paper focuses on the effect of road lighting on road safety at accesses and tries to quantitatively analyze the relationship between road lighting and road safety. An Artificial Neural Network (ANN) was applied in this study. This method is one of the most popular machine-learning methods in recent years and does not require any pre-defined assumptions. This method was applied using field data collected from ten road segments in Nanjing, Jiangsu Province, China. The results show that the impact of road lighting on road safety at accesses is significant. In addition, road lighting has greater influence when vehicle speeds are higher or the number of lanes is larger. A threshold illuminance was also found in this paper, and the results show that the safety level at accesses will become stable when reaching this value. The improvement of illuminance can decrease the speed variation among vehicles and improve the safety level. In addition, high-grade roads need better illuminance at accesses. A threshold value can also be obtained based on related variables and used to develop scientific guidelines for traffic management organizations.

  9. Automated analysis of timber access road alternatives.

    Treesearch

    Doyle Burke

    1974-01-01

    The evaluation of timber access road alternatives is one of the primary tasks in timber harvest planning and design. During the planning stages, it is also one of the most difficult to accomplish quantitatively because a basis for comparison is related to such values as grade, length, horizontal and vertical curvature, and volumes of excavation and embankment. Within...

  10. Trauma center accessibility for road traffic injuries in Hanoi, Vietnam.

    PubMed

    Nagata, Takashi; Takamori, Ayako; Kimura, Yoshinari; Kimura, Akio; Hashizume, Makoto; Nakahara, Shinji

    2011-09-30

    Rapid economic growth in Vietnam over the last decade has led to an increased frequency of road traffic injury (RTI), which now represents one of the leading causes of death in the nation. Various efforts toward injury prevention have not produced a significant decline in the incidence of RTIs. Our study sought to describe the geographic distribution of RTIs in Hanoi, Vietnam and to evaluate the accessibility of trauma centers to those injured in the city. We performed a cross-sectional study using Hanoi city police reports from 2006 to describe the epidemiology of RTIs occurring in Hanoi city. Additionally, we identified geographic patterns and determined the direct distance from injury sites to trauma centers by applying geographical information system (GIS) software. Factors associated with the accessibility of trauma centers were evaluated by multivariate regression analysis. We mapped 1,271 RTIs in Hanoi city. About 40% of RTIs occurred among people 20-29 years of age. Additionally, 63% of RTIs were motorcycle-associated incidents. Two peak times of injury occurrence were observed: 12 am-4 pm and 8 pm-0 am. "Hot spots" of road traffic injuries/fatalities were identified in the city area and on main highways using Kernel density estimation. Interestingly, RTIs occurring along the two north-south main roads were not within easy access of trauma centers. Further, fatal cases, gender and injury mechanism were significantly associated with the distance between injury location and trauma centers. Geographical patterns of RTIs in Hanoi city differed by gender, time, and injury mechanism; such information may be useful for injury prevention. Specifically, RTIs occurring along the two north-south main roads have lower accessibility to trauma centers, thus an emergency medical service system should be established.

  11. African Americans' Access to Vocational Rehabilitation Services after Antidiscrimination Legislation

    ERIC Educational Resources Information Center

    Mwachofi, Ari K.

    2008-01-01

    The purpose of this study was to determine changes in African Americans' access to occasional rehabilitation (VR) services subsequent to landmark legislative and judicial antidiscrimination provisions of the mid-20th century. This study compared African American VR access before the antidiscrimination legislation in 1937 and after the legislation…

  12. 1. Context view shows approach of access road to summit, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Context view shows approach of access road to summit, communication towers and NW corner of lookout tower at center right. Camera is pointed SE. - Chelan Butte Lookout, Summit of Chelan Butte, Chelan, Chelan County, WA

  13. Trends of child undernutrition in rural Ecuadorian communities with differential access to roads, 2004-2013.

    PubMed

    Lopez, Velma K; Dombecki, Carolyn; Trostle, James; Mogrovejo, Patricia; Castro Morillo, Nancy; Cevallos, William; Goldstick, Jason; Jones, Andrew D; Eisenberg, Joseph N S

    2018-02-07

    Road access can influence protective and risk factors associated with nutrition by affecting various social and biological processes. In northern coastal Ecuador, the construction of new roads created a remoteness gradient among villages, providing a unique opportunity to examine the impact of roads on child nutritional outcomes 10 years after the road was built. Anthropometric and haemoglobin measurements were collected from 2,350 children <5 years in Esmeraldas, Ecuador, from 2004 to 2013 across 28 villages with differing road access. Logistic generalized estimating equation models assessed the longitudinal association between village remoteness and prevalence of stunting, wasting, underweight, overweight, obesity, and anaemia. We examined the influence of socio-economic characteristics on the pathway between remoteness and nutrition by comparing model results with and without household-level socio-economic covariates. Remoteness was associated with stunting (OR = 0.43, 95% CI [0.30, 0.63]) and anaemia (OR = 0.56, 95% CI [0.44, 0.70]). Over time, the prevalence of stunting was generally decreasing but remained higher in villages closer to the road compared to those farther away. Obesity increased (0.5% to 3%) over time; wasting was high (6%) but stable during the study period. Wealth and education partially explained the better nutritional outcomes in remote vs. road villages more than a decade after some communities gained road access. Establishing the extent to which these patterns persist requires additional years of observation. © 2018 John Wiley & Sons Ltd.

  14. PERSPECTIVE OF HANGAR AND ACCESS ROAD LOOKING EAST (During the ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    PERSPECTIVE OF HANGAR AND ACCESS ROAD LOOKING EAST (During the 1940s the Arnold family leased part of their land to serve as a runway and airplane hangar. The building on the right of the photograph was originally two separate airplane hangars - they were joined in the early 1950s to provide covered combine parking between them. The building on the left of the photograph is a tractor shed. The building at a distance was gasoline and oil shed for the planes) - Arnold Farm, Hangar / Workshop, 1948 Arnold Road, Coupeville, Island County, WA

  15. 3. VIEW OF WATER TANKS FROM ACCESS ROAD TO HATCH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. VIEW OF WATER TANKS FROM ACCESS ROAD TO HATCH ADIT. VIEW NORTH. LUCKY TIGER MILL OFFICE (FEATURE B-I) IN DISTANCE. (OCTOBER, 1995) - Nevada Lucky Tiger Mill & Mine, Water Tanks, East slope of Buckskin Mountain, Paradise Valley, Humboldt County, NV

  16. 16. LOG AND PLANK BRIDGE ON ACCESS ROAD NEAR BRIDGE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    16. LOG AND PLANK BRIDGE ON ACCESS ROAD NEAR BRIDGE SITE; SAME STRUCTURE AS SHOWN IN PHOTO #12. ZION NP NEGATIVE NO. 967 ZIO. - Zion-Mount Carmel Highway, Virgin River Bridge, Spanning North Fork of Virgin River on Zion-Mount Carmel Highway, Springdale, Washington County, UT

  17. Amphibian and reptile road-kills on tertiary roads in relation to landscape structure: using a citizen science approach with open-access land cover data.

    PubMed

    Heigl, Florian; Horvath, Kathrin; Laaha, Gregor; Zaller, Johann G

    2017-06-26

    Amphibians and reptiles are among the most endangered vertebrate species worldwide. However, little is known how they are affected by road-kills on tertiary roads and whether the surrounding landscape structure can explain road-kill patterns. The aim of our study was to examine the applicability of open-access remote sensing data for a large-scale citizen science approach to describe spatial patterns of road-killed amphibians and reptiles on tertiary roads. Using a citizen science app we monitored road-kills of amphibians and reptiles along 97.5 km of tertiary roads covering agricultural, municipal and interurban roads as well as cycling paths in eastern Austria over two seasons. Surrounding landscape was assessed using open access land cover classes for the region (Coordination of Information on the Environment, CORINE). Hotspot analysis was performed using kernel density estimation (KDE+). Relations between land cover classes and amphibian and reptile road-kills were analysed with conditional probabilities and general linear models (GLM). We also estimated the potential cost-efficiency of a large scale citizen science monitoring project. We recorded 180 amphibian and 72 reptile road-kills comprising eight species mainly occurring on agricultural roads. KDE+ analyses revealed a significant clustering of road-killed amphibians and reptiles, which is an important information for authorities aiming to mitigate road-kills. Overall, hotspots of amphibian and reptile road-kills were next to the land cover classes arable land, suburban areas and vineyards. Conditional probabilities and GLMs identified road-kills especially next to preferred habitats of green toad, common toad and grass snake, the most often found road-killed species. A citizen science approach appeared to be more cost-efficient than monitoring by professional researchers only when more than 400 km of road are monitored. Our findings showed that freely available remote sensing data in combination with a

  18. Disability, caregiver's dependency and patterns of access to rehabilitation care: results from a national representative study in Peru.

    PubMed

    Bernabe-Ortiz, Antonio; Diez-Canseco, Francisco; Vásquez, Alberto; Miranda, J Jaime

    2016-01-01

    To determine the prevalence of disability in Peru, explore dependency on caregiver's assistance and assess access to rehabilitation care. Data from Disability National Survey (ENEDIS), including urban and rural areas, were analyzed. Disability was defined as a permanent limitation on movement, vision, communication, hearing, learning/remembering or social relationships. Dependency was defined as the self-reported need for a caregiver to help with daily activities; and access to rehabilitation care was defined as the self-report of any therapy for disabilities. Estimates and projections were calculated using sample strata, primary sampling units and population weights, and prevalence ratios (PRs) and 95%CI were reported. From 798,308 people screened, 37,524 (5.1%; 95%CI 4.9--5.2%) had at least one disability. A total of 37,117 were included in further analysis, mean age 57.8 (SD ± 24.1) years, 52.1% women. Dependency was self-reported by 14,980 (40.5%; 95%CI: 39.2-41.9%) individuals with disabilities. A family member, usually female, was identified as a caregiver in 94.3% (95%CI: 93.3-95.3%) of dependent participants. Only 2881 (10.7%; 95%CI: 9.7-11.9%) of people with disabilities reported access to rehabilitation care. Major inequality patterns of disability burden versus access to rehabilitation care were observed by age and education level. Older age groups had higher disability burden yet lower chances of access to rehabilitation care. Conversely, the higher the education level, the lesser the overall disability burden but also the higher chances of reporting receiving care. Private healthcare insurance doubled the probability of having access to rehabilitation compared with those without insurance. Approximately 1.6 million Peruvians have at least one disability, and 40% of them require assistance with daily activities. Informal caregiving, likely female and relative-provided, is highly common. Rehabilitation care access is low and inequitable. Our results

  19. Tablet and Smartphone Accessibility Features in the Low Vision Rehabilitation

    PubMed Central

    Irvine, Danielle; Zemke, Alex; Pusateri, Gregg; Gerlach, Leah; Chun, Rob; Jay, Walter M.

    2014-01-01

    Abstract Tablet and smartphone use is rapidly increasing in developed countries. With this upsurge in popularity, the devices themselves are becoming more user-friendly for all consumers, including the visually impaired. Traditionally, visually impaired patients have received optical rehabilitation in the forms of microscopes, stand magnifiers, handheld magnifiers, telemicroscopes, and electronic magnification such as closed circuit televisions (CCTVs). In addition to the optical and financial limitations of traditional devices, patients do not always view them as being socially acceptable. For this reason, devices are often underutilised by patients due to lack of use in public forums or when among peers. By incorporating smartphones and tablets into a patient’s low vision rehabilitation, in addition to traditional devices, one provides versatile and mainstream options, which may also be less expensive. This article explains exactly what the accessibility features of tablets and smartphones are for the blind and visually impaired, how to access them, and provides an introduction on usage of the features. PMID:27928274

  20. Environmental Assessment: Access Roads and An Associated Interior Road, Centennial Estates Lease, Ellsworth AFB, SD

    DTIC Science & Technology

    2012-05-01

    Currently, 283 military housing units are present at EAFB. Current plans indicate that the new access points and roads for Centennial Estates...will also be equipped with typical underground utilities, easements and standard street lights. This EA has been prepared to facilitate planning ...8 3.3 Outfall Map 9 Appendices 10 A Interagency and Intergovernmental Coordination for Environmental Planning Correspondence 11 B Public Notice

  1. Motorcycles entering from access points and merging with traffic on primary roads in Malaysia: behavioral and road environment influence on the occurrence of traffic conflicts.

    PubMed

    Abdul Manan, Muhammad Marizwan

    2014-09-01

    This paper uses data from an observational study, conducted at access points in straight sections of primary roads in Malaysia in 2012, to investigate the effects of motorcyclists' behavior and road environment attributes on the occurrence of serious traffic conflicts involving motorcyclists entering primary roads via access points. In order to handle the unobserved heterogeneity in the small sample data size, this study applies mixed effects logistic regression with multilevel bootstrapping. Two statistically significant models (Model 2 and Model 3) are produced, with 2 levels of random effect parameters, i.e. motorcyclists' attributes and behavior at Level 1, and road environment attributes at Level 2. Among all the road environment attributes tested, the traffic volume and the speed limit are found to be statistically significant, only contributing to 26-29% of the variations affecting the traffic conflict outcome. The implication is that 71-74% of the unmeasured or undescribed attributes and behavior of motorcyclists still have an importance in predicting the outcome: a serious traffic conflict. As for the fixed effect parameters, both models show that the risk of motorcyclists being involved in a serious traffic conflict is 2-4 times more likely if they accept a shorter gap to a single approaching vehicle (time lag <4s) and in between two vehicles (time gap <4s) when entering the primary road from the access point. A road environment factor, such as a narrow lane (seen in Model 2), and a behavioral factor, such as stopping at the stop line (seen in Model 3), also influence the occurrence of a serious traffic conflict compared to those entering into a wider lane road and without stopping at the stop line, respectively. A discussion of the possible reasons for this seemingly strange result, including a recommendation for further research, concludes the paper. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. A synthesis of studies of access point density as a risk factor for road accidents.

    PubMed

    Elvik, Rune

    2017-10-01

    Studies of the relationship between access point density (number of access points, or driveways, per kilometre of road) and accident frequency or rate (number of accidents per unit of exposure) have consistently found that accident rate increases when access point density increases. This paper presents a formal synthesis of the findings of these studies. It was found that the addition of one access point per kilometre of road is associated with an increase of 4% in the expected number of accidents, controlling for traffic volume. Although studies consistently indicate an increase in accident rate as access point density increases, the size of the increase varies substantially between studies. In addition to reviewing studies of access point density as a risk factor, the paper discusses some issues related to formally synthesising regression coefficients by applying the inverse-variance method of meta-analysis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. A qualitative study analyzing access to physical rehabilitation for traffic accident victims with severe disability in Brazil.

    PubMed

    Sousa, Kelienny de Meneses; Oliveira, Wagner Ivan Fonsêca de; Melo, Laiza Oliveira Mendes de; Alves, Emanuel Augusto; Piuvezam, Grasiela; Gama, Zenewton André da Silva

    2017-03-01

    Purpose To identify access barriers to physical rehabilitation for traffic accident (TA) victims with severe disability and build a theoretical model to provide guidance towards the improvement of these services. Methods Qualitative research carried out in the city of Natal (Northeast Brazil), with semi-structured interviews with 120 subjects (19 key informer health professionals and 101 TA victims) identified in a database made available by the emergency hospital. The interviews were analyzed using Alceste software, version 4.9. Results The main barriers present in the interviews were: (1) related to services: bureaucratic administrative practises, low offer of rehabilitation services, insufficient information on rehabilitation, lack of guidelines that integrate hospital and ambulatory care and (2) related to patients: financial difficulties, functional limitations, geographic distance, little information on health, association with low education levels and disbelief in the system and in rehabilitation. Conclusion The numerous access barriers were presented in a theoretical model with causes related to organizational structure, processes of care, professionals and patients. This model must be tested by health policy-makers and managers to improve the quality of physical rehabilitation and avoid unnecessary prolongation of the suffering and disability experienced by TA survivors. Implications for rehabilitation Traffic accidents (TAs) are a global health dilemma that demands integrality of preventive actions, pre-hospital and hospital care and physical rehabilitation (PR). This study lays the foundation for improving access to PR for TA survivors, an issue of quality of care that results in preventable disabilities. The words of the patients interviewed reveal the suffering of victims, which is often invisible to society and given low priority by health policies that relegate PR to a second plan ahead of prevention and urgent care. A theoretical model of the

  4. View of Staff Officers' Quarters Area from Access Road. Building ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View of Staff Officers' Quarters Area from Access Road. Building No. 401 is to the left, Building No. 405 is to the right, and Building No. 403 is in center background. Facing northeast - MacDill Air Force Base, Bounded by City of Tampa North, Tampa Bay South, Old Tampa Bay West, & Hillsborough Bay East, Tampa, Hillsborough County, FL

  5. Rehabilitation of traumatic brain injury in Italy: a multi-centred study.

    PubMed

    Zampolini, M; Zaccaria, B; Tolli, V; Frustaci, A; Franceschini, M

    2012-01-01

    The aims of this study were to analyse TBI rehabilitation in Italy, identifying the main factors conditioning motor and functional recovery and destination upon discharge of traumatic severe acquired brain injury (sABI) patients who had undergone intensive rehabilitative treatment. An observational prospective study of 863 consecutive patients admitted to 52 Rehabilitation Centres from January 2001 to December 2003. The main cause of trauma was road accidents (79.8%), the mean length of stay was 87.31 ± 77.26 days and 40.4% access to rehabilitation facilities after a month. Pressure sore rates fell from 26.1% to 6.6% during the rehabilitation programme. After discharge 615 patients returned home, whilst 212 were admitted to other health facilities. This study highlights some major criticisms of rehabilitation of TBI. The delay of admission and evitable complications such as pressure sores are correlated to a worse outcome. While LOS causes a problem of cost-effectiveness, the rate of home discharge is prevalent and very high compared with other studies.

  6. Accommodating pedestrian and bicycle access on Parkers Mill Road from New Circle Road to Man O War Boulevard in Lexington

    DOT National Transportation Integrated Search

    2001-12-01

    In the fall of 2000 the Kentucky Transportation Center (KTC) began a planning study on behalf of the Kentucky Transportation Cabinet (KyTC) to investigate the bicycle and pedestrian access on KY 1968 (Parkers Mill Road) from Man O War Boulevard to Ne...

  7. Accommodating pedestrian and bicycle access on Parkers Mill Road from New Circle Road to Man O War Boulevard in Lexington.

    DOT National Transportation Integrated Search

    2001-12-01

    In the fall of 2000 the Kentucky Transportation Center (KTC) began a planning study on behalf of the Kentucky Transportation Cabinet (KYTC) to investigate the bicycle and pedestrian access on KY 1968 (Parker Mill Road) from Man O War Boulevard to New...

  8. Road Maintenance Experience Using Polyurethane (PU) Foam Injection System and Geocrete Soil Stabilization as Ground Rehabilitation

    NASA Astrophysics Data System (ADS)

    Fakhar, A. M. M.; Asmaniza, A.

    2016-07-01

    There are many types of ground rehabilation and improvement that can be consider and implement in engineering construction works for soil improvement in order to prevent road profile deformation in later stage. However, when comes to road maintenance especially on operated expressways, not all method can be apply directly as it must comply to opreation's working window and lane closure basis. Key factors that considering ideal proposal for ground rehabilitation are time, cost, quality and most importantly practicality. It should provide long lifespan structure in order to reduce continuous cycle of maintenance. Thus, this paper will present two approaches for ground rehabilitation, namely Polyurethane (PU) Foam Injection System and Geocrete Soil Stabilization. The first approach is an injection system which consists two-parts chemical grout of Isocynate and Polyol when mixed together within soil structure through injection will polymerized with volume expansion. The strong expansion of grouting causes significant compression and compacting of the surrounding soil and subsequently improve ground properties and uplift sunken structure. The later is a cold in-place recyclying whereby mixture process that combines in-situ soil materials, cement, white powder (alkaline) additive and water to produce hard yet flexible and durable ground layer that act as solid foundation with improved bearing capacity. The improvement of the mechanical behaviour of soil through these two systems is investigated by an extensive testing programme which includes in-situ and laboratory test in determining properties such as strength, stiffness, compressibility, bearing capacity, differential settlement and etc.

  9. Effects of road traffic noise and the benefit of access to quietness

    NASA Astrophysics Data System (ADS)

    Öhrström, E.; Skånberg, A.; Svensson, H.; Gidlöf-Gunnarsson, A.

    2006-08-01

    Socio-acoustic surveys were carried out as part of the Soundscape Support to Health research programme to assess the health effects of various soundscapes in residential areas. The study was designed to test whether having access to a quiet side of one's dwelling enhances opportunities for relaxation and reduces noise annoyance and other adverse health effects related to noise. The dwellings chosen were exposed to sound levels from road traffic ranging from about L=45-68 dB at the most-exposed side. The study involved 956 individuals aged 18-75 years. The results demonstrate that access to quiet indoor and outdoor sections of one's dwelling supports health; it produces a lower degree and extent of annoyance and disturbed daytime relaxation, improves sleep and contributes to physiological and psychological well-being. Having access to a quiet side of one's dwelling reduces disturbances by an average of 30-50% for the various critical effects, and corresponds to a reduction in sound levels of ( LAeq,24h) 5 dB at the most-exposed side. To protect most people (80%) from annoyance and other adverse effects, sound levels from road traffic should not exceed ( LAeq,24h) 60 dB at the most-exposed side, even if there is access to a quiet side of one's dwelling ( LAeq,24h⩽45 dB).

  10. [Female patients with fibromyalgia syndrome in somatic and psychosomatic rehabilitation center - an exploratory study on access routes and differences in patient characteristics].

    PubMed

    Ullrich, A; Glattacker, M; Sibold, M; Egle, U T; Ehlebracht-König, I; Geigges, W; Köllner, V; Kruse, M; Jäckel, W H

    2013-10-01

    Fibromyalgia syndrome (FMS) is characterized by e. g. chronic, multilocular pain, and mental health problems. In Germany, patients with FMS are treated in somatic and psychosomatic rehabilitation centers - specialized for rheumatic diseases (somatic) or psychosomatic diseases. The aim of this study is to identify the status quo of FMS patients' access routes to the rehabilitation system, and to identify their predictors for being assigned to one or the other indication group. Our cohort consists of 197 FMS patients from 3 psychosomatic (M=49.9 years) and 223 FMS patients (M=50.2 years) from 3 somatic rehabilitation centers. At the beginning of rehabilitation, patients filled out a questionnaire packet to identify their access routes to the rehabilitation centers and to record patients' disease-related, psychosocial and socio-demographic characteristics. To analyze the results we used descriptive calculations, calculated bivariate correlations, and conducted binary logistic regression analysis for the prediction of group membership. The access routes of FMS patients to a somatic or a psychosomatic rehabilitation center were often similar. Some items revealed significant group differences, i. e., a higher primary -rejection rate, longer waiting period between application for rehabilitation and its approval, and between the application itself and initiation of psychosomatic rehabilitation in comparison to somatic FMS patients. Prior experience of out-patient psychotherapy, and expectations ("psychological support") for the rehabilitation were predictive patient characteristics for the assignment into a psychosomatic rehabilitation center. Marriage, motivation, and expectations ("physical improvement" and "interaction with other patients") for the rehabilitation were predictive patient characteristics for the assignment in a somatic rehabilitation center. The predictors clarified 32% of the variance of group membership. Our results provide initial evidence of how FMS

  11. Affordability, accountability, and accessibility in health care reform: implications for cardiovascular and pulmonary rehabilitation.

    PubMed

    King, Marjorie L

    2013-01-01

    Because health care costs in the United States have been growing disproportionately compared to inflation for many years, without a clear connection to improved quality or increased access to care, employers and payers have begun to test new models of health care delivery and payment. These models are linked to the concepts of affordability, accountability, and accessibility and incorporate the premise that there must be shared responsibility for improving meaningful patient outcomes, with attention to the coordination of team-based and patient-centered care, and value for services purchased. This article explores emerging health care delivery and payment models, including expanded access to care related to the Affordable Care Act of 2010, patient-centered medical homes and neighborhoods, accountable and coordinated care organizations, and value-based purchasing and insurance design, with an emphasis on implications for cardiovascular and pulmonary rehabilitation programs and the American Association of Cardiovascular and Pulmonary Rehabilitation.

  12. When roads appear jaguars decline: Increased access to an Amazonian wilderness area reduces potential for jaguar conservation

    PubMed Central

    Celis, Gerardo; Branch, Lyn C.

    2018-01-01

    Roads are a main threat to biodiversity conservation in the Amazon, in part, because roads increase access for hunters. We examine how increased landscape access by hunters may lead to cascading effects that influence the prey community and abundance of the jaguar (Panthera onca), the top Amazonian terrestrial predator. Understanding such ecological effects originating from anthropogenic actions is essential for conservation and management of wildlife populations in areas undergoing infrastructure development. Our study was conducted in Yasuní Biosphere Reserve, the protected area with highest potential for jaguar conservation in Ecuador, and an area both threatened by road development and inhabited by indigenous groups dependent upon bushmeat. We surveyed prey and jaguar abundance with camera traps in four sites that differed in accessibility to hunters and used site occupancy and spatially explicit capture-recapture analyses to evaluate prey occurrence and estimate jaguar density, respectively. Higher landscape accessibility to hunters was linked with lower occurrence and biomass of game, particularly white-lipped peccary (Tayassu pecari) and collared peccary (Pecari tajacu), the primary game for hunters and prey for jaguars. Jaguar density was up to 18 times higher in the most remote site compared to the most accessible site. Our results provide a strong case for the need to: 1) consider conservation of large carnivores and other wildlife in policies about road construction in protected areas, 2) coordinate conservation initiatives with local governments so that development activities do not conflict with conservation objectives, and 3) promote development of community-based strategies for wildlife management that account for the needs of large carnivores. PMID:29298311

  13. When roads appear jaguars decline: Increased access to an Amazonian wilderness area reduces potential for jaguar conservation.

    PubMed

    Espinosa, Santiago; Celis, Gerardo; Branch, Lyn C

    2018-01-01

    Roads are a main threat to biodiversity conservation in the Amazon, in part, because roads increase access for hunters. We examine how increased landscape access by hunters may lead to cascading effects that influence the prey community and abundance of the jaguar (Panthera onca), the top Amazonian terrestrial predator. Understanding such ecological effects originating from anthropogenic actions is essential for conservation and management of wildlife populations in areas undergoing infrastructure development. Our study was conducted in Yasuní Biosphere Reserve, the protected area with highest potential for jaguar conservation in Ecuador, and an area both threatened by road development and inhabited by indigenous groups dependent upon bushmeat. We surveyed prey and jaguar abundance with camera traps in four sites that differed in accessibility to hunters and used site occupancy and spatially explicit capture-recapture analyses to evaluate prey occurrence and estimate jaguar density, respectively. Higher landscape accessibility to hunters was linked with lower occurrence and biomass of game, particularly white-lipped peccary (Tayassu pecari) and collared peccary (Pecari tajacu), the primary game for hunters and prey for jaguars. Jaguar density was up to 18 times higher in the most remote site compared to the most accessible site. Our results provide a strong case for the need to: 1) consider conservation of large carnivores and other wildlife in policies about road construction in protected areas, 2) coordinate conservation initiatives with local governments so that development activities do not conflict with conservation objectives, and 3) promote development of community-based strategies for wildlife management that account for the needs of large carnivores.

  14. EPA GHG certification of medium- and heavy-duty vehicles: Development of road grade profiles representative of US controlled access highways

    DOE PAGES

    Wood, Eric; Duran, Adam; Kelly, Kenneth

    2016-09-27

    In collaboration with the U.S. Environmental Protection Agency and the U.S. Department of Energy, the National Renewable Energy Laboratory has conducted a national analysis of road grade characteristics experienced by U.S. medium- and heavy-duty trucks on controlled access highways. These characteristics have been developed using TomTom's commercially available street map and road grade database. Using the TomTom national road grade database, national statistics on road grade and hill distances were generated for the U.S. network of controlled access highways. These statistical distributions were then weighted using data provided by the U.S. Environmental Protection Agency for activity of medium- and heavy-dutymore » trucks on controlled access highways. Here, the national activity-weighted road grade and hill distance distributions were then used as targets for development of a handful of sample grade profiles potentially to be used in the U.S. Environmental Protection Agency's Greenhouse Gas Emissions Model certification tool as well as in dynamometer testing of medium- and heavy-duty vehicles and their powertrains.« less

  15. EPA GHG certification of medium- and heavy-duty vehicles: Development of road grade profiles representative of US controlled access highways

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wood, Eric; Duran, Adam; Kelly, Kenneth

    In collaboration with the U.S. Environmental Protection Agency and the U.S. Department of Energy, the National Renewable Energy Laboratory has conducted a national analysis of road grade characteristics experienced by U.S. medium- and heavy-duty trucks on controlled access highways. These characteristics have been developed using TomTom's commercially available street map and road grade database. Using the TomTom national road grade database, national statistics on road grade and hill distances were generated for the U.S. network of controlled access highways. These statistical distributions were then weighted using data provided by the U.S. Environmental Protection Agency for activity of medium- and heavy-dutymore » trucks on controlled access highways. Here, the national activity-weighted road grade and hill distance distributions were then used as targets for development of a handful of sample grade profiles potentially to be used in the U.S. Environmental Protection Agency's Greenhouse Gas Emissions Model certification tool as well as in dynamometer testing of medium- and heavy-duty vehicles and their powertrains.« less

  16. Factors associated with access to physical rehabilitation for victims of traffic accidents.

    PubMed

    Sousa, Kelienny de Meneses; Oliveira, Wagner Ivan Fonsêca de; Alves, Emanuel Augusto; Gama, Zenewton André da Silva

    2017-06-22

    Evaluate the level of access to physical rehabilitation for survivors of traffic accidents and the associated factors. A cross-sectional study performed in Natal, Northeastern Brazil, through a telephone survey of 155 victims of traffic accidents admitted to an emergency hospital between January and August of 2013, with a diagnosis of fracture, traumatic brain injury or amputation. Participants were identified in the database of the reference hospital for care of traffic accident victims. We calculated point estimates and confidence interval (95%CI) for the frequency of subjects who had access, in addition to multivariate analysis (logistic regression) between access (dependent variable) and sociodemographic, clinical, and assistance variables. Among the 155 respondents, the majority were adolescents and adults between 15-29 years of age (47.7%), men (82.6%), education up to high school (92.3%), income of up to two minimum wages (78.0%) and bikers (75.5%). Although 85.8% of traffic accident survivors reported the need for physical rehabilitation, there was little access (51.6%; 95%CI 43.7-59.4) and a delay to start the physical rehabilitation (average = 67 days). We classified factors associated with access to physical rehabilitation as: (i) unmodifiable individuals in the short term - family income greater than two minimum wages (OR = 3.7), informal worker (OR = 0.11) or unemployed (OR = 0.15) and possession of a private health care plan (OR = 0.07); and (ii) assistance modifiable by service management - written referral for physical rehabilitation (OR = 27.5) and perceived need of physical rehabilitation (OR = 10). This study found a low and slow access to physical rehabilitation for individuals potentially in need. The associated factors were the organizational processes of health care (health information and referral) and social determinants (income, occupation and private health care plan). Avaliar o nível de acesso à reabilitação física para

  17. A three-stage heuristic for harvest scheduling with access road network development

    Treesearch

    Mark M. Clark; Russell D. Meller; Timothy P. McDonald

    2000-01-01

    In this article we present a new model for the scheduling of forest harvesting with spatial and temporal constraints. Our approach is unique in that we incorporate access road network development into the harvest scheduling selection process. Due to the difficulty of solving the problem optimally, we develop a heuristic that consists of a solution construction stage...

  18. Driver rehabilitation: a systematic review of the types and effectiveness of interventions used by occupational therapists to improve on-road fitness-to-drive.

    PubMed

    Unsworth, Carolyn A; Baker, Anne

    2014-10-01

    Driver rehabilitation has the potential to improve on-road safety and is commonly recommended to clients. The aim of this systematic review was to identify what intervention approaches are used by occupational therapists as part of driver rehabilitation programmes, and to determine the effectiveness of these interventions. Six electronic databases (MEDLINE, CINAHL, PsycInfo, Embase, The Cochrane Library, and OTDBase) were searched. Two authors independently reviewed studies reporting all types of research designs and for all patient populations, provided the interventions could be administered by occupational therapists. The methodological quality of studies was assessed using the 'Downs and Black Instrument', and the level of evidence for each intervention approach was established using 'Centre for Evidence Based Medicine' criteria. Sixteen studies were included in the review. The most common type of intervention approach used was computer-based driving simulator training (n=8), followed by off-road skill-specific training (n=4), and off-road education programmes (n=3). Car adaptations/modifications were used in one of the included studies. There was significant variability between studies with regards to frequency, duration, and total number of intervention sessions, and the diagnoses of the participants. Of the four intervention approaches, there is evidence to support the effectiveness of off-road skill-specific training (with older clients), and computer-based driving simulator training (with both older clients and participants with acquired brain injury). Three types of intervention approaches are commonly reported, however, there is limited evidence to determine to effectiveness of these in improving fitness-to-drive. Further research is required, with clients from a range of diagnostic groups to establish evidence-based interventions and determine their effectiveness in improving these clients' on-road fitness-to-drive. Crown Copyright © 2014. Published by

  19. Study of a rehabilitated road using GPR and FWD

    NASA Astrophysics Data System (ADS)

    Marecos, Vania; Fontul, Simona; de Lurdes Antunes, Maria; Solla, Mercedes; Pajewski, Lara

    2017-04-01

    This work focus on the structural evaluation of a rehabilitated road after the conclusion of the first phase of the improvement works. The activities developed in the study comprised the characterization of the pavement layers condition (before the application of the asphalt surface layer) and the prediction of the pavement bearing capacity (taking into account the contribution of the wearing course, to be placed in accordance with the project specifications). For this study two non-destructive tests (NDT) were combined: Falling Weight Deflectometer (FWD) and Ground Penetrating Radar (GPR). The original pavement was essentially composed by a granular layer treated with a bituminous emulsion. The main objectives of the rehabilitation works were the enlargement of the road platform in selected locations, with the construction of a new pavement, and also the reinforcement of the existing pavement to increase its bearing capacity. The FWD tests were performed to assess the bearing capacity of the pavement and were conducted along the outer wheel path, in both directions. The spacing between measurement points was 75 m and the applied impulse load was 50 kN. The results showed a great variability of the deflections measured along the section under study. A preliminary zonation of the pavement was carried out, and was latter adjusted based on the results of the GPR. To determine the thickness of the pavement layers a GPR survey was carried out using a 1.8 GHz antenna and a radar control unit SIR-20, both from GSSI. The GPR tests were performed continuously along the same line as the FWD tests. The GPR tests allowed for the identification of the different structures of the pavement, corresponding to the zones with the new pavement and the existing pavement with reinforcement. Some cores were extracted to calibrate the thickness of the GPR bituminous layers, to verify the conditions of adhesion between layers and also to perform laboratory tests to characterize the

  20. A qualitative study examining methods of accessing and identifying research relevant to clinical practice among rehabilitation clinicians.

    PubMed

    Patel, Drasti; Koehmstedt, Christine; Jones, Rebecca; Coffey, Nathan T; Cai, Xinsheng; Garfinkel, Steven; Shaewitz, Dahlia M; Weinstein, Ali A

    2017-01-01

    Research examining the utilization of evidence-based practice (EBP) specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice. A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed. There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information. Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur.

  1. Accessing Inpatient Rehabilitation after Acute Severe Stroke: Age, Mobility, Prestroke Function and Hospital Unit Are Associated with Discharge to Inpatient Rehabilitation

    ERIC Educational Resources Information Center

    Hakkennes, Sharon; Hill, Keith D.; Brock, Kim; Bernhardt, Julie; Churilov, Leonid

    2012-01-01

    The objective of this study was to identify the variables associated with discharge to inpatient rehabilitation following acute severe stroke and to determine whether hospital unit contributed to access. Five acute hospitals in Victoria, Australia participated in this study. Patients were eligible for inclusion if they had suffered an acute severe…

  2. 25 CFR 170.128 - Are housing access roads and housing streets eligible for IRR Program funding?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the transportation planning process as required in subpart D, may include housing access roads and housing street projects on the Tribal Transportation Improvement Program (TTIP). IRR Program funds are...

  3. [Prevention of road accidents in the road haulage field].

    PubMed

    Rosso, G L; Zanelli, R; Corino, P; Bruno, S

    2007-01-01

    Every year many traffic accidents with fatal outcomes occur in our Country. According to the recent indications of the European Agency for Safety and Health at Work, the Piedmont region has financed the plan: Prevention of road accidents in the road haulage field. The aims of the plan are to stimulate transport companies to the target of road safety and to improve and enforce sanitary surveillance, in order to improve the safety on road haulage and to prevent traffic injuries. the plan foresees, over a period of two years, a few encounters with all the interested parties (companies, police forces, labour unions etc). During those encounters we have to give a questionnaire for evaluating the companies' knowledge about the problem and we have to choose a common plan with the aim of improving road safety. The Piedmont regional plan recalls the need to increase the attention to numerous and diversified hazards for safety on road haulage. It also imposes the choice of measures that include: risk assessment, health education, technical and environmental prevention, sanitary surveillance and clinical interventions (diagnosis and rehabilitation of occupational accidents).

  4. Public expectations about access fees and road closures on public lands

    USGS Publications Warehouse

    Cline, K.; Lamb, B.L.; Ponds, P.D.

    2006-01-01

    It is sometimes suggested that land managers could better communicate with the general public by relying on people who are active in community affairs to frame the message. By comparing responses from the 'attentive' and general public on the Colorado Plateau in the USA, this study investigated the expected effects of using recreation access fees or road closures to manage recreation on public lands. Although neither the attentive nor general public strongly anticipated benefits from the two management options, the attentive public was more likely than the general public to report positive expectations. Those more likely to expect fewer benefits from the management options do so because of factors that are outside the influence of managers (e.g., socio-demographics and value orientation). The results point out challenges for building public support through mobilizing the attentive public to develop a positive management atmosphere with fees and road closures. ?? 2006 University of Newcastle upon Tyne.

  5. 27. AERIAL VIEW LOOKING EAST DOWN THE WEST ACCESS ROAD. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    27. AERIAL VIEW LOOKING EAST DOWN THE WEST ACCESS ROAD. THE FIRST LARGE PROTEST AT THE PLANT CAME IN 1978. IT WAS THE FIRST MAJOR PROTEST AT ANY DEPARTMENT OF ENERGY PLANT. IN RESPONSE TO CONTINUING ANTI- NUCLEAR PROTESTS, IN PARTICULAR A 1979 RALLY THAT DREW 10,000 PARTICIPANTS, ROCKWELL EMPLOYEES AT THE PLANT FORMED A GRASSROOT ORGANIZATION, CITIZENS FOR ENERGY AND FREEDOM, AND ORGANIZED A PRO-NUCLEAR RALLY, 'POWER TO THE PEOPLE,' THAT ATTRACTED 16,000 PEOPLE (5/4/78). - Rocky Flats Plant, Bounded by Indiana Street & Routes 93, 128 & 72, Golden, Jefferson County, CO

  6. Characterizing on-road driving performance in individuals with traumatic brain injury who pass or fail an on-road driving assessment.

    PubMed

    Stolwyk, Renerus J; Charlton, Judith L; Ross, Pamela E; Bédard, Michel; Marshall, Shawn; Gagnon, Sylvain; Gooden, James R; Ponsford, Jennie L

    2018-01-15

    To characterise on-road driving performance in individuals with traumatic brain injury who fail on-road driving assessment, compared with both those who pass assessment and healthy controls, and the injury and cognitive factors associated with driving performance. Cross-sectional. Forty eight participants with traumatic brain injury (Age M = 40.50 SD = 14.62, 77% male, post-traumatic amnesia days M = 28.74 SD =27.68) and 48 healthy matched controls completed a standardised on-road driving assessment in addition to cognitive measures. Individuals with traumatic brain injury who passed on-road driving assessment performed no differently from controls while individuals with traumatic brain injury who failed the assessment demonstrated significantly worse driving performance relative to controls across a range of driving manoeuvres and error types including observation of on-road environment, speed control, gap selection, lane position, following distance and basic car control. Longer time post-injury and reduced visual perception were both significantly correlated with reduced driving skills. This exploratory study indicated that drivers with traumatic brain injury who failed on-road assessment demonstrated a heterogeneous pattern of impaired driving manoeuvres, characterised by skill deficits across both operational (e.g., basic car control and lane position) and tactical domains (e.g., following distance, gap selection, and observation) of driving. These preliminary findings can be used for implementation of future driving assessments and rehabilitation programs. Implications for rehabilitation Clinicians should be aware that the majority of individuals with traumatic brain injury were deemed fit to resume driving following formal on-road assessment, despite having moderate to very severe traumatic brain injuries. Drivers with traumatic brain injury who failed an on-road assessment demonstrated a heterogeneous pattern of impaired skills including errors

  7. 23 CFR 661.21 - When is a bridge eligible for rehabilitation?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 23 Highways 1 2011-04-01 2011-04-01 false When is a bridge eligible for rehabilitation? 661.21... TRAFFIC OPERATIONS INDIAN RESERVATION ROAD BRIDGE PROGRAM § 661.21 When is a bridge eligible for rehabilitation? To be eligible for rehabilitation, the bridge must be considered structurally deficient or...

  8. 23 CFR 661.21 - When is a bridge eligible for rehabilitation?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false When is a bridge eligible for rehabilitation? 661.21... TRAFFIC OPERATIONS INDIAN RESERVATION ROAD BRIDGE PROGRAM § 661.21 When is a bridge eligible for rehabilitation? To be eligible for rehabilitation, the bridge must be considered structurally deficient or...

  9. Examining the role of vocational rehabilitation on access to care and public health outcomes for people living with HIV/AIDS.

    PubMed

    Conyers, Liza; Boomer, K B

    2014-01-01

    The purpose of this study is to examine the role of vocational rehabilitation services in contributing to the goals of the National HIV/AIDS strategy. Three key research questions are addressed: (a) What is the relationship among factors associated with the use of vocational rehabilitation services for people living with HIV/AIDS? (b) Are the factors associated with use of vocational rehabilitation also associated with access to health care, supplemental employment services and reduced risk of HIV transmission? and (c) What unique role does use of vocational rehabilitation services play in access to health care and HIV prevention? Survey research methods were used to collect data from a broad sample of volunteer respondents who represented diverse racial (37% Black, 37% White, 18% Latino, 7% other), gender (65% male, 34% female, 1% transgender) and sexual orientation (48% heterosexual, 44% gay, 8% bisexual) backgrounds. The fit of the final structural equation model was good (root mean square error of approximation = 0.055), with 90% upper bound of 0.058, Comparative Fit Index = 0.953, TLI = 0.945). Standardized effects with bootstrap confidence intervals are reported. Overall, the findings support the hypothesis that vocational rehabilitation services can play an important role in health and prevention strategies outlined in the National HIV/AIDS strategy.

  10. Final priorities; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priorities.

    PubMed

    2013-06-11

    The Assistant Secretary for Special Education and Rehabilitative Services announces priorities under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce priorities for a Rehabilitation Engineering Research Center (RERC) on Rehabilitation Strategies, Techniques, and Interventions (Priority 1), Information and Communication Technologies Access (Priority 2), Individual Mobility and Manipulation (Priority 3), and Physical Access and Transportation (Priority 4). The Assistant Secretary may use one or more of these priorities for competitions in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend these priorities to improve community living and participation, health and function, and employment outcomes of individuals with disabilities.

  11. Health Benefits for Vocational Rehabilitation Consumers: Comparison of Access Rates with Workers in the General Population

    ERIC Educational Resources Information Center

    Lustig, Daniel C.; Strauser, David R.

    2010-01-01

    Access to health insurance is one of the critical aspects of securing employment for people with disabilities. This study investigated whether vocational rehabilitation consumers secured employment with an employer who offered health insurance at similar rates to workers in the general population. In general, the results show that vocational…

  12. Auditing Access to Outpatient Rehabilitation Services for Children With Traumatic Brain Injury and Public Insurance in Washington State.

    PubMed

    Fuentes, Molly M; Thompson, Leah; Quistberg, D Alex; Haaland, Wren L; Rhodes, Karin; Kartin, Deborah; Kerfeld, Cheryl; Apkon, Susan; Rowhani-Rahbar, Ali; Rivara, Frederick P

    2017-09-01

    To identify insurance-based disparities in access to outpatient pediatric neurorehabilitation services. Audit study with paired calls, where callers posed as a mother seeking services for a simulated child with history of severe traumatic brain injury and public or private insurance. Outpatient rehabilitation clinics. Sample of rehabilitation clinics (N=287): 195 physical therapy (PT) clinics, 109 occupational therapy (OT) clinics, 102 speech therapy (ST) clinics, and 11 rehabilitation medicine clinics. Not applicable. Acceptance of public insurance and the number of business days until the next available appointment. Therapy clinics were more likely to accept private insurance than public insurance (relative risk [RR] for PT clinics, 1.33; 95% confidence interval [CI], 1.22-1.44; RR for OT clinics, 1.40; 95% CI, 1.24-1.57; and RR for ST clinics, 1.42; 95% CI, 1.25-1.62), with no significant difference for rehabilitation medicine clinics (RR, 1.10; 95% CI, 0.90-1.34). The difference in median wait time between clinics that accepted public insurance and those accepting only private insurance was 4 business days for PT clinics and 15 days for ST clinics (P≤.001), but the median wait time was not significantly different for OT clinics or rehabilitation medicine clinics. When adjusting for urban and multidisciplinary clinic statuses, the wait time at clinics accepting public insurance was 59% longer for PT (95% CI, 39%-81%), 18% longer for OT (95% CI, 7%-30%), and 107% longer for ST (95% CI, 87%-130%) than that at clinics accepting only private insurance. Distance to clinics varied by discipline and area within the state. Therapy clinics were less likely to accept public insurance than private insurance. Therapy clinics accepting public insurance had longer wait times than did clinics that accepted only private insurance. Rehabilitation professionals should attempt to implement policy and practice changes to promote equitable access to care. Copyright © 2017

  13. An overview of road damages due to flooding: Case study in Kedah state, Malaysia

    NASA Astrophysics Data System (ADS)

    Ismail, Muhd Shahril Nizam; Ghani, Abdul Naser Abdul

    2017-10-01

    Flooding occurs frequently in many countries including Malaysia. Floods in Malaysia are usually due to heavy and prolonged rainfall, uncontrolled development, and drainage systems that are not being monitored. Road damage due to flooding event can cause huge expenditures for the post-flooding rehabilitation and maintenance. The required maintenance and rehabilitation could upset the original life cycle cost estimations. Data on road statistics were obtained from the Highway Planning Division, Ministry of Works Malaysia and data on flooding was collected from the Department of Irrigation and Drainage Malaysia for events between 2012 and 2015. The pilot sites were selected based on its historical cases of floods that caused road damages in Kedah. The pilot site indicated that the impact of flooding on road infrastructures systems can be used to plan better road design and maintenances. It also revealed that it costs more than RM 1 million to reinstate roads damaged by flooding in a typical district annually.

  14. Forest access roads: design, maintenance, and soil loss

    Treesearch

    Lloyd W. Swift

    1988-01-01

    The Regional Guide for,the South (United States Department of Agriculture 1984b) recognizes that roads and skid trails are the major sources of sediment from forestry-related activities. The overall environmental impact statement for Region 8 (United States Department of Agriculture 1984a) estimates an existing national forest road network of 56,300 km (3 1,000 miles)...

  15. 36 CFR 9.32 - Access.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... MANAGEMENT Non-Federal Oil and Gas Rights § 9.32 Access. (a) No access on, across or through lands or waters... access is by foot, pack animal, or designated road. Persons using designated roads for access to such a...

  16. 36 CFR 9.32 - Access.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... MANAGEMENT Non-Federal Oil and Gas Rights § 9.32 Access. (a) No access on, across or through lands or waters... access is by foot, pack animal, or designated road. Persons using designated roads for access to such a...

  17. 36 CFR 9.32 - Access.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MANAGEMENT Non-Federal Oil and Gas Rights § 9.32 Access. (a) No access on, across or through lands or waters... access is by foot, pack animal, or designated road. Persons using designated roads for access to such a...

  18. 36 CFR 9.32 - Access.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... MANAGEMENT Non-Federal Oil and Gas Rights § 9.32 Access. (a) No access on, across or through lands or waters... access is by foot, pack animal, or designated road. Persons using designated roads for access to such a...

  19. Final priority; National Institute on Disability and Rehabilitation Research--Rehabilitation Engineering Research Centers. Final priority.

    PubMed

    2014-07-09

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for a Rehabilitation Engineering Research Center (RERC) on Improving the Accessibility, Usability, and Performance of Technology for Individuals who are Deaf or Hard of Hearing. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus research attention on an area of national need. We intend the priority to contribute to improving the accessibility, usability, and performance of technology for individuals who are deaf or hard of hearing.

  20. [Social inequality in medical rehabilitation].

    PubMed

    Deck, Ruth; Hofreuter-Gätgens, Kerstin

    2016-02-01

    The analysis of inequalities in health care provision in Germany is of high sociopolitical relevance. For medical rehabilitation, which is an essential part of health care provision, only a few studies exist. With the example of psychosomatic and orthopedic medical rehabilitation, the present article investigates how features of social inequality influence different aspects of medical rehabilitation. The database consists of a written survey on the quality assurance of medical rehabilitation in northern Germany that includes 687 patients aged between 21 and 87 years. Aspects of the access to rehabilitation (e.g., the motivation for application), the process (participation in therapies) and the outcomes (e.g., subjective health and occupational risk) of rehabilitation were investigated in relation to social inequality. Social inequality was measured by means of a social class index. For the analysis, Chi-squared tests, t tests and a repeated measures analysis of variance, adjusted for sex and age, were conducted. Initially, the analyses indicate that social inequality is of minor importance for access to rehabilitation and processes within rehabilitation. As subjective health is unequally distributed at the beginning of rehabilitation, however, equal treatment has to be discussed critically in terms of demand-driven treatment. In rehabilitation outcome distinct differences between social classes exist. To reduce these differences, rehabilitation aftercare close to the individual's living environment is necessary, which promotes the empowerment of vulnerable social groups in burdensome living conditions.

  1. Development of a mix design process for cold-in-place rehabilitation using foamed asphalt.

    DOT National Transportation Integrated Search

    2003-12-01

    This study evaluates one of the recycling techniques used to rehabilitate pavement, called Cold In-Place Recycling (CIR). CIR is one of the fastest growing road rehabilitation techniques because it is quick and cost-effective. The document reports on...

  2. Driving and off-road impairments underlying failure on road testing in Parkinson's disease.

    PubMed

    Devos, Hannes; Vandenberghe, Wim; Tant, Mark; Akinwuntan, Abiodun E; De Weerdt, Willy; Nieuwboer, Alice; Uc, Ergun Y

    2013-12-01

    Parkinson's disease (PD) affects driving ability. We aimed to determine the most critical impairments in specific road skills and in clinical characteristics leading to failure on a road test in PD. In this cross-sectional study, certified driving assessment experts evaluated specific driving skills in 104 active, licensed drivers with PD using a standardized, on-road checklist and issued a global decision of pass/fail. Participants also completed an off-road evaluation assessing demographic features, disease characteristics, motor function, vision, and cognition. The most important driving skills and off-road predictors of the pass/fail outcome were identified using multivariate stepwise regression analyses. Eighty-six (65%) passed and 36 (35%) failed the on-road driving evaluation. Persons who failed performed worse on all on-road items. When adjusted for age and gender, poor performances on lateral positioning at low speed, speed adaptations at high speed, and left turning maneuvers yielded the best model that determined the pass/fail decision (R(2) = 0.56). The fail group performed poorer on all motor, visual, and cognitive tests. Measures of visual scanning, motor severity, PD subtype, visual acuity, executive functions, and divided attention were independent predictors of pass/fail decisions in the multivariate model (R(2) = 0.60). Our study demonstrated that failure on a road test in PD is determined by impairments in specific driving skills and associated with deficits in motor, visual, executive, and visuospatial functions. These findings point to specific driving and off-road impairments that can be targeted in multimodal rehabilitation programs for drivers with PD. © 2013 Movement Disorder Society.

  3. 23 CFR 660.517 - Maneuver area roads.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Maneuver area roads. 660.517 Section 660.517 Highways... PROGRAMS (DIRECT FEDERAL) Defense Access Roads § 660.517 Maneuver area roads. (a) Claims by a highway agency for costs incurred to restore, to their former condition, roads damaged by maneuvers involving a...

  4. Full road closure for work zone operations, a cross-cutting study : reducing congestion and crashes through full road closure for maintenance and construction.

    DOT National Transportation Integrated Search

    2003-08-01

    The objective of this report is to raise awareness among designers construction engineers, and managers of the applications and benefits of full road closure during rehabilitation and construction activities. Based on interviews with project personne...

  5. Barriers to low vision rehabilitation: the Montreal Barriers Study.

    PubMed

    Overbury, Olga; Wittich, Walter

    2011-11-21

    One objective of the Montreal Barriers Study was to examine demographic characteristics of people with vision impairment that may hinder their referral or decision to access rehabilitation services. Data collection was conducted in three phases, whereby during phase I, patients in ophthalmology department waiting rooms underwent a structured interview to ascertain demographic variables that may be related to their utilization of the rehabilitation process. Phase II examined variables recorded in the rehabilitation agency file of those who had made the choice to access services. Phase III examined the rehabilitation access behavior of those participants who were referred as part of phase I. In phase I, 54% of the 702 participants had been referred to and received rehabilitation services. An additional 13% were aware of these services but chose not to access them, whereas 33% were unaware of their existence. The variables associated with positive access choice were education, diagnosis, race, acuity at the time of interview, and living situation. In phase II, it was found that acuity at agency intake was markedly better than at the study interview. Of the participants who were referred to rehabilitation services as part of the phase I protocol, it was found in phase III that only 56% had engaged in rehabilitation services. It seems that even under ideal referral situations, there remain barriers to vision rehabilitation services that have not been specifically identified in the present study. Further research is necessary on the psychological and psychosocial contributors to this process.

  6. Survival, neurological recovery and morbidity after spinal cord injuries following road accidents in Israel.

    PubMed

    Tchvaloon, E; Front, L; Gelernter, I; Ronen, J; Bluvshtein, V; Catz, A

    2008-02-01

    A retrospective cohort study. Assess outcomes in patients with spinal cord injuries (SCI) following road accidents, and factors that affect them. Loewenstein Rehabilitation Hospital, Raanana, Israel. A total of 143 patients admitted for rehabilitation between 1962 and 2004. Survival rates were estimated using the product limit (Kaplan-Meyer) method and their association with risk factors was analyzed with the Cox model. Neurological recovery was determined by comparing the Frankel grade at admission to rehabilitation and at discharge. The relation between recovery and various factors was tested with logistic regression. The risk of SCI in road accidents is higher among car drivers and motorcycle or bicycle riders. Median survival was 43 years. Survival was negatively associated with age at injury (P<0.0002) and with diagnosis of pressure sores (P=0.0065). Recovery of at least one Frankel grade occurred in 29.1% of patients. Useful recovery (upgrade to Frankel grade D or E) occurred in 23.1% of all patients. Neurological recovery was negatively associated with the severity of neurological deficit (P<0.001) and with thoracic injuries (P=0.046). The most common complications were pressure sores and those of the urinary and respiratory systems. In SCI following road accidents, survival rates were higher and recovery rates lower than in mixed types of trauma. This may be related to better compensation followed by better nursing for road accident victims in Israel, which may prevent life-shortening complications, and to more severe injuries caused by road accidents.

  7. Forest roads, chronic turbidity, and salmon

    Treesearch

    L. M. Reid

    1998-01-01

    Certain impacts of forest roads on habitats used by anadromous salmonids are widely recognized and well-understood: road-related landslides increase sediment loads and modify channel morphology, and culverts restrict access to parts of the channel network. Other influences are less obvious, but may be even more pervasive. For example, road-related erosion significantly...

  8. Web Accessibility of the Higher Education Institute Websites Based on the World Wide Web Consortium and Section 508 of the Rehabilitation Act

    ERIC Educational Resources Information Center

    Alam, Najma H.

    2014-01-01

    The problem observed in this study is the low level of compliance of higher education website accessibility with Section 508 of the Rehabilitation Act of 1973. The literature supports the non-compliance of websites with the federal policy in general. Studies were performed to analyze the accessibility of fifty-four sample web pages using automated…

  9. Native plant restoration on the Going-to-the-Sun Road, Glacier National Park

    Treesearch

    David E. Lange; Joyce Lapp

    1999-01-01

    Since 1991, 53 acres of roadside vegetation and soil were removed along sections of the historic Going-to-the-Sun Road during road rehabilitation activities. Restoration strategies used indigenous plant material to re-establish plant cover, prevent erosion, compete with exotics, and improve aesthetics. From several hundred collections, simple seed mixes were created...

  10. Research related to roads in USDA experimental forests [Chapter 16

    Treesearch

    W. J. Elliot; P. J. Edwards; R. B. Foltz

    2014-01-01

    Forest roads are essential in experimental forests and rangelands (EFRs) to allow researchers and the public access to research sites and for fire suppression, timber extraction, and fuel management. Sediment from roads can adversely impact watershed health. Since the 1930s, the design and management of forest roads has addressed both access issues and watershed health...

  11. Final priority; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priority.

    PubMed

    2013-06-14

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for a Rehabilitation Engineering Research Center (RERC) on Universal Interfaces and Information Technology Access under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). The Assistant Secretary may use this priority for a competition in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend to use this priority to improve outcomes for individuals with disabilities.

  12. Individual- and area-level disparities in access to the road network, subway system and a public bicycle share program on the Island of Montreal, Canada.

    PubMed

    Fuller, Daniel; Gauvin, Lise; Kestens, Yan

    2013-02-01

    Few studies have examined potential disparities in access to transportation infrastructures, an important determinant of population health. To examine individual- and area-level disparities in access to the road network, public transportation system, and a public bicycle share program in Montreal, Canada. Examining associations between sociodemographic variables and access to the road network, public transportation system, and a public bicycle share program, 6,495 adult respondents (mean age, 48.7 years; 59.0 % female) nested in 33 areas were included in a multilevel analysis. Individuals with lower incomes lived significantly closer to public transportation and the bicycle share program. At the area level, the interaction between low-education and low-income neighborhoods showed that these areas were significantly closer to public transportation and the bicycle share program controlling for individual and urbanicity variables. More deprived areas of the Island of Montreal have better access to transportation infrastructure than less-deprived areas.

  13. Outpatient spinal cord injury rehabilitation: managing costs and funding in a changing health care environment.

    PubMed

    Riis, V; Verrier, M C

    2007-10-15

    To examine the literature describing the cost of outpatient rehabilitation for patients with spinal cord injury (SCI) as well as the effect of funding type on cost and outcome. A SCI rehabilitation planning and funding model is presented that calls for structured assessment of the client's economic environment, with follow through to promote full access to funding for rehabilitation plans. Literature review of specific outpatient rehabilitation intervention costs and effect of funding type, followed by development of a funding model to improve access to available funding for SCI rehabilitation. There is insufficient economic data to draw conclusions about the relationship between an individual's rehabilitation needs and access to appropriate funding for outpatient rehabilitation. Consequently, health providers and payers need to adopt an approach that will improve consistency of payment decisions and access to necessary funding for rehabilitation. A model for a more formal approach to: (a) Assessment of a client's economic environment; (b) use of evidence-based SCI rehabilitation; and (c) use of available financial resources should promote better access to appropriate rehabilitation following SCI.

  14. 75 FR 21039 - Notice of Temporary Road Closure of Coal Pit Spring-Cave Gulch Road (6287-0-B0), Within the Cave...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-22

    ... stabilization. The BLM posted signs at main entry points to the temporary closure area. Maps of the closed roads...; HAG10-0046] Notice of Temporary Road Closure of Coal Pit Spring--Cave Gulch Road (6287-0-B0), Within the... closure. SUMMARY: Notice is hereby given that a temporary road closure to public access, use, or occupancy...

  15. A Serious Games Platform for Cognitive Rehabilitation with Preliminary Evaluation.

    PubMed

    Rego, Paula Alexandra; Rocha, Rui; Faria, Brígida Mónica; Reis, Luís Paulo; Moreira, Pedro Miguel

    2017-01-01

    In recent years Serious Games have evolved substantially, solving problems in diverse areas. In particular, in Cognitive Rehabilitation, Serious Games assume a relevant role. Traditional cognitive therapies are often considered repetitive and discouraging for patients and Serious Games can be used to create more dynamic rehabilitation processes, holding patients' attention throughout the process and motivating them during their road to recovery. This paper reviews Serious Games and user interfaces in rehabilitation area and details a Serious Games platform for Cognitive Rehabilitation that includes a set of features such as: natural and multimodal user interfaces and social features (competition, collaboration, and handicapping) which can contribute to augment the motivation of patients during the rehabilitation process. The web platform was tested with healthy subjects. Results of this preliminary evaluation show the motivation and the interest of the participants by playing the games.

  16. Tundra Rehabilitation in Alaska's Arctic

    NASA Astrophysics Data System (ADS)

    Lynn, L. A.

    2012-12-01

    Oil exploration in Alaska's Arctic has been conducted for more than 40 years, resulting in over 3,640 ha of gravel fill placed for roads, pads, and airstrips to support the industry. Likewise, tundra disturbance from burying power lines and by tundra vehicle travel are also common. Rehabilitation of disturbed sites began around 2002, with well over 150 ha that has been previously treated or is currently being rehabilitated. Two primary goals of rehabilitation efforts have been 1) revegetation by indigenous species, and 2) limiting thermokarst. Early efforts were concerned that removing gravel and having exposed bare ground would lead to extensive subsidence and eolian erosion. Native grass cultivars (e.g. Poa glauca, Arctagrostis latifolia, and Festuca rubra) were seeded to create vegetation cover quickly with the expectation that these grasses would survive only temporarily. The root masses and leaf litter were also expected to trap indigenous seed to enhance natural recolonization by indigenous plants. Due to the remote location of these sites, many of which are only accessible by helicopter, most are visited only two to three times following cultivation treatments, providing a limited data pool. At many sites, the total live seeded grass cover declined about 15% over the first 5¬-6 years (from around 30% to 15% cover), while total live indigenous vascular cover increased from no or trace cover to an average of 10% cover in that time. Cover of indigenous vascular plants at sites that were not seeded with native grass cultivars averaged just less than 10% after 10 years, showing no appreciable difference between the two approaches. Final surface elevations at the sites affect local hydrology and soil moisture. Other factors that influence the success of vegetation cover are proximity to the Arctic coast (salt effects), depth of remaining gravel, and changes in characteristics of the near-surface soil. Further development of rehabilitation techniques and the

  17. Evaluation of Road Performance Based on International Roughness Index and Falling Weight Deflectometer

    NASA Astrophysics Data System (ADS)

    Hasanuddin; Setyawan, A.; Yulianto, B.

    2018-03-01

    Assessment to the performance of road pavement is deemed necessary to improve the management quality of road maintenance and rehabilitation. This research to evaluate the road base on functional and structural and recommendations handling done. Assessing the pavement performance is conducted with functional and structural evaluation. Functional evaluation of pavement is based on the value of IRI (International Roughness Index) which among others is derived from reading NAASRA for analysis and recommended road handling. Meanwhile, structural evaluation of pavement is done by analyzing deflection value based on FWD (Falling Weight Deflectometer) data resulting in SN (Structural Number) value. The analysis will result in SN eff (Structural Number Effective) and SN f (Structural Number Future) value obtained from comparing SN eff to SN f value that leads to SCI (Structural Condition Index) value. SCI value implies the possible recommendation for handling pavement. The study done to Simpang Tuan-Batas Kota Jambi road segment was based on functional analysis. The study indicated that the road segment split into 12 segments in which segment 1, 3, 5, 7, 9, and 11 were of regular maintenance, segment 2, 4, 8, 10, 12 belonged to periodic maintenance, and segment 6 was of rehabilitation. The structural analysis resulted in 8 segments consisting of segment 1 and 2 recommended for regular maintenance, segment 3, 4, 5, and 7 for functional overlay, and 6 and 8 were of structural overlay.

  18. [Is rehabilitation worth it? : Review of economic evaluations of rehabilitation in Germany].

    PubMed

    Krauth, Christian; Bartling, Tim

    2017-04-01

    Because of demographic change, the rehabilitation sector in Germany is going to face increasing demands in the future. Limited budgets make the optimal allocation of resources a top priority. To support decisions about the optimal scope and design of rehabilitation, studies on health economics are of utmost importance. The aim of this article is to provide an overview of the evaluation of rehabilitation with regard to health economics in Germany.Based on a comprehensive literature research, 17 studies on the cost-effectiveness of rehabilitation in Germany were identified. The health economics evaluation focuses on four main topics: patient education (5 studies), the comparison of outpatient and inpatient rehabilitation (7 studies), medico-occupational rehabilitation programs (2 studies) and aftercare programs (3 studies). All four topics show that innovative rehabilitation technologies can be cost-effective. Significant potential savings in program costs of 25-35% are demonstrated in outpatient rehabilitation (with comparable effectiveness with inpatient care). Designated patient education programs often lead to significant savings with indirect costs, by reducing periods of unfitness to work and extending the long-term ability to work. This review article also points out that some relevant areas of rehabilitation, such as the flexibilization of rehabilitation programs or the efficient organization of access to rehabilitation, have not been evaluated sufficiently on the basis of health economics. This article ends with the requirement to carry out more economics-based rehabilitation studies.

  19. Effect of referral strategies on access to cardiac rehabilitation among women.

    PubMed

    Gravely, Shannon; Anand, Sonia S; Stewart, Donna E; Grace, Sherry L

    2014-08-01

    Despite its proven benefits and need, women's access to cardiac rehabilitation (CR) is suboptimal. Referral strategies, such as systematic referral, have been advocated to improve access to CR. This study examined sex differences in CR referral and enrollment by referral strategies; and the impact of referral strategies for referral and enrollment concordance among women. Prospective cohort study. This prospective study included 2635 coronary artery disease inpatients from 11 Ontario hospitals that utilized one of four referral strategies. Participants completed a sociodemographic survey, and clinical data were extracted from charts. One year later, 1809 participants (452 (25%) women) completed a mailed survey that assessed CR utilization. Referral strategies were compared among women using generalized estimating equations to control for the effect of hospital. Overall, significantly more men than women were referred (67.2% and 57.8% respectively, p < 0.001), and enrolled in CR (58.6% and 49.3% respectively, p = 0.001). Of the retained women, combined systematic and liaison-facilitated referral resulted in significantly greater CR referral (OR 10.3, 95% CI 4.11-25.58) and enrollment (OR 6.6, 95% CI 4.34-9.92) among women when compared with usual referral. Conversely, concordance between referral and enrollment was greatest following usual referral (K = 0.85), and decreased with referral intensity. While a lower proportion of referred patients enroll, systematic and liaison-facilitated inpatient referral strategies result in the greatest CR enrollment rates among women. Such strategies have the potential to improve access among women, and reduce 'cherry picking' of patients for referral. © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  20. Supporting drivers in forming correct expectations about transitions between rural road categories.

    PubMed

    Stelling-Konczak, Agnieszka; Aarts, Letty; Duivenvoorden, Kirsten; Goldenbeld, Charles

    2011-01-01

    In order to support drivers in forming the right expectations on the road, road categories are being made recognisable and predictable in the Netherlands. The present study investigated which of the selected road layouts can make rural road categories most recognisable for road users, especially in transitions from one road category to another. A second objective was to study whether explicit information could contribute to a better recognisability of transitions. The experiment was performed with a series of photographs showing sections of two road categories with an intersection in between. The road layout of road categories varied in markings and separation of driving direction (within-subjects factor). Informed and non-informed participants (between-subjects factor) had to indicate their expectations regarding speed limit and access restriction of each road section, before and after a transition. The results show that for transitions between distributor and through roads, the physicality of separation of driving direction is a better distinctive characteristic than the currently used edge marking. The green centre marking on through roads also enhances recognisability, but only with additional information. As far as transitions between distributor and access roads are concerned, the results demonstrate that this type of transitions is better recognised when no markings on access roads are present. Physical separation of driving directions on distributor roads also improves recognisability, although this layout is associated with higher speed limits. Providing explicit information has in general a positive effect on the reconisability of transitions. Implications are discussed in the light of potential safety effects. Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. Access to low-vision rehabilitation services: barriers and enablers.

    PubMed

    Matti, Albert I; Pesudovs, Konrad; Daly, Andrew; Brown, Margaret; Chen, Celia S

    2011-03-01

    The current mismatch between the need for and uptake of low-vision services has been attributed to various barriers including different service delivery models and referral pathways. This study evaluates the referral pathway and low-vision service provision of the Royal Society for the Blind (RSB) in South Australia. All new referrals from the 2008-2009 financial year to the RSB were reviewed. Initially, patients were contacted by a triage officer within one week of referral. Initial appointments were made in the Low Vision Clinic with a multidisciplinary team. Reasons for declining the appointment or non-attendance were tracked via telephone. There were 1116 patients referred over a 12-month period and 1082 (97 per cent) were reviewed in the Low Vision Clinic. Most attendees (92 per cent) lived within 50 kilometres of the clinic. There were 34 referred patients, who declined or did not attend the assessment. All non-attendees also lived within 50 kilometres of the Low Vision Centre. Concurrent major health problems (27 per cent) and patients not feeling the need for low-vision rehabilitation (27 per cent) were the most common reasons for not accessing the service. Only 125 patients (11.6 per cent) accessed volunteer transport services and only 24 patients (2.2 per cent) needed an interpreter service. The attendance rate is significantly higher than in other published studies. The distance to travel or transport difficulties were not significant barriers. Patient perception that either the service was not required or would not help them was the main barrier. The referral and triage process appeared to be a major enabler of low-vision service uptake. © 2010 The Authors. Clinical and Experimental Optometry © 2010 Optometrists Association Australia.

  2. "Dance and go on": a project of psychosocial rehabilitation on the road.

    PubMed

    Tavormina, Romina; Tavormina, Maurilio Giuseppe Maria; Nemoianni, Eugenio

    2015-09-01

    The project "Dance and go on" was created with the intention of bringing out of the Day Centre of the Department of Mental Health of Torre del Greco, the dance group "Dance That you go" active since 2009. Dancing Bachata becomes a rehabilitation tool to express emotions through the body and to open to the outside, on the territory (local society), overcoming the fear of being judged by others, the prejudice and the social stigma about mental illness. The rehabilitation activities of the dancing group allowed patients to improve their care of self, self-esteem, confidence in their capacities and an increase in their social relations. The strength and cohesion of the rehabilitation group has given to the patients the opportunity to believe in their own abilities, to accept themselves with their difficulties and to improve the relationship with their body in relation with each other.

  3. 30 CFR 780.33 - Relocation or use of public roads.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Relocation or use of public roads. 780.33... PLAN § 780.33 Relocation or use of public roads. Each application shall describe, with appropriate maps... line of any public road, except where mine access or haul roads join that right-of-way; or (b...

  4. Surface-Water Exchange through Culverts beneath State Road 9336 within Everglades National Park, 2004-05

    USGS Publications Warehouse

    Schaffranek, Raymond W.; Stewart, Marc A.; Nowacki, Daniel J.

    2008-01-01

    The U.S. Geological Survey collected hydrologic data between June 2004 and December 2005 to investigate the temporal and spatial nature of flow exchanges through culverts beneath State Road 9336 within Everglades National Park. Continuous data collected during the study measured flow velocity, water level, salinity, conductivity, and water-temperature in or near seven culverts between Pa-hay-okee Overlook access road and Nine Mile Pond. The two culverts east of Pa-hay-okee Overlook access road flowed into Taylor Slough Basin from 87 to 96 percent of the study period, whereas flows through five culverts between Pa-hay-okee Overlook access road and Nine Mile Pond flowed into Shark River Slough Basin from 70 to 99 percent of the study period. Synoptic flow discharges measured at all culverts during three intensive field efforts revealed a net discharge into Taylor Slough Basin from Shark River Slough Basin through culverts between Royal Palm Road and Pa-hay-okee Overlook access road, and into Shark River Slough Basin from Taylor Slough Basin through culverts between Pa-hay-okee Overlook access road and Nine Mile Pond. Data collected during the study and presented in this report provided additional knowledge of the magnitude, direction, and nature of flow exchanges through the road culverts.

  5. Influence of the Palaeo-Landslides on the Project of Rehabilitation of a National Road in the Southern Carpathian Area

    NASA Astrophysics Data System (ADS)

    Mihailescu, Daniel; Milutinovici, Emilia

    2017-12-01

    The mountain Paduchiosu is a part of the Southern Carpathians, in the South-Eastern Bucegi National Park. Significant palaeo-landslides occur on the Eastern slope of the mountain Paduchiosu, affecting the DN 71 alignment, between Valea Dorului and Valea Carpinis, on a length of approx. 10 km [1]. The palaeo-landslides occur along the tectonic contacts of various cretaceous formations. The landslides occur both at the level of Quaternary deposits, forming the alteration layer of the old geological formations (alluvial, deluvial and colluvial soil deposits), and at the level of Pre-Quaternary geological formations, whose structure is clayey-marl, or within the harder rocky formations, with seams of clayey - marl nature also. Two large palaeo-landslides can be distinguished: landslide I, affecting the national road alignment between pk 96 and 101+500, with sliding orientation towards South and South-West and landslide II, affecting the analysed alignment between pk 102+500 and 106 (with sliding orientation towards East and North-East). The landslides are significant and very old. The main cause of occurrence of these landslides is the tectonic nature of the area. The two main landslides occur on large surfaces. Generally, the sliding plan is under the „fissure clay” level, so it tends to be 12 to15 m deep. Numerous reactivations occur within their congestion, on narrow or large surfaces. Many of the reactivations occur due to the malfunctions of the systems of rainfall draining and taking over from the national road that runs South to North on the Southern slope of the mountain Paduchiosu. There are no underground waters, but considering the change of the natural water drainage due to the existing road works, there are areas where the drainage is impeded or slowed, leading to the water infiltration and rocks moistening under the deluvial formation. The local reactivations may also be influenced by the unarranged torrential valleys. The project of rehabilitation of

  6. Driving simulation for evaluation and rehabilitation of driving after stroke.

    PubMed

    Akinwuntan, Abiodun Emmanuel; Wachtel, Jerry; Rosen, Peter Newman

    2012-08-01

    Driving is an important activity of daily living. Loss of driving privileges can lead to depression, decreased access to medical care, and increased healthcare costs. The ability to drive is often affected after stroke. In approximately 30% of stroke survivors, it is clear from the onset that driving will no longer be possible. Approximately 33% of survivors will be able to return to driving with little or no retraining, and 35% will require driving-related rehabilitation before they can resume safe driving again. The ability to drive is not routinely evaluated after stroke, and there is no established rehabilitation program for poststroke driving. When driving evaluation does occur, it is not always clear which tests are the most salient for accurately assessing poststroke driving ability. Investigators have examined the efficacy of various methodologies to predict driving performance after stroke and have found mixed results, with each method having unique weaknesses, including poor predictive ability, poor face validity, poor sensitivity or specificity, and limited reliability. Here we review common models of driving to gain insight into why single-construct visual or cognitive off-road measures are inadequate for evaluating driving, a complex and dynamic activity that involves timely interaction of multiple motor, visual, cognitive, and perceptual skills. We also examine the potential for driving simulators to overcome the problems currently faced in the evaluation and rehabilitation of driving after stroke. Finally, we offer suggestions for the future direction of simulator-based poststroke driving evaluation and training. Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  7. 30 CFR 784.18 - Relocation or use of public roads.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Relocation or use of public roads. 784.18... PLAN § 784.18 Relocation or use of public roads. Each application shall describe, with appropriate maps...-of-way line of any public road, except where mine access or haul roads join that right-of-way; or (b...

  8. [Trends in Medical Rehabilitation : Supply Structure and Target Groups].

    PubMed

    Buschmann-Steinhage, Rolf

    2017-04-01

    Medical rehabilitation in Germany has been changing continuously since its inception following the Bismarck Legislation. This article describes its development in past years and discusses quantitative and qualitative changes. Central quantitative changes are discussed using the examples of rehabilitation utilisation, spectrum of diseases, setting and follow-up rehabilitation. Important qualitative changes in medical rehabilitation pertain to multiple morbidities, the emphasis on work-related problems in rehabilitative concepts and their implementation, more flexible forms of rehabilitation, prevention, rehabilitation for people from other countries, mobile rehabilitation and rehabilitation after-care (also with new media). The article ends with an outlook on future developments within legislation, access to rehabilitation and the budget for rehabilitation, in addition to cooperation with the workplace.

  9. Cost estimate modeling of transportation management plans for highway projects.

    DOT National Transportation Integrated Search

    2012-05-01

    Highway rehabilitation and reconstruction projects frequently cause road congestion and increase safety concerns while limiting access for road users. State Transportation Agencies (STAs) are challenged to find safer and more efficient ways to renew ...

  10. Cost estimate modeling of transportation management plans for highway projects : [research brief].

    DOT National Transportation Integrated Search

    2012-05-01

    Highway rehabilitation and reconstruction projects frequently cause road congestion and increase safety concerns while limiting access for road users. State Transportation Agencies (STAs) are challenged to find safer and more efficient ways to renew ...

  11. Science You Can Use Bulletin: Road scholars for the western states: Protecting natural areas by improving road management research

    Treesearch

    Brian Cooke; Charlie Luce; Tom Black; David Tarboton

    2016-01-01

    A poorly placed or unsuitably designed road can result in landslides, flooding, gullies, stream damage, and wildlife habitat destruction. Particularly in natural areas, benefits of roads, such as accessibility and convenience, must be weighed against potential water quality degradation, scenic and wildlife habitat destruction, and hazardous driving conditions...

  12. Priority Scale of Drainage Rehabilitation of Cilacap City

    NASA Astrophysics Data System (ADS)

    Rudiono, Jatmiko

    2018-03-01

    Characteristics of physical condition of Cilacap City is relatively flat and low to sea level (approximately 6 m above sea level). In the event of a relatively heavy rainfall resulting in inundation at several locations. The problem of inundation is a serious problem if there is in a dense residential area or occurs in publicly-used infrastructure, such as roads and settlements. These problems require improved management of which include how to plan a sustainable urban drainage system and environmentally friendly. The development of Cilacap City is increasing rapidly, this causes drainage system based on the Drainage Masterplan Cilacap made in 2006 has not been able to accommodate rain water, so, it is necessary to evaluate the drainage masterplan for subsequent rehabilitation. Priority scale rehabilitation of the drainage sections as a guideline is an urgent need of rehabilitation in the next time period.

  13. CONTEMPORARY SITUATIONS AND PROBLEMS OF ROAD/BRIDGE MAINTENANCE TECHNICAL COOPERATION PROJECTS

    NASA Astrophysics Data System (ADS)

    Nishimiya, Noriaki; Sanui, Kazumasa; Mizota, Yuzo

    It is widely acknowledged that roads are the most important transport infrastructure in developing countries. Unlike railroads requiring organizations and systems to operate, individuals can drive on roads. Almost all donors have assisted developing countr ies for new road constructions and rehabilitations. Report of insufficient maintenance in the developing countries, however, has been notable. As a result of the maintenance problems, deterioration of roads is pr ogressing with speed more than expected. It causes the traffic safety problems and an obstacle of economic development. JICA and other donors recognize that this situation can not be overlooked and reci pient countries are increasing their expectation of obtaining assistance on road/bridge maintenance. JICA has implemented over 10 technical cooper ation projects for road/b ridge maintenance in developing countries. JICA conducted a study to review those projects comprehensively. That study aims at obtaining problems, lessons learned and discussion material for policy making and method improvement for future similar pr ojects. This report introduces the outline of the study including additional analysis and recommendations by the authors.

  14. Accessibility | NREL

    Science.gov Websites

    electronic and information technologies accessible to individuals with disabilities in accordance with Section 508 of the Rehabilitation Act (29 U.S.C. 794d), as amended in 1998. Contact us with feedback or concerns related to the accessibility of this website.

  15. Telecommunications technology in cognitive rehabilitation.

    PubMed

    Caltagirone, Carlo; Zannino, Gian Daniele

    2008-01-01

    Cognitive disorders are a common long-term consequence of many forms of acquired neurological damage of different aetiology. The already high prevalence of diseases causing cognitive deficits (in particular stroke) is expected to increase in the near future, leading to a greater need for cognitive rehabilitation. The impact of cognitive impairment on daily functioning may be even greater than that of physical limitations in affected patients, contributing to the high cost of brain disorders. New technologies, including telerehabilitation, may provide an effective response to this challenge, allowing increased access to rehabilitation services as well as reduced care costs for individuals needing cognitive rehabilitation.

  16. Access to cardiac rehabilitation among South-Asian patients by referral method: a qualitative study.

    PubMed

    Grewal, Keerat; Leung, Yvonne W; Safai, Parissa; Stewart, Donna E; Anand, Sonia; Gupta, Milan; Parsons, Cynthia; Grace, Sherry L

    2010-01-01

    People of South-Asian origin have an increased prevalence of coronary artery disease. Although cardiac rehabilitation (CR) is effective, South Asians are among the least likely people to participate in these programs. Automatic referral increases CR use and may reduce access inequalities. This study qualitatively explored whether CR referral knowledge and access varied among South-Asian patients. Participants were South-Asian cardiac patients receiving treatment at hospitals in Ontario, Canada. Each hospital refers to CR via one offour methods: automatically through paper or electronically, through discussion with allied health professionals (liaison referral), or through referral at the physician's discretion. Data were collected via interviews and analyzed using interpretive-descriptive analysis. Four themes emerged: the importance of predischarge CR discussions with healthcare providers, limited knowledge of CR, ease of the referral process for facilitators of CR attendance, and participants'needs for personal autonomy regarding their decision to attend CR. Liaison referral was perceived to be the most suitable referral method for participants. It facilitated communication between patients and providers, ensuring improved understanding of CR. Automatic referral may not be as well suited to this population because of reduced patient-provider communication.

  17. Modelling Drug Abuse Epidemics in the Presence of Limited Rehabilitation Capacity.

    PubMed

    Mushanyu, J; Nyabadza, F; Muchatibaya, G; Stewart, A G R

    2016-12-01

    The abuse of drugs is now an epidemic globally whose control has been mainly through rehabilitation. The demand for drug abuse rehabilitation has not been matched with the available capacity resulting in limited placement of addicts into rehabilitation. In this paper, we model limited rehabilitation through the Hill function incorporated into a system of nonlinear ordinary differential equations. Not every member of the community is equally likely to embark on drug use, risk structure is included to help differentiate those more likely (high risk) to abuse drugs and those less likely (low risk) to abuse drugs. It is shown that the model has multiple equilibria, and using the centre manifold theory, the model exhibits the phenomenon of backward bifurcation whose implications to rehabilitation are discussed. Sensitivity analysis and numerical simulations are performed. The results show that saturation in rehabilitation will in the long run lead to the escalation of drug abuse. This means that limited access to rehabilitation has negative implications in the fight against drug abuse where rehabilitation is the main form of control. This suggests that increased access to rehabilitation is likely to lower the drug abuse epidemic.

  18. Accessibility

    EPA Pesticide Factsheets

    Federal laws, including Section 508 of the Rehabilitation Act, mandate that people with disabilities have access to the same information that someone without a disability would have. 508 standards cover electronic and information technology (EIT) products.

  19. Effects of off-road recreation on mule deer and elk.

    Treesearch

    Michael J. Wisdom; Alan A. Ager; Haiganoush K. Preisler; Norman J. Cimon; Bruce K. Johnson

    2004-01-01

    Off-road recreation is increasing rapidly in the United States, especially on public land (Havlick 2002, U.S. Department of Agriculture Forest Service 2004). An expansive network of roads provides easy access to much public land, which facilitates off-road uses in the form of all-terrain vehicles (ATVs), horses, mountain bikes and foot traffic. No research, however,...

  20. Rehabilitation Needs of Stroke Survivors After Discharge From Hospital in India.

    PubMed

    Kamalakannan, Sureshkumar; Gudlavalleti Venkata, Murthy; Prost, Audrey; Natarajan, Subbulakshmy; Pant, Hira; Chitalurri, Naveen; Goenka, Shifalika; Kuper, Hannah

    2016-09-01

    To assess the rehabilitation needs of stroke survivors in Chennai, India, after discharge from the hospital. Mixed-methods research design. Home-based. Stroke survivors (n=50; mean age ± SD, 58.9±10.5y) and primary caregivers of these stroke survivors (n=50; mean age ± SD, 43.1±11.8y) took part in the quantitative survey. A subsample of stroke survivors (n=12), primary caregivers (n=10), and health care professionals (n=8) took part in the qualitative in-depth interviews. Not applicable. Rehabilitation needs after hospital discharge. About 82% of the needs expressed by stroke survivors and 92% of the needs expressed by caregivers indicated that they had a substantial need for information. The proportion of financial needs reported by the stroke survivors and the caregivers was 70% and 75%, respectively. The qualitative data revealed major gaps in access to stroke rehabilitation services. Service providers identified availability and affordability of services as key problems. Stroke survivors and their caregivers identified lack of information about stroke as major barriers to accessibility of stroke rehabilitation services. Caregivers expressed a tremendous need for support to manage family dynamics. The study highlights a considerable unmet need for poststroke rehabilitation services. Given the lack of rehabilitation resources in India, developing an accessible, innovative, patient-centered, culturally sensitive rehabilitation intervention is of public health importance. It is crucial for low- and middle-income countries like India to develop technology-driven stroke rehabilitation strategies to meet the growing rehabilitation needs of stroke survivors. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. Glacier Going to the Sun Road Rehabilitation Mitigation Shuttle Bus Evaluation.

    DOT National Transportation Integrated Search

    2008-03-31

    As a mitigation measure during reconstruction of the Going to the Sun Road, Glacier National Park operated a shuttle bus system along three routes during the 2007 season. This report presents a multi-dimensional evaluation of the transportation servi...

  2. Women's experiences accessing a women-centered cardiac rehabilitation program: a qualitative study.

    PubMed

    Rolfe, Danielle E; Sutton, Erica J; Landry, Mireille; Sternberg, Len; Price, Jennifer A D

    2010-01-01

    The health benefits of cardiac rehabilitation (CR) for women living with heart disease are well documented, yet women remain underrepresented in traditionally structured CR programs. This health service delivery gap has been attributed to a number of sex-related factors experienced by women, including lower rates of physician referral, travel-related barriers, competing work and caregiving responsibilities, greater cardiovascular disease severity, and number of comorbid health conditions. Whether a program specifically designed for women is able to address these barriers and facilitate women's participation is a question that has seldom been explored in the CR literature. As part of a larger study exploring whether 6 predefined principles of women's health (empowerment of women, accessible programs, broad definition of health care, high-quality of care, collaborative planning, and innovative and creative approaches) are reflected in the practices of the Women's Cardiovascular Health Initiative (WCHI) (a comprehensive CR and primary prevention program designed for women), the objective of this analysis was to explore how the principle of "accessible programs" is experienced by women participating in the WCHI. Fourteen women previously enrolled in the WCHI program participated in a single, in-person qualitative interview. Transcripts were analyzed using a constant-comparative approach to identify relevant themes related to program accessibility. Key themes identified included participants' experiences with acquiring physician referral, negotiating transportation issues, and navigating program schedules. Women discussed how peer support and staff members' willingness to address their health-related concerns facilitated their participation. While a women-centered CR/primary prevention program may facilitate and encourage women's participation by providing flexible program schedules as well as peer and professional support, efforts are still required to address

  3. [Indications and approaches in rehabilitation with children].

    PubMed

    Petermann, F; Bauer, C-P

    2011-04-01

    Against the background of rising prevalence of chronic diseases in childhood and adolescence, the rehabilitation of children and adolescents plays a major role in medical treatment. Early diagnosis and multimodal intervention are necessary to prevent a chronic course of disease and disease consequences for those affected and their families. In recent years, significant content and structural improvement of child and youth rehabilitation has been observed; currently some trends that affect not only the access to rehabilitation but also the quality of outcomes are becoming apparent. These include salutogenetic approaches, the development of specific diagnostic and treatment guidelines, the establishment of networks, integrated care, modularization, and flexibility of rehabilitation measures.

  4. Thermoelectric generator installation at Divide Road Weather Information Systems (RWIS).

    DOT National Transportation Integrated Search

    2016-04-13

    The Department of Transportation and Public Facilities (DOT&PF) has a network of Road Weather Information System (RWIS) environmental sensor stations (ESS) deployed along the road network. Six of the stations do not have access to commercial power an...

  5. [Comparison of Psychosomatic Rehabilitation for German and Foreign Patients].

    PubMed

    Zollmann, P; Pimmer, V; Rose, A D; Erbstößer, S

    2016-12-01

    Aim: This study aims to comprehensively analyse the course of psychosomatic rehabilitation - from access to quantifiable rehabilitation outcomes. A comparison is made between 3 groups of patients: German citizens, patients of Turkish nationality or patients of foreign or unknown nationality. Methods: The data set used comprises routine data of the German Pension Insurance regarding psychosomatic rehabilitation from the so called Reha-Statistik-Database (RSD, database for rehabilitation statistics) over a period from 2007 to 2014. We included 128,165 compulsorily insured persons who underwent psychosomatic rehabilitation in 2012. Results: Among the patients in psychosomatic rehabilitation in 2012 5.8 % were of foreign nationality. Turkish patients were with 2.0 % the largest group, patients with another or unknown nationality or stateless patients constitute the additional group. The most common diagnoses for all groups were affective disorders and neurotic, somatoform and stress disorders. Differences between the groups can be demonstrated with regard to sociodemographics and employment status prior to rehabilitation: Patients of foreign nationality, and here especially Turkish patients, are on average younger, more often married and have less advanced vocational training than German patients. Accordingly, they work more often in less qualified jobs with lower wages. The health status prior rehabilitation, measured as days of sick leave, is also worse compared to German patients. In contrast to other indications there is no disadvantage regarding access to psychosomatic rehabilitation. On the contrary: the age-standardised uptake ratios of Turkish patients, especially of women, are markedly higher than in Germans. Treatment during psychosomatic rehabilitation is more or less identical. With regards to outcome of rehabilitation, reintegration into working life or transition into disability pension Turkish patients are less successful. As important influential

  6. 25 CFR 247.20 - What are the road and trail prohibitions?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What are the road and trail prohibitions? 247.20 Section... RIVER TREATY FISHING ACCESS SITES § 247.20 What are the road and trail prohibitions? (a) You cannot damage or leave in a damaged condition any road, trail, or segment thereof. (b) You cannot block...

  7. DETAIL VIEW OF SRB/ET ACCESS PANELS, THROUGH VEHICLE ACCESS PLATFORMS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF SRB/ET ACCESS PANELS, THROUGH VEHICLE ACCESS PLATFORMS E-NORTH, E-SOUTH, B-NORTH, AND B-SOUTH, HB-3, FACING NORTH - Cape Canaveral Air Force Station, Launch Complex 39, Vehicle Assembly Building, VAB Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  8. Geophysical methods for road construction and maintenance

    NASA Astrophysics Data System (ADS)

    Rasul, Hedi; Karlson, Caroline; Jamali, Imran; Earon, Robert; Olofsson, Bo

    2015-04-01

    Infrastructure, such as road transportation, is a vital in civilized societies; which need to be constructed and maintained regularly. A large part of the project cost is attributed to subsurface conditions, where unsatisfactory conditions could increase either the geotechnical stabilization measures needed or the design cost itself. A way to collect information of the subsurface and existing installations which can lead to measures reducing the project cost and damage is to use geophysical methods during planning, construction and maintenance phases. The moisture in road layers is an important factor, which will affect the bearing capacity of the construction as well as the maintenances. Moisture in the road is a key factor for a well-functioning road. On the other hand the excessive moisture is the main reason of road failure and problems. From a hydrological point of view geophysical methods could help road planners identify the water table, geological strata, pollution arising from the road and the movement of the pollution before, during and after construction. Geophysical methods also allow road planners to collect valuable data for a large area without intrusive investigations such as with boreholes, i.e. minimizing the environmental stresses and costs. However, it is important to specify the investigation site and to choose the most appropriate geophysical method based on the site chosen and the objective of the investigation. Currently, numerous construction and rehabilitation projects are taking places around the world. Many of these projects are focused on infrastructural development, comprising both new projects and expansion of the existing infrastructural network. Geophysical methods can benefit these projects greatly during all phases. During the construction phase Ground Penetrating radar (GPR) is very useful in combination with Electrical Resistivity (ER) for detecting soil water content and base course compaction. However, ER and Electromagnetic

  9. Attitudes toward roads on the National Forests: An analysis of the News Media.

    Treesearch

    David Bengston; David Fan

    1997-01-01

    Key Findings: *Recreational uses of roads were expressed most often: Recreational uses and benefits of roads on the national forests were discussed most often in the news media overall. This discussion included both expressions of opinion about the value of roads for recreational purposes and, more commonly, descriptions of roads being useful for recreational access....

  10. Integrating rehabilitation engineering technology with biologics.

    PubMed

    Collinger, Jennifer L; Dicianno, Brad E; Weber, Douglas J; Cui, Xinyan Tracy; Wang, Wei; Brienza, David M; Boninger, Michael L

    2011-06-01

    Rehabilitation engineers apply engineering principles to improve function or to solve challenges faced by persons with disabilities. It is critical to integrate the knowledge of biologics into the process of rehabilitation engineering to advance the field and maximize potential benefits to patients. Some applications in particular demonstrate the value of a symbiotic relationship between biologics and rehabilitation engineering. In this review we illustrate how researchers working with neural interfaces and integrated prosthetics, assistive technology, and biologics data collection are currently integrating these 2 fields. We also discuss the potential for further integration of biologics and rehabilitation engineering to deliver the best technologies and treatments to patients. Engineers and clinicians must work together to develop technologies that meet clinical needs and are accessible to the intended patient population. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  11. Alcohol intoxication in non-motorised road trauma.

    PubMed

    Mitra, Biswadev; Charters, Kate E; Spencer, John C; Fitzgerald, Mark C; Cameron, Peter A

    2017-02-01

    To determine the proportion of non-motorised road users involved in road traffic crashes that presents to hospital intoxicated. We undertook a retrospective cohort study using data collected from the Alfred Trauma Registry. All patients presenting to an adult major trauma centre in Victoria, Australia from July 2009 to June 2014 who were involved in a road traffic crash as a non-motorised road user - pedestrians, pedal-cyclists, non-motorised scooter users, horse riders - were included. Patients who had a blood alcohol measurement were included, and intoxication was defined as a blood alcohol concentration ≥0.05 g/100 mL. There were 1323 patients included for analysis with data on presenting blood alcohol concentration. Alcohol was detected in 248 (18.7%; 95% CI: 16.7-20.9) patients, whereas 211 (15.9%; 95% CI: 14.1-18.0) were intoxicated. Among all included pedestrians, 161 (24.7%) were intoxicated; among all included pedal-cyclists, 47 (7.3%) were intoxicated. Intoxicated patients were significantly younger, and a higher proportion were males and more likely to present after hours and on public holidays (P < 0.01). Survival to hospital discharge and inpatient rehabilitation requirements were similar among intoxicated and non-intoxicated patients. Intoxication was common among non-motorised road users, and the proportion of intoxicated patients in this subgroup appears unchanged over time despite public awareness programmes. The true burden of intoxication in non-motorised road users remains unknown because of a lack of routine testing. Legislation directed at testing for intoxication of non-motorised users and introduction of penalties should be considered to improve safety of all road users. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  12. Costs of performance based maintenance for local roads: Case study Albania

    NASA Astrophysics Data System (ADS)

    Jokanović, Igor; Grujić, Bojana; Zeljić, Dragana; Grujić, Žarko; Svilar, Mila

    2017-12-01

    The provision and maintenance of road infrastructure is a major global business, consequently it is essential that road maintenance services are provided in the most cost effective manner. Without regular maintenance, roads can rapidly fall into disrepair, preventing realization of the longer term impacts of road improvements on development, such as increased agricultural production and growth in school enrollment, which is of particular importance for a network of local (access) roads. Inadequate local roads maintenance in Albania is proposed to be solved by implementing performance based maintenance approach for which the costing exercise is presented within the paper.

  13. 4. What do we need to know about roads?

    Treesearch

    Leslie M. Reid; Robert R. Ziemer; Michael J. Furniss

    1994-01-01

    Abstract - Roads facilitate forest management activities, recreational access, and fire suppression. At the same time, they damage wildlife habitat, destroy the remoteness many seek in wildland recreation, produce sediment, alter aquatic ecosystems, and abet the dispersal of noxious weeds. Design of appropriate road networks is thus a controversial task for land...

  14. Specialized stroke rehabilitation services in seven countries: Preliminary results from nine rehabilitation centers.

    PubMed

    Langhammer, Birgitta; Becker, Frank; Sunnerhagen, Katharina S; Zhang, Tong; Du, Xiaoxia; Bushnik, Tamara; Panchenko, Maria; Keren, Ofer; Banura, Samir; Elessi, Khamis; Luzon, Fuad; Lundgren-Nilsson, Åsa; Li, Xie; Sällström, Susanne; Stanghelle, Johan Kvalvik

    2015-12-01

    There is a lack of defined levels of rehabilitation, indicating possibly random content and access to specialized services. The aim of the study was to perform a multinational descriptive study of specialized rehabilitation in persons with stroke, to elucidate what the different centers define as prerequisites for specialized rehabilitation, and to analyze whether these descriptions map to currently applied standards or constructs of specialized rehabilitation. A secondary aim was to look for similarities and differences between therapies and services for persons with stroke in the sub-acute stage in the different institutions. Descriptive data of the collaborating centers regarding structure and processes of services were recorded and compared with the British Society of Rehabilitation Medicine and Specialized Services National Definitions sets. Comparisons of the definitions showed that all centers admitted severely disabled persons with stroke, in need of complex rehabilitation, and provided high levels of physical services, with specialized equipment and facilities. However, funding, size, university affiliation, quality accreditation, staffing levels, specialist training, cognitive and vocational services, coordination of the professional teams, admission procedures, time and type of therapies, estimated length of stay, and follow-up procedures differed between the centers. This multinational study of specialized stroke rehabilitation centers shows that a universal definition of specialized rehabilitation is possible, even in quite different countries and settings, in terms of general principles. There were however differences in structures and procedures, which may influence patients' outcomes, indicating a need for refinement of the definitions to be globally applicable. © 2015 World Stroke Organization.

  15. Outcome measurement in Australian rehabilitation environments.

    PubMed

    Douglas, Heather; Swanson, Cheryl; Gee, Travis; Bellamy, Nicholas

    2005-09-01

    To determine the frequency and pattern of methods of outcome assessment used in Australian physical rehabilitation environments. Postal survey. A questionnaire on service type, staffing, numbers of adults treated and outcome measures used for 7 conditions related to injury and road trauma as well as stroke and neuromuscular disorders was sent to 973 services providing adult physical rehabilitation treatment. Questionnaires were completed by 440 service providers for a response rate of 45%, similar to that reported in a recent European survey reported in this journal. A small number of measures were reported as in use by most respondents, while a large number of measures were used by a few respondents. Measures of physical changes were used more frequently than those of generic well-being or quality of life. Ease of use and reporting to other professionals were cited as the most important reasons in selection of outcome measures. This Australian-wide survey detected considerable heterogeneity in outcome measurement procedures used in rehabilitation environments. While the goal of measurement may vary between providers and differ between conditions, the results highlight opportunities for harmonization, bench-marking and measurement of health-related quality of life.

  16. Congestion road tax and physical activity.

    PubMed

    Bergman, Patrick; Grjibovski, Andrej M; Hagströmer, Maria; Patterson, Emma; Sjöström, Michael

    2010-02-01

    Large-scale policy and environmental changes, such as congestion road taxes, may be a way to promote active transportation. This study aimed to examine the potential effect of a congestion road tax on physical activity. Baseline data were collected during October-November 2003, follow-up data in May 2006, and analysis was performed in September 2008. The short self-administered version of the International Physical Activity Questionnaire was used to assess physical activity. Data from those with access to motorized vehicles in the Stockholm region (n=165), where the tax was in place, were compared with those from the Göteborg/Malmö regions (n=138). Within each region before and during the road tax implementation, the data were analyzed for differences in time spent at different intensity levels of physical activity, in addition to sitting, as well as for changes in reported time in overall (weighted) physical activity. There were no significant differences in the magnitude of the changes of the intensity levels of physical activity, weighted overall physical activity, or sitting, between Stockholm and Göteborg/Malmö. Among those exposed to the congestion road tax and with access to motorized vehicles, an increase in moderate physical activity (p=0.036); overall physical activity (p=0.015); and a reduction in time spent sitting (p=0.009) was observed. No differences were observed among those unexposed. The results from this study on the influence of a congestion road tax on levels of physical activity, though inconclusive, suggest that policy changes such as a congestion road tax might promote improvements in physical activity levels in individuals with motorized vehicles. Copyright 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Integrating Rehabilitation Engineering Technology With Biologics

    PubMed Central

    Collinger, Jennifer L.; Dicianno, Brad E.; Weber, Douglas J.; Cui, Xinyan Tracy; Wang, Wei; Brienza, David M.; Boninger, Michael L.

    2017-01-01

    Rehabilitation engineers apply engineering principles to improve function or to solve challenges faced by persons with disabilities. It is critical to integrate the knowledge of biologics into the process of rehabilitation engineering to advance the field and maximize potential benefits to patients. Some applications in particular demonstrate the value of a symbiotic relationship between biologics and rehabilitation engineering. In this review we illustrate how researchers working with neural interfaces and integrated prosthetics, assistive technology, and biologics data collection are currently integrating these 2 fields. We also discuss the potential for further integration of biologics and rehabilitation engineering to deliver the best technologies and treatments to patients. Engineers and clinicians must work together to develop technologies that meet clinical needs and are accessible to the intended patient population. PMID:21703573

  18. Estimating diesel fuel consumption and carbon dioxide emissions from forest road construction

    Treesearch

    Dan Loeffler; Greg Jones; Nikolaus Vonessen; Sean Healey; Woodam Chung

    2009-01-01

    Forest access road construction is a necessary component of many on-the-ground forest vegetation treatment projects. However, the fuel energy requirements and associated carbon dioxide emissions from forest road construction are unknown. We present a method for estimating diesel fuel consumed and related carbon dioxide emissions from constructing forest roads using...

  19. Gold or green: the debate on open access policies.

    PubMed

    Abadal, Ernest

    2013-09-01

    The movement for open access to science seeks to achieve unrestricted and free access to academic publications on the Internet. To this end, two mechanisms have been established: the gold road, in which scientific journals are openly accessible, and the green road, in which publications are self-archived in repositories. The publication of the Finch Report in 2012, advocating exclusively the adoption of the gold road, generated a debate as to whether either of the two options should be prioritized. The recommendations of the Finch Report stirred controversy among academicians specialized in open access issues, who felt that the role played by repositories was not adequately considered and because the green road places the burden of publishing costs basically on authors. The Finch Report's conclusions are compatible with the characteristics of science communication in the UK and they could surely also be applied to the (few) countries with a powerful publishing industry and substantial research funding. In Spain, both the current national legislation and the existing rules at universities largely advocate the green road. This is directly related to the structure of scientific communication in Spain, where many journals have little commercial significance, the system of charging a fee to authors has not been adopted, and there is a good repository infrastructure. As for open access policies, the performance of the scientific communication system in each country should be carefully analyzed to determine the most suitable open access strategy.

  20. Consumer satisfaction with a rehabilitation mobile outreach program.

    PubMed

    Wilson, K G; Crupi, C D; Greene, G; Gaulin-Jones, B; Dehoux, E; Korol, C T

    1995-10-01

    Accessibility to rehabilitation services is often difficult for people with disabilities who live in rural areas. This study examined consumer satisfaction with a rehabilitation outreach approach that utilizes a mobile clinic to provide consultation services. The descriptive survey took place in fifteen rural communities in eastern and northeastern Ontario, Canada. Valid postconsultation mail surveys were completed by 143 consecutive patients with mixed diagnoses (or proxy family members) who had been seen during mobile clinic visits to their home communities (85.1% of patients approached). There were 59 men and 84 women, with an average age of 58.7 years. The main outcome measure was a consumer satisfaction scale. A high level of global satisfaction was reported, with 97.2% of respondents reporting a preference for community outreach over the alternative of traveling to an urban rehabilitation center. Enhanced accessibility was considered to be the major advantage of the outreach program, but concerns about the continuity of care were also expressed. Providing interdisciplinary rehabilitation consultation services on an outreach basis is associated with a high level of consumer satisfaction. From a consumer perspective, the outreach approach seems to be a viable way of addressing some of the rehabilitation needs of rural people with disabilities.

  1. The three R's of roads: redesign, reconstruction, and restoration

    Treesearch

    Lloyd W. Swift; Richard G. Burns

    1999-01-01

    All too often, unpaved forest access roads in the Southern Appalachian Mountains were located near streams and rivers, thereby contributing storm flow and sediment to the aquatic ecosystem.Landowners may not have the resources to reconstruct and relocate all these roads to protect water quality.However, simple techniques for redesign of storm water drainage structures...

  2. 25 CFR 170.120 - What restrictions apply to the use of an Indian Reservation Road?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Reservation Road? 170.120 Section 170.120 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Use of Irr and Cultural Access Roads § 170.120 What restrictions apply to the use of an Indian...

  3. 25 CFR 170.120 - What restrictions apply to the use of an Indian Reservation Road?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Reservation Road? 170.120 Section 170.120 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Use of Irr and Cultural Access Roads § 170.120 What restrictions apply to the use of an Indian...

  4. 25 CFR 170.120 - What restrictions apply to the use of an Indian Reservation Road?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Reservation Road? 170.120 Section 170.120 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Use of Irr and Cultural Access Roads § 170.120 What restrictions apply to the use of an Indian...

  5. 25 CFR 170.120 - What restrictions apply to the use of an Indian Reservation Road?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Reservation Road? 170.120 Section 170.120 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Use of Irr and Cultural Access Roads § 170.120 What restrictions apply to the use of an Indian...

  6. 25 CFR 170.120 - What restrictions apply to the use of an Indian Reservation Road?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Reservation Road? 170.120 Section 170.120 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Use of Irr and Cultural Access Roads § 170.120 What restrictions apply to the use of an Indian...

  7. Rehabilitation in the real-life environment of a shopping mall.

    PubMed

    Labbé, Delphine; Poldma, Tiiu; Fichten, Catherine; Havel, Alice; Kehayia, Eva; Mazer, Barbara; McKinley, Patricia; Rochette, Annie; Swaine, Bonnie

    2018-04-01

    The aim of this study was to explore how shopping malls could be used during rehabilitation and to identify the facilitators and barriers to their use. Two focus groups, conducted with 15 rehabilitation professionals from various disciplines and working with people with disabilities of all ages were structured around two topics: (i) The usage of malls for rehabilitation and (ii) Factors that facilitate or limit rehabilitation professionals' use of the mall as an environment for clinical assessment and/or intervention. The thematic analysis revealed that shopping malls were used to achieve several rehabilitation goals targeting physical and cognitive skills, psychological health and socialization. This real-life environment is motivating and helps foster independence and normalization. Factors affecting mall use during rehabilitation included personal factors (e.g. clients' personality and level of readiness) and environmental factors (e.g. clinical context, accessibility of the mall and social attitudes of store owners). Shopping malls may be a relevant rehabilitation assessment and treatment environment that could contribute to optimizing community integration of people with disabilities. Implications for rehabilitation To ensure successful community reintegration, clients could be trained at some point during their rehabilitation, to perform activities in real-life settings, such as a shopping mall. Shopping malls appear to enable the attainment of rehabilitation goals targeting a variety of skills. This real-life environment appears to be motivating and helps foster independence and normalization. Factors felt to affect mall use during rehabilitation include personal factors (e.g. clients' personality and level of readiness) and environmental factors (e.g. clinical context, accessibility of the mall and social attitudes of store owners). The shopping mall may be an untapped resource as it appears to be a relevant rehabilitation assessment and treatment

  8. Paver automation for road surfacing

    NASA Astrophysics Data System (ADS)

    Tihonov, A.; Velichkin, V.

    2017-10-01

    The paper discusses factors that bear on the quality of motor road pavement as access roads and highways are built and used. A block diagram is proposed to organize elements of the automatic control system to control the asphalt paver’s mechanisms; the system is based on a microprocessor onboard controller to maintain preset elevation of the finishing plate; description of its operation principle is offered. The paper names primary converters to control the finishing plate elevation. A new control method is described to control the machine’s straight-line movement with GLONASS Satellite Positioning System (SPS) during operation.

  9. Unofficial Road Building in the Amazon: Socioeconomic and Biophysical Explanations

    NASA Technical Reports Server (NTRS)

    Perz, Stephen G.; Caldas, Marcellus M.; Arima, Eugenio; Walker, Robert J.

    2007-01-01

    Roads have manifold social and environmental impacts, including regional development, social conflicts and habitat fragmentation. 'Road ecology' has emerged as an approach to evaluate the various ecological and hydrological impacts of roads. This article aims to complement road ecology by examining the socio-spatial processes of road building itself. Focusing on the Brazilian Amazon, a heavily-studied context due to forest fragmentation by roads, the authors consider non-state social actors who build 'unofficial roads' for the purpose of gaining access to natural resources to support livelihoods and community development. They examine four case studies of roads with distinct histories in order to explain the socio-spatial processes behind road building in terms of profit maximization, land tenure claims, co-operative and conflictive political ecologies, and constraints as well as opportunities afforded by the biophysical environment. The study cases illustrate the need for a multi-pronged theoretical approach to understanding road building, and call for more attention to the role of non-state actors in unofficial road construction.

  10. Advances in wearable technology for rehabilitation.

    PubMed

    Bonato, Paolo

    2009-01-01

    Assessing the impact of rehabilitation interventions on the real life of individuals is a key element of the decision-making process required to choose a rehabilitation strategy. In the past, therapists and physicians inferred the effectiveness of a given rehabilitation approach from observations performed in a clinical setting and self-reports by patients. Recent developments in wearable technology have provided tools to complement the information gathered by rehabilitation personnel via patient's direct observation and via interviews and questionnaires. A new generation of wearable sensors and systems has emerged that allows clinicians to gather measures in the home and community settings that capture patients' activity level and exercise compliance, the effectiveness of pharmacological interventions, and the ability of patients to perform efficiently specific motor tasks. Available unobtrusive sensors allow clinical personnel to monitor patients' movement and physiological data such as heart rate, respiratory rate, and oxygen saturation. Cell phone technology and the widespread access to the Internet provide means to implement systems designed to remotely monitor patients' status and optimize interventions based on individual responses to different rehabilitation approaches. This chapter summarizes recent advances in the field of wearable technology and presents examples of application of this technology in rehabilitation.

  11. Unifying and Elevating Rehabilitation Counseling through Model-Driven, Diversity-Sensitive Evidence-Based Practice

    ERIC Educational Resources Information Center

    Chan, Fong; Tarvydas, Vilia; Blalock, Kacie; Strauser, David; Atkins, Bobbie J.

    2009-01-01

    Rehabilitation counseling must embrace an evidence-based practice paradigm to remain a vital and respected member of the future community of professions in rehabilitation and mental health care and to fully discharge its responsibility to assist consumers in accessing effective rehabilitation interventions and exercising truly informed choice. The…

  12. Frontage Roads in Texas: Legal Issues, Operational Issues, and Land Use Distinctions

    DOT National Transportation Integrated Search

    2000-08-01

    This research project investigates frontage roads as an element of limited-access highway design. The discussion in this paper reviews legal statutes affecting public access to roadways, summarizes studies on access-right valuation, and considers a v...

  13. Virtual rehabilitation--benefits and challenges.

    PubMed

    Burdea, G C

    2003-01-01

    To discuss the advantages and disadvantages of rehabilitation applications of virtual reality. VR can be used as an enhancement to conventional therapy for patients with conditions ranging from musculoskeletal problems, to stroke-induced paralysis, to cognitive deficits. This approach is called "VR-augmented rehabilitation." Alternately, VR can replace conventional interventions altogether, in which case the rehabilitation is "VR-based." If the intervention is done at a distance, then it is called "telerehabilitation." Simulation exercises for post-stroke patients have been developed using a "teacher object" approach or a video game approach. Simulations for musculo-skeletal patients use virtual replicas of rehabilitation devices (such as rubber ball, power putty, peg board). Phobia-inducing virtual environments are prescribed for patients with cognitive deficits. VR-augmented rehabilitation has been shown effective for stroke patients in the chronic phase of the disease. VR-based rehabilitation has been improving patients with fear of flying, Vietnam syndrome, fear of heights, and chronic stroke patients. Telerehabilitation interventions using VR have improved musculo-skeletal and post-stroke patients, however less data is available at this time. Virtual reality presents significant advantages when applied to rehabilitation of patients with varied conditions. These advantages include patient motivation, adaptability and variability based on patient baseline, transparent data storage, online remote data access, economy of scale, reduced medical costs. Challenges in VR use for rehabilitation relate to lack of computer skills on the part of therapists, lack of support infrastructure, expensive equipment (initially), inadequate communication infrastructure (for telerehabilitation in rural areas), and patient safety concerns.

  14. Problematising risk in stroke rehabilitation.

    PubMed

    Egan, Mary Y; Kessler, Dorothy; Ceci, Christine; Laliberté-Rudman, Debbie; McGrath, Colleen; Sikora, Lindsey; Gardner, Paula

    2016-11-01

    Following stroke, re-engagement in personally valued activities requires some experience of risk. Risk, therefore, must be seen as having positive as well as negative aspects in rehabilitation. Our aim was to identify the dominant understanding of risk in stroke rehabilitation and the assumptions underpinning these understandings, determine how these understandings affect research and practise, and if necessary, propose alternate ways to conceptualise risk in research and practise. Alvesson and Sandberg's method of problematisation was used. We began with a historical overview of stroke rehabilitation, and proceeded through five steps undertaken in an iterative fashion: literature search and selection; data extraction; syntheses across texts; identification of assumptions informing the literature and; generation of alternatives. Discussion of risk in stroke rehabilitation is largely implicit. However, two prominent conceptualisations of risk underpin both knowledge development and clinical practise: the risk to the individual stroke survivor of remaining dependent in activities of daily living and the risk that the health care system will be overwhelmed by the costs of providing stroke rehabilitation. Conceptualisation of risk in stroke rehabilitation, while implicit, drives both research and practise in ways that reinforce a focus on impairment and a generic, decontextualised approach to rehabilitation. Implications for rehabilitation Much of stroke rehabilitation practise and research seems to centre implicitly on two risks: risk to the patient of remaining dependent in ADL and risk to the health care system of bankruptcy due to the provision of stroke rehabilitation. The implicit focus on ADL dependence limits the ability of clinicians and researchers to address other goals supportive of a good life following stroke. The implicit focus on financial risk to the health care system may limit access to rehabilitation for people who have experienced either milder or

  15. EPA Accessibility Statement

    EPA Pesticide Factsheets

    EPA is committed to making its websites and other electronic and information technology (EIT) accessible to the widest possible audience, including people with disabilities, in accordance with Section 508 of the Rehabilitation Act.

  16. Prevention, The Beginning of the Rehabilitation Process: A View from New Zealand. Monograph #46.

    ERIC Educational Resources Information Center

    Campbell, Ian B.

    The monograph argues that prevention should be considered the first step in the rehabilitation process, and examines preventive efforts in the areas of occupational safety, road safety, home safety, and sporting and recreational safety. Following an introductory chapter, other chapters discuss: (1) the close relationship between compensation,…

  17. 'Surfing the Silk Road': a study of users' experiences.

    PubMed

    Van Hout, Marie Claire; Bingham, Tim

    2013-11-01

    The online drug marketplace called 'Silk Road' has operated anonymously on the 'Deep Web' since 2011. It is accessible through computer encrypting software (Tor) and is supported by online transactions using peer to peer anonymous and untraceable crypto-currency (Bit Coins). The study aimed to describe user motives and realities of accessing, navigating and purchasing on the 'Silk Road' marketplace. Systematic online observations, monitoring of discussion threads on the site during four months of fieldwork and analysis of anonymous online interviews (n=20) with a convenience sample of adult 'Silk Road' users was conducted. The majority of participants were male, in professional employment or in tertiary education. Drug trajectories ranged from 18 months to 25 years, with favourite drugs including MDMA, 2C-B, mephedrone, nitrous oxide, ketamine, cannabis and cocaine. Few reported prior experience of online drug sourcing. Reasons for utilizing 'Silk Road' included curiosity, concerns for street drug quality and personal safety, variety of products, anonymous transactioning, and ease of product delivery. Vendor selection appeared to be based on trust, speed of transaction, stealth modes and quality of product. Forums on the site provided user advice, trip reports, product and transaction reviews. Some users reported solitary drug use for psychonautic and introspective purposes. A minority reported customs seizures, and in general a displacement away from traditional drug sourcing (street and closed markets) was described. Several reported intentions to commence vending on the site. The study provides an insight into 'Silk Road' purchasing motives and processes, the interplay between traditional and 'Silk Road' drug markets, the 'Silk Road' online community and its communication networks. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. 77 FR 36289 - Implementation of Indian Reservation Roads Program and Streamlining the Federal Delivery of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-18

    ... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Implementation of Indian Reservation Roads..., announcing tribal consultations to discuss the following topics: (1) Changes in how Proposed Roads and Access Roads are considered in the calculation of the Relative Needs Distribution Formula (RNDF) used for the...

  19. Rehabilitation and indigenous peoples: the Māori experience.

    PubMed

    Harwood, Matire

    2010-01-01

    Indigenous peoples often have the worst health status in comparison to non-indigenous people in their own nations; urgent action to address the health inequities for indigenous people is required. The role of rehabilitation in addressing health and disability inequities is particularly important due to the health need of indigenous peoples; the unequal distribution of health determinants; and disparities in access to, quality of care through and outcomes following rehabilitation. This article will present a perspective for Māori, the indigenous peoples of New Zealand, on a framework for improving rehabilitation services for Māori and ultimately their health and wellbeing.

  20. Physiotherapy rehabilitation in the context of HIV and disability in KwaZulu-Natal, South Africa.

    PubMed

    Cobbing, Saul; Hanass-Hancock, Jill; Deane, Margaret

    2014-01-01

    The purpose of this study was to describe the experiences of people living with HIV (PLHIV) who had undergone a physiotherapy-led rehabilitation programme, with the aim of informing and improving future rehabilitation. The study population included patients living with HIV who were referred for physiotherapy rehabilitation at a public-funded KwaZulu-Natal hospital. Eight participants were considered for final analysis in the study. A qualitative research design was adopted using in-depth interviews to explore their experiences of their rehabilitation programme. Additionally all eligible participants were requested to complete the World Health Organisation Disability Assessment Schedule. Participants presented varying activity-related challenges with mobility, self-care and life activities being the most severely affected areas. Participants showed little understanding of their health conditions, prescribed medication and in some cases therapy. HIV and disability impacted their daily lives, adversely affecting work and domestic activities. Although participants reflected positively on the rehabilitation experience they faced a number of barriers to accessing continued rehabilitation. PLHIV who experience disability are affected in major life areas but the current model of delivering rehabilitation provides a number of barriers to patients. A more accessible approach of delivering HIV-care and rehabilitation needs to be developed. Implications for Rehabilitation Physiotherapists and other rehabilitation professionals, particularly those working in the South African public sector, need to consider developing and implementing home-based rehabilitation interventions for patients living with HIV and disability. This will counter some of the barriers these patients face in accessing hospital-based therapy. With the increasing incidence of HIV-related disabilities as PLHIV live longer lives, rehabilitation professionals working with this patient population should keep up

  1. Water Quality Effects of Forest Roads in Bottomland Hardwood Stands

    Treesearch

    Robert B. Rummer

    1999-01-01

    Management of bottomland hardwood sites requires adequate access to support forest operations. A study conducted in a bottomland forest in central Georgia has evaluated the effect of forest road design on sediment movement and water quality. Five years of measurement indicate that a conventional crowned road design is a net sink for sediment, primarily due to settling...

  2. Student Access: Section 504 of the Rehabilitation Act of 1973.

    ERIC Educational Resources Information Center

    Oregon State Dept. of Education, Salem.

    This paper addresses educational implications of Section 504 of the Rehabilitation Act of 1973 which prohibits programs receiving federal financial assistance from denying services to or discriminating against individuals with disabilities. Individual sections cover: legal definitions (e.g., "individual with handicaps" and…

  3. Improving brain injury cognitive rehabilitation by personalized telerehabilitation services: Guttmann neuropersonal trainer.

    PubMed

    Solana, Javier; Cáceres, César; García-Molina, Alberto; Opisso, Eloy; Roig, Teresa; Tormos, José M; Gómez, Enrique J

    2015-01-01

    Cognitive rehabilitation aims to remediate or alleviate the cognitive deficits appearing after an episode of acquired brain injury (ABI). The purpose of this work is to describe the telerehabilitation platform called Guttmann Neuropersonal Trainer (GNPT) which provides new strategies for cognitive rehabilitation, improving efficiency and access to treatments, and to increase knowledge generation from the process. A cognitive rehabilitation process has been modeled to design and develop the system, which allows neuropsychologists to configure and schedule rehabilitation sessions, consisting of set of personalized computerized cognitive exercises grounded on neuroscience and plasticity principles. It provides remote continuous monitoring of patient's performance, by an asynchronous communication strategy. An automatic knowledge extraction method has been used to implement a decision support system, improving treatment customization. GNPT has been implemented in 27 rehabilitation centers and in 83 patients' homes, facilitating the access to the treatment. In total, 1660 patients have been treated. Usability and cost analysis methodologies have been applied to measure the efficiency in real clinical environments. The usability evaluation reveals a system usability score higher than 70 for all target users. The cost efficiency study results show a relation of 1-20 compared to face-to-face rehabilitation. GNPT enables brain-damaged patients to continue and further extend rehabilitation beyond the hospital, improving the efficiency of the rehabilitation process. It allows customized therapeutic plans, providing information to further development of clinical practice guidelines.

  4. Rehabilitation in Madagascar: Challenges in implementing the World Health Organization Disability Action Plan.

    PubMed

    Khan, Fary; Amatya, Bhasker; Mannan, Hasheem; Burkle, Frederick M; Galea, Mary P

    2015-09-01

    To provide an update on rehabilitation in Madagascar by using local knowledge to outline the potential barriers and facilitators for implementation of the World Health Organization (WHO) Disability Action Plan (DAP). A 14-day extensive workshop programme (September-October 2014) was held at the University Hospital Antananarivo and Antsirabe, with the Department of Health Madagascar, by rehabilitation staff from Royal Melbourne Hospital, Australia. Attendees were rehabilitation professionals (n=29) from 3 main rehabilitation facilities in Madagascar, who identified various challenges faced in service provision, education and attitudes/approaches to people with disabilities. Their responses and suggested barriers/facilitators were recorded following consensus agreement, using objectives listed in the DAP. The barriers and facilitators outlined by participants in implementing the DAP objectives include: engagement of health professionals and institutions using a multi-sectoral approach, new partnerships, strategic collaboration, provision of technical assistance, future policy directions, and research and development. Other challenges for many basic policies included: access to rehabilitation services, geographical coverage, shortage of skilled work-force, limited info-technology systems; lack of care-models and facility/staff accreditation standards; limited health services infrastructure and "disconnect" between acute and community-based rehabilitation. The DAP summary actions were useful planning tools to improve access, strengthen rehabilitation services and community-based rehabilitation, and collate data for outcome research.

  5. Improving playground surface accessibility

    Treesearch

    Theodore L. Laufenberg

    2004-01-01

    Could accessibility be improved and maintenance be reduced for wood fiber- based playgrounds? In July 2001, the US Access Board asked the Forest Products Laboratory (FPL) for advice and a potential solution. Since that time new product standards have been adopted by ASTM for engineered wood fiber (EWF), new test techniques have been promulgated by RESNA (Rehabilitation...

  6. 77 FR 25529 - Over-the-Road Bus Accessibility Program Grants

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-30

    ... Century (TEA-21). The OTRB program makes funds available to private operators of over-the-road buses to... bus services. These services are an important element of the U.S. transportation system. TEA-21... delivered after June 8, 1998, the date that the TEA-21 became effective, are eligible for funding under the...

  7. COPD online-rehabilitation versus conventional COPD rehabilitation - rationale and design for a multicenter randomized controlled trial study protocol (CORe trial).

    PubMed

    Hansen, Henrik; Bieler, Theresa; Beyer, Nina; Godtfredsen, Nina; Kallemose, Thomas; Frølich, Anne

    2017-11-16

    Rehabilitation of patients with chronic obstructive pulmonary disease (COPD) is a key treatment in COPD. However, despite the existing evidence and a strong recommendation from lung associations worldwide, 50% of patients with COPD decline to participate in COPD rehabilitation program and 30-50% drop-out before completion. The main reasons are severe symptoms, inflexible accessibility and necessity for transportation. Currently there are no well-established and evident rehabilitation alternatives. Supervised online screen rehabilitation could be a useful approach to increase accessibility and compliance. The aim of this multicenter RCT study is to compare the potential benefits of a 10-week online COPD rehabilitation program (CORe) with conventional outpatient COPD rehabilitation (CCRe). This study is a randomized assessor- and statistician blinded superiority multicenter trial with two parallel groups, employing 1:1 allocation to the intervention and the comparison group.On the basis of a sample size calculation, 134 patients with severe or very severe COPD and eligible to conventional hospital based outpatient COPD rehabilitation will be included and randomized from eight different hospitals. The CORe intervention group receives group supervised resistance- and endurance training and patient education, 60 min, three times/week for 10 weeks at home via online-screen. The CCRe comparison group receives group based supervised resistance- and endurance training and patient education, 90 min, two times/week for 10 weeks (two hospitals) or 12 weeks (six hospitals) in groups at the local hospital. The primary outcome is change in the 6-min walking distance after 10/12 weeks; the secondary outcomes are changes in 30 s sit-to-stand chair test, physical activity level, symptoms, anxiety and depression symptoms, disease specific and generic quality of life. Primary endpoint is 10/12 weeks from baseline, while secondary endpoints are 22, 36, 62 weeks from baseline

  8. Incorporating aquatic ecology into decisions on prioritization of road decommissioning

    Treesearch

    Charles H. Luce; Bruce E. Rieman; Jason B. Dunham; James L. Clayton; John G. King; Thomas A. Black

    2001-01-01

    Roads provide increased access to lands rich in natural resources and beauty, but they can also damage those lands and the ecological values therein. In particular, much interest has been focused on the hydrologic and geomorphic changes in roaded watersheds and their effects on aquatic ecosystems (Lee et al., 1997; Dunham and Rieman, 1999; also see papers in Luce and...

  9. Prioritizing Road Treatments using the Geomorphic Roads Analysis and Inventory Package (GRAIP) to Improve Watershed Conditions in the Wall Creek Watershed, Oregon

    NASA Astrophysics Data System (ADS)

    Day, K. T.; Black, T.; Clifton, C.; Luce, C.; McCune, S.; Nelson, N.

    2010-12-01

    the current rate. These data are being used by the Umatilla National Forest to prioritize road rehabilitation activities including storm risk reduction and road decommissioning, and to move toward an ecologically and economically sustainable road system. The highest sediment-delivering road segments were evaluated in 2010 to prioritize stabilization and storm damage risk reduction projects. Approximately 30 km of hydrologically connected road segments will be proposed for treatments including closure, decommissioning, and stabilization activities. Once complete, these improvements would result in the reduction of about 7,000 kg/year of fine sediment delivered to the fluvial system from the road network, or a third of the total road contribution to stream sedimentation. Methods and results presented are part of federal land management agency involvement in Total Maximum Daily Load development in the John Day Basin. The project is a collaborative effort with funding and support from the Environmental Protection Agency, Bureau of Land Management, and Oregon Department of Environmental Quality.

  10. Code of Ethics for Rehabilitation Educators and Counselors: A Call for Evidence-Based Practice

    ERIC Educational Resources Information Center

    Burker, Eileen J.; Kazukauskas, Kelly A.

    2010-01-01

    Given the emphasis on evidence-based practice (EBP) in the 2010 Code of Professional Ethics for Rehabilitation Counselors, it has become even more critical for rehabilitation educators and rehabilitation counselors to understand EBP, how to implement it in teaching and in practice, and how to access available EBP resources. This paper defines and…

  11. New optimization strategies of pavement maintenance: A case study for national road network in Indonesia using integrated road management system

    NASA Astrophysics Data System (ADS)

    Hamdi, Hadiwardoyo, Sigit P.; Correia, A. Gomes; Pereira, Paulo

    2017-06-01

    A road network requires timely maintenance to keep the road surface in good condition onward better services to improve accessibility and mobility. Strategies and maintenance techniques must be chosen in order to maximize road service level through cost-effective interventions. This approach requires an updated database, which the road network in Indonesia is supported by a manual and visual survey, also using NAASRA profiler. Furthermore, in this paper, the deterministic model of deterioration was used. This optimization model uses life cycle cost analysis (LCCA), applied in an integrated manner, using IRI indicator, and allows determining the priority of treatment, type of treatment and its relation to the cost. The purpose of this paper was focussed on the aspects of road maintenance management, i.e., maintenance optimization models for different levels of traffic and various initial of road distress conditions on the national road network in Indonesia. The implementation of Integrated Road Management System (IRMS) can provide a solution to the problem of cost constraints in the maintenance of the national road network. The results from this study found that as the lowest as agency cost, it will affect the increasing of user cost. With the achievement of the target plan scenario Pl000 with initial value IRI 2, it was found that the routine management throughout the year and in early reconstruction and periodic maintenance with a 30 mm thick overlay, will simultaneously provide a higher net benefit value and has the lowest total cost of transportation.

  12. Sedimentation associated with forest road surfacing in a bottomland hardwood ecosystem

    Treesearch

    Robert B. Rummer; Bryce Stokes; Graeme Lockaby

    1997-01-01

    Access systems are a necessary element of resource production in bottomland hardwood sites. However, road building may have a detrimental effect on hydrologic function of the site. This report describes initial results of a study designed to examine the effect of different road surfacing treatments on water quality.Four Surfacing treatments installed on two...

  13. Rehabilitation reliability of the road pavement structure with recycled base course with foamed bitumen

    NASA Astrophysics Data System (ADS)

    Buczyński, P.

    2018-05-01

    This article presents a new approach to reliability assessment of the road structure in which the base layer will be constructed in the process of cold deep recycling with foamed bitumen. In order to properly assess the reliability of the structure with the recycled base, it is necessary to determine the distribution of stress and strain in typical pavement layer systems. The true stress and strain values were established for particular structural layers using the complex modulus (E*) determined based on the master curves. The complex modulus was determined by the direct tension-compression test on cylindrical specimens (DTC-CY) at five temperatures (-7°C, 5°C, 13°C, 25°C, 40°C) and six loading times (0.1 Hz, 0.3 Hz, 1 Hz, 3 Hz, 10 Hz, 20 Hz) in accordance with EN 12697-26 in the linear viscoelasticity (LVE) range for small strains ranging from 25 to 50 με. The master curves of the complex modulus were constructed using the Richards model for the mixtures typically incorporated in structural layers, i.e., SMA11, AC16W, AC22P and MCAS. The values of the modulus characterizing particular layers were determined with temperature distribution in the structure taken into account, when the surface temperature was 40°C. The stress distribution was established for those calculation models. The stress values were used to evaluate the fatigue life under controlled stress conditions (IT-FT). This evaluation, with the controlled stress corresponding to that in the structure, facilitated the quality assessment of the rehabilitated recycled base course. Results showed that the recycled base mixtures having the indirect tensile strength (ITSDRY) similar to the stress in the structure under analysis needed an additional fatigue life evaluation in the indirect tensile test ITT. This approach to the recycled base quality assessment will allow eliminating the damage induced by overloading.

  14. Human resources for health (and rehabilitation): Six Rehab-Workforce Challenges for the century.

    PubMed

    Jesus, Tiago S; Landry, Michel D; Dussault, Gilles; Fronteira, Inês

    2017-01-23

    People with disabilities face challenges accessing basic rehabilitation health care. In 2006, the United Nations Convention on the Rights of Persons with Disabilities (CRPD) outlined the global necessity to meet the rehabilitation needs of people with disabilities, but this goal is often challenged by the undersupply and inequitable distribution of rehabilitation workers. While the aggregate study and monitoring of the physical rehabilitation workforce has been mostly ignored by researchers or policy-makers, this paper aims to present the 'challenges and opportunities' for guiding further long-term research and policies on developing the relatively neglected, highly heterogeneous physical rehabilitation workforce. The challenges were identified through a two-phased investigation. Phase 1: critical review of the rehabilitation workforce literature, organized by the availability, accessibility, acceptability and quality (AAAQ) framework. Phase 2: integrate reviewed data into a SWOT framework to identify the strengths and opportunities to be maximized and the weaknesses and threats to be overcome. The critical review and SWOT analysis have identified the following global situation: (i) needs-based shortages and lack of access to rehabilitation workers, particularly in lower income countries and in rural/remote areas; (ii) deficiencies in the data sources and monitoring structures; and (iii) few exemplary innovations, of both national and international scope, that may help reduce supply-side shortages in underserved areas. Based on the results, we have prioritized the following 'Six Rehab-Workforce Challenges': (1) monitoring supply requirements: accounting for rehabilitation needs and demand; (2) supply data sources: the need for structural improvements; (3) ensuring the study of a whole rehabilitation workforce (i.e. not focused on single professions), including across service levels; (4) staffing underserved locations: the rising of education, attractiveness and

  15. Road Damage Extraction from Post-Earthquake Uav Images Assisted by Vector Data

    NASA Astrophysics Data System (ADS)

    Chen, Z.; Dou, A.

    2018-04-01

    Extraction of road damage information after earthquake has been regarded as urgent mission. To collect information about stricken areas, Unmanned Aerial Vehicle can be used to obtain images rapidly. This paper put forward a novel method to detect road damage and bring forward a coefficient to assess road accessibility. With the assistance of vector road data, image data of the Jiuzhaigou Ms7.0 Earthquake is tested. In the first, the image is clipped according to vector buffer. Then a large-scale segmentation is applied to remove irrelevant objects. Thirdly, statistics of road features are analysed, and damage information is extracted. Combining with the on-filed investigation, the extraction result is effective.

  16. [Screening for rehabilitation needs of patients in care of family practitioners].

    PubMed

    Pullwitt, D H; Krause, O; Hildebrand, F; Fischer, G C

    1997-11-01

    Family doctors play an important role in promoting the access of patients to rehabilitation. On the one hand they are very often the first professionals to be contacted if patients want to take part in rehabilitation procedures whereas on the other hand there are also many patients whose need for rehabilitation remains undisclosed. No detailed estimates are available on how many of such patients exist in German GP-practices although it should be an important task of family doctors to discuss the pros and cons of rehabilitation particularly with their patients who are in need of it. We performed a non-representative pilot study in three GP offices during ten working days. patients older than 29 years were screened for their "rehabilitation status" with an instrument frequently used in German rehabilitation clinics. The patients were also asked whether or not they would like to participate in a rehabilitation procedure and what was the reason for their decision. Not knowing the patients' answers their doctors rated whether or not it would be appropriate for their patients to take part in rehabilitation. Additionally the doctors stated what kind of rehabilitation should be performed and what could be ist aims. In a sample of 181 patients about one-third was found to be in a severe "rehabilitation status", about one third in a state with higher than normal values--although not severe--and also approx. another third had a normal status. Family doctors stated that for one-third of their patients rehabilitation would be undoubtedly suitable at the time of the screening. In about two thirds of the cases the results of the questionnaire and the doctors' ratings corresponded. Some patients felt completely healthy although the results of the questionnaire and the doctors' statements rated them as being in need of rehabilitation. Other patients in need of rehabilitation rejected it for other than health-related reasons. The results of our study give evidence to the family

  17. A rehabilitation model as key to comprehensive care in the era of HIV as a chronic disease in South Africa.

    PubMed

    Chetty, Verusia; Hanass-Hancock, Jill

    2016-01-01

    In the era of widespread access to antiretroviral therapy, people living with HIV survive; however, this comes with new experiences of comorbidities and HIV-related disability posing new challenges to rehabilitation professionals and an already fragile health system in Southern Africa. Public health approaches to HIV need to include not only prevention, treatment and support but also rehabilitation. While some well-resourced countries have developed rehabilitation approaches for HIV, resource-poor settings of Southern Africa lack a model of care that includes rehabilitation approaches providing accessible and comprehensive care for people living with HIV. In this study, a learning in action approach was used to conceptualize a comprehensive model of care that addresses HIV-related disability and a feasible rehabilitation framework for resource-poor settings. The study used qualitative methods in the form of a focus group discussion with thirty participants including people living with HIV, the multidisciplinary healthcare team and community outreach partners at a semi-rural health facility in South Africa. The discussion focused on barriers and enablers of access to rehabilitation. Participants identified barriers at various levels, including transport, physical access, financial constraints and poor multi-stakeholder team interaction. The results of the group discussions informed the design of an inclusive model of HIV care. This model was further informed by established integrated rehabilitation models. Participants emphasized that objectives need to respond to policy, improve access to patient-centered care and maintain a multidisciplinary team approach. They proposed that guiding principles should include efficient communication, collaboration of all stakeholders and leadership in teams to enable staff to implement the model. Training of professional staff and lay personnel within task-shifting approaches was seen as an essential enabler to implementation. The

  18. Medical Rehabilitation in Natural Disasters: A Review.

    PubMed

    Khan, Fary; Amatya, Bhasker; Gosney, James; Rathore, Farooq A; Burkle, Frederick M

    2015-09-01

    To present an evidence-based overview of the effectiveness of medical rehabilitation intervention in natural disaster survivors and outcomes that are affected. A literature search was conducted using medical and health science electronic databases (PubMed, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PsycINFO) up to September 2014. Two independent reviewers selected studies reporting outcomes for natural disaster survivors after medical rehabilitation that addressed functional restoration and participation. Two reviewers independently extracted data and assessed the methodologic quality of the studies using the Critical Appraisal Skills Program's appraisal tools. A meta-analysis was not possible because of heterogeneity among included trials; therefore, a narrative analysis was performed for best evidence synthesis. Ten studies (2 randomized controlled trials, 8 observational studies) investigated a variety of medical rehabilitation interventions for natural disaster survivors to evaluate best evidence to date. The interventions ranged from comprehensive multidisciplinary rehabilitation to community educational programs. Studies scored low on quality assessment because of methodologic limitations. The findings suggest some evidence for the effectiveness of inpatient rehabilitation in reducing disability and improving participation and quality of life and for community-based rehabilitation for participation. There were no data available for associated costs. The findings highlight the need to incorporate medical rehabilitation into response planning and disaster management for future natural catastrophes. Access to rehabilitation and investment in sustainable infrastructure and education are crucial. More methodologically robust studies are needed to build evidence for rehabilitation programs, cost-effectiveness, and outcome measurement in such settings. Copyright © 2015 American Congress of Rehabilitation Medicine

  19. Accessibility information in New Delhi for "EasenAccess" Android-based app for persons with disability: an observational study.

    PubMed

    Agarwal, Yashovardhan

    2018-06-14

    The World Health Organization and the World Bank's "World Report on Disability" reported that over 1 billion people have various kinds of disability worldwide while Indian Census 2011 reported about 26 million in India. The United Nations Convention states, "The Rights of Persons with Disabilities (PwD) include accessibility to Information, Transportation, Environment, Communication Technology and Services". This article takes forward the reason of making the "EasenAccess" (EnA) Android-based app to empower PwD with wheelchair-accessibility information, communication sentences and sending SOS signals with location. A survey of 25 most frequented places in New Delhi by common people and tourist with chosen 12 parameters in comparison the Government of India's survey of 100 most important buildings nationally. A statistical analysis and recommendations about areas for improvement, for the Government of India. EasenAccess helps millions of PwD to enable them with freedom of movement for employment and socio-economic activities to lead an independent lifestyle. EasenAccess increases government's access to information about lacunae, gives them an easy way to tabulate the places where more accessibility needs updating, and helps the government in facilitating information flow to the PwD. Implication for Rehabilitation The Rights of Persons with Disability Act in 2016 covers both the concepts of Universal Design of products, environments and programs; and accessibility. We are exploring with them the ways technology can help bridge the gap between rehabilitation and accessibility. In the higher income countries such as the UK or USA, it is normal for a person to receive training when being given a wheelchair to prevent future injuries. Frequently, even with this, training people develop upper limb injuries, due in part to the high, repetitive loads needed to push a wheelchair. This training is given as part of a package of rehabilitation, which also normally includes

  20. Functional outcome after road-crash injury: description of the ESPARR victims cohort and 6-month follow-up results.

    PubMed

    Hours, Martine; Bernard, Marlène; Charnay, Pierrette; Chossegros, Laetitia; Javouhey, Etienne; Fort, Emmanuel; Boisson, Dominique; Sancho, Pierre-Olivier; Laumon, Bernard

    2010-03-01

    It is essential to know about the long-term consequences of road crashes involving corporal injury in order to adopt relevant public health measures. The ESPARR cohort comprises 1168 road-crash victims, aged 16 or over, managed in hospitals in the Rhône administrative départment (France). It is based on the Registry of Road Traffic Casualties, which has been collecting exhaustive data since 1995. Two groups are monitored: mild to moderate (M-AIS 1 or 2) and severe (M-AIS > or =3). Patients were interviewed at the point of primary care, between 1 October 2004 and 31 July 2006. 6 months later, their state of health and presence of pain were compared. Multivariate analysis (logistic regression) was performed to identify factors related to residual pain. Adults of the cohort were compared to the road crash population as a whole recorded over the same period in the same area. At 6 months post-accident, only 31.9% of victims deemed their health status to have entirely returned to normal; 63.8% of mild to moderate and 89.2% of severe cases reported residual pain, but neither pain frequency nor intensity correlated with M-AIS. Residual pain was related to lower limb injuries (OR=1.6; 95% CI=1.1-2.4). After adjustment, pain was essentially related to age, seriousness of the lesions and a stay in a rehabilitation unit. The ESPARR cohort provides a unique opportunity in France to describe the trajectory of a road crash victim, in terms both of care and rehabilitation and of resumption of work and personal activity. Copyright 2009 Elsevier Ltd. All rights reserved.

  1. Warning! Slippery Road Ahead: Internet Access and District Liability.

    ERIC Educational Resources Information Center

    Mazur, Joan M.

    1995-01-01

    As schools merge onto the information highway, districts must address their liability associated with Internet access. Schools need a practical policy supporting high access to global educational resources while limiting district liability. USENET provides easy access to controversial and pornographic materials. This article outlines federal…

  2. How equitable is vocational rehabilitation in Sweden? A review of evidence on the implementation of a national policy framework.

    PubMed

    Burstrom, Bo; Nylen, Lotta; Clayton, Stephen; Whitehead, Margaret

    2011-01-01

    Under the national framework law in Sweden, all eligible people should have equal chances of receiving vocational rehabilitation. We aimed to review the evidence on (1) whether access to vocational rehabilitation is equitable in practice and (2) whether the outcomes vary for different groups in the population. Systematic review of studies in Sweden that reported diagnostic or socio-demographic characteristics of people offered or taking up rehabilitation programmes and outcomes of such programmes for different diagnostic and socio-demographic groups. Searches of 11 relevant electronic databases, 15 organisational websites, citation searching and contact with experts in the field, for the period 1990-2009. A total of 11 studies were included in the final review, six of which addressed review question (1) and seven addressed review question (2). All the six observational studies of access reported biased selection into vocational rehabilitation: greater likelihood for men, younger people, those with longer-term sick leave, those with lower income, employed rather than unemployed people and those with musculoskeletal and mental disorders or alcohol abuse. Having had a rehabilitation investigation also increased the likelihood of receiving vocational rehabilitation. Differential outcome of rehabilitation was reported in seven studies: outcomes were better for men, younger people, employed individuals, those with shorter sick leave and those with higher income. Selection into vocational rehabilitation was perceived as important for successful outcomes, but success also depended on the state of the local labour market. There is evidence of socio-demographic differences in access to and outcomes of vocational rehabilitation in Sweden, even though the national framework law is meant to apply to everyone. Few studies have deliberately measured differential access or outcomes, and there is a need for this kind of equity analysis of population-wide policies. Studies

  3. Survey of wildlife rehabilitators on infection control and personal protective behaviors

    USGS Publications Warehouse

    Saito, E.K.; Shreve, A.A.

    2005-01-01

    Wildlife veterinarians and rehabilitators treat a number of wildlife species that can carry infectious and zoonotic diseases. These can rapidly spread within a facility and to the caregivers when adequate measures are not taken. Financial constraints and reduced access to laboratories often limit identification of disease etiology of many cases admitted into wildlife rehabilitation centers. A survey to investigate wildlife rehabilitator illness during the 2002 West Nile virus season indicated that many rehabilitators do not follow adequate protective measures in their facilities and may not seek medical care when disease symptoms arise or even linger. The recommended precautions and proper infection control measures for those handling and housing wildlife cases should be discussed between rehabilitators and their attending veterinarian(s).

  4. Improving Web Accessibility in a University Setting

    ERIC Educational Resources Information Center

    Olive, Geoffrey C.

    2010-01-01

    Improving Web accessibility for disabled users visiting a university's Web site is explored following the World Wide Web Consortium (W3C) guidelines and Section 508 of the Rehabilitation Act rules for Web page designers to ensure accessibility. The literature supports the view that accessibility is sorely lacking, not only in the USA, but also…

  5. Disability and access to health care - a community based descriptive study.

    PubMed

    Maart, Soraya; Jelsma, Jennifer

    2014-01-01

    The World Disability Report highlighted the need for adequate access to health and medical rehabilitation services for those with disability. Participants in a large community based survey in a low-income area were asked questions relating to their use of health related services. Using random, cluster sampling a representative sample of 1083 households in a deprived area of Cape Town were approached and 152 people with disability were interviewed. Those with disability were more likely to be male (χ² = 4.24, p = 0.03) and unemployed (χ² = 66.89, p > 0.001) compared to those without disability. The percentages reporting unmet needs were respectively: 54% for home-based care; 34.5% for assistive devices, 28.9% for medical rehabilitation services; and 2.5% for health services. Those over 65 years of age were less likely to have had the medical rehabilitation that they required (χ² = 8.00, p = 0.018). There were fewer respondents with sensory and language disorders but these groups reported proportionately more unmet needs. The main problems with accessing services included inadequate finances (71%) and transport problems (72%). It is recommended that all efforts be expended to extend appropriate rehabilitation services, including home based-care and appliances to those identified as having disability, particularly to those older than 65 years. In addition, the services need to be affordable and accessible in terms of suitable transport, particularly in the light of the high unemployment rate and the large number of respondents with mobility problems. Implications for Rehabilitation People with disability may be the most in need of additional health related care and the least able to access it. Transport and financial considerations were found to limit the ability to access appropriate care. Rehabilitation and health services need to reach out through home-based care and appropriate forms of rehabilitation delivery to ensure that those who are most in need

  6. Quantifying the key factors that create road flooding.

    DOT National Transportation Integrated Search

    2013-01-01

    Road flooding is a serious operational hazard in the low-lying areas of southern Louisiana. This hazard is especially acute for the regions emergency evacuation routes, which must be accessible by coastal residents who plan evacuations ahead of an...

  7. 25 CFR 170.813 - When can access to IRR transportation facilities be restricted?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false When can access to IRR transportation facilities be restricted? 170.813 Section 170.813 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.813 When can access to IRR...

  8. Urbanization, roads, and rural population change in the Ecuadorian Andes.

    PubMed

    Rudel, T K; Richards, S

    1990-01-01

    "Like many developing countries Ecuador has experienced extensive ubanization in the past twenty-five years as well as a shift in the pattern of rural population change between the 1960s and 1970s. Rural places with difficult access to cities (without roads and located far from cities) gained population during the 1960s but lost population during the 1970s. Rural places with easy access to cities (i.e., located near cities or on all-weather roads) continued to gain population during the 1970s. The explanation for the differential ability of rural places to retain their population during the 1970s focuses on increases in labor circulation by peasants and growth in the numbers of small, urban-oriented manufacturing and agricultural enterprises in accessible rural areas. The article concludes with a discussion on the implications of these findings for policies to reduce rates of rural-urban migration." excerpt

  9. 1. VIEW OF THE WATER FILTRATION PLANT FROM THE ACCESS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. VIEW OF THE WATER FILTRATION PLANT FROM THE ACCESS ROAD, LOOKING NORTHWEST. - Tower Hill No. 2 Mine, Approximately 0.47 mile Southwest of intersection of Stone Church Road & Township Route 561, Hibbs, Fayette County, PA

  10. 78 FR 37558 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-21

    ... Section 508 of the Rehabilitation Act to permit accessibility to people with disabilities. Every 2 years... Reports Clearance Officer, Room 2-1057, One Choke Cherry Road, Rockville, MD 20857 OR email her a copy at...

  11. Rehabilitation of people with spinal cord damage due to tumor: literature review, international survey and practical recommendations for optimizing their rehabilitation.

    PubMed

    New, Peter Wayne; Marshall, Ruth; Stubblefield, Michael D; Scivoletto, Giorgio

    2017-03-01

    People with spinal cord dysfunction (SCDys) due to tumor (benign and malignant) pose enormous rehabilitation challenges. Objectives were: conduct literature search regarding epidemiology, clinical features and outcomes for SCDys due to tumor following rehabilitation, the ideal setting for rehabilitation and practical considerations for rehabilitation; and propose framework and practical considerations for managing people with SCDys due to tumor in spinal rehabilitation units (SRUs). Survey of rehabilitation health care professionals, consensus opinion from experts and literature search. Workshop at International Spinal Cord Society and American Spinal Injury Association combined annual meeting, May 16, 2015, Montréal, Canada. Workshop attendees and experts in the rehabilitation of people with SCDys due to tumor. Reports of services offered to people with SCDys due to tumor, including whether those with benign and malignant tumors are admitted into rehabilitation, any admission criteria used and the rational for declining admission. Most respondents (n = 33, 83%) reported that people with benign tumors were routinely admitted for rehabilitation but only 18 (45%) reported that people with malignant tumors were routinely admitted. A range of criteria and reasons for declining admission were given. Evidence from the literature and the opinion of experts support the admission of people with SCDys due to tumor into specialist SRUs. A framework and practical considerations for managing people with SCDys due to tumor in SRUs are proposed. Patients with tumor causing SCDys should be given greater access to specialist SRU in order to achieve the best outcomes.

  12. Physical Medicine and Rehabilitation Resident Use of iPad Mini Mobile Devices.

    PubMed

    Niehaus, William; Boimbo, Sandra; Akuthota, Venu

    2015-05-01

    Previous research on the use of tablet devices in residency programs has been undertaken in radiology and medicine or with standard-sized tablet devices. With new, smaller tablet devices, there is an opportunity to assess their effect on resident behavior. This prospective study attempts to evaluate resident behavior after receiving a smaller tablet device. To evaluate whether smaller tablet computers facilitate residents' daily tasks. Prospective study that administered surveys to evaluate tablet computer use. Residency program. Thirteen physical medicine and rehabilitation residents. Residents were provided 16-GB iPad Minis and surveyed with Redcap to collect usage information at baseline, 3, and 6 months. Survey analysis was conducted using SAS (SAS, Cary, NC) for descriptive analysis. To evaluate multiple areas of resident education, the following tasks were selected: accessing e-mail, logging duty hours, logging procedures, researching clinical information, accessing medical journals, reviewing didactic presentations, and completing evaluations. Then, measurements were taken of: (1) residents' response to how tablet computers made it easier to access the aforementioned tasks; and (2) residents' response to how tablet computers affected the frequency they performed the aforementioned tasks. After being provided tablet computers, our physical medicine and rehabilitation residents reported significantly greater access to e-mail, medical journals, and didactic material. Also, receiving tablet computers was reported to increase the frequency that residents accessed e-mail, researched clinical information, accessed medical journals, reviewed didactic presentations, and completed evaluations. After receiving a tablet computer, residents reported an increase in the use of calendar programs, note-taking programs, PDF readers, online storage programs, and file organization programs. These physical medicine and rehabilitation residents reported tablet computers

  13. Safety evaluation of access management policies and techniques, TechBrief

    DOT National Transportation Integrated Search

    2015-08-01

    Access management is the process that provides (or manages) access to land development while simultaneously preserving the flow of traffic on the surrounding road network for safety, capacity, and speed. Access management provides important benefits ...

  14. Planning practice in support of economically and environmentally sustainable roads in floodplains: the case of the Mekong delta floodplains.

    PubMed

    Douven, Wim; Buurman, Joost

    2013-10-15

    Road development in relatively undisturbed floodplain systems, such as the floodplains of the Mekong River, will impact hydraulics and interrupt the natural flow of water. This affects the ecology and environment, and the livelihoods of people who depend on fishing and agriculture. On the other hand, floods can severely damage road infrastructure in years with large floods and can cause high annual maintenance costs. Improving road development practices in floodplains is a complex, multidimensional task involving hydraulic and geotechnical analysis, ecosystem analysis, socio-economic analysis, policy analysis, etc. This paper analyses the planning practice of road development and rehabilitation and how this practice can be improved in support of economically and environmentally sustainable roads in floodplains. It is concluded that although ample technical, planning and environmental assessment guidelines exist, guidelines need updating to address cumulative impacts at floodplain level and factors hampering the implementation in guidelines should be addressed in the guideline design (process). Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Road to the Future: Strategies for Wildlife Crossings and Youth Empowerment to Improve Wildlife Habitat in Roaded Landscapes

    ERIC Educational Resources Information Center

    Tanner, Dawn Renee

    2010-01-01

    As the footprint of human society expands upon the earth, habitat loss and landscape fragmentation is an increasing global problem. That problem includes loss of native habitats as these areas are harvested, converted to agricultural crops, and occupied by human settlement. Roads increase human access to previously inaccessible areas, encourage…

  16. Provider perspectives on rehabilitation of patients with polytrauma.

    PubMed

    Friedemann-Sánchez, Greta; Sayer, Nina A; Pickett, Treven

    2008-01-01

    To describe, from the perspective of U.S. Department of Veterans Affairs (VA) polytrauma rehabilitation providers, (1) patients with combat-related polytrauma and their rehabilitation, (2) polytrauma patient family member involvement in rehabilitation, and (3) the impact on providers of providing polytrauma rehabilitation. Qualitative study based on rapid assessment process methodology, which included semistructured interviews, observation, and use of a field liaison. The 4 VA polytrauma rehabilitation centers (PRCs). Fifty-six purposefully selected PRC providers and providers from consulting services. Not applicable. Provider self-report of polytrauma patient characteristics, polytrauma patient family member involvement in rehabilitation, and the impact of polytrauma rehabilitation on providers themselves. According to PRC providers, polytrauma patients are younger than VA rehabilitation patients. Strong military identities affect rehabilitation needs and reactions to severe injury. The public and the media have particular interest in war-injured patients. Patients with blast-related polytrauma have unique constellations of visible (including amputations, craniectomies, and burns) and invisible (including traumatic brain injury, pain, and posttraumatic stress disorder) injuries. Providers have adjusted treatment strategies and involved services outside of rehabilitation because of this clinical complexity. Family members are intensely involved in rehabilitation and have service needs that may surpass those of families of rehabilitation patients without polytrauma. Sources of provider stress include new responsibilities, media attention, increased oversight, and emotional costs associated with treating severely injured young patients and their families. Providers also described the work as deeply rewarding. The VA should prioritize the identification or development and implementation of strategies to address family member needs and to monitor and ensure that PRC

  17. Vocational Rehabilitation of Young Adults with Psychological Disabilities.

    PubMed

    Tophoven, Silke; Reims, Nancy; Tisch, Anita

    2018-05-10

    Objective Vocational rehabilitation measures support youth and young adults with disabilities to obtain vocational training and to enter the labor market. In Germany, a growing number of young people with psychological disabilities in vocational rehabilitation can be observed. The study at hand focuses on this group and examines their (un-)unemployment biographies before vocational rehabilitation, their access to vocational rehabilitation and identifies their individual challenges within the process of vocational rehabilitation. Methods Using a multi-methods approach, we analyze representative administrative data of the German Federal Employment Agency as well as biographical interviews conducted with young rehabilitants. We compare the population of young rehabilitants with psychological disorders to those with other disabilities in terms of vocational rehabilitation and initial labor market entry in order to get a representative picture about their school to work transitions. Since rehabilitants with psychological disabilities tend to be older than the remaining population, analyses are stratified by age groups. In addition, qualitative in-depth interviews provide an additional and deeper understanding of specific employment barriers youth with psychological disorders have to overcome. Furthermore, the individual perspective gives insight on how the crucial transition from school to work is perceived by the population under study. Results The pathway into vocational rehabilitation of youth with psychological disorders is often characterized by obstacles in their transition from school to work. During rehabilitation, it appears essential to provide psychological stabilization along with vocational training. Although their average level of education is higher than those of other rehabilitants, labor market transition after (often company-external) vocational training challenges many young people with psychological disabilities, leaving many of them with

  18. Between ideals and reality in home-based rehabilitation

    PubMed Central

    Steihaug, Sissel; Lippestad, Jan-W.; Werner, Anne

    2016-01-01

    Setting and objective The growing elderly population and the rising number of people with chronic diseases indicate an increasing need for rehabilitation. Norwegian municipalities are required by law to offer rehabilitation. The aim of this study was to investigate how rehabilitation work is perceived and carried out by first-line service providers compared with the guidelines issued by Norway’s health authorities. Design and subjects In this action research project, qualitative data were collected through 24 individual interviews and seven group interviews with employees – service providers and managers – in the home-based service of two boroughs in Oslo, Norway. The data were analysed using a systematic text-condensation method. Results The results show that rehabilitation receives little attention in the boroughs and that patients are seldom rehabilitated at home. There is disagreement among professional staff as to what rehabilitation is and should be. The purchaser–provider organization, high speed of service delivery, and scarcity of resources are reported to hamper rehabilitation work. Conclusion and implications A discrepancy exists between the high level of ambitious goals of Norwegian health authorities and the possibilities that practitioners have to achieve them. This situation results in healthcare staff being squeezed by the increasing expectations and demands of the population and the promises and statutory rights coming from politicians and administrators. For the employees in the municipalities to place rehabilitation on the agenda, it is a requirement that authorities understand the clinical aspect of rehabilitation and provide the municipalities with adequate framework conditions for successful rehabilitation work. Key pointsHome-based rehabilitation is documented to be effective, and access to rehabilitation has been established in Norwegian law.The purchaser–provider organization, high rate of speed, and a scarcity of resources in

  19. Improving Vocational Rehabilitation Access and Return to Work and Career Outcomes among African American Wounded Warriors, Gulf War, and Vietnam War Era Veterans with Disabilities: A White Paper Series

    ERIC Educational Resources Information Center

    Moore, Corey L., Ed.: Johnson, Jean E., Ed.; Washington, Andre L., Ed.

    2011-01-01

    The purpose of this monograph is to present documents that discuss issues related to improving access to vocational rehabilitation services and return to work rates of African American Wounded Warriors, Gulf War and Vietnam War Era veterans with disabilities. This monograph also includes a review of relevant literature on barriers to employment…

  20. Gross human rights violations and reparation under international law: approaching rehabilitation as a form of reparation.

    PubMed

    Sveaass, Nora

    2013-01-01

    The strengthening of international criminal law through an increased focus on the right to reparation and rehabilitation for victims of crimes against humanity represents an important challenge to health professionals, particularly to those in the field of trauma research and treatment. A brief outline of some developments in the field of international law and justice for victims of gross human rights violations is presented, with a focus on the right to reparation including the means for rehabilitation. The fulfillment of this right is a complex endeavor which raises many questions. The road to justice and reparation for those whose rights have been brutally violated is long and burdensome. The active presence of trauma-informed health professionals in this process is a priority. Some of the issues raised within the context of states' obligations to provide and ensure redress and rehabilitation to those subjected to torture and gross human rights violations are discussed, and in particular how rehabilitation can be understood and responded to by health professionals.

  1. Accessible Electronic and Information Technology

    EPA Pesticide Factsheets

    This Policy establishes EPA's responsibilities and procedures for making its Electronic and Information Technology (EIT) products accessible to all people, including people with disabilities, in accordance with Section 508 of the Rehabilitation Act.

  2. Exploring Barriers of the Health System to Rehabilitation Services for People with Disabilities in Iran: A Qualitative Study

    PubMed Central

    Abdi, Kianoush; Arab, Mohammad; Rashidian, Arash; Kamali, Mohammad; Khankeh, Hamid Reza; Farahani, Farideh Khalajabadi

    2015-01-01

    Introduction The United Nations (UN) identified health as a basic human right, but, unfortunately, the evidence shows that people with disabilities (PWD) often have lower levels of health than the general population. This can be associated with problems in access to the services and programs. The aim of this study was to explore barriers of the health system to rehabilitation services for PWD in Iran. Methods This was a qualitative study conducted on 21 participants using semi-structured, in-depth interviews and content analysis from June 2014 to July 2015. Data analysis was performed by MAXQDA version 10. Results “Barriers” were the most prominent challenge of people with disabilities that needed access to rehabilitation services. These barriers were categorized into eight concepts of deficiency in the system that provides rehabilitation services, defect of education, deficiency in detecting and screening of people with disability, defect of stewardship in rehabilitation, ignoring socio-cultural factors, accessibility hardships, lack of identification, and financial hardships in rehabilitation. Conclusions An efficient rehabilitation plan requires a common understanding, considering the long-term complications involved in addressing the barriers. Understanding the barriers of the health system to rehabilitation services requires comprehensive management that first should be familiar with all of PWD, providers, policy makers, and other beneficiaries. It also is necessary for policy makers to consider rehabilitation services as a main part of the health plan; especially, they must change their oversight of rehabilitation services and programs. Thus, policy makers should have need comprehensive management and recommended further research. PMID:26767101

  3. Value for money - recasting the problem in terms of dynamic access prioritisation.

    PubMed

    Taylor, William J; Laking, George

    2010-01-01

    To develop an approach for achieving value for money in rehabilitation based on dynamic prioritisation of access to services according to individual capacity to benefit. A critical review of economic evaluation and adaptation of a prioritisation method used in determining access to elective surgical services in New Zealand to a rehabilitation context. The cost-effectiveness frontier is not straight but curved, suggesting that some people benefit more from a given intervention than others. An approach that identifies those most likely to benefit from inpatient rehabilitation following stroke (as an example) and enables access in order of capacity to benefit is presented in the context of a quality improvement programme. The approach is operationalised as a prioritisation tool that is dynamic in the sense that is can be reapplied subject to changes in the patient's clinical status. The steps proposed to develop such a tool include qualitative research with expert clinicians, pair-wise comparison of alternative scenarios (1000Minds survey), construction of an economic model of the tool's operation and an observational cohort study to help populate the model and calibrate the tool. A dynamic prioritisation approach to guide access to scarce health-care resources (such as inpatient rehabilitation following stroke) offers a transparent and equitable way of achieving value for money in the delivery of rehabilitation services.

  4. Use of certain alternative fuels in road transport in Poland

    NASA Astrophysics Data System (ADS)

    Gis, W.; Pielecha, J.; Waśkiewicz, J.; Gis, M.; Menes, M.

    2016-09-01

    The development of biomethane and hydrogen technology in the road transport in the EU countries is recommended, among the others, in the Directive of the European Parliament and of the Council 2014/94/EU of 22 October 2014. Under the provisions of the said Directive, it is recommended to EU countries to use biomethane and progressively ensure accessibility to hydrogen cars on their territories, and above all to ensure the possibility of driving hydrogen vehicles between the member States. The territorial accessibility for biomethane vehicles is determined by the availability of biomethane refuelling infrastructure in the first place in cities and then on the road network distances recommended in this directive. The territorial accessibility for hydrogen vehicles is determined by the availability of hydrogen refuelling infrastructure, in the first place along the TEN-T network. The article presents the possibilities of using these alternative fuels in Poland, presenting some of the results of research and analysis in this area.

  5. Driving assessment and rehabilitation using a driving simulator in individuals with traumatic brain injury: A scoping review.

    PubMed

    Imhoff, Sarah; Lavallière, Martin; Teasdale, Normand; Fait, Philippe

    2016-06-30

    Due to the heterogeneity of the lesion following a traumatic brain injury (TBI) and the complexity of the driving task, driving assessment and rehabilitation in TBI individuals is challenging. Conventional driving assessment (on-road and in-clinic evaluations) has failed demonstrating effectiveness to assess fitness to drive in TBI individuals. We aimed to determine if driving simulators represent an interesting opportunity in assessing and rehabilitating driving skills in TBI individuals. We searched PubMed, CINAHL and Cochrane library databases between 27-02-2014 and 08-04-2014 for articles published since 2000 with the contents of simulator driving assessment and rehabilitation. Out of 488, eight articles with the subject of simulator driving assessment and two with the subject of simulator driving rehabilitation in individuals with TBI were reviewed. Driving simulators represent a promising avenue for the assessment and rehabilitation of driving skills in TBI individuals as it allows control of stimuli in a safe, challenging and ecologically valid environment and offer the opportunity to measure and record driving performance. Additional studies, however, are needed to document strengths and limitations of this method.

  6. Rehabilitation of people with spinal cord damage due to tumor: literature review, international survey and practical recommendations for optimizing their rehabilitation

    PubMed Central

    Marshall, Ruth; Stubblefield, Michael D.; Scivoletto, Giorgio

    2017-01-01

    Background People with spinal cord dysfunction (SCDys) due to tumor (benign and malignant) pose enormous rehabilitation challenges. Objectives were: conduct literature search regarding epidemiology, clinical features and outcomes for SCDys due to tumor following rehabilitation, the ideal setting for rehabilitation and practical considerations for rehabilitation; and propose framework and practical considerations for managing people with SCDys due to tumor in spinal rehabilitation units (SRUs). Design Survey of rehabilitation health care professionals, consensus opinion from experts and literature search. Setting Workshop at International Spinal Cord Society and American Spinal Injury Association combined annual meeting, May 16, 2015, Montréal, Canada. Participants Workshop attendees and experts in the rehabilitation of people with SCDys due to tumor. Outcomes Measures Reports of services offered to people with SCDys due to tumor, including whether those with benign and malignant tumors are admitted into rehabilitation, any admission criteria used and the rational for declining admission. Results Most respondents (n = 33, 83%) reported that people with benign tumors were routinely admitted for rehabilitation but only 18 (45%) reported that people with malignant tumors were routinely admitted. A range of criteria and reasons for declining admission were given. Evidence from the literature and the opinion of experts support the admission of people with SCDys due to tumor into specialist SRUs. Conclusions A framework and practical considerations for managing people with SCDys due to tumor in SRUs are proposed. Patients with tumor causing SCDys should be given greater access to specialist SRU in order to achieve the best outcomes. PMID:27088581

  7. Predicting fitness-to-drive following stroke using the Occupational Therapy - Driver Off Road Assessment Battery.

    PubMed

    Unsworth, Carolyn A; Baker, Anne; Lannin, Natasha; Harries, Priscilla; Strahan, Janene; Browne, Matthew

    2018-02-28

    It is difficult to determine if, or when, individuals with stroke are ready to undergo on-road fitness-to-drive assessment. The Occupational Therapy - Driver Off Road Assessment Battery was developed to determine client suitability to resume driving. The predictive validity of the Battery needs to be verified for people with stroke. Examine the predictive validity of the Occupational Therapy - Driver Off Road Assessment Battery for on-road performance among people with stroke. Off-road data were collected from 148 people post stroke on the Battery and the outcome of their on-road assessment was recorded as: fit-to-drive or not fit-to-drive. The majority of participants (76%) were able to resume driving. A classification and regression tree (CART) analysis using four subtests (three cognitive and one physical) from the Battery demonstrated an area under the curve (AUC) of 0.8311. Using a threshold of 0.5, the model correctly predicted 98/112 fit-to-drive (87.5%) and 26/36 people not fit-to-drive (72.2%). The three cognitive subtests from the Occupational Therapy - Driver Off Road Assessment Battery and potentially one of the physical tests have good predictive validity for client fitness-to-drive. These tests can be used to screen client suitability for proceeding to an on-road test following stroke. Implications for Rehabilitation: Following stroke, drivers should be counseled (including consideration of local legislation) concerning return to driving. The Occupational Therapy - Driver Off Road Assessment Battery can be used in the clinic to screen people for suitability to undertake on road assessment. Scores on four of the Occupational Therapy - Driver Off Road Assessment Battery subtests are predictive of resumption of driving following stroke.

  8. Accessibility | Smokefree 60+

    Cancer.gov

    60plus.smokefree.gov is committed to making its websites accessible to all individuals—disabled or not—who are seeking information. To provide this information, the Smokefree 60+ website has been designed to comply with Section 508 of the Rehabilitation Act (as amended). Section 508 requires that all individuals with disabilities (whether they are federal government employees or members of the general public) have access to and use of information and data comparable to that provided to individuals without disabilities, unless an undue burden would be imposed.

  9. Exercise-Based Oncology Rehabilitation: Leveraging the Cardiac Rehabilitation Model

    PubMed Central

    Dittus, Kim L.; Lakoski, Susan G.; Savage, Patrick D.; Kokinda, Nathan; Toth, Michael; Stevens, Diane; Woods, Kimberly; O’Brien, Patricia; Ades, Philip A.

    2014-01-01

    PURPOSE The value of exercise and rehabilitative interventions for cancer survivors is increasingly clear and oncology rehabilitation programs could provide these important interventions. However, a pathway to create oncology rehabilitation has not been delineated. Community-based cardiac rehabilitation (CR) programs staffed by health care professionals with experience in providing rehabilitation and secondary prevention services to individuals with coronary heart disease are widely available and provide a potential model and location for oncology rehabilitation programs. Our purpose is to outline the rehabilitative needs of cancer survivors and demonstrate how oncology rehabilitation can be created using a cardiac rehabilitation model. METHODS We identify the impairments associated with cancer and its therapy that respond to rehabilitative interventions. Components of the CR model that would benefit cancer survivors are described. An example of an oncology rehabilitation program using a CR model is presented. RESULTS Cancer survivors have impairments associated with cancer and its therapy that improve with rehabilitation. Our experience demonstrates that effective rehabilitation services can be provided utilizing an existing CR infrastructure. Few adjustments to current cardiac rehabilitation models would be needed to provide oncology rehabilitation. Preliminary evidence suggests that cancer survivors participating in an oncology rehabilitation program experience improvements in psychological and physiologic parameters. CONCLUSIONS Utilizing the CR model of rehabilitative services and disease management provides a much needed mechanism to bring oncology rehabilitation to larger numbers of cancer survivors. PMID:25407596

  10. The Vocational Rehabilitation of Minorities [and] Reactions.

    ERIC Educational Resources Information Center

    Giles, Frank L.; And Others

    This paper addresses problems encountered by minorities in accessing the state/federal vocational rehabilitation (VR) system, how minorities have fared in the system, the lack of trained minorities in the VR counseling profession, and a comparison of private-for-profit and state/federal VR programs. Minorities considered include Blacks, Hispanic…

  11. 77 FR 39656 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-05

    ...-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards Advisory Committee AGENCY... Diagnostic Equipment Accessibility Standards. DATES: The first meeting of the committee will be held at a... Equipment Accessibility Standards. See 77 FR 14706 (March 13, 2012). Section 510 of the Rehabilitation Act...

  12. 77 FR 26785 - Implementation of Indian Reservation Roads Program and Streamlining the Federal Delivery of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-07

    ... does not currently exist and needs to be constructed.'' A primary access route is the shortest feasible... Introductions 9:15 a.m.-10:45 a.m. Proposed/Access Roads (Recommendation, Expectations, Implementation) 10:45 a...

  13. 76 FR 77738 - Telecommunications Act Accessibility Guidelines; Electronic and Information Technology...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-14

    ... Telecommunications Act Accessibility Guidelines and its Electronic and Information Technology Accessibility Standards... electronic and information technology covered by Section 508 of the Rehabilitation Act Amendments of 1998. 76.... 2011-07] RIN 3014-AA37 Telecommunications Act Accessibility Guidelines; Electronic and Information...

  14. The importance of daily physical activity for improved exercise tolerance in heart failure patients with limited access to centre-based cardiac rehabilitation.

    PubMed

    Sato, Noriaki; Origuchi, Hideki; Yamamoto, Umpei; Takanaga, Yasuhiro; Mohri, Masahiro

    2012-09-01

    Supervised cardiac rehabilitation provided at dedicated centres ameliorates exercise intolerance in patients with chronic heart failure. To correlate the amount of physical activity outside the hospital with improved exercise tolerance in patients with limited access to centre-based programs. Forty patients (median age 69 years) with stable heart failure due to systolic left ventricular dysfunction participated in cardiac rehabilitation once per week for five months. Using a validated single-axial accelerometer, the number of steps and physical activity-related energy expenditures on nonrehabilitation days were determined. Median (interquartile range) peak oxygen consumption was increased from 14.4 mL/kg/min (range 12.9 mL/kg/min to 17.8 mL/kg/min) to 16.4 mL/kg/min (range 13.9 mL/kg/min to 19.1 mL/kg/min); P<0.0001, in association with a decreased slope of the minute ventilation to carbon dioxide production plot (34.2 [range 31.3 to 38.1] versus 32.7 [range 30.3 to 36.5]; P<0.0001). Changes in peak oxygen consumption were correlated with the daily number of steps (P<0.01) and physical activity-related energy expenditures (P<0.05). Furthermore, these changes were significantly correlated with total exercise time per day and time spent for light (≤3 metabolic equivalents) exercise, but not with time spent for moderate/vigorous (>3 metabolic equivalents) exercise. The number of steps and energy expenditures outside the hospital were correlated with improved exercise capacity. An accelerometer may be useful for guiding home-based cardiac rehabilitation.

  15. Population Accessibility to Radiotherapy Services in New South Wales Region of Australia: a methodological contribution

    NASA Astrophysics Data System (ADS)

    Shukla, Nagesh; Wickramasuriya, Rohan; Miller, Andrew; Perez, Pascal

    2015-05-01

    This paper proposes an integrated modelling process to assess the population accessibility to radiotherapy treatment services in future based on future cancer incidence and road network-based accessibility. Previous research efforts assessed travel distance/time barriers affecting access to cancer treatment services, as well as epidemiological studies that showed that cancer incidence rates vary with population demography. It is established that travel distances to treatment centres and demographic profiles of the accessible regions greatly influence the demand for cancer radiotherapy (RT) services. However, an integrated service planning approach that combines spatially-explicit cancer incidence projections, and the RT services accessibility based on patient road network have never been attempted. This research work presents this novel methodology for the accessibility assessment of RT services and demonstrates its viability by modelling New South Wales (NSW) cancer incidence rates for different age-sex groups based on observed cancer incidence trends; estimating the road network-based access to current NSW treatment centres; and, projecting the demand for RT services in New South Wales, Australia from year 2011 to 2026.

  16. Road user behaviour changes following a self-explaining roads intervention.

    PubMed

    Mackie, Hamish W; Charlton, Samuel G; Baas, Peter H; Villasenor, Pablo C

    2013-01-01

    The self-explaining roads (SER) approach uses road designs that evoke correct expectations and driving behaviours from road users to create a safe and user-friendly road network. Following the implementation of an SER process and retrofitting of local and collector roads in a suburb within Auckland City, lower speeds on local roads and less variation in speed on both local and collector roads were achieved, along with a closer match between actual and perceived safe speeds. Preliminary analyses of crash data shows that the project has resulted in a 30% reduction crash numbers and an 86% reduction in crash costs per annum, since the road changes were completed. In order to further understand the outcomes from this project, a study was carried out to measure the effects of the SER intervention on the activity and behaviour of all road users. Video was collected over nine separate days, at nine different locations, both before and after SER construction. Road user behaviour categories were developed for all potential road users at different location types and then used to code the video data. Following SER construction, on local roads there was a relatively higher proportion of pedestrians, less uniformity in vehicle lane keeping and less indicating by motorists along with less through traffic, reflecting a more informal/low speed local road environment. Pedestrians were less constrained on local roads following SER construction, possibly reflecting a perceptually safer and more user-friendly environment. These behaviours were not generally evident on collector roads, a trend also shown by the previous study of speed changes. Given that one of the objectives of SER is to match road user behaviour with functionally different road categories, the road user behaviour differences demonstrated on different road types within the SER trial area provides further reinforcement of a successful SER trial. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Barriers to Low Vision Rehabilitation: A Qualitative Approach

    ERIC Educational Resources Information Center

    Southall, Kenneth; Wittich, Walter

    2012-01-01

    Introduction: This study sought to describe and better understand barriers to accessing low vision rehabilitation services. Methods: A qualitative description research paradigm was employed. Focus group participants were recruited through their involvement in the Montreal Barriers Study in Montreal, Canada. Six focus groups (n = 21 participants)…

  18. EPA GHG Certification of Medium- and Heavy-Duty Vehicles: Development of Road Grade Profiles Representative of US Controlled Access Highways

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wood, Eric; Duran, Adam; Burton, Evan

    This report includes a detailed comparison of the TomTom national road grade database relative to a local road grade dataset generated by Southwest Research Institute and a national elevation dataset publically available from the U.S. Geological Survey. This analysis concluded that the TomTom national road grade database was a suitable source of road grade data for purposes of this study.

  19. Gross human rights violations and reparation under international law: approaching rehabilitation as a form of reparation

    PubMed Central

    Sveaass, Nora

    2013-01-01

    The strengthening of international criminal law through an increased focus on the right to reparation and rehabilitation for victims of crimes against humanity represents an important challenge to health professionals, particularly to those in the field of trauma research and treatment. A brief outline of some developments in the field of international law and justice for victims of gross human rights violations is presented, with a focus on the right to reparation including the means for rehabilitation. The fulfillment of this right is a complex endeavor which raises many questions. The road to justice and reparation for those whose rights have been brutally violated is long and burdensome. The active presence of trauma-informed health professionals in this process is a priority. Some of the issues raised within the context of states’ obligations to provide and ensure redress and rehabilitation to those subjected to torture and gross human rights violations are discussed, and in particular how rehabilitation can be understood and responded to by health professionals. PMID:23671765

  20. Verification of road databases using multiple road models

    NASA Astrophysics Data System (ADS)

    Ziems, Marcel; Rottensteiner, Franz; Heipke, Christian

    2017-08-01

    In this paper a new approach for automatic road database verification based on remote sensing images is presented. In contrast to existing methods, the applicability of the new approach is not restricted to specific road types, context areas or geographic regions. This is achieved by combining several state-of-the-art road detection and road verification approaches that work well under different circumstances. Each one serves as an independent module representing a unique road model and a specific processing strategy. All modules provide independent solutions for the verification problem of each road object stored in the database in form of two probability distributions, the first one for the state of a database object (correct or incorrect), and a second one for the state of the underlying road model (applicable or not applicable). In accordance with the Dempster-Shafer Theory, both distributions are mapped to a new state space comprising the classes correct, incorrect and unknown. Statistical reasoning is applied to obtain the optimal state of a road object. A comparison with state-of-the-art road detection approaches using benchmark datasets shows that in general the proposed approach provides results with larger completeness. Additional experiments reveal that based on the proposed method a highly reliable semi-automatic approach for road data base verification can be designed.

  1. Rehabilitation access and effectiveness for persons with back pain: the protocol of a cohort study (REHAB-BP, DRKS00011554).

    PubMed

    Bethge, Matthias; Mattukat, Kerstin; Fauser, David; Mau, Wilfried

    2017-07-14

    Back pain is one of the most common chronic diseases in Germany and has a major impact on work ability and social participation. The German Pension Insurance (GPI) is the main provider of medical rehabilitation to improve work ability and prevent disability pensions in Germany. However, over half of the persons granted a disability pension have never used a medical rehabilitation service. Furthermore, evidence on the effects of medical rehabilitation in Germany is inconclusive. Consequently, this study has two aims: first, to determine barriers to using rehabilitation services, and second, to examine the effectiveness of medical rehabilitation in German residents with chronic back pain. In 2017 a postal questionnaire will be sent to 45,000 persons aged 45 to 59 years whose pension insurance contributions are managed by the GPI North or the GPI Central Germany. In 2019 respondents who report back pain in the first survey (n = 5760 expected) will be sent a second questionnaire. Individuals will be eligible for the first survey if they are employed, have neither used nor applied for a rehabilitation programme during the last 4 years and neither received nor applied for a disability pension. The sample will be drawn randomly from the registers of the GPI North (n = 22,500) and the GPI Central Germany (n = 22,500) and stratified by sex and duration of sickness absence benefits. Barriers to rehabilitation services will be related to socio-demographic and social characteristics, pain and attitudes to pain, health and health behaviour, healthcare utilisation, experiences and cognitions about rehabilitation services and job conditions. Propensity score matched analyses will be used to examine the effectiveness of rehabilitation services. Data on use of medical rehabilitation will be extracted from administrative records. The primary outcome is pain disability. Secondary outcomes are pain intensity and days of disability, pain self-efficacy, fear avoidance beliefs

  2. Comparing Recruitment and Retention Strategies for Rehabilitation Professionals among Hospital and Home Care Employers

    PubMed Central

    Tran, Diem; Davis, Aileen; McGillis Hall, Linda

    2012-01-01

    ABSTRACT Purpose: The objective of this study was to compare hospital and home care employers' rankings of both the importance and the feasibility of workforce strategies for recruiting and retaining rehabilitation professionals. Methods: An online self-administered questionnaire was distributed to all employers of rehabilitation professionals in Ontario hospitals (n=144) and Community Care Access Centre home care providers (n=34). Importance and feasibility rankings were based on the percentage of high ratings; 95% CIs were used to determine significant differences between hospital and home care rankings of recruitment and retention strategies. Results: The response rate was 50% (72/144) from hospitals and 73.5% (25/34) from home-care settings. The recruitment and retention strategies considered most important and feasible for rehabilitation therapists, regardless of setting, were communication between employer and worker, compensation packages, access to research, and professional development in budget planning. Tangible resources, support personnel, work safety, and marketing rehabilitation careers to high school students were ranked significantly higher by hospitals than by home care providers. Conclusions: Similarities exist between hospital and home care employers in terms of the importance and feasibility of recruitment and retention strategies for rehabilitation professionals. However, when developing a rehabilitation health human resources plan, the strategies identified as different between hospital and home care settings should be taken into account. PMID:23277683

  3. Quantifying the key factors that create road flooding : [tech summary].

    DOT National Transportation Integrated Search

    2013-01-01

    Road fl ooding is a serious operational hazard for many low-lying areas across southern Louisiana. This hazard is especially acute for : the regions emergency evacuation routes, which must be accessible for safe evacuation prior to an approaching ...

  4. Access Denied: Future Military Operations in an Anti-Access Environment

    DTIC Science & Technology

    2011-05-04

    Naval War College 686 Cushing Road Newport, RI 02841-1207 9. SPONSORING/MONITORING AGENCY NAME( S ...Haddick, “This Week at War: Gates‟ s China Syndrome ,” Foreign Policy, http://www.foreignpolicy.com/articles/2011/01/07...accessed 23 February 2011). Haddick, Robert. “This Week at War: Gates‟ s China Syndrome .” Foreign Policy. http://www.foreignpolicy.com/articles/2011

  5. Effectiveness of post-fire Burned Area Emergency Response (BAER) road treatments: Results from three wildfires

    Treesearch

    Randy B. Foltz; Peter Robichaud

    2013-01-01

    Wildland fires often cause extreme changes in the landscape that drastically influence surface runoff and soil erosion, which can impact forest resources, aquatic habitats, water supplies, public safety, and forest access infrastructure such as forest roads. Little information is available on the effectiveness of various post-fire road treatments, thus this study was...

  6. Road profile estimation of city roads using DTPS

    NASA Astrophysics Data System (ADS)

    Wang, Qi; McDaniel, J. Gregory; Sun, Nian X.; Wang, Ming L.

    2013-04-01

    This work presents a non-destructive and non-contact acoustic sensing approach for measuring road profile of road and bridge deck with vehicles running at normal speed without stopping traffic. This approach uses an instantaneous and real-time dynamic tire pressure sensor (DTPS) that can measure dynamic response of the tire-road interaction and increases the efficiency of currently used road profile measuring systems with vehicle body-mounted profilers and axle-mounted accelerometers. In this work, a prototype of real-time DTPS system has been developed and demonstrated on a testing van at speeds from 5 to 80 miles per hour (mph). A data analysis algorithm has been developed to remove axle dynamic motions from the measured DTPS data and to find the transfer function between dynamic tire pressure change and the road profile. Field test has been performed to estimate road profiles. The road profile resolution is approximately 5 to 10 cm in width and sensitivity is 0. 3 cm for the height road surface features at driving speeds of 5 to 80 mph.

  7. Cardiac Rehabilitation Series: Canada

    PubMed Central

    Grace, Sherry L.; Bennett, Stephanie; Ardern, Chris I.; Clark, Alexander

    2015-01-01

    Cardiovascular disease is among the leading causes of mortality and morbidity in Canada. Cardiac rehabilitation (CR) has a long robust history here, and there are established clinical practice guidelines. While the effectiveness of CR in the Canadian context is clear, only 34% of eligible patients participate, and strategies to increase access for under-represented groups (e.g., women, ethnic minority groups) are not yet universally applied. Identified CR barriers include lack of referral and physician recommendation, travel and distance, and low perceived need. Indeed there is now a national policy position recommending systematic inpatient referral to CR in Canada. Recent development of 30 CR Quality Indicators and the burgeoning national CR registry will enable further measurement and improvement of the quality of CR care in Canada. Finally, the Canadian Association of CR is one of the founding members of the International Council of Cardiovascular Prevention and Rehabilitation, to promote CR globally. PMID:24607018

  8. Tank 188A, detail of valves, pipes, and top access ladder ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Tank 188-A, detail of valves, pipes, and top access ladder on east side. Ordnance warehouse A-199 is in the far distance. View to south. - Mare Island Naval Shipyard, Fresh Water Tanks, East of Mesa Road & north of Kieper Road, Vallejo, Solano County, CA

  9. 32 CFR 323.5 - Access to systems of records information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (CONTINUED) PRIVACY PROGRAM DEFENSE LOGISTICS AGENCY PRIVACY PROGRAM § 323.5 Access to systems of records... Logistics Agency, ATTN: DGA, 8725 John J. Kingman Road, Suite 1644, Fort Belvoir, VA 22060-6221. Any written... General Counsel, Defense Logistics Agency, ATTN: DGA, Suite 1644, 8725 John J. Kingman Road, Fort Belvoir...

  10. 32 CFR 323.5 - Access to systems of records information.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (CONTINUED) PRIVACY PROGRAM DEFENSE LOGISTICS AGENCY PRIVACY PROGRAM § 323.5 Access to systems of records... Logistics Agency, ATTN: DGA, 8725 John J. Kingman Road, Suite 1644, Fort Belvoir, VA 22060-6221. Any written... General Counsel, Defense Logistics Agency, ATTN: DGA, Suite 1644, 8725 John J. Kingman Road, Fort Belvoir...

  11. Accessing timely rehabilitation services for a global aging society? Exploring the realities within Canada's universal health care system.

    PubMed

    Landry, Michel D; Raman, Sudha; Al-Hamdan, Elham

    2010-07-01

    The proportion of older persons is increasing in developed and developing countries: this aging trend can be viewed as a two-edged sword. On the one hand, it represents remarkable successes regarding advances in health care; and on the other hand, it represents a considerable challenge for health systems to meet growing demand. A growing disequilibrium between supply and demand may be particularly challenging within publicly funding health systems that 'guarantee' services to eligible populations. Rehabilitation, including physical therapy, is a service that if provided in a timely manner, can maximize function and mobility for older persons, which may in turn optimize efficiency and effectiveness of overall health care systems. However, physical therapy services are not considered an insured service under the legislative framework of the Canadian health system, and as such, a complex public/private mix of funding and delivery has emerged. In this article, we explore the consequences of a public/private mix of physical therapy on timely access to services, and use the World Health Organization (WHO) health system performance framework to assess the extent to which the emerging system influences the goal of aggregated and equitable health. Overall, we argue that a shift to a public/private mix may not have positive influences at the population level, and that innovative approaches to deliver services would be desirable to strengthening rather than weaken the publicly funded system. We signal that strategies aimed at scaling up rehabilitation interventions are required in order to improve health outcomes in an evolving global aging society.

  12. Prospect for Development of Open Access in Argentina

    ERIC Educational Resources Information Center

    Miguel, Sandra; Bongiovani, Paola C.; Gomez, Nancy D.; Bueno-de-la-Fuente, Gema

    2013-01-01

    This perspective article presents an overview of the Open Access movement in Argentina, from a global and regional (Latin American) context. The article describes the evolution and current state of initiatives by examining two principal approaches to Open Access in Argentina: "golden" and "green roads". The article will then…

  13. Systematic Development of Intelligent Systems for Public Road Transport.

    PubMed

    García, Carmelo R; Quesada-Arencibia, Alexis; Cristóbal, Teresa; Padrón, Gabino; Alayón, Francisco

    2016-07-16

    This paper presents an architecture model for the development of intelligent systems for public passenger transport by road. The main objective of our proposal is to provide a framework for the systematic development and deployment of telematics systems to improve various aspects of this type of transport, such as efficiency, accessibility and safety. The architecture model presented herein is based on international standards on intelligent transport system architectures, ubiquitous computing and service-oriented architecture for distributed systems. To illustrate the utility of the model, we also present a use case of a monitoring system for stops on a public passenger road transport network.

  14. Stakeholders' perceptions of rehabilitation services for individuals living with disability: a survey study.

    PubMed

    Darzi, Andrea J; Officer, Alana; Abualghaib, Ola; Akl, Elie A

    2016-01-08

    The World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services. Stakeholders' perceptions are an essential factor to take into account in the guideline development process. The aim of this study was to assess stakeholders' perceived feasibility and acceptability of eighteen rehabilitation services and the values they attach to ten rehabilitation outcomes. We disseminated an online self-administered questionnaire through a number of international and regional organizations from the different WHO regions. Eligible individuals included persons with disability, caregivers of persons with disability, health professionals, administrators and policy makers. The answer options consisted of a 9-point Likert scale. Two hundred fifty three stakeholders participated. The majority of participants were health professional (64 %). In terms of outcomes, 'Increasing access' and 'Optimizing utilization' were the top service outcomes rated as critical (i.e., 7, 8 or 9 on the Likert scale) by >70 % of respondents. 'Fewer hospital admissions', 'Decreased burden of care' and 'Increasing longevity' were the services rated as least critical (57 %, 63 % and 58 % respectively). In terms of services, 'Community based rehabilitation' and 'Home based rehabilitation' were found to be both definitely feasible and acceptable (75 % and 74 % respectively). 'Integrated and decentralized rehabilitation services' was found to be less feasible than acceptable according to stakeholders (61 % and 71 % respectively). As for 'Task shifting', most stakeholders did not appear to find task shifting as either definitely feasible or definitely acceptable (63 % and 64 % respectively). The majority of stakeholder's perceived 'Increasing access' and 'Optimizing utilization' as most critical amongst rehabilitation outcomes. The feasibility of the 'Integrated and decentralized rehabilitation services' was perceived to be less than their

  15. CCP Crew Access Arm Arrival

    NASA Image and Video Library

    2016-08-11

    A heavy-lift transport truck, carrying the Crew Access Arm for Space Launch Complex 41, travels along the road toward Complex 41 at Cape Canaveral Air Force Station in Florida. The arm will be installed on the Complex 41 Crew Access Tower. It will be used as a bridge by astronauts to board Boeing's CST-100 Starliner spacecraft as it stands on the launch pad atop a United Launch Alliance Atlas V rocket.

  16. Rehabilitation of asbestos mining waste: a Rehabilitation Prioritisation Index (RPI) for South Africa

    NASA Astrophysics Data System (ADS)

    van Rensburg, L.; Claassens, S.; Bezuidenhout, J. J.; Jansen van Rensburg, P. J.

    2009-03-01

    The much publicised problem with major asbestos pollution and related health issues in South Africa, has called for action to be taken to negate the situation. The aim of this project was to establish a prioritisation index that would provide a scientifically based sequence in which polluted asbestos mines in Southern Africa ought to be rehabilitated. It was reasoned that a computerised database capable of calculating such a Rehabilitation Prioritisation Index (RPI) would be a fruitful departure from the previously used subjective selection prone to human bias. The database was developed in Microsoft Access and both quantitative and qualitative data were used for the calculation of the RPI value. The logical database structure consists of a number of mines, each consisting of a number of dumps, for which a number of samples have been analysed to determine asbestos fibre contents. For this system to be accurate as well as relevant, the data in the database should be revalidated and updated on a regular basis.

  17. Concurrent criterion validity of the safe driving behavior measure: a predictor of on-road driving outcomes.

    PubMed

    Classen, Sherrilene; Wang, Yanning; Winter, Sandra M; Velozo, Craig A; Lanford, Desiree N; Bédard, Michel

    2013-01-01

    We determined the concurrent criterion validity of the Safe Driving Behavior Measure (SDBM) for on-road outcomes (passing or failing the on-road test as determined by a certified driving rehabilitation specialist) among older drivers and their family members-caregivers. On the basis of ratings from 168 older drivers and 168 family members-caregivers, we calculated receiver operating characteristic curves. The drivers' area under the curve (AUC) was .620 (95% confidence interval [CI] = .514-.725, p = .043). The family members-caregivers' AUC was .726 (95% CI = .622-.829, p ≤ .01). Older drivers' ratings showed statistically significant yet poor concurrent criterion validity, but family members-caregivers' ratings showed good concurrent criterion validity for the criterion on-road driving test. Continuing research with a more representative sample is being pursued to confirm the SDBM's concurrent criterion validity. This screening tool may be useful for generalist practitioners to use in making decisions regarding driving. Copyright © 2013 by the American Occupational Therapy Association, Inc.

  18. Concurrent Criterion Validity of the Safe Driving Behavior Measure: A Predictor of On-Road Driving Outcomes

    PubMed Central

    Wang, Yanning; Winter, Sandra M.; Velozo, Craig A.; Lanford, Desiree N.; Bédard, Michel

    2013-01-01

    We determined the concurrent criterion validity of the Safe Driving Behavior Measure (SDBM) for on-road outcomes (passing or failing the on-road test as determined by a certified driving rehabilitation specialist) among older drivers and their family members–caregivers. On the basis of ratings from 168 older drivers and 168 family members–caregivers, we calculated receiver operating characteristic curves. The drivers’ area under the curve (AUC) was .620 (95% confidence interval [CI] = .514–.725, p = .043). The family members–caregivers’ AUC was .726 (95% CI = .622–.829, p ≤ .01). Older drivers’ ratings showed statistically significant yet poor concurrent criterion validity, but family members–caregivers’ ratings showed good concurrent criterion validity for the criterion on-road driving test. Continuing research with a more representative sample is being pursued to confirm the SDBM’s concurrent criterion validity. This screening tool may be useful for generalist practitioners to use in making decisions regarding driving. PMID:23245789

  19. Advanced driver assistance system: Road sign identification using VIAPIX system and a correlation technique

    NASA Astrophysics Data System (ADS)

    Ouerhani, Y.; Alfalou, A.; Desthieux, M.; Brosseau, C.

    2017-02-01

    We present a three-step approach based on the commercial VIAPIX® module for road traffic sign recognition and identification. Firstly, detection in a scene of all objects having characteristics of traffic signs is performed. This is followed by a first-level recognition based on correlation which consists in making a comparison between each detected object with a set of reference images of a database. Finally, a second level of identification allows us to confirm or correct the previous identification. In this study, we perform a correlation-based analysis by combining and adapting the Vander Lugt correlator with the nonlinear joint transformation correlator (JTC). Of particular significance, this approach permits to make a reliable decision on road traffic sign identification. We further discuss a robust scheme allowing us to track a detected road traffic sign in a video sequence for the purpose of increasing the decision performance of our system. This approach can have broad practical applications in the maintenance and rehabilitation of transportation infrastructure, or for drive assistance.

  20. Road Safety Barriers, the Need and Influence on Road Traffic Accidents

    NASA Astrophysics Data System (ADS)

    Butāns, Ž.; Gross, K. A.; Gridnevs, A.; Karzubova, E.

    2015-11-01

    Constantly increasing intensity of road traffic and the allowed speed limits seem to impose stronger requirements on road infrastructure and use of road safety systems. One of the ways to improve road safety is the use of road restraint systems. Road safety barriers allow not only reducing the number of road traffic accidents, but also lowering the severity of accidents. The paper provides information on the technical requirements of road safety barriers. Various types of road safety barriers and their selection criteria for different types of road sections are discussed. The article views an example of a road traffic accident, which is also modelled by PC-Crash computer program. The given example reflects a road accident mechanism in case of a car-to-barrier collision, and provides information about the typical damage to the car and the barrier. The paper describes an impact of the road safety barrier type and its presence on the road traffic accident mechanism. Implementation and maintenance costs of different barrier types are viewed. The article presents a discussion on the necessity to use road safety barriers, as well as their optimal choice.

  1. A secondary meta-synthesis of qualitative studies of gender and access to cardiac rehabilitation.

    PubMed

    Angus, Jan E; King-Shier, Kathryn M; Spaling, Melisa A; Duncan, Amanda S; Jaglal, Susan B; Stone, James A; Clark, Alexander M

    2015-08-01

    To discuss issues in the theorization and study of gender observed during a qualitative meta-synthesis of influences on uptake of secondary prevention and cardiac rehabilitation services. Women and men can equally benefit from secondary prevention/cardiac rehabilitation and there is a need to understand gender barriers to uptake. Meta-method analysis secondary to meta-synthesis. For the meta-synthesis, a systematic search was performed to identify and retrieve studies published as full papers during or after 1995 and contained: a qualitative research component wholly or in a mixed method design, extractable population specific data or themes for referral to secondary prevention programmes and adults ≥18 years. Databases searched between January 1995-31 October 2011 included: CSA Sociological Abstracts, EBSCOhost CINAHL, EBSCOhost Gender Studies, EBSCOhost Health Source Nursing: Academic Edition, EBSCOhost SPORTDiscus, EBSCOhost SocINDEX. Studies were reviewed against inclusion/exclusion criteria. Included studies were subject to quality appraisal and standardized data extraction. Of 2264 screened articles, 69 were included in the meta-method analysis. Only four studies defined gender or used gender theories. Findings were mostly presented as inherently the characteristic of gendered worldviews of participants. The major themes suggest a mismatch between secondary prevention/cardiac rehabilitation services and consumers' needs, which are usually portrayed as differing according to gender but may also be subject to intersecting influences such as age or socioeconomic status. There is a persistent lack of theoretically informed gender analysis in qualitative literature in this field. Theory-driven gender analysis will improve the conceptual clarity of the evidence base for gender-sensitive cardiac rehabilitation programme development. © 2015 John Wiley & Sons Ltd.

  2. A Method for Extracting Road Boundary Information from Crowdsourcing Vehicle GPS Trajectories.

    PubMed

    Yang, Wei; Ai, Tinghua; Lu, Wei

    2018-04-19

    Crowdsourcing trajectory data is an important approach for accessing and updating road information. In this paper, we present a novel approach for extracting road boundary information from crowdsourcing vehicle traces based on Delaunay triangulation (DT). First, an optimization and interpolation method is proposed to filter abnormal trace segments from raw global positioning system (GPS) traces and interpolate the optimization segments adaptively to ensure there are enough tracking points. Second, constructing the DT and the Voronoi diagram within interpolated tracking lines to calculate road boundary descriptors using the area of Voronoi cell and the length of triangle edge. Then, the road boundary detection model is established integrating the boundary descriptors and trajectory movement features (e.g., direction) by DT. Third, using the boundary detection model to detect road boundary from the DT constructed by trajectory lines, and a regional growing method based on seed polygons is proposed to extract the road boundary. Experiments were conducted using the GPS traces of taxis in Beijing, China, and the results show that the proposed method is suitable for extracting the road boundary from low-frequency GPS traces, multi-type road structures, and different time intervals. Compared with two existing methods, the automatically extracted boundary information was proved to be of higher quality.

  3. A Method for Extracting Road Boundary Information from Crowdsourcing Vehicle GPS Trajectories

    PubMed Central

    Yang, Wei

    2018-01-01

    Crowdsourcing trajectory data is an important approach for accessing and updating road information. In this paper, we present a novel approach for extracting road boundary information from crowdsourcing vehicle traces based on Delaunay triangulation (DT). First, an optimization and interpolation method is proposed to filter abnormal trace segments from raw global positioning system (GPS) traces and interpolate the optimization segments adaptively to ensure there are enough tracking points. Second, constructing the DT and the Voronoi diagram within interpolated tracking lines to calculate road boundary descriptors using the area of Voronoi cell and the length of triangle edge. Then, the road boundary detection model is established integrating the boundary descriptors and trajectory movement features (e.g., direction) by DT. Third, using the boundary detection model to detect road boundary from the DT constructed by trajectory lines, and a regional growing method based on seed polygons is proposed to extract the road boundary. Experiments were conducted using the GPS traces of taxis in Beijing, China, and the results show that the proposed method is suitable for extracting the road boundary from low-frequency GPS traces, multi-type road structures, and different time intervals. Compared with two existing methods, the automatically extracted boundary information was proved to be of higher quality. PMID:29671792

  4. Accessibility assessment of Houston's roadway network during Harvey through integration of observed flood impacts and hydrologic modeling

    NASA Astrophysics Data System (ADS)

    Gidaris, I.; Gori, A.; Panakkal, P.; Padgett, J.; Bedient, P. B.

    2017-12-01

    The record-breaking rainfall produced over the Houston region by Hurricane Harvey resulted in catastrophic and unprecedented impacts on the region's infrastructure. Notably, Houston's transportation network was crippled, with almost every major highway flooded during the five-day event. Entire neighborhoods and subdivisions were inundated, rendering them completely inaccessible to rescue crews and emergency services. Harvey has tragically highlighted the vulnerability of major thoroughfares, as well as neighborhood roads, to severe inundation during extreme precipitation events. Furthermore, it has emphasized the need for detailed accessibility characterization of road networks under extreme event scenarios in order to determine which areas of the city are most vulnerable. This analysis assesses and tracks the accessibility of Houston's major highways during Harvey's evolution by utilizing road flood/closure data from the Texas DOT. In the absence of flooded/closure data for local roads, a hybrid approach is adopted that utilizes a physics-based hydrologic model to produce high-resolution inundation estimates for selected urban watersheds in the Houston area. In particular, hydrologic output in the form of inundation depths is used to estimate the operability of local roads. Ultimately, integration of hydrologic-based estimation of road conditions with observed data from DOT supports a network accessibility analysis of selected urban neighborhoods. This accessibility analysis can identify operable routes for emergency response (rescue crews, medical services, etc.) during the storm event.

  5. Factors Involved in Access and Utilization of Adult Hearing Healthcare: A Systematic Review

    PubMed Central

    Barnett, Margaret; Hixon, Brian; Okwiri, Neville; Irungu, Catherine; Ayugi, John; Thompson, Robin; Shinn, Jennifer B.; Bush, Matthew L.

    2016-01-01

    Objective/Hypothesis Hearing loss is a public health concern yet hearing healthcare disparities exist and influence utilization of rehabilitation services. The objective of this review was to systematically analyze the published literature on motivators, barriers, and compliance factors affecting adult patient access and utilization of hearing rehabilitation healthcare. Data Sources and Study Eligibility Criteria Pubmed, PsychINFO, CINAHL, Web of Science were searched for relevant articles. Eligible studies were those containing original, peer-reviewed research in English pertaining to factors affecting adult hearing healthcare access and utilization of hearing aids and cochlear implantation. The search encompassed 1990-2015. Study Appraisal and Synthesis Methods Two investigators independently reviewed all articles and extracted data. Specific variables regarding access to care and compliance to recommended care were extracted from each study. Results Thirty articles were reviewed. The factors affecting access and utilization of hearing rehabilitation could be classified into motivators, barriers, and compliance in treatment or device use. The key motivators to seek care include degree of hearing loss, self-efficacy, family support, and self-recognition of hearing loss. The primary barriers to care were financial limitations, stigma of hearing devices, inconvenience, competing chronic health problems, and unrealistic expectations. Compliance is most affected by self-efficacy, education level, and engagement in the rehabilition process. Conclusion Accessing hearing healthcare is complicated by multiple factors. Considering the current climate in healthcare policy and legislation towards improved access of care, a deeper understanding of motivators, barriers and compliance factors can aid in delivery of effective and efficient hearing healthcare. PMID:27545324

  6. Factors involved in access and utilization of adult hearing healthcare: A systematic review.

    PubMed

    Barnett, Margaret; Hixon, Brian; Okwiri, Neville; Irungu, Catherine; Ayugi, John; Thompson, Robin; Shinn, Jennifer B; Bush, Matthew L

    2017-05-01

    Hearing loss is a public health concern, yet hearing healthcare disparities exist and influence utilization of rehabilitation services. The objective of this review was to systematically analyze the published literature on motivators, barriers, and compliance factors affecting adult patient access and utilization of hearing rehabilitation healthcare. Pubmed, PsychINFO, CINAHL, and Web of Science were searched for relevant articles. Eligible studies were those containing original, peer-reviewed research in English pertaining to factors affecting adult hearing healthcare access and utilization of hearing aids and cochlear implantation. The search encompassed 1990 to 2015. Two investigators independently reviewed all articles and extracted data. Specific variables regarding access to care and compliance to recommended care were extracted from each study. Thirty articles were reviewed. The factors affecting access and utilization of hearing rehabilitation could be classified into motivators, barriers, and compliance in treatment or device use. The key motivators to seek care include degree of hearing loss, self-efficacy, family support, and self-recognition of hearing loss. The primary barriers to care were financial limitations, stigma of hearing devices, inconvenience, competing chronic health problems, and unrealistic expectations. Compliance is most affected by self-efficacy, education level, and engagement in the rehabilitation process. Accessing hearing healthcare is complicated by multiple factors. Considering the current climate in healthcare policy and legislation toward improved access of care, a deeper understanding of motivators, barriers, and compliance factors can aid in delivery of effective and efficient hearing healthcare. Laryngoscope, 127:1187-1194, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  7. [Domiciliary rehabilitation: an innovative form of outpatient medical rehabilitation].

    PubMed

    Schmidt-Ohlemann, M; Schweizer, C

    2009-02-01

    Domiciliary rehabilitation is an innovative form of outpatient medical rehabilitation. All components of service provision are delivered in the rehabilitant's home by a multidisciplinary team headed by a physician. The key context factors in the rehab process can be taken into account firsthand. The target group of domiciliary rehabilitation consists of multimorbid patients with severe functional limitations and complex assistance needs, whose rehabilitation options would be poor without this outreach service. Here, as suggested by the WHO concept of functional health, the interaction between health condition and environmental factors is kept in view much better than in other forms of rehabilitation. The positive effects and the efficiency of the rehabilitation measures provided can be assessed very well at a high descriptive level. This fact had been a precondition for legal establishment of domiciliary rehabilitation as a regular service. Domiciliary rehabilitation not only complies with key demands in the health and social policy fields, such as priority of outpatient over inpatient treatment or rehabilitation to precede and accompany long term care, it also constitutes an alternative concept challenging the traditional inpatient rehabilitation approach. The patient, hence, no longer is to fit into the institutional framework of outpatient or inpatient rehabilitation, but the team will fit into the specifics of the patient's unique social and material situation.

  8. Cognitive rehabilitation in traumatic brain injury.

    PubMed

    Cernich, Alison N; Kurtz, Shira M; Mordecai, Kristen L; Ryan, Patricia B

    2010-09-01

    Traumatic brain injury (TBI) is a major public health problem with neurobehavioral sequelae contributing to the long-term disability that is often associated with the moderate to severe levels of injury. Rehabilitation of cognitive skills is central to encouraging the full participation of the individual in home, vocational, and social roles. The review of available evidence points to four major recommendations for the rehabilitation of cognition following brain injury: 1) Access to subacute rehabilitation that is holistic in nature and involves a multidisciplinary or transdisciplinary team to work in an integrated fashion to support physical, cognitive, and social skill retraining is vital to support positive outcome following TBI. The collaborative effort of these individuals allows for continual reinforcement and evaluation of treatment goals and will often involve the family and/or important others in the individual's life to prepare for community re-entry. 2) Trials of medication, especially methylphenidate, to assist individuals with significant attention and memory impairment appear well supported by the available evidence. Though some data suggest that the use of cholinesterase inhibitors may be of use for individuals with memory impairments, there is less support for this practice and there are indications that it may worsen the behavioral sequelae of the injury. 3) Randomized controlled trials demonstrate the utility of specific rehabilitation approaches to attention retraining and retraining of executive functioning skills. Future research is needed on rehabilitation techniques in other domains of cognition. 4) Training in the use of supportive devices (either a memory book or more technologically enhanced compensatory devices) to support the individual's daily activities remains central to the independent function of the individual in the community. Though emerging treatments (eg, virtual reality environments) show relative degrees of promise for

  9. Nuclear gauge application in road industry

    NASA Astrophysics Data System (ADS)

    Azmi Ismail, Mohd

    2017-11-01

    Soil compaction is essential in road construction. The evaluation of the degree of compaction relies on the knowledge of density and moisture of the compacted layers is very important to the performance of the pavement structure. Among the various tests used for making these determinations, the sand replacement density test and the moisture content determination by oven drying are perhaps the most widely used. However, these methods are not only time consuming and need wearisome procedures to obtain the results but also destructive and the number of measurements that can be taken at any time is limited. The test can on be fed back to the construction site the next day. To solve these problems, a nuclear technique has been introduced as a quicker and easier way of measuring the density and moisture of construction materials. Nuclear moisture density gauges have been used for many years in pavement construction as a method of non-destructive density testing The technique which can determine both wet density and moisture content offers an in situ method for construction control at the work site. The simplicity, the speed, and non-destructive nature offer a great advantage for quality control. This paper provides an overview of nuclear gauge application in road construction and presents a case study of monitoring compaction status of in Sedenak - Skudai, Johor rehabilitation projects.

  10. Virtual rehabilitation: What are the practical barriers for home-based research?

    PubMed Central

    Threapleton, Kate; Drummond, Avril; Standen, Penny

    2016-01-01

    Virtual reality technologies are becoming increasingly accessible and affordable to deliver, and consequently the interest in applying virtual reality within rehabilitation is growing. This has resulted in the emergence of research exploring the utility of virtual reality and interactive video gaming interventions for home use by patients. The aim of this paper is to highlight the practical factors and difficulties that may be encountered in research in this area, and to make recommendations for addressing these. Whilst this paper focuses on examples drawn mainly from stroke rehabilitation research, many of the issues raised are relevant to other conditions where virtual reality approaches have the potential to be applied to home-based rehabilitation. PMID:29942551

  11. Assessing health and rehabilitation needs of people with disabilities in Cameroon and India.

    PubMed

    Mactaggart, Islay; Kuper, Hannah; Murthy, G V S; Sagar, Jayanthi; Oye, Joseph; Polack, Sarah

    2016-09-01

    To assess the association between disability and serious health problems, and the access and uptake of health and rehabilitation services in Cameroon and India. We undertook a population-based case-control study, nested within a survey in Fundong Health District, North West Cameroon (August-October 2013) and in Mahbubnagar District, Telangana State, India (February-April 2014). Disability was defined as the presence of self-reported difficulties in functioning or clinical impairments. One control without disability was selected per case, matched by age, gender and cluster. Information was collected using structured questionnaires on: socioeconomic status, health, access to health services and rehabilitation. Cases with disability were significantly more likely to report a serious health problem in the last year compared to controls in both India (OR = 3.2, 95% CI 2.1-4.8) and Cameroon (OR = 1.9, 1.4-2.7). The vast majority of people sought care when seriously ill, and this did not vary between cases and controls. Awareness and use of rehabilitation services was extremely low in both Cameroon and India. Further focus is needed to improve awareness of rehabilitation services among people with disabilities in India and Cameroon to ensure that their rights are fulfilled and to achieve the goal of Universal Health Coverage. Implications for Rehabilitation People with and without disabilities equally seek health care in India and Cameroon. However, people with disabilities experience more frequent serious health problems than people without. Extremely few people with disabilities were aware of rehabilitation services despite their existence in the study settings.

  12. Adapting Road Safety Audits to Local Rural Roads

    DOT National Transportation Integrated Search

    1998-10-01

    Many rural governments do not have an effective safety improvement program for their roads, yet crash rates are significantly higher on rural roads than on urban, state, and federal roads. Smaller agencies seldom have the financial resources or exper...

  13. Measuring accessibility of sustainable transportation using space syntax in Bojonggede area

    NASA Astrophysics Data System (ADS)

    Suryawinata, B. A.; Mariana, Y.; Wijaksono, S.

    2017-12-01

    Changes in the physical structure of regional space as a result of the increase of planned and unplanned settlements in the Bojonggede area have an impact on the road network pattern system. Changes in road network patterns will have an impact on the permeability of the area. Permeability measures the extent to which road network patterns provide an option in traveling. If the permeability increases the travel distance decreases and the route of travel choice increases, permeability like this can create an easy access system and physically integrated. This study aims to identify the relationship of physical characteristics of residential area and road network pattern to the level of space permeability in Bojonggede area. By conducting this research can be a reference for the arrangement of circulation, accessibility, and land use in the vicinity of Bojonggede. This research uses quantitative method and space syntax method to see global integration and local integration on the region which become the parameter of permeability level. The results showed that the level of permeability globally and locally high in Bojonggede physical area is the physical characteristics of the area that has a grid pattern of road network grid.

  14. Distributed road assessment system

    DOEpatents

    Beer, N. Reginald; Paglieroni, David W

    2014-03-25

    A system that detects damage on or below the surface of a paved structure or pavement is provided. A distributed road assessment system includes road assessment pods and a road assessment server. Each road assessment pod includes a ground-penetrating radar antenna array and a detection system that detects road damage from the return signals as the vehicle on which the pod is mounted travels down a road. Each road assessment pod transmits to the road assessment server occurrence information describing each occurrence of road damage that is newly detected on a current scan of a road. The road assessment server maintains a road damage database of occurrence information describing the previously detected occurrences of road damage. After the road assessment server receives occurrence information for newly detected occurrences of road damage for a portion of a road, the road assessment server determines which newly detected occurrences correspond to which previously detected occurrences of road damage.

  15. 23 CFR Appendix C to Subpart B of... - Additional Required Contract Provisions, Appalachian Development Highway System and Local Access...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Additional Required Contract Provisions, Appalachian Development Highway System and Local Access Roads Contracts Other Than Construction Contracts C Appendix C to..., Appalachian Development Highway System and Local Access Roads Contracts Other Than Construction Contracts...

  16. Influence of solid noise barriers on near-road and on-road air quality

    NASA Astrophysics Data System (ADS)

    Baldauf, Richard W.; Isakov, Vlad; Deshmukh, Parikshit; Venkatram, Akula; Yang, Bo; Zhang, K. Max

    2016-03-01

    Public health concerns regarding adverse health effects for populations spending significant amounts of time near high traffic roadways has increased substantially in recent years. Roadside features, including solid noise barriers, have been investigated as potential methods that can be implemented in a relatively short time period to reduce air pollution exposures from nearby traffic. A field study was conducted to determine the influence of noise barriers on both on-road and downwind pollutant concentrations near a large highway in Phoenix, Arizona, USA. Concentrations of nitrogen dioxide, carbon monoxide, ultrafine particles, and black carbon were measured using a mobile platform and fixed sites along two limited-access stretches of highway that contained a section of noise barrier and a section with no noise barrier at-grade with the surrounding terrain. Results of the study showed that pollutant concentrations behind the roadside barriers were significantly lower relative to those measured in the absence of barriers. The reductions ranged from 50% within 50 m from the barrier to about 30% as far as 300 m from the barrier. Reductions in pollutant concentrations generally began within the first 50 m of the barrier edge; however, concentrations were highly variable due to vehicle activity behind the barrier and along nearby urban arterial roadways. The concentrations on the highway, upwind of the barrier, varied depending on wind direction. Overall, the on-road concentrations in front of the noise barrier were similar to those measured in the absence of the barrier, contradicting previous modeling results that suggested roadside barriers increase pollutant levels on the road. Thus, this study suggests that noise barriers do reduce potential pollutant exposures for populations downwind of the road, and do not likely increase exposures to traffic-related pollutants for vehicle passengers on the highway.

  17. Exploring interest and goals for videoconferencing delivered cognitive rehabilitation with rural individuals with mild cognitive impairment or dementia.

    PubMed

    Burton, Rachel; O'Connell, Megan E; Morgan, Debra G

    2016-06-30

    Goal oriented cognitive rehabilitation is a promising intervention for individuals diagnosed with mild cognitive impairment (MCI) or dementia due to Alzheimer Disease (AD). Videoconferencing delivered cognitive rehabilitation is a potential avenue for increasing accessibility for rural patients and their families. First, we were concerned with the accessibility of the treatment for individuals in rural and remote areas. Second, client-centered goal setting was explored by asking this sample about their goals for cognitive rehabilitation. We mailed questions to all active patients with diagnoses of MCI or dementia due to AD of a rural memory clinic and compare features of the responders versus the non-responders. We asked about interest in videoconferencing delivered treatment and about goals for cognitive rehabilitation, which were thematically analyzed. The responders (N = 25) were similar to non-responders in severity, depression, and caregiver burden. Of the responders, 80% were interested in videoconferencing developed treatment. A thematic analysis coded 95% of responses as amenable to cognitive rehabilitation. Participants' goals were focused on memory, household activities, other cognitive domains, recreation, and higher order tasks. This work informs the development of both in-person and videoconferencing delivered cognitive rehabilitation for individuals diagnosed with MCI or dementia.

  18. Environmental Assessment for a Taxiway M Bypass Road at Travis Air Force Base, California

    DTIC Science & Technology

    2011-10-01

    California Species Scientific Name Species Common Name Protection Status Presence Plants Astragalus tener var. tener Alkali milk -vetch CNPS 1B...Downingia pusilla Dwarf downingia CNPS 2.2 Potential Astragalus tener var. ferrisiae Ferris’ milk -vetch CNPS 1B.1 Potential Fritillaria liliacea...Bypass Road and C Bunker Access Road improvements. Use of raw building materials for construction would be an irretrievable commitment of

  19. Quantifying the key factors that create road flooding : research project capsule.

    DOT National Transportation Integrated Search

    2012-02-01

    Road fl ooding is a serious operational hazard for low-lying areas of south Louisiana. This is : especially true for emergency evacuation routes, which must be accessible for coastal residents : evacuating ahead of an approaching hurricane or tropica...

  20. A novel framework for virtual prototyping of rehabilitation exoskeletons.

    PubMed

    Agarwal, Priyanshu; Kuo, Pei-Hsin; Neptune, Richard R; Deshpande, Ashish D

    2013-06-01

    Human-worn rehabilitation exoskeletons have the potential to make therapeutic exercises increasingly accessible to disabled individuals while reducing the cost and labor involved in rehabilitation therapy. In this work, we propose a novel human-model-in-the-loop framework for virtual prototyping (design, control and experimentation) of rehabilitation exoskeletons by merging computational musculoskeletal analysis with simulation-based design techniques. The framework allows to iteratively optimize design and control algorithm of an exoskeleton using simulation. We introduce biomechanical, morphological, and controller measures to quantify the performance of the device for optimization study. Furthermore, the framework allows one to carry out virtual experiments for testing specific "what-if" scenarios to quantify device performance and recovery progress. To illustrate the application of the framework, we present a case study wherein the design and analysis of an index-finger exoskeleton is carried out using the proposed framework.

  1. The Present and Future of Robotic Technology in Rehabilitation

    PubMed Central

    Laut, Jeffrey; Porfiri, Maurizio; Raghavan, Preeti

    2016-01-01

    Robotic technology designed to assist rehabilitation can potentially increase the efficiency of and accessibility to therapy by assisting therapists to provide consistent training for extended periods of time, and collecting data to assess progress. Automatization of therapy may enable many patients to be treated simultaneously and possibly even remotely, in the comfort of their own homes, through telerehabilitation. The data collected can be used to objectively assess performance and document compliance as well as progress. All of these characteristics can make therapists more efficient in treating larger numbers of patients. Most importantly for the patient, it can increase access to therapy which is often in high demand and rationed severely in today’s fiscal climate. In recent years, many consumer grade low-cost and off-the-shelf devices have been adopted for use in therapy sessions and methods for increasing motivation and engagement have been integrated with them. This review paper outlines the effort devoted to the development and integration of robotic technology for rehabilitation. PMID:28603663

  2. Systematic Development of Intelligent Systems for Public Road Transport

    PubMed Central

    García, Carmelo R.; Quesada-Arencibia, Alexis; Cristóbal, Teresa; Padrón, Gabino; Alayón, Francisco

    2016-01-01

    This paper presents an architecture model for the development of intelligent systems for public passenger transport by road. The main objective of our proposal is to provide a framework for the systematic development and deployment of telematics systems to improve various aspects of this type of transport, such as efficiency, accessibility and safety. The architecture model presented herein is based on international standards on intelligent transport system architectures, ubiquitous computing and service-oriented architecture for distributed systems. To illustrate the utility of the model, we also present a use case of a monitoring system for stops on a public passenger road transport network. PMID:27438836

  3. Designing informed game-based rehabilitation tasks leveraging advances in virtual reality.

    PubMed

    Lange, Belinda; Koenig, Sebastian; Chang, Chien-Yen; McConnell, Eric; Suma, Evan; Bolas, Mark; Rizzo, Albert

    2012-01-01

    This paper details a brief history and rationale for the use of virtual reality (VR) technology for clinical research and intervention, and then focuses on game-based VR applications in the area of rehabilitation. An analysis of the match between rehabilitation task requirements and the assets available with VR technology is presented. Low-cost camera-based systems capable of tracking user behavior at sufficient levels for game-based virtual rehabilitation activities are currently available for in-home use. Authoring software is now being developed that aims to provide clinicians with a usable toolkit for leveraging this technology. This will facilitate informed professional input on software design, development and application to ensure safe and effective use in the rehabilitation context. The field of rehabilitation generally stands to benefit from the continual advances in VR technology, concomitant system cost reductions and an expanding clinical research literature and knowledge base. Home-based activity within VR systems that are low-cost, easy to deploy and maintain, and meet the requirements for "good" interactive rehabilitation tasks could radically improve users' access to care, adherence to prescribed training and subsequently enhance functional activity in everyday life in clinical populations.

  4. Pulmonary rehabilitation in COPD - available resources and utilization in Swedish primary and secondary care.

    PubMed

    Sundh, Josefin; Lindgren, Helena; Hasselgren, Mikael; Montgomery, Scott; Janson, Christer; Ställberg, Björn; Lisspers, Karin

    2017-01-01

    Pulmonary rehabilitation is effective in all stages of COPD. The availability and utilization of pulmonary rehabilitation resources, and the characteristics of COPD patients receiving rehabilitation, were investigated in primary and secondary care in central Sweden. Data on available pulmonary rehabilitation resources were collected using questionnaires, to 14 hospitals and 54 primary health care centers, and information on utilization of different rehabilitation professionals was obtained from questionnaires completed by 1,329 COPD patients from the same centers. Multivariable logistic regression examined associations with having received rehabilitation in the previous year. In primary care, nurse-based asthma/COPD clinics were common (87%), with additional separate access to other rehabilitation professionals. In secondary care, rehabilitation was more often offered as part of a multidisciplinary teamwork (71%). In total, 36% of the patients met an asthma/COPD nurse in the previous year. Utilization was lower in primary than in secondary care for physiotherapists (7% vs 16%), occupational therapists (3% vs 10%), nutritionists (5% vs 13%), and counselors (1% vs 4%). A higher COPD Assessment Test score and frequent exacerbations were associated with higher utilization of all rehabilitation professionals. Pulmonary rehabilitation resources are available but underutilized, and receiving rehabilitation is more common in severe COPD. Treatment recommendations need to be better implemented, especially in mild and moderate COPD.

  5. Disability and employee benefits receipt: evidence from the U.S. Vocational Rehabilitation Services Program.

    PubMed

    Sosulski, Marya R; Donnell, Chandra; Kim, Woo Jong

    2012-01-01

    Studies indicate positive effects of the U.S. Vocational Rehabilitation Services (VRS) in assisting people with disabilities to find independent employment. Underemployment continues to impact access to adequate health care and other benefits. Workers with disabilities receive fewer benefits, overall. With data from the Longitudinal Study of Vocational Rehabilitation Services Program (LSVRSP), the authors compare the rates of receipt of 6 types of benefits for people with physical, mental, and sensory impairments. Although those with physical disabilities are most likely to receive benefits, all groups lack adequate access to health care, sick leave, and vacation. The authors discuss implications for services provision in the current job market.

  6. The road not taken.

    PubMed

    Messerle, J

    2001-01-01

    The annual Janet Doe Lecture was established in 1966 to honor Janet Doe, emerita librarian of the New York Academy of Medicine. The lecture focuses on either the history or philosophy of health sciences librarianship. This lecture addresses three fundamental values of the field, highlighting basic beliefs of the profession that are at risk: privacy, intellectual property rights, and access to quality information. It calls upon readers to make the everyday choices required to keep the value system of health sciences librarianship in place. Robert Frost's poignant poem "The Road Not Taken" provides the metaphor for examining choices in an information economy.

  7. Rehabilitate Newsome Creek Watershed, 2007-2008 Annual Report.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bransford, Stephanie

    2009-05-01

    The Nez Perce Tribe Department of Fisheries Resource Management, Watershed Division approaches watershed restoration with a ridge-top to ridgetop approach. The Nez Perce Tribe (NPT) and the Nez Perce National Forest (NPNF) have formed a partnership in completing watershed restoration activities, and through this partnership more work is accomplished by sharing funding and resources in our effort. The Nez Perce Tribe began watershed restoration projects within the Newsome Creek watershed of the South Fork Clearwater River in 1997. Progress has been made in restoring the watershed through road decommissioning and culvert replacement. Starting in FY 2001 and continuing into themore » present, a major stream restoration effort on the mainstem of Newsome Creek has been pursued. From completing a watershed assessment to a feasibility study of 4 miles of mainstem rehabilitation to carrying that forward into NEPA and a final design, we will begin the effort of restoring the mainstem channel of Newsome Creek to provide spawning and rearing habitat for anadromous and resident fish species. Roads have been surveyed and prioritized for removal or improvement as well as culverts being prioritized for replacement to accommodate fish passage throughout the watershed.« less

  8. [Interdisciplinary Cooperation as a Characteristic of Successful Rehabilitation Facilities--Results from the Project MeeR].

    PubMed

    Kleineke, V; Stamer, M; Zeisberger, M; Brandes, I; Meyer, T

    2015-08-01

    To determine if there is a difference between successful and less successful rehabilitation facilities concerning their extent and quality of interdisciplinary cooperation? This analysis is part of the project MeeR, that aims to identify characteristics of rehabilitation facilities related to successful rehabilitation. 6 facilities were recruited based on a quantitative analysis; 3 facilities that ranked as above average and 3 as below average in terms of their success in rehabilitating patients. Comprehensive qualitative data were collected on these 6 facilities. In above average rehabilitation facilities, the extent of interdisciplinary cooperation was higher than in below average facilities; the position of the medical profession was less dominant and there was a wider access to team meetings. Promotion of interdisciplinary cooperation is an important component for the improvement of the success of rehabilitation facilities. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Private Rehabilitation.

    ERIC Educational Resources Information Center

    McMahon, Brian T., Ed.

    1983-01-01

    Discusses the expanding role of the rehabilitation counselor into private sector rehabilitation in the seven articles of this special issue. Topics cover private rehabilitation in an insurance context including forensics issues, computer applications, recent trends, services in a multiprogram private clinic, and rehabilitation counselor training.…

  10. Water system hardware and management rehabilitation: Qualitative evidence from Ghana, Kenya, and Zambia.

    PubMed

    Klug, Tori; Shields, Katherine F; Cronk, Ryan; Kelly, Emma; Behnke, Nikki; Lee, Kristen; Bartram, Jamie

    2017-05-01

    Sufficient, safe, continuously available drinking water is important for human health and development, yet one in three handpumps in sub-Saharan Africa are non-functional at any given time. Community management, coupled with access to external technical expertise and spare parts, is a widely promoted model for rural water supply management. However, there is limited evidence describing how community management can address common hardware and management failures of rural water systems in sub-Saharan Africa. We identified hardware and management rehabilitation pathways using qualitative data from 267 interviews and 57 focus group discussions in Ghana, Kenya, and Zambia. Study participants were water committee members, community members, and local leaders in 18 communities (six in each study country) with water systems managed by a water committee and supported by World Vision (WV), an international non-governmental organization (NGO). Government, WV or private sector employees engaged in supporting the water systems were also interviewed. Inductive analysis was used to allow for pathways to emerge from the data, based on the perspectives and experiences of study participants. Four hardware rehabilitation pathways were identified, based on the types of support used in rehabilitation. Types of support were differentiated as community or external. External support includes financial and/or technical support from government or WV employees. Community actor understanding of who to contact when a hardware breakdown occurs and easy access to technical experts were consistent reasons for rapid rehabilitation for all hardware rehabilitation pathways. Three management rehabilitation pathways were identified. All require the involvement of community leaders and were best carried out when the action was participatory. The rehabilitation pathways show how available resources can be leveraged to restore hardware breakdowns and management failures for rural water systems in sub

  11. Economic, Socio-Political and Environmental Risks of Road Development in the Tropics.

    PubMed

    Alamgir, Mohammed; Campbell, Mason J; Sloan, Sean; Goosem, Miriam; Clements, Gopalasamy Reuben; Mahmoud, Mahmoud I; Laurance, William F

    2017-10-23

    It is projected that 25 million km of new paved roads will be developed globally by 2050 - enough to encircle the planet more than 600 times. Roughly 90% of new roads will be built in developing nations, frequently in tropical and subtropical regions with high biodiversity and environmental values. Many developing nations are borrowing from international lenders or negotiating access to their natural resources in order to expand their transportation infrastructure. Given the unprecedented pace and extent of these initiatives, it is vital to thoroughly assess the potential consequences of large-scale road and highway projects. In appropriate contexts and locales, new roads can promote sizeable economic and social benefits. If poorly planned or implemented, however, new roads can provoke serious cost overruns, corruption and environmental impacts, while generating sparse economic benefits and intense social and political conflict. Using examples from developing nations, we identify risks that can hinder road projects in wet and dry tropical environments. Such risks, we assert, are often inadequately considered by project proponents, evaluators and the general public, creating a systematic tendency to overestimate project benefits while understating project risks. A more precautionary approach is needed to reduce risks while maximizing benefits of new road projects in the tropics. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. [An epidemiological study of visual disability and visual rehabilitation in Beijing].

    PubMed

    Zou, Yan-hong; Ding, Ji-yuan; Peng, Hong; Shi, Ji-liang; Qu, Cheng-yi; Liu, Xi-pu

    2009-12-01

    To investigate the status of visual disability and the demands for visual rehabilitation services in Beijing. Five hundred and fifty-five persons with visual disability in Beijing from the Second National Survey on Disability of China were involved in this study. Their visual disability and demands for rehabilitation were evaluated. About three fourth of the visual disabled persons were over 60 years of age. Cataract, retinal and choroidal diseases, and glaucoma were the three leading causes of the visual impairment. Medical service was the number one (82.0%) demand for the persons with visual disability, although 89.4% of them had previously received some kinds of medial services. People who had received visual aid devices or rehabilitation training were 26.7% and 5.8%, respectively, while more people showed their demand for these service (36.6% and 11.9%, respectively). The demand for visual rehabilitation varied in different groups of age and severity of disability. Accessibility of high quality medical services for preventable blindness diseases should be further promoted. Public health education on visual rehabilitation is also needed.

  13. The World Report on Disability and its implications for rehabilitation psychology.

    PubMed

    MacLachlan, Malcolm; Mannan, Hasheem

    2014-05-01

    This study reviewed the World Report on Disability (World Health Organization & World Bank, 2011) and explored its implications for rehabilitation psychology. Key findings and recommendations were identified within the World Report and issues that are salient to the profession, practice and research within rehabilitation psychology were highlighted. The World Report has a particular emphasis on disability in low-income countries, where the majority of people with disabilities live. Despite the origins and development of rehabilitation psychology within high-income countries, the profession has much to contribute to addressing many of the challenges identified in the World Report. Specific targeted contributions might include addressing the human resources for health crisis in rehabilitation; developing prosocial and community-based interventions and programs; helping to identify and overcome difficulties to accessing health care; refining the measurement and classification of disability; and strengthening research, policy and advocacy for and with people with disabilities. The World Report on Disability presents exciting and challenging opportunities that exist for rehabilitation psychology practitioners and researchers, and for the profession itself. (c) 2014 APA, all rights reserved.

  14. Variations in Utilization of Inpatient Rehabilitation Services among Pediatric Trauma Patients.

    PubMed

    Nguyen, Huong T; Newton, Christopher; Pirrotta, Elizabeth A; Aguilar, Christine; Wang, N Ewen

    2017-03-01

    To assess clinical and nonclinical characteristics associated with the use of pediatric inpatient rehabilitation services among children with traumatic injuries. We hypothesized there would be no nonclinical variations in the use of pediatric inpatient rehabilitation services. Retrospective analysis of 1139 patients who were injured seriously (0-18 years of age) from our institutional trauma registry (2004-2014). Patients' nonclinical and clinical characteristics were analyzed. We used a full matching technique to compare characteristics between those admitted to rehabilitation (cases) to those discharged home (controls). We matched patients by age category, sex, maximum Abbreviated Injury Scale, and body region of maximum Abbreviated Injury Scale. We used survey-based multivariate logistic regression to identify characteristics associated with inpatient rehabilitation services, controlling for multiple injuries, distance from home to rehabilitation center, year of service, hospital length of stay, and clinically relevant interactions. Ninety-eight patients (8.6%) were admitted to inpatient rehabilitation and 968 (85.0%) were discharged home. Black and other minority patients had increased odds of receiving inpatient rehabilitation compared with white patients (OR, 7.6 [P< .001] and OR, 1.6 [P= .03], respectively). Patients with private compared with public insurance had increased odds of receiving inpatient rehabilitation (OR, 2.4; P< .001). Pediatric inpatient rehabilitation beds are a scarce resource that should be available to those with the greatest clinical need. The mechanism creating differences in the use of inpatient rehabilitation based on nonclinical characteristics such as race/ethnicity or insurance status must be understood to prevent disparities in access to inpatient rehabilitation services. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Cost of and soil loss on "minimum-standard" forest truck roads constructed in the central Appalachians

    Treesearch

    J. N. Kochenderfer; G. W. Wendel; H. Clay Smith

    1984-01-01

    A "minimum-standard" forest truck road that provides efficient and environmentally acceptable access for several forest activities is described. Cost data are presented for eight of these roads constructed in the central Appalachians. The average cost per mile excluding gravel was $8,119. The range was $5,048 to $14,424. Soil loss was measured from several...

  16. Roads On The U.S. nation Forests: An Analysis of Public Attitudes, Beliefs, and Values Expressed in the News Media

    Treesearch

    David N. Bengston; David P. Fan

    1999-01-01

    Public attitudes, beliefs, and underlying values about roads on the U.S. national forests expressed in more than 4,000 on-line news stories during a 3-year period are analyzed by using computer methods. The belief that forest roads provide access for recreation was expressed most frequently, accounting for about 40% of all beliefs expressed. The belief that roads cause...

  17. Computer Technology/Special Education/Rehabilitation: Proceedings of the Conference (2nd, Northridge, California, October 16-18, 1986).

    ERIC Educational Resources Information Center

    Murphy, Harry J., Ed.

    The following 25 papers (with their authors) are presented from a conference on computer technology in special education and rehabilitation: "Computers for Business--Computers for Life" (I. Keith Austin); "Rehabilitation and the Computer: How to Find What You Need" (Thomas Backer); "Computer Access Alternatives for Visually Impaired People in…

  18. Invasive Brown Treesnake movements at road edges indicate road-crossing avoidance

    USGS Publications Warehouse

    Siers, Shane R.; Savidge, Julie S; Reed, Robert N.

    2014-01-01

    Roads have significant impacts on the dispersal of wildlife. Although this poses a threat to the abundance and diversity of desirable flora and fauna, it also affords some opportunity for enhancing control of invasive species. Roads are the most common terrain features that may affect the rate of landscape-scale movements of invasive Brown Treesnakes (Boiga irregularis) throughout Guam. We radio tracked 45 free-ranging Brown Treesnakes in close proximity to two roads in Guam and recorded instances where daily relocations of snakes spanned roads. Then we reconstructed observed movement histories with randomized turning angles, which served as a useful null hypothesis for assessing the effect of roads or road edge habitat on Brown Treesnake movement patterns. Random walk simulations demonstrated that Brown Treesnakes crossed these roads at a rate far lower than would be expected if snake movement was random with respect to roads and road edge habitat. We discuss two alternative hypotheses for these results: 1) habitat gaps posed by roads physically or behaviorally restrict snake movement; or 2) road edges provide preferred foraging habitat from which snakes are reluctant to depart. Because roads often form the boundaries of jurisdictional and management units, the effects of roads on the movement of invasive Brown Treesnakes will influence the prospects for success of future landscape-level suppression efforts.

  19. The road plan model: Information model for planning road building activities

    NASA Technical Reports Server (NTRS)

    Azinhal, Rafaela K.; Moura-Pires, Fernando

    1994-01-01

    The general building contractor is presented with an information model as an approach for deriving a high-level work plan of construction activities applied to road building. Road construction activities are represented in a Road Plan Model (RPM), which is modeled in the ISO standard STEP/EXPRESS and adopts various concepts from the GARM notation. The integration with the preceding road design stage and the succeeding phase of resource scheduling is discussed within the framework of a Road Construction Model. Construction knowledge is applied to the road design and the terrain model of the surrounding road infrastructure for the instantiation of the RPM. Issues regarding the implementation of a road planner application supporting the RPM are discussed.

  20. Pediatric rehabilitation psychology: Rehabilitating a moving target.

    PubMed

    Kaufman, Jacqueline N; Lahey, Sarah; Slomine, Beth S

    2017-08-01

    The current special section includes manuscripts focusing on four aspects of pediatric rehabilitation psychology that are unique to this practice area. The first domain addressed is natural developmental progression in the context of a disability (i.e., habilitation). The next domain addressed in this special section is pediatric rehabilitation; pediatric rehabilitation psychology addresses the reacquisition of previously attained skills and abilities within the context of the natural developmental milieu. This special section also highlights the inherently interdisciplinary and transdisciplinary nature of pediatric rehabilitation psychology given the complex environment in which children exist. Finally, the special section includes illustrations of the crucial role pediatric rehabilitation psychologists play in facilitating transitions through major milestones, particularly from pediatrics to adulthood when living with a disability. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Restoration and Rehabilitation of world heritage Site of Chupan Church

    NASA Astrophysics Data System (ADS)

    Darvish Rohani, S.

    2015-08-01

    Church of Chupan is located in Jolfa cityin north of Iran and is laid at south side of Arax River. Built of the church traced back to 14th to 15th century and the time when Armenians were inhabited in the region. Chupan church had been inscribed at World Heritage List of UNESCO under no 1262 in 2008, as one of the five churches of "Armenian Monasteries of Azerbaijan province of Iran" dossier. As it is located at a religious and tourism road of Darresham and each year most of Armenian from all over the world visited the church as a part of a religious ceremony, also as the same church on opposite side of the Arax in Republic of Nakhchivan is completely destroyed between 1998-2002 and the church is the only existing evidence of these two couple church, the restoration and rehabilitation of chupan church is very important. Because of very bad statues of structure stability and long-term neglect of the conservation and preservation of the building, restoration and rehabilitation of the church in the earliest was necessary. Restoration of this church was my MA degree thesis and now as a Ph.D student in field of urban design and planning student, I am working on the next step which is to revitalization and rehabilitation of the church.

  2. ML Crew Access Arm Move

    NASA Image and Video Library

    2017-11-10

    A heavy-load transport truck carries the Orion crew access arm along the NASA Causeway east toward State Road 3 at NASA's Kennedy Space Center in Florida. The access arm will be moved to the mobile launcher (ML) near the Vehicle Assembly Building at the center. The crew access arm will be installed at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

  3. Movement-based interaction applied to physical rehabilitation therapies.

    PubMed

    Garrido Navarro, Juan Enrique; Ruiz Penichet, Victor Manuel; Lozano Pérez, María Dolores

    2014-12-09

    important feedback needed to improve the system. The system improves the rehabilitation conditions of people with balance disorder. The main contribution comes from the fact that it allows patients to carry out the rehabilitation process at home under the supervision of physiotherapists. As a result, patients avoid having to attend medical centers. Additionally, medical staff have access to an assistant, which means their presence is not required in many exercises that involve constant repetition.

  4. 75 FR 2583 - Over-the-Road Bus Accessibility Program Grants

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... Transportation Equity Act for the 21st Century (TEA-21). The OTRB Accessibility Program makes funds available to... (TEA-21), Public Law 105-85 as amended by the Safe, Accountable, Flexible, Efficient, Transportation.... transportation system. TEA-21 authorized FTA's OTRB Accessibility Program to assist OTRB operators in complying...

  5. Evaluating drug trafficking on the Tor Network: Silk Road 2, the sequel.

    PubMed

    Dolliver, Diana S

    2015-11-01

    Housing an illicit, online drug retail market generating sales in the millions of USD, the Silk Road was a profitable marketplace with a growing and loyal consumer base. Following its FBI-forced shut down in October 2013, the Silk Road enjoyed newfound fame that contributed to an increase in new users downloading and accessing the Tor Network; however, with this particular marketplace out of order, Silk Road 2 was launched to fill the void. The goals of this study were to (1) compare the metrics of Silk Road 2 to the original site, and to (2) determine if there were any indications of the presence of more sophisticated drug trafficking operations. Data were collected from Silk Road 2 during the months of August and September 2014 using webcrawling software. Silk Road 2 was a much smaller marketplace than the original Silk Road. Of the 1834 unique items for sale, 348 were drug items sold by 145 distinct vendors shipping from 19 countries. Of the drug items advertised, most were stimulants and hallucinogens. The United States is both the number one country of origin for drug sales on Silk Road 2 and the number one destination country. Interestingly, 73% of all vendor accounts on Silk Road 2 advertised drug items, even though drugs only constituted 19% of all items advertised. This study was the first to research Silk Road 2, the replacement illicit marketplace to the original virtual Silk Road. This study was also the first to examine indications of the presence of more coordinated drug trafficking efforts in an online setting. The findings indicated that while Silk Road 2 was not primarily a drug market, there were indications that some vendor accounts may have connections reaching beyond a base retail market. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Pocket facts 2008 : Swedish Road Administration, roads and traffic

    DOT National Transportation Integrated Search

    2008-05-01

    Pocket Facts offers an overall picture of the road : transport system. Here you will find a selection of : brief facts about roads, road transports, vehicles and : people in traffic. In addition, it presents the functions : and organisation at the SR...

  7. Pocket facts 2009 : Swedish Road Administration, roads and traffic

    DOT National Transportation Integrated Search

    2009-05-01

    This publication offers an overall picture of the road transport : system. Here you will find a selection of brief facts about roads, : road transports, vehicles and people in traffic. In addition, it : includes an overview of SRA tasks and organisat...

  8. Rehabilitation and education are underutilized for mild stroke and TIA sufferers.

    PubMed

    Faux, Steven G; Arora, Pooja; Shiner, Christine T; Thompson-Butel, Angelica G; Klein, Linda A

    2018-06-01

    Transient ischemic attack (TIA) and mild stroke represent a large proportion of cerebrovascular events, at high risk of being followed by recurrent, serious events. The importance of early education addressing risk management, secondary prevention and lifestyle modifications is the centerpiece of further stroke prevention. However, delivering education and rehabilitation to this population can be complex and challenging. Via synthesis of a narrative review and clinical experience, we explore the unique and inherent complexities of rehabilitation management and education provision for patients following mild stroke and TIA. A considerable proportion of TIA/mild stroke survivors have ongoing rehabilitation needs that are poorly addressed. The need for rehabilitation in these patients is often overlooked, and available assessment tools lack the sensitivity to identify common subtle impairments in cognition, mood, language and fatigue. Active and accessible education interventions need to be initiated early after the event, and integrated with ongoing rehabilitation management. Priority areas in need of future development in this field are highlighted and discussed. Implications for rehabilitation Survivors of mild stroke and TIA have ongoing unmet rehabilitation needs and require a unique approach to rehabilitation and education. Rehabilitation needs are difficult to assess and poorly addressed in this cohort, where available assessment tools lack the sensitivity required to identify subtle impairments. Education needs to be initiated early after the event and involve active engagement of the patient in order to improve stroke knowledge, mood and motivate adherence to lifestyle modifications and secondary prevention. Rehabilitation physicians are currently an underutilized resource, who should be more involved in the management of all patients following TIA or mild stroke.

  9. 14. VIEW OF NORTHSOUTH ROAD WHICH PARALLELS ROAD TO HATCH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. VIEW OF NORTH-SOUTH ROAD WHICH PARALLELS ROAD TO HATCH ADIT (FEATURE B-28). NOTE MODERN 'LAY DOWN' FENCE ON ROAD. ROAD LIES TO THE WEST OF THE HATCH ADIT AND PHOTOGRAPH IS VIEW TO THE SOUTH. (OCTOBER, 1995) - Nevada Lucky Tiger Mill & Mine, East slope of Buckskin Mountain, Paradise Valley, Humboldt County, NV

  10. Preferences for rehabilitation services among women with major limb amputations.

    PubMed

    Elnitsky, Christine A; Latlief, Gail A; Andrews, Erin E; Adams-Koss, Laurel B; Phillips, Samuel L

    2013-01-01

    We present five cases of adult females with major limb amputations, their concerns and preferences for services across the life span. A convenience sample of five veteran and nonveteran women aged 19-58 with major limb amputations participating in a regional VA Prosthetics Conference in 2010 took part in a panel interview. The concerns identified by these women as high priorities included independence and participation in a full range of life activities, limitations in access, patient decision-making and body image concerns, and preferences for selected services. Maximizing function and quality of life for women amputees requires identifying patient preferences for rehabilitation and prosthetic services. Lessons learned could inform development of clinic-based rehabilitation care, prosthetic services, and studies of women with major limb amputations. As the current conflicts in Iraq and Afghanistan wind down, the number of women veterans seeking rehabilitation and prosthetic services will increase. With this information, rehabilitation and prosthetic service providers and organizations will be uniquely positioned to provide prevention and treatment of amputations for this growing population of women veterans in national care delivery systems and in communities. An open-ended facilitated discussion among a panel of women with major limb amputations provided insights for providers and organizations with respect to needs, concerns, and preferences for rehabilitation and prosthetic services. © 2013 Association of Rehabilitation Nurses.

  11. Are web-based questionnaires accepted in patients attending rehabilitation?

    PubMed

    Engan, Harald K; Hilmarsen, Christina; Sittlinger, Sverre; Sandmæl, Jon Arne; Skanke, Frode; Oldervoll, Line M

    2016-12-01

    The aim of the present paper was to study preferences for web based self-administered questionnaires (web SAQs) vs. paper-based self-administered questionnaires (paper SAQs) and to evaluate the feasibility of using web SAQs in patients referred to cardiac, lung, occupational and cancer rehabilitation programs. The patients were approached by mail and given the choice to answer the compulsory SAQs either on paper or on a web-based platform. Hundred and twenty seven out of 183 eligible patients (69.3%) were willing to participate and 126 completed the study. Web SAQs were preferred by 77.7%, and these patients were significantly younger, more often cohabiting and tended to have higher level of education than paper SAQ users. Mean number of data missing per patient was less among the web SAQ users than the paper SAQ users (0.55 vs. 2.15, p < 0.001). Costs related to human resources were estimated to be 60% lower with web SAQs compared to paper SAQs. Web SAQs were well accepted among the patients scheduled for rehabilitation, led to less missing data and considerable cost savings related to human resources. Patients referred to rehabilitation should be offered the choice to complete self-administered questionnaires on internet platforms when internet access is common and available. Implications for Rehabilitation The high acceptability of web-based self-administered questionnaires among rehabilitation patients suggests that internet platforms are suitable tools to collect patient information for rehabilitation units. Web-based modes of patient data collection demonstrate low number of missing data and can therefore improve the quality of data collection from rehabilitation patients. Use of web-based questionnaires considerably reduces administrative costs of data collection in rehabilitation settings compared to traditional pen and paper methods.

  12. Remote Sensing Decision Support System for Optimal Access Restoration in Post Disaster Environments

    DOT National Transportation Integrated Search

    2017-01-01

    Access restoration is an extremely important part of disaster response. Without access to the site, critically important emergency functions like search and rescue, emergency evacuation, and relief distribution, cannot commence. Frequently, roads are...

  13. 24. OLD TIOGA ROAD VIEW, NOW MAY LAKE ROAD , ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    24. OLD TIOGA ROAD VIEW, NOW MAY LAKE ROAD , AT SNOW FLAT. MOUNT HOFFMAN AT CENTER REAR. LOOKING NW. GIS: N-37 49 34.6 / W-119 29 58.2 - Tioga Road, Between Crane Flat & Tioga Pass, Yosemite Village, Mariposa County, CA

  14. Survey of rehabilitation support for children 0-15 years in a rural part of Kenya.

    PubMed

    Bunning, Karen; Gona, Joseph K; Odera-Mung'ala, Victor; Newton, Charles R; Geere, Jo-Anne; Hong, Chia Swee; Hartley, Sally

    2014-01-01

    Information regarding the nature, availability and distribution of rehabilitation services for children with disabilities across developing countries is scarce, and data that do exist are of variable quality. If planning and development are to progress, information about service provision is vital. The aim was to establish the scope and nature of rehabilitation support available to children with disabilities (0-15 years) and their families in rural Kenya. A comprehensive sample comprising service provision in the health and special education sectors was established. Non-governmental and community-based organisations were also included. A survey of rehabilitation services was conducted through examination of service-related documentation and key informant interviews with the heads of services. Rehabilitation comprised hospital-based occupational therapy, physiotherapy and orthopaedic technology; and seven special education establishments plus an education assessment resource centre. There was one non-government organisation and one community-based organisation relevant to children with disabilities. Activities focused on assessment, diagnosis and raising community awareness. Provision was challenged by inadequate staffing, resources and transport. Government funding was supplemented variously by donations and self-sufficiency initiatives. Rehabilitation approaches appeared to be informed by professional background of practitioner, rather than the needs of child. Service documentation revealed use of inconsistent recording methods. The data highlight the challenges of rehabilitation, demanding greater investment in personnel and their training, more material resources, improved access to the community and better recording mechanisms. There needs to be greater investment in rehabilitation provision in developing countries. Consideration of community-based initiatives is required to support better access for all. In order to argue the case for improved resources

  15. Road Development and the Geography of Hunting by an Amazonian Indigenous Group: Consequences for Wildlife Conservation

    PubMed Central

    Espinosa, Santiago; Branch, Lyn C.; Cueva, Rubén

    2014-01-01

    Protected areas are essential for conservation of wildlife populations. However, in the tropics there are two important factors that may interact to threaten this objective: 1) road development associated with large-scale resource extraction near or within protected areas; and 2) historical occupancy by traditional or indigenous groups that depend on wildlife for their survival. To manage wildlife populations in the tropics, it is critical to understand the effects of roads on the spatial extent of hunting and how wildlife is used. A geographical analysis can help us answer questions such as: How do roads affect spatial extent of hunting? How does market vicinity relate to local consumption and trade of bushmeat? How does vicinity to markets influence choice of game? A geographical analysis also can help evaluate the consequences of increased accessibility in landscapes that function as source-sink systems. We applied spatial analyses to evaluate the effects of increased landscape and market accessibility by road development on spatial extent of harvested areas and wildlife use by indigenous hunters. Our study was conducted in Yasuní Biosphere Reserve, Ecuador, which is impacted by road development for oil extraction, and inhabited by the Waorani indigenous group. Hunting activities were self-reported for 12–14 months and each kill was georeferenced. Presence of roads was associated with a two-fold increase of the extraction area. Rates of bushmeat extraction and trade were higher closer to markets than further away. Hunters located closer to markets concentrated their effort on large-bodied species. Our results clearly demonstrate that placing roads within protected areas can seriously reduce their capacity to sustain wildlife populations and potentially threaten livelihoods of indigenous groups who depend on these resources for their survival. Our results critically inform current policy debates regarding resource extraction and road building near or within

  16. Road development and the geography of hunting by an Amazonian indigenous group: consequences for wildlife conservation.

    PubMed

    Espinosa, Santiago; Branch, Lyn C; Cueva, Rubén

    2014-01-01

    Protected areas are essential for conservation of wildlife populations. However, in the tropics there are two important factors that may interact to threaten this objective: 1) road development associated with large-scale resource extraction near or within protected areas; and 2) historical occupancy by traditional or indigenous groups that depend on wildlife for their survival. To manage wildlife populations in the tropics, it is critical to understand the effects of roads on the spatial extent of hunting and how wildlife is used. A geographical analysis can help us answer questions such as: How do roads affect spatial extent of hunting? How does market vicinity relate to local consumption and trade of bushmeat? How does vicinity to markets influence choice of game? A geographical analysis also can help evaluate the consequences of increased accessibility in landscapes that function as source-sink systems. We applied spatial analyses to evaluate the effects of increased landscape and market accessibility by road development on spatial extent of harvested areas and wildlife use by indigenous hunters. Our study was conducted in Yasuní Biosphere Reserve, Ecuador, which is impacted by road development for oil extraction, and inhabited by the Waorani indigenous group. Hunting activities were self-reported for 12-14 months and each kill was georeferenced. Presence of roads was associated with a two-fold increase of the extraction area. Rates of bushmeat extraction and trade were higher closer to markets than further away. Hunters located closer to markets concentrated their effort on large-bodied species. Our results clearly demonstrate that placing roads within protected areas can seriously reduce their capacity to sustain wildlife populations and potentially threaten livelihoods of indigenous groups who depend on these resources for their survival. Our results critically inform current policy debates regarding resource extraction and road building near or within

  17. Temporary traffic control and enforcement of traffic laws in closed road sections.

    DOT National Transportation Integrated Search

    2007-06-01

    "Public travel by motor vehicles is often necessary in road and street sections that have been officially closed for construction, repair, and/or other reasons. This authorization is permitted in order to provide access to homes and businesses locate...

  18. Stroke rehabilitation in ontario: an opportunity for health care transformation.

    PubMed

    Meyer, Matthew J; Meyer, John P; Foley, Norine; Salter, Katherine; McClure, J Andrew; Teasell, Robert

    2011-11-01

    In this article, Ontario's stroke rehabilitation system is used to exemplify the challenges faced by rehabilitation and healthcare systems across Canada who are attempting to provide quality care to patients in the face of increasing demands. Currently, Ontario's rehabilitation system struggles in its efforts to provide accessible and comprehensive care to patients recovering from stroke. We begin our exploration by identifying both the primary stakeholders and the underlying factors that have contributed to the current challenges. The framework put forward in the Canadian Medical Association's recommendations for transformation is then used to suggest a vision for a more patient-focused system incorporating three key principles: a broader perspective, a patient-first approach, and greater unity. The use of health information technology, proper incentives, and greater accountability are discussed as mechanisms to improve the quality and efficiency of care.

  19. Driver fatigue and road safety on Poland's national roads.

    PubMed

    Jamroz, Kazimierz; Smolarek, Leszek

    2013-01-01

    This paper presents an overview of factors causing driver fatigue as described in the literature. Next, a traffic crash database for 2003-2007 is used to identify the causes, circumstances and consequences of accidents caused by driver fatigue on Poland's national roads. The results of the study were used to build a model showing the relationship between the concentration of road accidents and casualties, and the time of day. Finally, the level of relative accident risk at night-time versus daytime is defined. A map shows the risk of death and severe injury on the network of Poland's national roads. The paper suggests to road authorities steps to reduce fatigue-related road accidents in Poland.

  20. White Book on Physical and Rehabilitation Medicine in Europe. Chapter 2. Why rehabilitation is needed by individual and society.

    PubMed

    2018-04-01

    In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper describes the background to the context of PRM services and comprises the following: - Epidemiological Aspects of Functioning and Disability - Ethical Aspects and Human Rights - Rehabilitation and Health Systems - Economic Burden of Disability - Effects of Lack of Rehabilitation Health care service planning accounts for the burden of disability among society and the chapter describes the justification for specialist rehabilitation, the background of PRM and why making a functional diagnosis and a management plan based on function is its core competence. The chapter describes the increasing burden of disability due to conditions seen in PRM practice rather than on all those diseases contributing to physical disablement and does not include mental illness, learning disabilities, etc. Ten percent of Western Europe's population have a disability and are surviving longer, resulting in higher costs for health and social care and a greater impact of co-morbidities. The chapter also describes the impact and increased costs in the absence of rehabilitation. Not only is money spent on rehabilitation recovered with five to nine-fold savings (e.g. in return to work), but rehabilitation is effective in all phases of health conditions. Specialized rehabilitation (as delivered by PRM services) is highly cost-efficient for all neurological conditions, producing substantial savings in ongoing care costs, especially in high-dependency patients. Disability discrimination has been outlawed and the text describes the legal context and status of a person living in Europe with a disability. The second part highlights the United Nations Conventions on human rights, confirmed in the World Report on Disability, but also on the principles of ethical practice among PRM physicians. The third part addresses the variability of access to and funding of rehabilitation services across countries. The

  1. Behaviourally relevant road categorisation: a step towards self-explaining rural roads.

    PubMed

    Weller, Gert; Schlag, Bernhard; Friedel, Tino; Rammin, Carmen

    2008-07-01

    In contrast to motorways, rural roads are characterised by a large variation in design, appearance and function which is reflected in a comparatively large number of rural road categories. Depending on these categories, a certain (normative) behaviour is usually expected from the driver. These normative behavioural expectations are conveyed to the driver either by formal cues (e.g. speed limit signs) or are expected to be inferred from the road appearance or the affordance (Gibson, J.J., 1986. The Ecological Approach to Visual Perception. Lawrence Erlbaum, Hillsdale (New Jersey)) of the respective road situation. Unsafe situations are likely to occur if the perceived message conveyed by cues or affordances does not match the normative behavioural expectations of the official road category. In order to avoid such mismatch it is important to know how drivers categorise (rural) roads and which elements are used for this subjective and behaviourally relevant road categorisation. We therefore summarized the processes behind this categorisation in a model and conducted a study in a laboratory setting during which subjects were asked to rate a variety of rural road pictures. The study revealed that drivers distinguish between three different rural road categories which can be distinguished with comparatively few objective criteria. Applying these criteria helps to categorise and design rural roads along self-explaining road principles.

  2. Cancer rehabilitation in Austria--aspects of Physical Medicine and Rehabilitation.

    PubMed

    Maehr, Bruno; Keilani, Mohammad; Wiltschke, Christoph; Hassler, Marco; Licht, Thomas; Marosi, Christine; Huetterer, Elisabeth; Cenik, Fadime; Crevenna, Richard

    2016-02-01

    In Austria, cancer rehabilitation is an important issue in the management of cancer patients. Survival rates and survival time of cancer patients are increasing, and cancer rehabilitation is an important part in the treatment and care of cancer patients with the goal to improve functional status, quality of life, and (social) participation. Today, in Austria there are approximately 600 beds for inpatient rehabilitation. The field of outpatient rehabilitation will maybe be expanded after evaluating the existing pilot projects. Beside other specialities, the field of Physical Medicine and Rehabilitation (PM&R) plays an important role in cancer rehabilitation. In cancer rehabilitation, especially activating modalities from PM&R such as exercise are very important and well-accepted parts to improve functional status, quality of life, and participation of patients.

  3. 7. LASSEN PARK ROAD BRIDGE AT SULFUR WORKS. NOTE ROAD ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. LASSEN PARK ROAD BRIDGE AT SULFUR WORKS. NOTE ROAD TRAVERSING DISTANT RIDGE BEYOND BRIDGE. SEEN FROM WEST OF HIGHWAY FROM OLD HIGHWAY LOOP. LOOKING E. - Lassen Park Road, Mineral, Tehama County, CA

  4. Lucy Montoro Rehabilitation Network mobile unit: an alternative public healthcare policy.

    PubMed

    Battistella, Linamara Rizzo; Juca, Sueli Satie H; Tateishi, Mariane; Oshiro, Milton Seigui; Yamanaka, Eduardo Inglez; Lima, Eliana; Ramos, Vinicius Delgado

    2015-07-01

    The aim is to analyze rehabilitation services provided by a mobile rehabilitation clinic (MU) in nine regions of the State of São Paulo, demonstrating the distribution of orthoses, prostheses and other mobility aids for persons with physical disabilities according to age groups and impairments, as well as the number of persons with physical disabilities as estimated by Brazilian official data sources. The number of persons with disabilities in each region was obtained through estimations from the 2010 Brazilian IBGE Census. The number of assistive technologies suppliers and technicians were provided by the Brazilian Technical Orthopedics Association (ABOTEC). Patients were referred to the MU by Regional Health Departments. After examination of a multidisciplinary team, assistive devices are prescribed and delivered according to patients' needs. Data on patients were also assessed according to questionnaires on their age, diagnosis, gender, marital status and education level. From 2009 to 2011, the MU went through 15,000 km providing rehabilitation services through the Public Health System to 1801 patients. Additionally, 3328 devices were delivered in this period. Different age, diagnosis, gender, marital status and schooling profiles are highlighted in each of the analyzed regions. Data on patients' profiles were made available through services provided by the MU--including the average index of 1.85 devices delivered to each patient and demand projections--which can be used in the planning of public policies. The MU made rehabilitation services more accessible, trained professionals, raised awareness on the correct delivery and use of assistive devices, and identified and organized people's demand in each region. Implications for Rehabilitation Delivering prostheses, orthoses and other mobility aids fulfills the rights of persons with disabilities to personal mobility with the greatest possible independence, as foreseen by the Convention on the Rights of Persons

  5. Virtual reality and cognitive rehabilitation: a review of current outcome research.

    PubMed

    Larson, Eric B; Feigon, Maia; Gagliardo, Pablo; Dvorkin, Assaf Y

    2014-01-01

    Recent advancement in the technology of virtual reality (VR) has allowed improved applications for cognitive rehabilitation. The aim of this review is to facilitate comparisons of therapeutic efficacy of different VR interventions. A systematic approach for the review of VR cognitive rehabilitation outcome research addressed the nature of each sample, treatment apparatus, experimental treatment protocol, control treatment protocol, statistical analysis and results. Using this approach, studies that provide valid evidence of efficacy of VR applications are summarized. Applications that have not yet undergone controlled outcome study but which have promise are introduced. Seventeen studies conducted over the past eight years are reviewed. The few randomized controlled trials that have been completed show that some applications are effective in treating cognitive deficits in people with neurological diagnoses although further study is needed. Innovations requiring further study include the use of enriched virtual environments that provide haptic sensory input in addition to visual and auditory inputs and the use of commercially available gaming systems to provide tele-rehabilitation services. Recommendations are offered to improve efficacy of rehabilitation, to improve scientific rigor of rehabilitation research and to broaden access to the evidence-based treatments that this research has identified.

  6. Development of early comprehensive stroke inpatient rehabilitation in Poland - current status and future requirements.

    PubMed

    Sarzyńska-Długosz, Iwona; Krawczyk, Maciej; Członkowska, Anna

    2011-01-01

    Every stroke patient should undergo early rehabilitation. We aimed to evaluate accessibility, development and needs in early stroke inpatient rehabilitation in Poland. A questionnaire evaluating rehabilitation departments was prepared and sent (in 2004 and 2008) to rehabilitation wards in Poland, where stroke patients are treated and undergo early rehabilitation. We divided departments into classes: class A - having comprehensive rehabilitation (physiotherapy minimum 60 minutes/day, speech therapy minimum 30 minutes/5 days/week, rehabilitation of other cognitive impairments minimum 30 minutes/5 days/week, group physiotherapy); B - having the possibility of all types of therapy, but done less frequently; C - physiotherapy and speech therapy; D - physiotherapy and cognitive rehabilitation; E - only physiotherapy. In 2004, we obtained responses from 115 of 172 (66.9%) rehabilitation departments. According to prespecified criteria there were 11 class A, 31 class B, 28 class C, 4 class D, and 41 class E wards. In 2008, we received response from 89 of 149 (59.7%) rehabilitation departments. According to prespecified criteria there were 17 class A, 40 class B, 22 class C, 0 class D, and 10 class E wards. In 2004, 159 beds and in 2008, 294 beds in class A departments were available for stroke patients. The minimal number of needed but lacking beds was 604 in 2004 and 469 in 2008. Development of departments providing early comprehensive stroke rehabilitation from 2004 to 2008 is marked, but still insufficient. In 2008, 19% of rehabilitation departments could provide comprehensive stroke rehabilitation and this was 38.5% of beds actually needed.

  7. Strengthening health information systems for disability-related rehabilitation in LMICs

    PubMed Central

    McPherson, Anna; Richards, Nicola; Gouda, Hebe; Rampatige, Rasika; Whittaker, Maxine

    2017-01-01

    Abstract The purpose of this study was to describe the state of rehabilitation health information systems (HIS) in different settings, and identify key processes and actions which contribute to the development of HIS which can effectively support low- and middle-income countries (LMICs) allocate resources to health-related rehabilitation to people with disabilities. Nine case studies were conducted across different disability and developmental settings using documentary review and semi-structured key informant interviews (N = 41). Results were analysed against the six building blocks of a HIS, based on the Health Metrics Network Framework and Standards for Country Health Information Systems and existing HIS capacity. Key barriers or enablers to good disability data collection and use, were documented for each HIS component. Research results suggest there is no gold standard HIS for rehabilitation. There was broad consensus however, that effective health related disability planning requires reliable data on disability prevalence, functional status, access to rehabilitation services and functional outcomes of rehabilitation. For low-resource settings, and where routine HIS are already challenged, planning to include disability and rehabilitation foci starting with a minimum dataset on functioning, and progressively improving the system for increased utility and harmonization, is likely to be most effective and minimize the potential for overburdening fragile systems. The recommendations from this study are based on the successes and challenges of countries with established information systems, and will assist LMICs to prioritize strategic measures to strengthen the collection and use of data for rehabilitation, and progressively realize the rights of people with disabilities. PMID:27935799

  8. Joint road safety operations in tunnels and open roads

    NASA Astrophysics Data System (ADS)

    Adesiyun, Adewole; Avenoso, Antonio; Dionelis, Kallistratos; Cela, Liljana; Nicodème, Christophe; Goger, Thierry; Polidori, Carlo

    2017-09-01

    The objective of the ECOROADS project is to overcome the barrier established by the formal interpretation of the two Directives 2008/96/EC and 2004/54/EC, which in practice do not allow the same Road Safety Audits/Inspections to be performed inside tunnels. The projects aims at the establishment of a common enhanced approach to road infrastructure and tunnel safety management by using the concepts and criteria of the Directive 2008/96/CE on road infrastructure safety management and the results of related European Commission (EC) funded projects. ECOROADS has already implemented an analysis of national practices regarding Road Safety Inspections (RSI), two Workshops with the stakeholders, and an exchange of best practices between European tunnel experts and road safety professionals, which led to the definition of common agreed safety procedures. In the second phase of the project, different groups of experts and observers applied the above common procedures by inspecting five European road sections featuring both open roads and tunnels in Belgium, Albania, Germany, Serbia and Former Yugoslav Republic of Macedonia. This paper shows the feedback of the 5 joint safety operations and how they are being used for a set of - recommendations and guidelines for the application of the RSA and RSI concepts within the tunnel safety operations.

  9. ML Crew Access Arm Move

    NASA Image and Video Library

    2017-11-10

    A heavy-load transport truck carries the Orion crew access arm along the NASA Causeway east toward State Road 3 at NASA's Kennedy Space Center in Florida. The access arm will be moved to the mobile launcher (ML) near the Vehicle Assembly Building at the center. The crew access arm will be installed at about the 274-foot level on the mobile launcher tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower to prepare for Exploration Mission-1.

  10. Silk Roads or Steppe Roads? The Silk Roads in World History.

    ERIC Educational Resources Information Center

    Christian, David

    2000-01-01

    Explores the prehistory of the Silk Roads, reexamines their structure and history in the classical era, and explores shifts in their geography in the last one thousand years. Explains that a revised understanding of the Silk Roads demonstrates how the Afro-Eurasian land mass has been linked by networks of exchange since the Bronze Age. (CMK)

  11. Pulmonary rehabilitation in COPD – available resources and utilization in Swedish primary and secondary care

    PubMed Central

    Sundh, Josefin; Lindgren, Helena; Hasselgren, Mikael; Montgomery, Scott; Janson, Christer; Ställberg, Björn; Lisspers, Karin

    2017-01-01

    Introduction Pulmonary rehabilitation is effective in all stages of COPD. The availability and utilization of pulmonary rehabilitation resources, and the characteristics of COPD patients receiving rehabilitation, were investigated in primary and secondary care in central Sweden. Materials and methods Data on available pulmonary rehabilitation resources were collected using questionnaires, to 14 hospitals and 54 primary health care centers, and information on utilization of different rehabilitation professionals was obtained from questionnaires completed by 1,329 COPD patients from the same centers. Multivariable logistic regression examined associations with having received rehabilitation in the previous year. Results In primary care, nurse-based asthma/COPD clinics were common (87%), with additional separate access to other rehabilitation professionals. In secondary care, rehabilitation was more often offered as part of a multidisciplinary teamwork (71%). In total, 36% of the patients met an asthma/COPD nurse in the previous year. Utilization was lower in primary than in secondary care for physiotherapists (7% vs 16%), occupational therapists (3% vs 10%), nutritionists (5% vs 13%), and counselors (1% vs 4%). A higher COPD Assessment Test score and frequent exacerbations were associated with higher utilization of all rehabilitation professionals. Conclusion Pulmonary rehabilitation resources are available but underutilized, and receiving rehabilitation is more common in severe COPD. Treatment recommendations need to be better implemented, especially in mild and moderate COPD. PMID:28652722

  12. Experience of social support in rehabilitation: a phenomenological study.

    PubMed

    Nätterlund, B; Ahlström, G

    1999-12-01

    The progressive muscular weakness brought on by muscular dystrophy causes the sufferer many problems in everyday life. Earlier studies in Sweden have shown that adults with hereditary muscular dystrophy often have difficulty in gaining access to rehabilitation. For this reason a special rehabilitation programme was drawn up and carried out, extending over a period of 18 months. The purpose of the study is to describe the participants' experience of social support in connection with the programme. Thirty-seven participants (21 women and 16 men) were interviewed. The analytical method was phenomenological, incorporating validation by independent judges. Nine overall themes emerged from the interviews: psychosocial support, meeting other people with muscular dystrophy, knowledge and learning, adjustment in daily life, coping with illness-related problems, adjustment at work, management of physical disability, medical examination and treatment, and involvement of relatives. The results indicate that the participants encountered staff with a sense of commitment and felt themselves to be 'seen and confirmed'. From the discussions and the contact with others in the same situation there arises a sense of affinity and a better understanding of one's own situation. There was appreciation of the education about the disease, its hereditary aspect, technical aids, grants and physical training. Hardly any of the participants spoke of knowing such things before. In conclusion there was approval of the received support, and recognition that persons with muscular dystrophy should be given access to recurrent rehabilitation.

  13. How Effective Is Road Mitigation at Reducing Road-Kill? A Meta-Analysis.

    PubMed

    Rytwinski, Trina; Soanes, Kylie; Jaeger, Jochen A G; Fahrig, Lenore; Findlay, C Scott; Houlahan, Jeff; van der Ree, Rodney; van der Grift, Edgar A

    2016-01-01

    Road traffic kills hundreds of millions of animals every year, posing a critical threat to the populations of many species. To address this problem there are more than forty types of road mitigation measures available that aim to reduce wildlife mortality on roads (road-kill). For road planners, deciding on what mitigation method to use has been problematic because there is little good information about the relative effectiveness of these measures in reducing road-kill, and the costs of these measures vary greatly. We conducted a meta-analysis using data from 50 studies that quantified the relationship between road-kill and a mitigation measure designed to reduce road-kill. Overall, mitigation measures reduce road-kill by 40% compared to controls. Fences, with or without crossing structures, reduce road-kill by 54%. We found no detectable effect on road-kill of crossing structures without fencing. We found that comparatively expensive mitigation measures reduce large mammal road-kill much more than inexpensive measures. For example, the combination of fencing and crossing structures led to an 83% reduction in road-kill of large mammals, compared to a 57% reduction for animal detection systems, and only a 1% for wildlife reflectors. We suggest that inexpensive measures such as reflectors should not be used until and unless their effectiveness is tested using a high-quality experimental approach. Our meta-analysis also highlights the fact that there are insufficient data to answer many of the most pressing questions that road planners ask about the effectiveness of road mitigation measures, such as whether other less common mitigation measures (e.g., measures to reduce traffic volume and/or speed) reduce road mortality, or to what extent the attributes of crossing structures and fences influence their effectiveness. To improve evaluations of mitigation effectiveness, studies should incorporate data collection before the mitigation is applied, and we recommend a

  14. How Effective Is Road Mitigation at Reducing Road-Kill? A Meta-Analysis

    PubMed Central

    Rytwinski, Trina; Soanes, Kylie; Jaeger, Jochen A. G.; Fahrig, Lenore; Findlay, C. Scott; Houlahan, Jeff; van der Ree, Rodney; van der Grift, Edgar A

    2016-01-01

    Road traffic kills hundreds of millions of animals every year, posing a critical threat to the populations of many species. To address this problem there are more than forty types of road mitigation measures available that aim to reduce wildlife mortality on roads (road-kill). For road planners, deciding on what mitigation method to use has been problematic because there is little good information about the relative effectiveness of these measures in reducing road-kill, and the costs of these measures vary greatly. We conducted a meta-analysis using data from 50 studies that quantified the relationship between road-kill and a mitigation measure designed to reduce road-kill. Overall, mitigation measures reduce road-kill by 40% compared to controls. Fences, with or without crossing structures, reduce road-kill by 54%. We found no detectable effect on road-kill of crossing structures without fencing. We found that comparatively expensive mitigation measures reduce large mammal road-kill much more than inexpensive measures. For example, the combination of fencing and crossing structures led to an 83% reduction in road-kill of large mammals, compared to a 57% reduction for animal detection systems, and only a 1% for wildlife reflectors. We suggest that inexpensive measures such as reflectors should not be used until and unless their effectiveness is tested using a high-quality experimental approach. Our meta-analysis also highlights the fact that there are insufficient data to answer many of the most pressing questions that road planners ask about the effectiveness of road mitigation measures, such as whether other less common mitigation measures (e.g., measures to reduce traffic volume and/or speed) reduce road mortality, or to what extent the attributes of crossing structures and fences influence their effectiveness. To improve evaluations of mitigation effectiveness, studies should incorporate data collection before the mitigation is applied, and we recommend a

  15. Predictors of the On-Road Driving Assessment After Traumatic Brain Injury: Comparing Cognitive Tests, Injury Factors, and Demographics.

    PubMed

    McKay, Adam; Liew, Carine; Schönberger, Michael; Ross, Pamela; Ponsford, Jennie

    (1) To examine the relations between performance on cognitive tests and on-road driving assessment in a sample of persons with traumatic brain injury (TBI). (2) To compare cognitive predictors of the on-road assessment with demographic and injury-related predictors. Ninety-nine people with mild-severe TBI who completed an on-road driving assessment in an Australian rehabilitation setting. Retrospective case series. Wechsler Test of Adult Reading or National Adult Reading Test-Revised; 4 subtests from the Wechsler Adult Intelligence Scale-III; Rey Auditory Verbal Leaning Test; Rey Complex Figure Test; Trail Making Test; demographic factors (age, sex, years licensed); and injury-related factors (duration of posttraumatic amnesia; time postinjury). Participants who failed the driving assessment did worse on measures of attention, visual memory, and executive processing; however, cognitive tests were weak correlates (r values <0.3) and poor predictors of the driving assessment. Posttraumatic amnesia duration mediated by time postinjury was the strongest predictor of the driving assessment-that is, participants with more severe TBIs had later driving assessments and were more likely to fail. Cognitive tests are not reliable predictors of the on-road driving assessment outcome. Traumatic brain injury severity may be a better predictor of on-road driving; however, further research is needed to identify the best predictors of driving behavior after TBI.

  16. Singapore Tele-technology Aided Rehabilitation in Stroke (STARS) trial: protocol of a randomized clinical trial on tele-rehabilitation for stroke patients.

    PubMed

    Koh, Gerald Choon-Huat; Yen, Shih Cheng; Tay, Arthur; Cheong, Angela; Ng, Yee Sien; De Silva, Deidre Anne; Png, Carolina; Caves, Kevin; Koh, Karen; Kumar, Yogaprakash; Phan, Shi Wen; Tai, Bee Choo; Chen, Cynthia; Chew, Effie; Chao, Zhaojin; Chua, Chun En; Koh, Yen Sin; Hoenig, Helen

    2015-09-05

    Most acute stroke patients with disabilities do not receive recommended rehabilitation following discharge to the community. Functional and social barriers are common reasons for non-adherence to post-discharge rehabilitation. Home rehabilitation is an alternative to centre-based rehabilitation but is costlier. Tele-rehabilitation is a possible solution, allowing for remote supervision of rehabilitation and eliminating access barriers. The objective of the Singapore Tele-technology Aided Rehabilitation in Stroke (STARS) trial is to determine if a novel tele-rehabilitation intervention for the first three months after stroke admission improves functional recovery compared to usual care. This is a single blind (evaluator blinded), parallel, two-arm randomised controlled trial study design involving 100 recent stroke patients. The inclusion criteria are age ≥40 years, having caregiver support and recent stroke defined as stroke diagnosis within 4 weeks. Consenting participants will be randomized with varying block size of 4 or 6 assuming a 1:1 treatment allocation with the participating centre as the stratification factor. The baseline assessment will be done within 4 weeks of stroke onset, followed by follow-up assessments at 3 and 6 months. The tele-rehabilitation intervention lasts for 3 months and includes exercise 5-days-a-week using an iPad-based system that allows recording of daily exercise with video and sensor data and weekly video-conferencing with tele-therapists after data review. Those allocated to the control group will receive usual care. The primary outcome measure is improvement in life task's social activity participation at three months as measured by the disability component of the Jette Late Life Functional and Disability Instrument (LLFDI). Secondary outcome variables consist of gait speed (Timed 5-Meter Walk Test) and endurance (Two-Minute Walk test), performance of basic activities of daily living (Shah-modified Barthel Index), balance

  17. 77 FR 37022 - Disability and Rehabilitation Research Projects and Centers Program; Rehabilitation Engineering...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ...; Rehabilitation Engineering Research Centers AGENCY: Office of Special Education and Rehabilitative Services... Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers (RERC). SUMMARY... amended (Rehabilitation Act). Rehabilitation Engineering Research Centers Program (RERCs) The purpose of...

  18. Final priority; Rehabilitation Services Administration--Assistive Technology Alternative Financing Program. Final priority.

    PubMed

    2014-08-14

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Assistive Technology Alternative Financing Program administered by the Rehabilitation Services Administration (RSA). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. This priority is designed to ensure that the Department funds high-quality assistive technology (AT) alternative financing programs (AFPs) that meet rigorous standards in order to enable individuals with disabilities to access and acquire assistive technology devices and services necessary to achieve education, community living, and employment goals.

  19. Effect of the Road Environment on Road Safety in Poland

    NASA Astrophysics Data System (ADS)

    Budzynski, Marcin; Jamroz, Kazimierz; Antoniuk, Marcin

    2017-10-01

    Run-off-road accidents tend to be very severe because when a vehicle leaves the road, it will often crash into a solid obstacle (tree, pole, supports, front wall of a culvert, barrier). A statistical analysis of the data shows that Poland’s main roadside hazard is trees and the severity of vehicles striking a tree in a run-off-road crash. The risks are particularly high in north-west Poland with many of the roads lined up with trees. Because of the existing rural road cross-sections, i.e. having trees directly on road edge followed immediately by drainage ditches, vulnerable road users are prevented from using shoulders and made to use the roadway. With no legal definition of the road safety zone in Polish regulations, attempts to remove roadside trees lead to major conflicts with environmental stakeholders. This is why a compromise should be sought between the safety of road users and protection of the natural environment and the aesthetics of the road experience. Rather than just cut the trees, other road safety measures should be used where possible to treat the hazardous spots by securing trees and obstacles and through speed management. Accidents that are directly related to the road environment fall into the following categories: hitting a tree, hitting a barrier, hitting a utility pole or sign, vehicle rollover on the shoulder, vehicle rollover on slopes or in ditch. The main consequence of a roadside hazard is not the likelihood of an accident itself but of its severity. Poland’s roadside accident severity is primarily the result of poor design or operation of road infrastructure. This comes as a consequence of a lack of regulations or poorly defined regulations and failure to comply with road safety standards. The new analytical model was designed as a combination of the different factors and one that will serve as a comprehensive model. It was assumed that it will describe the effect of the roadside on the number of accidents and their consequences

  20. Movement-Based Interaction Applied to Physical Rehabilitation Therapies

    PubMed Central

    Ruiz Penichet, Victor Manuel; Lozano Pérez, María Dolores

    2014-01-01

    interaction with the system allowed us to obtain important feedback needed to improve the system. Conclusions The system improves the rehabilitation conditions of people with balance disorder. The main contribution comes from the fact that it allows patients to carry out the rehabilitation process at home under the supervision of physiotherapists. As a result, patients avoid having to attend medical centers. Additionally, medical staff have access to an assistant, which means their presence is not required in many exercises that involve constant repetition. PMID:25491148

  1. A study on the relationship between urban roads and car fuel consumption based on the ST-matching algorithm

    NASA Astrophysics Data System (ADS)

    Liu, Mingshan; Zhang, Wenbo; Zhou, Yuan; Xun, Yanqin; Wang, Rui

    2017-07-01

    Since the study of fuel consumptions is of great importance and the related data is accessible, many researches about factors affecting fuel consumptions have appeared.To sum up, the driving style of drivers, automobile emissions and the type of the routes are the mainly three factors.Classification is relatively single.In order to improve the classification accuracy' this text studies that there exist some special roads,when drivers drive through them,their fuel consumptions will be similar because of road qualities.To achieve this goal, the first step is to calculate fuel consumptions per 100km of all city roads.Recognizing and examining special roads based on the ST-Matching algorithm.Third is to analyze road qualities of special roads like the length of roads, the speed of driving, and compare them with other common roads.Then we choose 4 cases to analyze. We find that when driving through special roads, fuel consumptions would be similar because of road qualities.Besides, the average length of special roads is longer than common roads' and the mean velocity, the speed of getting and off special roads are faster than common roads'.The findings in this paper can filter out special road segments as noisy data in the study of relationship between driving styles and fuel consumptions,and it also has very high practical significance on recommending fuel-efficient paths.

  2. Image feature based GPS trace filtering for road network generation and road segmentation

    DOE PAGES

    Yuan, Jiangye; Cheriyadat, Anil M.

    2015-10-19

    We propose a new method to infer road networks from GPS trace data and accurately segment road regions in high-resolution aerial images. Unlike previous efforts that rely on GPS traces alone, we exploit image features to infer road networks from noisy trace data. The inferred road network is used to guide road segmentation. We show that the number of image segments spanned by the traces and the trace orientation validated with image features are important attributes for identifying GPS traces on road regions. Based on filtered traces , we construct road networks and integrate them with image features to segmentmore » road regions. Lastly, our experiments show that the proposed method produces more accurate road networks than the leading method that uses GPS traces alone, and also achieves high accuracy in segmenting road regions even with very noisy GPS data.« less

  3. Image feature based GPS trace filtering for road network generation and road segmentation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yuan, Jiangye; Cheriyadat, Anil M.

    We propose a new method to infer road networks from GPS trace data and accurately segment road regions in high-resolution aerial images. Unlike previous efforts that rely on GPS traces alone, we exploit image features to infer road networks from noisy trace data. The inferred road network is used to guide road segmentation. We show that the number of image segments spanned by the traces and the trace orientation validated with image features are important attributes for identifying GPS traces on road regions. Based on filtered traces , we construct road networks and integrate them with image features to segmentmore » road regions. Lastly, our experiments show that the proposed method produces more accurate road networks than the leading method that uses GPS traces alone, and also achieves high accuracy in segmenting road regions even with very noisy GPS data.« less

  4. Trace Authored Papers from the Annual Conference on Rehabilitation Technology (13th, Washington, D.C., 1990).

    ERIC Educational Resources Information Center

    Wisconsin Univ., Madison. Trace Center.

    This document brings together eight papers presented at a rehabilitation technology conference, authored by individuals affiliated with the Trace R & D Center on Communication, Control and Computer Access for Handicapped Individuals. Titles and authors of the papers are as follows: "Current Initiatives in Accessible Computing" (Jane Berliss);…

  5. The impact of roads on the demography of grizzly bears in Alberta.

    PubMed

    Boulanger, John; Stenhouse, Gordon B

    2014-01-01

    One of the principal factors that have reduced grizzly bear populations has been the creation of human access into grizzly bear habitat by roads built for resource extraction. Past studies have documented mortality and distributional changes of bears relative to roads but none have attempted to estimate the direct demographic impact of roads in terms of both survival rates, reproductive rates, and the interaction of reproductive state of female bears with survival rate. We applied a combination of survival and reproductive models to estimate demographic parameters for threatened grizzly bear populations in Alberta. Instead of attempting to estimate mean trend we explored factors which caused biological and spatial variation in population trend. We found that sex and age class survival was related to road density with subadult bears being most vulnerable to road-based mortality. A multi-state reproduction model found that females accompanied by cubs of the year and/or yearling cubs had lower survival rates compared to females with two year olds or no cubs. A demographic model found strong spatial gradients in population trend based upon road density. Threshold road densities needed to ensure population stability were estimated to further refine targets for population recovery of grizzly bears in Alberta. Models that considered lowered survival of females with dependant offspring resulted in lower road density thresholds to ensure stable bear populations. Our results demonstrate likely spatial variation in population trend and provide an example how demographic analysis can be used to refine and direct conservation measures for threatened species.

  6. The Impact of Roads on the Demography of Grizzly Bears in Alberta

    PubMed Central

    2014-01-01

    One of the principal factors that have reduced grizzly bear populations has been the creation of human access into grizzly bear habitat by roads built for resource extraction. Past studies have documented mortality and distributional changes of bears relative to roads but none have attempted to estimate the direct demographic impact of roads in terms of both survival rates, reproductive rates, and the interaction of reproductive state of female bears with survival rate. We applied a combination of survival and reproductive models to estimate demographic parameters for threatened grizzly bear populations in Alberta. Instead of attempting to estimate mean trend we explored factors which caused biological and spatial variation in population trend. We found that sex and age class survival was related to road density with subadult bears being most vulnerable to road-based mortality. A multi-state reproduction model found that females accompanied by cubs of the year and/or yearling cubs had lower survival rates compared to females with two year olds or no cubs. A demographic model found strong spatial gradients in population trend based upon road density. Threshold road densities needed to ensure population stability were estimated to further refine targets for population recovery of grizzly bears in Alberta. Models that considered lowered survival of females with dependant offspring resulted in lower road density thresholds to ensure stable bear populations. Our results demonstrate likely spatial variation in population trend and provide an example how demographic analysis can be used to refine and direct conservation measures for threatened species. PMID:25532035

  7. Correspondence between Simulator and On-Road Drive Performance: Implications for Assessment of Driving Safety.

    PubMed

    Aksan, Nazan; Hacker, Sarah D; Sager, Lauren; Dawson, Jeffrey; Anderson, Steven; Rizzo, Matthew

    2016-03-01

    Forty-two younger (Mean age = 35) and 37 older drivers (Mean age = 77) completed four similar simulated drives. In addition, 32 younger and 30 older drivers completed a standard on-road drive in an instrumented vehicle. Performance in the simulated drives was evaluated using both electronic drive data and video-review of errors. Safety errors during the on-road drive were evaluated by a certified driving instructor blind to simulator performance, using state Department of Transportation criteria. We examined the degree of convergence in performance across the two platforms on various driving tasks including lane change, lane keeping, speed control, stopping, turns, and overall performance. Differences based on age group indicated a pattern of strong relative validity for simulator measures. However, relative rank-order in specific metrics of performance suggested a pattern of moderate relative validity. The findings have implications for the use of simulators in assessments of driving safety as well as its use in training and/or rehabilitation settings.

  8. Correspondence between Simulator and On-Road Drive Performance: Implications for Assessment of Driving Safety

    PubMed Central

    Aksan, Nazan; Hacker, Sarah D.; Sager, Lauren; Dawson, Jeffrey; Anderson, Steven; Rizzo, Matthew

    2017-01-01

    Forty-two younger (Mean age = 35) and 37 older drivers (Mean age = 77) completed four similar simulated drives. In addition, 32 younger and 30 older drivers completed a standard on-road drive in an instrumented vehicle. Performance in the simulated drives was evaluated using both electronic drive data and video-review of errors. Safety errors during the on-road drive were evaluated by a certified driving instructor blind to simulator performance, using state Department of Transportation criteria. We examined the degree of convergence in performance across the two platforms on various driving tasks including lane change, lane keeping, speed control, stopping, turns, and overall performance. Differences based on age group indicated a pattern of strong relative validity for simulator measures. However, relative rank-order in specific metrics of performance suggested a pattern of moderate relative validity. The findings have implications for the use of simulators in assessments of driving safety as well as its use in training and/or rehabilitation settings. PMID:28649572

  9. Vocational Rehabilitation and the Dilemma of Race in Rural Communities: Sociopolitical Realities and Myths from the Past.

    ERIC Educational Resources Information Center

    Wilson, Keith B.; Edwards, Dothel W., Jr.; Alston, Reginald J.; Harley, Debra A.; Doughty, Jhan D.

    2001-01-01

    Examines social factors that influence outcomes and access to vocational rehabilitation (VR) services for rural people of color with disabilities. Discusses attitudes toward disabilities, racial attitudes, formal and informal support systems in rural areas, religious influences, informal communication systems, access to health care and employment…

  10. Rehabilitation Engineering Sourcebook [and] Rehabilitation Engineering Sourcebook Supplement I.

    ERIC Educational Resources Information Center

    Institute for Information Studies, Falls Church, VA.

    Intended for use by rehabilitation counselors and work supervisors, the sourcebook contains 173 problems and solutions provided by rehabilitation engineering. A section titled "Guidelines for Formulating Problem Statements" is intended to summarize the most effective ways for either disabled individuals or rehabilitation practitioners to…

  11. 76 FR 63289 - Advisory Commission on Accessible Instructional Materials in Postsecondary Education for Students...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ... DEPARTMENT OF EDUCATION Advisory Commission on Accessible Instructional Materials in Postsecondary Education for Students With Disabilities AGENCY: U.S. Department of Education, Office of Special Education and Rehabilitative Services, Advisory Commission on Accessible Instructional Materials in...

  12. Economic and cultural correlates of road-traffic accident fatality rates in OECD countries.

    PubMed

    Gaygisiz, Esma

    2009-10-01

    The relationships between economic conditions, cultural characteristics, personality dimensions, intelligence scores, and road-traffic accident mortality rates were investigated in 30 member and five accession countries of the Organisation for Economic Co-operation and Development (OECD). Economic indicators included the Gross Domestic Product (GDP) per capita, the unemployment rate, and the Gini index. Cultural variables included five Hofstede's cultural dimensions, seven Schwartz cultural value dimensions, NEO-PI-R scales, and the intelligence quotient (IQ). The results showed positive associations between favorable economic conditions (high income per capita, high employment rate, and low income inequality) and high traffic safety. Countries with higher road-traffic accident fatality rates were characterized by higher power distance and uncertainty avoidance as well as embeddedness and emphasis on social hierarchy. Countries with lower road-traffic accident fatality rates were more individualistic, egalitarian, and emphasized autonomy of individuals. Conscientiousness (from NEO-PI-R) and IQ correlated negatively with road-traffic accident fatalities.

  13. Assistive Technology: A Funding Workbook. Part I, A Road Map to Funding Sources. Part II, An Outline of Federal Laws and Rules. 1991 Edition. RESNA Technical Assistance Project.

    ERIC Educational Resources Information Center

    Morris, Michael W.; Golinker, Lewis A.

    This compilation on assistive technology devices and services aims to improve understanding of funding streams and creative ways to eliminate funding barriers in Medicaid, special education, and vocational rehabilitation. The first part comprises a workbook titled "A Road Map to Funding Sources." It assists in creating a systematic…

  14. The role of systematic inpatient cardiac rehabilitation referral in increasing equitable access and utilization.

    PubMed

    Grace, Sherry L; Leung, Yvonne W; Reid, Robert; Oh, Paul; Wu, Gilbert; Alter, David A; CRCARE Investigators

    2012-01-01

    While systematic referral strategies have been shown to significantly increase cardiac rehabilitation (CR) enrollment to approximately 70%, whether utilization rates increase among patient groups who are traditionally underrepresented has yet to be established. This study compared CR utilization based on age, marital status, rurality, socioeconomic indicators, clinical risk, and comorbidities following systematic versus nonsystematic CR referral. Coronary artery disease inpatients (N = 2635) from 11 Ontario hospitals, utilizing either systematic (n = 8 wards) or nonsystematic referral strategies (n = 8 wards), completed a survey including sociodemographics and activity status. Clinical data were extracted from charts. At 1 year, 1680 participants completed a mailed survey that assessed CR utilization. The association of patient characteristics and referral strategy on CR utilization was tested using χ. When compared to nonsystematic referral, systematic strategies resulted in significantly greater CR referral and enrollment among obese (32 vs 27% referred, P = .044; 33 vs 26% enrolled, P = .047) patients of lower socioeconomic status (41 vs 34% referred, P = .026; 42 vs 32% enrolled, P = .005); and lower activity status (63 vs 54% referred, P = .005; 62 vs 51% enrolled, P = .002). There was significantly greater enrollment among those of lower education (P = .04) when systematically referred; however, no significant differences in degree of CR participation based on referral strategy. Up to 11% more socioeconomically disadvantaged patients and those with more risk factors utilized CR where systematic processes were in place. They participated in CR to the same high degree as their nonsystematically referred counterparts. These referral strategies should be implemented to promote equitable access.

  15. A pathway to personalization of integrated treatment: informatics and decision science in psychiatric rehabilitation.

    PubMed

    Spaulding, William; Deogun, Jitender

    2011-09-01

    Personalization of treatment is a current strategic goal for improving health care. Integrated treatment approaches such as psychiatric rehabilitation benefit from personalization because they involve matching diverse arrays of treatment options to individually unique profiles of need. The need for personalization is evident in the heterogeneity of people with severe mental illness and in the findings of experimental psychopathology. One pathway to personalization lies in analysis of the judgments and decision making of human experts and other participants as they respond to complex circumstances in pursuit of treatment and rehabilitation goals. Such analysis is aided by computer simulation of human decision making, which in turn informs development of computerized clinical decision support systems. This inspires a research program involving concurrent development of databases, domain ontology, and problem-solving algorithms, toward the goal of personalizing psychiatric rehabilitation through human collaboration with intelligent cyber systems. The immediate hurdle is to demonstrate that clinical decisions beyond diagnosis really do affect outcome. This can be done by supporting the hypothesis that a human treatment team with access to a reasonably comprehensive clinical database that tracks patient status and treatment response over time achieves better outcome than a treatment team without such access, in a controlled experimental trial. Provided the hypothesis can be supported, the near future will see prototype systems that can construct an integrated assessment, formulation, and rehabilitation plan from clinical assessment data and contextual information. This will lead to advanced systems that collaborate with human decision makers to personalize psychiatric rehabilitation and optimize outcome.

  16. Patient perspectives on navigating the field of traumatic brain injury rehabilitation: a qualitative thematic analysis.

    PubMed

    Graff, Heidi J; Christensen, Ulla; Poulsen, Ingrid; Egerod, Ingrid

    2018-04-01

    This study aimed to provide an understanding of the lived experience of rehabilitation in adults with traumatic brain injury (TBI) from hospital discharge up to four years post-injury. We used a qualitative explorative design with semi-structured in-depth interviews. Twenty participants with TBI were included from a level I Trauma Center in Denmark at 1-4 years post-injury. Qualitative thematic analysis was applied for data analysis. Three main themes emerged during analysis: A new life, Family involvement, and Rehabilitation impediments. These themes and their sub-themes described the patient perspective of TBI and rehabilitation post hospitalization. Participants reassessed their values and found a new life after TBI. Family caregivers negotiated rehabilitation services and helped the participant to overcome barriers to rehabilitation. Although participants were entitled to TBI rehabilitation, they had to fight for the services they were entitled to. Individuals with TBI found ways of coping after injury and created a meaningful life. Barriers to TBI rehabilitation were overcome with help from family caregivers rather than health care professionals. Future studies need to find ways to ease the burden on family caregivers and pave the way for more accessible rehabilitation in this vulnerable group of patients. Implications for rehabilitation TBI rehabilitation might benefit from:    • Increased transparency in rehabilitation options    • More systematic follow-up programs    • Age-appropriate rehabilitation facilities    • Inclusion of patient and family in the planning of long-term rehabilitation.

  17. Relationship between Self-Administered Cues and Rehabilitation Outcomes in Individuals with Aphasia: Understanding Individual Responsiveness to a Technology-Based Rehabilitation Program.

    PubMed

    Des Roches, Carrie A; Mitko, Annette; Kiran, Swathi

    2017-01-01

    participants continued to used a greater number of cues. It is possible that self-administered cues help some individuals to access information that is otherwise inaccessible, even if there is not an immediate effect. Ultimately, the results demonstrate the need for individually modifying the levels of assistance during rehabilitation. time, though more severe participants continued to used a greater number of cues. It is possible that self-administered cues help some individuals to access information that is otherwise inaccessible, even if there is not an immediate effect. Ultimately, the results demonstrate the need for individually modifying the levels of assistance during rehabilitation.

  18. All-terrain vehicle fatalities on paved roads, unpaved roads, and off-road: Evidence for informed roadway safety warnings and legislation.

    PubMed

    Denning, Gerene M; Jennissen, Charles A

    2016-05-18

    All-terrain vehicles (ATVs) are designed for off-highway use only, and many of their features create increased risk with roadway travel. Over half of all ATV-related fatalities occur on roadways, and nonfatal roadway crashes result in more serious injuries than those off the road. A number of jurisdictions have passed or have considered legislation allowing ATVs on public roadways, sometimes limiting them to those unpaved, arguing that they are safe for ATVs. However, no studies have determined the epidemiology of ATV-related fatalities on different road surface types. The objective of the study was to compare ATV-related deaths on paved versus unpaved roads and to contrast them with off-road fatalities. Retrospective descriptive and multivariable analyses were performed using U.S. Consumer Product Safety Commission fatality data from 1982 through 2012. After 1998, ATV-related deaths increased at twice the rate on paved versus unpaved roads. Still, 42% of all roadway deaths during the study period occurred on unpaved surfaces. States varied considerably, ranging from 18% to 79% of their ATV-related roadway deaths occurring on unpaved roads. Paved road crashes were more likely than those on unpaved surfaces to involve males, adolescents and younger adults, passengers, and collisions with other vehicles. Both the pattern of other vehicles involved in collisions and which vehicle hit the other were different for the 2 road types. Alcohol use was higher, helmet use was lower, and head injuries were more likely in paved versus unpaved roadway crashes. However, head injuries still occurred in 76% of fatalities on unpaved roads. Helmets were associated with lower proportions of head injuries among riders, regardless of road surface type. Relative to off-road crashes, both paved and unpaved roads were more likely to involve collisions with another vehicle. The vast majority of roadway crashes, however, did not involve a traffic collision on either paved or unpaved roads

  19. Using endemic road features to create self-explaining roads and reduce vehicle speeds.

    PubMed

    Charlton, Samuel G; Mackie, Hamish W; Baas, Peter H; Hay, Karen; Menezes, Miguel; Dixon, Claire

    2010-11-01

    This paper describes a project undertaken to establish a self-explaining roads (SER) design programme on existing streets in an urban area. The methodology focussed on developing a process to identify functional road categories and designs based on endemic road characteristics taken from functional exemplars in the study area. The study area was divided into two sections, one to receive SER treatments designed to maximise visual differences between road categories, and a matched control area to remain untreated for purposes of comparison. The SER design for local roads included increased landscaping and community islands to limit forward visibility, and removal of road markings to create a visually distinct road environment. In comparison, roads categorised as collectors received increased delineation, addition of cycle lanes, and improved amenity for pedestrians. Speed data collected 3 months after implementation showed a significant reduction in vehicle speeds on local roads and increased homogeneity of speeds on both local and collector roads. The objective speed data, combined with residents' speed choice ratings, indicated that the project was successful in creating two discriminably different road categories. 2010 Elsevier Ltd. All rights reserved.

  20. Road-networks, a practical indicator of human impacts on biodiversity in Tropical forests

    NASA Astrophysics Data System (ADS)

    Hosaka, T.; Yamada, T.; Okuda, T.

    2014-02-01

    Tropical forests sustain the most diverse plants and animals in the world, but are also being lost most rapidly. Rapid assessment and monitoring using remote sensing on biodiversity of tropical forests is needed to predict and evaluate biodiversity loss by human activities. Identification of reliable indicators of forest biodiversity and/or its loss is an urgent issue. In the present paper, we propose the density of road networks in tropical forests can be a good and practical indicator of human impacts on biodiversity in tropical forests through reviewing papers and introducing our preliminary survey in peninsular Malaysia. Many previous studies suggest a strong negative impact of forest roads on biodiversity in tropical rainforests since they changes microclimate, soil properties, drainage patterns, canopy openness and forest accessibility. Moreover, our preliminary survey also showed that even a narrow logging road (6 m wide) significantly lowered abundance of dung beetles (well-known bio-indicator in biodiversity survey in tropical forests) near the road. Since these road networks are readily to be detected with remote sensing approach such as aerial photographs and Lider, regulation and monitoring of the road networks using remote sensing techniques is a key to slow down the rate of biodiversity loss due to forest degradation in tropical forests.

  1. The impact of logging roads on dung beetle assemblages in a tropical rainforest reserve.

    PubMed

    Edwards, Felicity A; Finan, Jessica; Graham, Lucy K; Larsen, Trond H; Wilcove, David S; Hsu, Wayne W; Chey, V K; Hamer, Keith C

    2017-01-01

    The demand for timber products is facilitating the degradation and opening up of large areas of intact habitats rich in biodiversity. Logging creates an extensive network of access roads within the forest, yet these are commonly ignored or excluded when assessing impacts of logging on forest biodiversity. Here we determine the impact of these roads on the overall condition of selectively logged forests in Borneo, Southeast Asia. Focusing on dung beetles along > 40 km logging roads we determine: (i) the magnitude and extent of edge effects alongside logging roads; (ii) whether vegetation characteristics can explain patterns in dung beetle communities, and; (iii) how the inclusion of road edge forest impacts dung beetle assemblages within the overall logged landscape. We found that while vegetation structure was significantly affected up to 34 m from the road edge, impacts on dung beetle communities penetrated much further and were discernible up to 170 m into the forest interior. We found larger species and particularly tunnelling species responded more than other functional groups which were also influenced by micro-habitat variation. We provide important new insights into the long-term ecological impacts of tropical logging. We also support calls for improved logging road design both during and after timber extraction to conserve more effectively biodiversity in production forests, for instance, by considering the minimum volume of timber, per unit length of logging road needed to justify road construction. In particular, we suggest that governments and certification bodies need to highlight more clearly the biodiversity and environmental impacts of logging roads.

  2. Strengthening health information systems for disability-related rehabilitation in LMICs.

    PubMed

    McPherson, Anna; Durham, Jo; Richards, Nicola; Gouda, Hebe; Rampatige, Rasika; Whittaker, Maxine

    2017-04-01

    The purpose of this study was to describe the state of rehabilitation health information systems (HIS) in different settings, and identify key processes and actions which contribute to the development of HIS which can effectively support low- and middle-income countries (LMICs) allocate resources to health-related rehabilitation to people with disabilities. Nine case studies were conducted across different disability and developmental settings using documentary review and semi-structured key informant interviews (N = 41). Results were analysed against the six building blocks of a HIS, based on the Health Metrics Network Framework and Standards for Country Health Information Systems and existing HIS capacity. Key barriers or enablers to good disability data collection and use, were documented for each HIS component. Research results suggest there is no gold standard HIS for rehabilitation. There was broad consensus however, that effective health related disability planning requires reliable data on disability prevalence, functional status, access to rehabilitation services and functional outcomes of rehabilitation. For low-resource settings, and where routine HIS are already challenged, planning to include disability and rehabilitation foci starting with a minimum dataset on functioning, and progressively improving the system for increased utility and harmonization, is likely to be most effective and minimize the potential for overburdening fragile systems. The recommendations from this study are based on the successes and challenges of countries with established information systems, and will assist LMICs to prioritize strategic measures to strengthen the collection and use of data for rehabilitation, and progressively realize the rights of people with disabilities. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  3. Assessment of Vestibular Rehabilitation Therapy Training and Practice Patterns.

    PubMed

    Bush, Matthew L; Dougherty, William

    2015-08-01

    Vestibular rehabilitation therapy (VRT) can benefit patients with a variety of balance and vestibular disorders. This expanding field requires knowledgeable and experienced therapists; however, the practice and experience of those providing this care may vary greatly. The purpose of this study was to analyze variations in training and practice patterns among practicing vestibular rehabilitation therapists. Case-controlled cohort study. Investigation of outpatient physical therapy and audiology practices that offer vestibular rehabilitation conducted by a tertiary academic referral center. Questionnaire-based investigation of level of training in vestibular disorders and therapy, practice patterns of vestibular rehabilitation, and referral sources for VRT patients. We identified 27 subjects within the state of Kentucky who practice vestibular rehabilitation and the questionnaire response rate was 63%. Responses indicated that 53% of respondents had no training in VRT during their professional degree program. Attendance of a course requiring demonstration of competence and techniques was 24% of participants. The development of VRT certification was significantly more favored by those who attended such courses compared with those who did not (p = 0.01). 50% of therapists have direct access to patients without physician referrals. There is a wide range of educational background and training among those practicing VRT. This variability in experience may affect care provided within some communities. Certification is not necessary for the practice of VRT but the development of certification is favored among some therapists to improve standardization of practice of this important specialty.

  4. Usability evaluation of low-cost virtual reality hand and arm rehabilitation games.

    PubMed

    Seo, Na Jin; Arun Kumar, Jayashree; Hur, Pilwon; Crocher, Vincent; Motawar, Binal; Lakshminarayanan, Kishor

    2016-01-01

    The emergence of lower-cost motion tracking devices enables home-based virtual reality rehabilitation activities and increased accessibility to patients. Currently, little documentation on patients' expectations for virtual reality rehabilitation is available. This study surveyed 10 people with stroke for their expectations of virtual reality rehabilitation games. This study also evaluated the usability of three lower-cost virtual reality rehabilitation games using a survey and House of Quality analysis. The games (kitchen, archery, and puzzle) were developed in the laboratory to encourage coordinated finger and arm movements. Lower-cost motion tracking devices, the P5 Glove and Microsoft Kinect, were used to record the movements. People with stroke were found to desire motivating and easy-to-use games with clinical insights and encouragement from therapists. The House of Quality analysis revealed that the games should be improved by obtaining evidence for clinical effectiveness, including clinical feedback regarding improving functional abilities, adapting the games to the user's changing functional ability, and improving usability of the motion-tracking devices. This study reports the expectations of people with stroke for rehabilitation games and usability analysis that can help guide development of future games.

  5. [Costs of hospitalisation for exacerbations of COPD in patients receiving domiciliary rehabilitation].

    PubMed

    Romain, D; Bernady, A; Etchamendy, E; Barokas, T; Pignede, P

    2011-09-01

    The aim of this study was to estimate the costs related to hospitalisation for exacerbations of COPD in patients who received domiciliary rehabilitation. The hospital costs (obtained from the health insurance office of Bayonne) of 31 patients suffering from COPD of all stages, were analysed for the year of rehabilitation and for the preceding year. All the patients had access to the same management programme in a health care system: domiciliary bicycle ergometry, collective gymnastics, dietary advice, psychological support and education. The analysis of the costs of respiratory care revealed two populations: a minority in whom costs were increased (two end of life situations requiring palliative care and two severe episodes requiring intensive care), and a majority in whom domiciliary rehabilitation led to a reduction of over 60% in the costs related to hospitalisation. Respiratory rehabilitation reduces the costs of hospitalisation secondary to exacerbations in patients suffering from COPD but does not reduce the high costs related to severe episodes of respiratory failure or terminal care. It is important that rehabilitation is adapted to the needs of each patient until the end of his life. Copyright © 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  6. Salamander abundance along road edges and within abandoned logging roads in Appalachian forests.

    PubMed

    Semlitsch, Raymond D; Ryan, Travis J; Hamed, Kevin; Chatfield, Matt; Drehman, Bethany; Pekarek, Nicole; Spath, Mike; Watland, Angie

    2007-02-01

    Roads may be one of the most common disturbances in otherwise continuous forested habitat in the southern Appalachian Mountains. Despite their obvious presence on the landscape, there is limited data on the ecological effects along a road edge or the size of the "road-effect zone." We sampled salamanders at current and abandoned road sites within the Nantahala National Forest, North Carolina (U.S.A.) to determine the road-effect zone for an assemblage of woodland salamanders. Salamander abundance near the road was reduced significantly, and salamanders along the edges were predominantly large individuals. These results indicate that the road-effect zone for these salamanders extended 35 m on either side of the relatively narrow, low-use forest roads along which we sampled. Furthermore, salamander abundance was significantly lower on old, abandoned logging roads compared with the adjacent upslope sites. These results indicate that forest roads and abandoned logging roads have negative effects on forest-dependent species such as plethodontid salamanders. Our results may apply to other protected forests in the southern Appalachians and may exemplify a problem created by current and past land use activities in all forested regions, especially those related to road building for natural-resource extraction. Our results show that the effect of roads reached well beyond their boundary and that abandonment or the decommissioning of roads did not reverse detrimental ecological effects; rather, our results indicate that management decisions have significant repercussions for generations to come. Furthermore, the quantity of suitable forested habitat in the protected areas we studied was significantly reduced: between 28.6% and 36.9% of the area was affected by roads. Management and policy decisions must use current and historical data on land use to understand cumulative impacts on forest-dependent species and to fully protect biodiversity on national lands.

  7. Road safety performance indicators for the interurban road network.

    PubMed

    Yannis, George; Weijermars, Wendy; Gitelman, Victoria; Vis, Martijn; Chaziris, Antonis; Papadimitriou, Eleonora; Azevedo, Carlos Lima

    2013-11-01

    Various road safety performance indicators (SPIs) have been proposed for different road safety research areas, mainly as regards driver behaviour (e.g. seat belt use, alcohol, drugs, etc.) and vehicles (e.g. passive safety); however, no SPIs for the road network and design have been developed. The objective of this research is the development of an SPI for the road network, to be used as a benchmark for cross-region comparisons. The developed SPI essentially makes a comparison of the existing road network to the theoretically required one, defined as one which meets some minimum requirements with respect to road safety. This paper presents a theoretical concept for the determination of this SPI as well as a translation of this theory into a practical method. Also, the method is applied in a number of pilot countries namely the Netherlands, Portugal, Greece and Israel. The results show that the SPI could be efficiently calculated in all countries, despite some differences in the data sources. In general, the calculated overall SPI scores were realistic and ranged from 81 to 94%, with the exception of Greece where the SPI was relatively lower (67%). However, the SPI should be considered as a first attempt to determine the safety level of the road network. The proposed method has some limitations and could be further improved. The paper presents directions for further research to further develop the SPI. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Web Accessibility in Europe and the United States: What We Are Doing to Increase Inclusion

    ERIC Educational Resources Information Center

    Wheaton, Joseph; Bertini, Patrizia

    2007-01-01

    Accessibility is hardly a new problem and certainly did not originate with the Web. Lack of access to buildings long preceded the call for accessible Web content. Although it is unlikely that rehabilitation educators look at Web page accessibility with indifference, many may also find it difficult to implement. The authors posit three reasons why…

  9. Identification of rehabilitation needs after a stroke: an exploratory study

    PubMed Central

    Talbot, Lise R; Viscogliosi, Chantal; Desrosiers, Johanne; Vincent, Claude; Rousseau, Jacqueline; Robichaud, Line

    2004-01-01

    Background Services to meet adequate rehabilitation needs of elderly stroke survivors are not always provided. Indeed, since 1995, in the wake of the Quebec shift to ambulatory care, home care services, mainly those related to rehabilitation of the elderly, are either unavailable or incomplete. The aim of this study was to examine the rehabilitation needs of this clientele from their hospitalization to their reintegration into the community. Methods The "Handicap Production Process" conceptual approach was chosen to help identify the rehabilitation needs of persons affected by physical or cognitive disabilities due to the interactions between personal and environmental factors, and (activities of daily living, social roles). This qualitative exploratory study was performed in 2003. Data were collected among four groups of experts: patients, caregivers, health care providers and administrators. Data triangulation was used to ensure a rigorous analysis and validity of the results. Results Unfulfilled needs could be found in the categories of pertaining to residence, community living, psychological and emotional needs. Indeed, it appears that a psychological follow-up to discuss acceptance and consequences of non-acceptance would facilitate mid-to long-term rehabilitation. Conclusion Improving accessibility to healthcare services, respecting priority parking spaces for the disabled as well as promoting public awareness would enable a better social reintegration and recovery of social roles, thus limiting the onset of handicap situations. PMID:15383147

  10. Identification of rehabilitation needs after a stroke: an exploratory study.

    PubMed

    Talbot, Lise R; Viscogliosi, Chantal; Desrosiers, Johanne; Vincent, Claude; Rousseau, Jacqueline; Robichaud, Line

    2004-09-21

    Services to meet adequate rehabilitation needs of elderly stroke survivors are not always provided. Indeed, since 1995, in the wake of the Quebec shift to ambulatory care, home care services, mainly those related to rehabilitation of the elderly, are either unavailable or incomplete. The aim of this study was to examine the rehabilitation needs of this clientele from their hospitalization to their reintegration into the community. The "Handicap Production Process" conceptual approach was chosen to help identify the rehabilitation needs of persons affected by physical or cognitive disabilities due to the interactions between personal and environmental factors, and (activities of daily living, social roles). This qualitative exploratory study was performed in 2003. Data were collected among four groups of experts: patients, caregivers, health care providers and administrators. Data triangulation was used to ensure a rigorous analysis and validity of the results. Unfulfilled needs could be found in the categories of pertaining to residence, community living, psychological and emotional needs. Indeed, it appears that a psychological follow-up to discuss acceptance and consequences of non-acceptance would facilitate mid-to long-term rehabilitation. Improving accessibility to healthcare services, respecting priority parking spaces for the disabled as well as promoting public awareness would enable a better social reintegration and recovery of social roles, thus limiting the onset of handicap situations.

  11. Risk assessment on an Argentinean road with a dynamic traffic simulator

    NASA Astrophysics Data System (ADS)

    Voumard, Jérémie; Baumann, Valérie; Jaboyedoff, Michel; Derron, Marc-Henri; Penna, Ivanna

    2014-05-01

    The National Route 7 in Argentina is one of the most important corridors crossing the Andean Cordillera. It concentrates most of the traffic related to the Southern Common Market (MERCOSUR), it also connects Mendoza city (the fourth most populated in Argentina) with Santiago de Chile (the Chile capital city), and is used by tourists to access to the Aconcagua National park, Puente del Inca natural monument, skiing resorts, and to local displacements for the villages along the Mendoza valley. The road crosses the Andes through the Mendoza river valley at an elevation between 2'000 and 3'000 m. The traffic (2500 vehicles/day) is composed of motorcycles, cars and pickup trucks, trucks without trailer, buses, and semi-trailer trucks. Debris flows developed along tributaries of the Mendoza River, and due to remobilization of talus materials, impact frequently the road, causing traffic disruptions, bridges damages, etc. Rock falls detached from highly fractured outcrops also impact frequently the road, causing sometimes casualties. The aim of this study is to evaluate risk along sections of the National Road 7 develop along the Mendoza river, using a dynamic traffic simulator based on MATLAB© routine. The dynamic traffic simulator developed for natural hazards events on roads consider different scenarios based on traffic speeds, vehicle types, interactions types, road properties and natural processes. Here we show that vehicle types and traffic variations may influence the risk estimation. The analyzed risk on several critical sections of the National Route 7 demonstrates that risk may significantly increase: 1) on sinuous sections, steep sections and because of road conditions changes (exit of tunnel, bridges, road width, etc.) because of decreasing vehicle speed, particularly with semi-trailer trucks; 2) when an event, such a debris flow, occurs and generates a vehicle tailback increasing their duration presence in the risk area.

  12. On-Road Driving Performance by Persons with Hemianopia and Quadrantanopia

    PubMed Central

    Wood, Joanne M.; McGwin, Gerald; Elgin, Jennifer; Vaphiades, Michael S.; Braswell, Ronald A.; DeCarlo, Dawn K.; Kline, Lanning B.; Meek, G. Christine; Searcey, Karen; Owsley, Cynthia

    2009-01-01

    Purpose This study was designed to examine the on-road driving performance of drivers with hemianopia and quadrantanopia compared with age-matched controls. Methods Participants included persons with hemianopia or quadrantanopia and those with normal visual fields. Visual and cognitive function tests were administered, including confirmation of hemianopia and quadrantanopia through visual field testing. Driving performance was assessed using a dual-brake vehicle and monitored by a certified driving rehabilitation specialist. The route was 14.1 miles of city and interstate driving. Two “back-seat” evaluators masked to drivers’ clinical characteristics independently assessed driving performance using a standard scoring system. Results Participants were 22 persons with hemianopia and 8 with quadrantanopia (mean age, 53 ± 20 years) and 30 participants with normal fields (mean age, 52 ± 19 years). Inter-rater agreement for back-seat evaluators was 96%. All drivers with normal fields were rated as safe to drive, while 73% (16/22) of hemianopic and 88% (7/8) of quadrantanopic drivers received safe ratings. Drivers with hemianopia or quadrantanopia who displayed on-road performance problems tended to have difficulty with lane position, steering steadiness, and gap judgment compared to controls. Clinical characteristics associated with unsafe driving were slowed visual processing speed, reduced contrast sensitivity and visual field sensitivity. Conclusions Some drivers with hemianopia or quadrantanopia are fit to drive compared with age-matched control drivers. Results call into question the fairness of governmental policies that categorically deny licensure to persons with hemianopia or quadrantanopia without the opportunity for on-road evaluation. PMID:18936138

  13. Rehabilitation service utilization models: changes in the opportunity structure for disabled women.

    PubMed

    Altman, B M; Smith, R T

    1990-01-01

    The focus of this paper is the opportunity structure for rehabilitation and subsequent outcome for disabled women, in comparison with disabled men. From evidence cited in the literature the differential provision of rehabilitation and other supportive services to disabled women suggests variation in outcome, based on two analytic service utilization models of rehabilitation: medical and psychosocial. Aggregate trend data (1972 and 1978) were used in the analysis of adult disabled groups, by gender and selected disabling conditions. There are two striking results from the analysis of these data sets. One indicates that receipt of rehabilitation is greatly influenced by sociodemographic factors, particularly gender and age. A detailed examination of the combination effects of gender and other sociodemographic variables shows that there are subtleties, such as an interaction between race and gender and education and gender, as well as between age and gender, that put uneducated, younger, white women at a disadvantage in their access to rehabilitation resources. The analysis of these sociodemographic factors over two points in time, however, demonstrates what can be considered a diffusion of the distinctions of social inequality, probably due to changes in rehabilitation legislation that redefined eligibility criteria for rehabilitation services and expanded programme goals. The second result of note is that neither form of rehabilitation is associated with a positive outcome, in this case ability to work. In the earlier data set (1972), indications were that neither the medical model of rehabilitation nor the psychosocial model were effective in returning the individual to the work role. This was true for both men and women.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Rural rustic roads improvement program

    DOT National Transportation Integrated Search

    2002-11-11

    This program provides for the initial pavement of rural roads. Under the Rural Rustic Roads Program, the governing body of any county, in consultation with the Department, may designate a road or road segment as a Rural Rustic Road provided such road...

  15. Road funds and road maintenance : an Asian perspective

    DOT National Transportation Integrated Search

    2003-07-01

    It is widely accepted that roads play an important role in development, and help reduce poverty. To realize their potential contribution, however, roads need to be properly maintained. In many of the Asian Development Bank's (ADB's) developing member...

  16. Road accident rates: strategies and programmes for improving road traffic safety.

    PubMed

    Goniewicz, K; Goniewicz, M; Pawłowski, W; Fiedor, P

    2016-08-01

    Nowadays, the problem of road accident rates is one of the most important health and social policy issues concerning the countries in all continents. Each year, nearly 1.3 million people worldwide lose their life on roads, and 20-50 million sustain severe injuries, the majority of which require long-term treatment. The objective of the study was to identify the most frequent, constantly occurring causes of road accidents, as well as outline actions constituting a basis for the strategies and programmes aiming at improving traffic safety on local and global levels. Comparative analysis of literature concerning road safety was performed, confirming that although road accidents had a varied and frequently complex background, their causes have changed only to a small degree over the years. The causes include: lack of control and enforcement concerning implementation of traffic regulation (primarily driving at excessive speed, driving under the influence of alcohol, and not respecting the rights of other road users (mainly pedestrians and cyclists), lack of appropriate infrastructure and unroadworthy vehicles. The number of fatal accidents and severe injuries, resulting from road accidents, may be reduced through applying an integrated approach to safety on roads. The strategies and programmes for improving road traffic should include the following measures: reducing the risk of exposure to an accident, prevention of accidents, reduction in bodily injuries sustained in accidents, and reduction of the effects of injuries by improvement of post-accident medical care.

  17. [Clinical application of super-link system theory in spinal cord injury patients during rehabilitation stage].

    PubMed

    Chen, Hsiao-Yu

    2008-04-01

    The purpose of this paper is to introduce Super-Link System Theory, which is a theory of spinal cord injury rehabilitation. This theory has been developed using the grounded theory research method. By explaining the procedure for establishing a super-link system the paper explains the complex structure of this theory. Super-Link System Theory emphasizes that rehabilitation nurses 'build up their interpersonal relationships' with clients, family caregivers, the interdisciplinary team, and the community, and attempt to 'establish links' among them. They know these links have to be made with appropriate 'timing', and must be able to access the appropriate people when necessary. Super-link systems include the following four links: link to client with spinal cord injury, link to family caregiver, link to interdisciplinary rehabilitation team, and link to community. It can enable rehabilitation nurses to provide a better quality of nursing care to clients and their family caregivers, as well as promote their professional position in the interdisciplinary rehabilitation team.

  18. Road traffic injury on rural roads in Tanzania: measuring the effectiveness of a road safety program.

    PubMed

    Zimmerman, Karen; Jinadasa, Deepani; Maegga, Bertha; Guerrero, Alejandro

    2015-01-01

    Road traffic injuries (RTIs) are a major public health burden, especially in low- and middle-income countries. There is limited data on RTIs in low-volume, rural African settings. This study attempted to survey all individuals living in households within 200 m of two low-volume rural roads in Tanzania and to collect data on RTIs. Local communities and users of the Bago to Talawanda road (intervention site) and Kikaro to Mihuga road (control site) were targeted and received an intensive program of road safety measures tailored using the crash characteristics of the baseline sample. Demographic data on all household members were collected, and those individuals who suffered an RTI in the previous 3 months had comprehensive information collected about the crash characteristics and the socioeconomic impact. The follow-up data collection occurred nine months after the baseline data were collected. The majority of crashes that caused an RTI involved a motorcycle (71%) and the majority of victims were male (82%) with an average age of 27. Injuries to the legs (55%) were most common and the average length of time away from normal activity was 27 (±33) days. RTI incidence at the intervention site increased during the course of the study (incidence before vs. incidence after) and was unchanged in the community control (incidence before vs. incidence after). The incidence of RTIs in the low-volume rural setting is unacceptably high and most commonly associated with motorcycles. The change in incidence is unreliable due to logistic restraints of the project and more research is needed to quantify the impact of various RTI prevention strategies in this setting. This study provides insight into road traffic injuries on low-volume rural roads, areas where very little research has been captured. Additionally, it provides a replicable study design for those interested in collecting similar data on low-volume rural roads.

  19. 78 FR 38840 - Final Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-28

    ... Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY: Office of Special Education and... Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for a Rehabilitation...

  20. Barriers to rehabilitative care for young breast cancer survivors: a qualitative understanding.

    PubMed

    Miedema, Baukje; Easley, Julie

    2012-06-01

    The goal of this study was to assess the rehabilitation needs of young women breast cancer survivors under the age of 50 and to identify factors that may impact or prevent cancer rehabilitation utilization. Utilizing a grounded theory methodology, 35 young breast cancer survivors were interviewed twice in four Atlantic Canadian provinces. A considerable number of barriers exist to receiving rehabilitative care post-treatment for young breast cancer survivors. The systemic barriers include the lack of availability of services, travel issues, cost of services, and the lack of support to address the unique needs for this age group. However, the most complicated barriers to accessing rehabilitative care were personal barriers which related more to choice and circumstances, such as the lack of time due to family responsibilities and appointment fatigue. Many of these personal barriers were rooted in the complex set of gender roles of young women as patients, mothers, workers, and caregivers. The contexts of young women's lives can have a substantial impact on their decisions to seek and receive rehabilitative care after breast cancer treatment. The systemic barriers can be reduced by introducing more services or financial assistance; however, the personal barriers to rehabilitation services are difficult to ameliorate due to the complex set of roles within and outside the family for this group of young breast cancer survivors. Health care providers need to take into consideration the multiple contexts of women's lives when developing and promoting breast cancer rehabilitation services and programs.

  1. Gravel roads management : volume 1, gravel roads management.

    DOT National Transportation Integrated Search

    2010-10-01

    This report establishes procedures for managing dirt and gravel roads, with a primary focus on smaller agencies, such as Wyoming counties, that must manage their roads with very limited resources. The report strives, first, to guide and assist smalle...

  2. Rehabilitation

    MedlinePlus

    ... help. A younger person who has had a heart attack may go through cardiac rehabilitation to try to return to work and normal activities. Someone with a lung disease may get pulmonary rehabilitation to be able to breathe better and improve their quality of life.

  3. Long-term hand tele-rehabilitation on the PlayStation 3: benefits and challenges.

    PubMed

    Burdea, Grigore C; Jain, Abhishek; Rabin, Bryan; Pellosie, Richard; Golomb, Meredith

    2011-01-01

    Rehabilitation interventions for the hand have shown benefits for children with Hemiplegia due to cerebral palsy or traumatic brain injury. Longer interventions are facilitated if training is provided in the patient's home, due to easier access to care and reduced impact on school or work activities. Providing remote rehabilitation over lengthy periods of time has however its own challenges. This paper presents two pediatric patients with hemiplegia, who practiced virtual hand rehabilitation games using a modified PlayStation 3 and 5DT sensing gloves. Despite severe initial hand spasticity, and occasional technology shortcomings, the subjects practiced for about 14 months, and 6 months, respectively. Game performance data for the second patient is presented. Follow-up evaluations 14 months from the removal of the PlayStation 3 from the home of the child with cerebral palsy showed that the patient had good retention in terms of grasp strength, hand function and bone health. Challenges of long-term home tele-rehabilitation are also discussed.

  4. A web-based intervention to promote applications for rehabilitation: a study protocol for a randomized controlled trial.

    PubMed

    Spanier, Katja; Streibelt, Marco; Ünalan, Firat; Bethge, Matthias

    2015-09-29

    The German welfare system follows the principle "rehabilitation rather than pension," but more than the half of all disability pensioners did not utilize medical rehabilitation before their early retirement. A major barrier is the application procedure. Lack of information about the opportunity to utilize rehabilitation services restricts the chance to improve work ability and to prevent health-related early retirement by rehabilitation programs. The establishment of new access paths to medical rehabilitation services was, therefore, identified as a major challenge for rehabilitation research in a recent expertise. Thus, a web-based information guide was developed to support the application for a medical rehabilitation program. For this study, the development of a web-based information guide was based on the health action process approach. Four modules were established. Three modules support forming an intention by strengthening risk perception (module 1), positive outcome expectancies (module 2) and self-efficacy (module 3). A fourth module aims at the realization of actual behavior by offering instructions on how to plan and to push the application process. The study on the effectiveness of the web-based information guide will be performed as a randomized controlled trial. Persons aged 40 to 59 years with prior sick leave benefits during the preceding year will be included. A sample of 16,000 persons will be randomly drawn from the registers of 3 pension insurance agencies. These persons will receive a questionnaire to determine baseline characteristics. Respondents of this first survey will be randomly allocated either to the intervention or the control group. Both study groups will then receive letters with general information about rehabilitation. The intervention group will additionally receive a link to the web-based information guide. After 1 year, a second survey will be conducted. Additionally, administrative data will be used to determine if participants

  5. First Responders and Prehospital Care for Road Traffic Injuries in Malawi.

    PubMed

    Chokotho, Linda; Mulwafu, Wakisa; Singini, Isaac; Njalale, Yasin; Maliwichi-Senganimalunje, Limbika; Jacobsen, Kathryn H

    2017-02-01

    Introduction Road traffic collisions are a common cause of injuries and injury-related deaths in sub-Saharan Africa (SSA). Basic prehospital care can be the difference between life and death for injured drivers, passengers, and pedestrians. Problem This study examined the challenges associated with current first response practices in Malawi. In April 2014, focus groups were conducted in two areas of Malawi: Karonga (in the Northern Region) and Blantyre (in the Southern Region; both are along the M1 highway), and a qualitative synthesis approach was used to identify themes. All governmental and nongovernmental first response organizations identified by key informants were contacted, and a checklist was used to identify the services they offer. Access to professional prehospital care in Malawi is almost nonexistent, aside from a few city fire departments and private ambulance services. Rapid transportation to a hospital is usually the primary goal of roadside care because of limited first aid knowledge and a lack of access to basic safety equipment. The key informants recommended: expanding community-based first aid training; emphasizing umunthu (shared humanity) to inspire bystander involvement in roadside care; empowering local leaders to coordinate on-site responses; improving emergency communication systems; equipping traffic police with road safety gear; and expanding access to ambulance services. Prehospital care in Malawi would be improved by the creation of a formal network of community leaders, police, commercial drivers, and other lay volunteers who are trained in basic first aid and are equipped to respond to crash sites to provide roadside care to trauma patients and prepare them for safe transport to hospitals. Chokotho L , Mulwafu W , Singini I , Njalale Y , Maliwichi-Senganimalunje L , Jacobsen KH . First responders and prehospital care for road traffic injuries in Malawi. Prehosp Disaster Med. 2017;32(1):14-19.

  6. Quantifying the influence of safe road systems and legal licensing age on road mortality among young adolescents: steps towards system thinking.

    PubMed

    Twisk, Divera; Commandeur, Jacques J F; Bos, Niels; Shope, Jean T; Kok, Gerjo

    2015-01-01

    Based on existing literature, a system thinking approach was used to set up a conceptual model on the interrelationships among the components influencing adolescent road mortality, distinguishing between components at the individual level and at the system level. At the individual level the role of risk behaviour (sometimes deliberate and sometimes from inexperience or other non-deliberate causes) in adolescent road mortality is well documented. However, little is known about the extent to which the 'road system' itself may also have an impact on younger adolescents' road mortality. This, by providing a safe or unsafe road environment for all road users (System-induced exposure) and by allowing access to high-risk vehicles at a young or older age through the legal licensing age. This study seeks to explore these relationships by analysing the extent to which the road mortality of 10 to 17 year olds in various jurisdictions can be predicted from the System-induced Exposure (SiE) in a jurisdiction and from its legal licensing age to drive motor vehicles. SiE was operationalized as the number of road fatalities per 10(5) inhabitants/all ages together, but excluding the 10 to 17 year olds. Data on road fatalities during the years 2001 through 2008 were obtained from the OECD International Road Traffic Accident Database (IRTAD) and from the USA NHTSA's Fatality Analysis Reporting System (FARS) database for 29 early and 10 late licensing jurisdictions. Linear mixed models were fitted with annual 'Adolescent road mortality per capita' for 2001 through 2008 as the dependent variable, and time-dependent 'SiE' and time-independent 'Licensing system' as predictor variables. To control for different levels of motorisation, the time-dependent variable 'Annual per capita vehicle distance travelled' was used as a covariate. Licensing system of a jurisdiction was entered as a categorical predictor variable with late licensing countries as a baseline group. The study found support

  7. Advanced Vehicle Testing Activity Cold Weather On-road Testing of the Chevrolet Volt

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Smart, John

    This report details cold weather on-road testing of a Chevrolet Volt. It quantifies changes in efficiency and electric range as ambient temperature changes. It will be published to INL's AVTA website as an INL technical report and will be accessible to the general public.

  8. Comprehensive Outpatient Rehabilitation Program: Hospital-Based Stroke Outpatient Rehabilitation.

    PubMed

    Rice, Danielle; Janzen, Shannon; McIntyre, Amanda; Vermeer, Julianne; Britt, Eileen; Teasell, Robert

    2016-05-01

    Few studies have considered the effectiveness of outpatient rehabilitation programs for stroke patients. The objective of this study was to assess the effectiveness of a hospital-based interdisciplinary outpatient stroke rehabilitation program with respect to physical functioning, mobility, and balance. The Comprehensive Outpatient Rehabilitation Program provides a hospital-based interdisciplinary approach to stroke rehabilitation in Southwestern Ontario. Outcome measures from physiotherapy and occupational therapy sessions were available at intake and discharge from the program. A series of paired sample t-tests were performed to assess patient changes between time points for each outcome measure. A total of 271 patients met the inclusion criteria for analysis (56.1% male; mean age = 62.9 ± 13.9 years). Significant improvements were found between admission and discharge for the Functional Independence Measure, grip strength, Chedoke-McMaster Stroke Assessment, two-minute walk test, maximum walk test, Timed Up and Go, Berg Balance Scale, and one-legged stance (P < .003 for all). The findings indicate that an interdisciplinary rehabilitation program was effective at improving the physical functioning, mobility, and balance of individuals after a stroke. A hospital-based, stroke-specific rehabilitation program should be considered when patients continue to experience deficits after inpatient rehabilitation. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  9. Access to the Arts through Assistive Technology.

    ERIC Educational Resources Information Center

    Frame, Charles

    Personnel in the rehabilitation field have come to recognize the possibilities and implications of computers as assistive technology for disabled persons. This manual provides information on how to adapt the Unicorn Board, Touch Talker/Light Talker overlays, the Adaptive Firmware Card setup disk, and Trace-Transparent Access Module (T-TAM) to…

  10. Nilsson's Power Model connecting speed and road trauma: applicability by road type and alternative models for urban roads.

    PubMed

    Cameron, M H; Elvik, R

    2010-11-01

    Nilsson (1981) proposed power relationships connecting changes in traffic speeds with changes in road crashes at various levels of injury severity. Increases in fatal crashes are related to the 4(th) power of the increase in mean speed, increases in serious casualty crashes (those involving death or serious injury) according to the 3(rd) power, and increases in casualty crashes (those involving death or any injury) according to the 2(nd) power. Increases in numbers of crash victims at cumulative levels of injury severity are related to the crash increases plus higher powers predicting the number of victims per crash. These relationships are frequently applied in OECD countries to estimate road trauma reductions resulting from expected speed reductions. The relationships were empirically derived based on speed changes resulting from a large number of rural speed limit changes in Sweden during 1967-1972. Nilsson (2004) noted that there had been very few urban speed limit changes studied to test his power model. This paper aims to test the assumption that the model is equally applicable in all road environments. It was found that the road environment is an important moderator of Nilsson's power model. While Nilsson's model appears satisfactory for rural highways and freeways, the model does not appear to be directly applicable to traffic speed changes on urban arterial roads. The evidence of monotonically increasing powers applicable to changes in road trauma at increasing injury severity levels with changes in mean speed is weak. The estimated power applicable to serious casualties on urban arterial roads was significantly less than that on rural highways, which was also significantly less than that on freeways. Alternative models linking the parameters of speed distributions with road trauma are reviewed and some conclusions reached for their use on urban roads instead of Nilsson's model. Further research is needed on the relationships between serious road trauma

  11. Advances in rehabilitation medicine.

    PubMed

    Ng, Yee Sien; Chew, Effie; Samuel, Geoffrey S; Tan, Yeow Leng; Kong, Keng He

    2013-10-01

    Rehabilitation medicine is the medical specialty that integrates rehabilitation as its core therapeutic modality in disability management. More than a billion people worldwide are disabled, and the World Health Organization has developed the International Classification of Functioning, Disability and Health as a framework through which disability is addressed. Herein, we explore paradigm shifts in neurorehabilitation, with a focus on restoration, and provide overviews on developments in neuropharmacology, rehabilitation robotics, virtual reality, constraint-induced therapy and brain stimulation. We also discuss important issues in rehabilitation systems of care, including integrated care pathways, very early rehabilitation, early supported discharge and telerehabilitation. Finally, we highlight major new fields of rehabilitation such as spasticity management, frailty and geriatric rehabilitation, intensive care and cancer rehabilitation.

  12. Experience of exclusion: A framework analysis of socioeconomic factors affecting cardiac rehabilitation participation among patients with acute coronary syndrome.

    PubMed

    Pedersen, Maria; Overgaard, Dorthe; Andersen, Ingelise; Baastrup, Marie; Egerod, Ingrid

    2017-12-01

    The Danish public healthcare system provides comprehensive care based on the principle of equal access. However, it is well documented that patients with low socioeconomic position are less likely to participate in cardiac rehabilitation. More knowledge is needed to understand this phenomenon. The aim of the study was to explore the patient experience of barriers to completion of phase II cardiac rehabilitation, and to investigate the impact of socioeconomic factors on completion of cardiac rehabilitation. The study had a qualitative explorative design using semi-structured individual or dyadic interviews with patients ( n = 24) and close relatives ( n = 12). Informants were sampled from a quantitative prospective study of 302 patients with acute coronary syndrome and data were analyzed using the framework method. Patients in different socioeconomic groups were challenged by a rigid and non-individualized rehabilitation program. A total of five themes were identified that might explain non-participation in cardiac rehabilitation: exclusion by time and place, exclusion by health beliefs, exclusion from counseling, exclusion by alienation, and exclusion of relatives. The themes were described in a matrix of socioeconomic factors of age, sex, education and employment. Patients in various socioeconomic subgroups felt excluded from cardiac rehabilitation for different reasons. This study supports earlier findings and provides examples of real-life issues that need to be addressed to prevent attrition and encourage participation. Equal access to cardiac rehabilitation can only be reached if the physical and psychological needs of patient and family are met by tailoring therapy to consider age, sex, education and employment groups.

  13. Integration of students with physical impairment in Canadian university rehabilitation sciences programs.

    PubMed

    Guitard, Paulette; Duguay, Elise; Thériault, France-Andrée; Sirois, Nathalie Julie; Lajoie, Mélissa

    2010-03-01

    The purpose of this research was two-fold. First, it sought to determine if Canadian rehabilitation science programs are equipped to admit students with physical impairments and, second, to document the experience of these students. A survey (questionnaire) conducted among all Canadian university rehabilitation science programs (n=34) and interviews with students with physical impairments (n=3) from one university help better delineate this problem. Twenty-three programs completed the survey. Of these, 21 (91%) rehabilitation science programs have admitted students with a variety of physical impairments. Programs have access to their university's Special Service Center to help answer the needs of these students. Strategies have been developed to overcome the difficulties encountered and to meet the programs' requirements. Canadian university rehabilitation science programs seem well equipped to facilitate the integration of individuals with physical impairments. Students report a positive university experience; however, they voice several recommendations to smooth the integration process. Although significant efforts have been made to facilitate the integration process of students with physical limitations, adjustments are still warranted.

  14. Road rage and road traffic accidents among commercial vehicle drivers in Lahore, Pakistan.

    PubMed

    Shaikh, M A; Shaikh, I A; Siddiqui, Z

    2012-04-01

    Road rage and road traffic accidents increase the burden of morbidity and mortality in a population. A cross-sectional survey with convenience sampling was conducted among commercial vehicle drivers in Lahore, Pakistan (n = 901) to record their behaviours/experiences regarding road rage and road traffic accidents. Respondents were asked about incidents of shouting/cursing/rude gestures or threats to physically hurt the person/vehicle, by others or themselves, in the previous 24 hours or 3 months, and their involvement in road traffic accidents in the previous 12 months. Auto-rickshaw drivers were significantly more likely to report various road rage experiences/behaviours and involvement in accidents compared with bus and wagon drivers. A total of 112 respondents (12.4%) reported being involved in a road traffic accident in the previous 12 months but traffic police did not record the accident in 52.7% of cases. The results of this study underline the need to improve road safety in Pakistan.

  15. Road Risk Modeling and Cloud-Aided Safety-Based Route Planning.

    PubMed

    Li, Zhaojian; Kolmanovsky, Ilya; Atkins, Ella; Lu, Jianbo; Filev, Dimitar P; Michelini, John

    2016-11-01

    This paper presents a safety-based route planner that exploits vehicle-to-cloud-to-vehicle (V2C2V) connectivity. Time and road risk index (RRI) are considered as metrics to be balanced based on user preference. To evaluate road segment risk, a road and accident database from the highway safety information system is mined with a hybrid neural network model to predict RRI. Real-time factors such as time of day, day of the week, and weather are included as correction factors to the static RRI prediction. With real-time RRI and expected travel time, route planning is formulated as a multiobjective network flow problem and further reduced to a mixed-integer programming problem. A V2C2V implementation of our safety-based route planning approach is proposed to facilitate access to real-time information and computing resources. A real-world case study, route planning through the city of Columbus, Ohio, is presented. Several scenarios illustrate how the "best" route can be adjusted to favor time versus safety metrics.

  16. Optimizing the process of recovery after road network break-up

    NASA Astrophysics Data System (ADS)

    Bíl, Michal; Vodák, Rostislav; Křivánková, Zuzana

    2016-04-01

    A functioning road network provides accessibility to municipalities, important services and facilities. This basic role of the network can be disrupted by natural disasters which usually affect large areas and cause temporal blockages or even destruction of many roads at the same time. This often leads to road network break-up, when a number of disconnected parts emerge. These parts are often of varying importance to society. Some of them may contain large cities or important facilities such as hospitals. This should be reflected during reconnection works when the most important parts of the network should be reconnected among the first in order to reduce the impact of the event. Decision makers and crisis managers, however, do still not have any dynamic tool which might help them with prioritizing the necessary steps. In our presentation we introduce an algorithm and examples of suitable loss functions which enable us to rapidly identify isolated parts of the network, evaluate them and consequently establish an optimal ranked sequence of interrupted links which have to be repaired to reduce the consequences of the disasters.

  17. Stroke Rehabilitation.

    PubMed

    Belagaje, Samir R

    2017-02-01

    Rehabilitation is an important aspect of the continuum of care in stroke. With advances in the acute treatment of stroke, more patients will survive stroke with varying degrees of disability. Research in the past decade has expanded our understanding of the mechanisms underlying stroke recovery and has led to the development of new treatment modalities. This article reviews and summarizes the key concepts related to poststroke recovery. Good data now exist by which one can predict recovery, especially motor recovery, very soon after stroke onset. Recent trials have not demonstrated a clear benefit associated with very early initiation of rehabilitative therapy after stroke in terms of improvement in poststroke outcomes. However, growing evidence suggests that shorter and more frequent sessions of therapy can be safely started in the first 24 to 48 hours after a stroke. The optimal amount or dose of therapy for stroke remains undetermined, as more intensive treatments have not been associated with better outcomes compared to standard intensities of therapy. Poststroke depression adversely affects recovery across a variety of measures and is an important target for therapy. Additionally, the use of selective serotonin reuptake inhibitors (SSRIs) appears to benefit motor recovery through pleiotropic mechanisms beyond their antidepressant effect. Other pharmacologic approaches also appear to have a benefit in stroke rehabilitation. A comprehensive rehabilitation program is essential to optimize poststroke outcomes. Rehabilitation is a process that uses three major principles of recovery: adaptation, restitution, and neuroplasticity. Based on these principles, multiple different approaches, both pharmacologic and nonpharmacologic, exist to enhance rehabilitation. In addition to neurologists, a variety of health care professionals are involved in stroke rehabilitation. Successful rehabilitation involves understanding the natural history of stroke recovery and a

  18. Educational content related to postcolonialism and indigenous health inequities recommended for all rehabilitation students in Canada: a qualitative study.

    PubMed

    Hojjati, Ala; Beavis, Allana S W; Kassam, Aly; Choudhury, Daniel; Fraser, Michelle; Masching, Renée; Nixon, Stephanie A

    2017-10-02

    Postcolonial analysis can help rehabilitation providers understand how colonization and racialization create and sustain health inequities faced by indigenous peoples. However, there is little guidance in the literature regarding inclusion of postcolonialism within rehabilitation educational curricula. Therefore, this study explored perspectives regarding educational content related to postcolonialism and indigenous health that rehabilitation students in Canada should learn to increase health equity. This qualitative study involved in-depth, semi-structured interviews with 19 individuals with insight into postcolonialism and health in Canada. Data were analyzed collaboratively to identify, code, and translate themes according to a structured six-phase method. Four themes emerged regarding educational content for rehabilitation students: (1) the historic trauma of colonization and its ongoing impacts on rehabilitation for indigenous peoples; (2) disproportionate health burden and inequitable access to health services; (3) how rehabilitation is related to Indigenous ways of knowing; and (4) why rehabilitation is well-positioned to address health inequities with Indigenous Peoples. Results call for reflection on assumptions underpinning the rehabilitation professions that may unintentionally reinforce health inequities. A postcolonial lens can help rehabilitation educators promote culturally safe services for people whose ill health and disability are linked to the effects of colonization. Implications for Rehabilitation Given the powerful, ongoing effects of colonization and racialization on health and disability, recommendation #24 from the Truth and Reconciliation Commission of Canada calls for the education of health professionals related to Indigenous history, rights, and anti-racism. However, there is little curricula on these areas in the education of rehabilitation professional students or in continuing education programs for practicing clinicians. This is the

  19. Assessment of Vestibular Rehabilitation Therapy Training and Practice Patterns

    PubMed Central

    Bush, Matthew L.; Dougherty, William

    2015-01-01

    Objective Vestibular rehabilitation therapy (VRT) can benefit patients with a variety of balance and vestibular disorders. This expanding field requires knowledgeable and experienced therapists; however, the practice and experience of those providing this care may vary greatly. The purpose of this study was to analyze variations in training and practice patterns among practicing vestibular rehabilitation therapists. Study Design Case-controlled cohort study Setting Investigation of outpatient physical therapy and audiology practices that offer vestibular rehabilitation conducted by a tertiary academic referral center. Main Outcome Measure Questionnaire-based investigation of level of training in vestibular disorders and therapy, practice patterns of vestibular rehabilitation, and referral sources for VRT patients. Results We identified 27 subjects within the state of Kentucky who practice vestibular rehabilitation and the questionnaire response rate was 63%. Responses indicated that 53% of respondents had no training in VRT during their professional degree program. Attendance of a course requiring demonstration of competence and techniques was 24% of participants. The development of VRT certification was significantly more favored by those who attended such courses compared with those who did not (p=0.01). 50% of therapists have direct access to patients without physician referrals. Conclusions There is a wide range of educational background and training among those practicing VRT. This variability in experience may affect care provided within some communities. Certification is not necessary for the practice of VRT but the development of certification is favored among some therapists to improve standardization of practice of this important specialty. PMID:25700790

  20. Distribution of green infrastructure along walkable roads ...

    EPA Pesticide Factsheets

    Low-income and minority neighborhoods frequently lack healthful resources to which wealthier communities have access. Though important, the addition of facilities such as recreation centers can be costly and take time to implement. Urban green infrastructure, such as street trees and other green space, can be a low-cost alternative to promote frequency and duration of outdoor physical activity. Street trees and other green space may increase outdoor physical activity levels by providing shade, improving aesthetics, and promoting social engagement. Though street trees and green space provide many benefits and are publicly accessible at all times, these resources are not evenly distributed between neighborhoods. An objective analysis of street tree cover and green space in 6,407 block groups across 10 urban areas was conducted using fine-scale land cover data. Distribution of green infrastructure was then analyzed by minority status, income, car ownership, housing density, and employment density. The objective measure of street tree cover and green space is based on 1-meter resolution land cover data from the U.S. EPA-led EnviroAtlas. Tree cover was analyzed along each side of walkable road centerlines in the areas where sidewalks are estimated to be. Green space was calculated within 25 meters of road centerlines. Percent tree cover and green space per city block were then summarized to census block group (CBG). CBG demographics from the U.S. Census and built env

  1. Health professionals' perceptions of cultural influences on stroke experiences and rehabilitation in Kuwait.

    PubMed

    Omu, Onutobor; Reynolds, Frances

    2012-01-01

    The aim of this study was to investigate the perceptions of health professionals who treat stroke patients in Kuwait regarding cultural influences on the experience of stroke and rehabilitation in Kuwait. Health professionals interviewed were from a variety of cultural backgrounds thus providing an opportunity to investigate how they perceived the influence of culture on stroke recovery and rehabilitation in Kuwait. Semi-structured interviews were carried out with 12 health professionals with current/recent stroke rehabilitation experience in Kuwait, followed by thematic analysis of the verbatim transcripts. The health professionals identified several features of the Kuwaiti culture that they believed affected the experiences of stroke patients. These were religious beliefs, family involvement, limited education and public information about stroke, prevailing negative attitudes toward stroke, access to finances for private treatment, social stigma and the public invisibility of disabled people, difficulties identifying meaningful goals for rehabilitation, and an acceptance of dependency linked with the widespread presence of maids and other paid assistants in most Kuwaiti homes. To offer culturally sensitive care, these issues should be taken into account during the rehabilitation of Kuwaiti stroke patients in their home country and elsewhere.

  2. Access and perceived need for physical and occupational therapy in chronic arthritis.

    PubMed

    Feldman, Debbie Ehrmann; Bernatsky, Sasha; Lévesque, Jean Frédéric; Van, My Tram; Houde, Michelle; April, Karine Toupin

    2010-01-01

    Physical and occupational therapy are beneficial for persons with chronic arthritis; however, access is problematic. The goal was to examine issues related to access to these services for patients with chronic arthritis. We used two data sources: 1) questionnaires sent to a random sample of 600 family physicians and to all 85 rheumatologists in the province of Quebec; and 2) interviews of 211 patients with physician-confirmed chronic arthritis recruited from 34 primary care settings in Quebec. Only 11.5% of family physicians and 31.7% of rheumatologists referred patients with rheumatoid arthritis (RA) to rehabilitation, whereas 60.4% of family doctors referred patients with osteoarthritis. Only 26.1% of patients felt that they required rehabilitation and this was associated with lower self-efficacy (OR: 0.84, 95% CI: 0.72, 0.99) and higher educational level (OR: 2.10, 95% CI: 1.01, 4.36). Family physicians are less likely to refer patients with RA to therapy. Only about a quarter of patients with chronic arthritis treated in primary care perceived the need for these services. Efforts to improve arthritis care should address education of physicians and patients regarding the benefits of rehabilitation and there should be efforts to increase therapy resources in order to enhance access.

  3. Rehabilitation robotics

    PubMed Central

    KREBS, H.I.; VOLPE, B.T.

    2015-01-01

    This chapter focuses on rehabilitation robotics which can be used to augment the clinician’s toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual’s functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We will provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we will then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We will present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost. PMID:23312648

  4. Rehabilitation robotics.

    PubMed

    Krebs, H I; Volpe, B T

    2013-01-01

    This chapter focuses on rehabilitation robotics which can be used to augment the clinician's toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual's functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs.

    PubMed

    McGurk, Susan R; Mueser, Kim T; Watkins, Melanie A; Dalton, Carline M; Deutsch, Heather

    2017-03-01

    Adding cognitive remediation to vocational rehabilitation services improves cognitive and work functioning in people with serious mental illness, but despite interest, the uptake of cognitive programs into community services has been slow. This study evaluated the feasibility of implementing an empirically supported cognitive remediation program in routine rehabilitation services at 2 sites. The Thinking Skills for Work (TSW) program was adapted for implementation at 2 sites of a large psychiatric rehabilitation agency providing prevocational services, but not community-based vocational services, which were provided off-site. Agency staff were trained to deliver TSW to clients with work or educational goals. Cognitive assessments were conducted at baseline and posttreatment, with work and school activity tracked for 2 years. Eighty-three participants enrolled in TSW, of whom 79.5% completed at least 6 of the 24 computer cognitive exercise sessions (M = 16.7) over an average of 18 weeks. Participants improved significantly from baseline to posttreatment in verbal learning and memory, speed of processing, and overall cognitive functioning. Over the follow-up, 25.3% of participants worked and 47.0% were involved in work or school activity. Higher work rates were observed at the site where participants had easier access to vocational services. The results support the feasibility of implementing the TSW program by frontline staff in agencies providing psychiatric rehabilitation, and suggest that ease of access to vocational services may influence work outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. Inpatient cancer rehabilitation: the experience of a national comprehensive cancer center.

    PubMed

    Shin, Ki Y; Guo, Ying; Konzen, Benedict; Fu, Jack; Yadav, Rajesh; Bruera, Eduardo

    2011-05-01

    Cancer rehabilitation is an important but often underutilized treatment in the comprehensive care of the cancer patient. Cancer patients have varying levels of access to rehabilitation services. Acute inpatient, inpatient consultation-based, and outpatient-based cancer rehabilitation services have been described in the literature. We will discuss acute inpatient cancer rehabilitation and some of its outcomes at the University of Texas MD Anderson Cancer Center in Houston, TX, which is the only national comprehensive cancer center to have its own acute inpatient rehabilitation unit dedicated solely to cancer patients. We retrospectively reviewed the inpatient medical records of consecutive inpatients admitted to the acute inpatient cancer rehabilitation unit from September 2008 to August 2009 for the following information: patient age, sex, primary tumor type, rehabilitation diagnoses, length of stay, discharge destination, and payer source. From September 2008 to August 2009, the physical medicine and rehabilitation service at MD Anderson Cancer Center had 1098 inpatient consultations, of which 427 patients were admitted to the inpatient rehabilitation unit with a mean length of stay of 11 days. Of the 427 patients, 73 (17%) were patients with primary neurologic-based tumor, 71 (16%) were patients with hematologic-based tumors, 48 (11%) were sarcoma patients, 35 (8%) were gastrointestinal tumor patients, 27 (6%) were head and neck tumor patients, 25 (6%) were prostate and bladder cancer patients, 24 (6%) were lung cancer patients, 22 (5%) were melanoma patients, 20 (5%) were breast cancer patients, 15 (4%) were renal cancer patients, 14 (3%) were gynecologic cancer patients, and 53 (12%) were patients with other types of cancer. Of the 427 patients admitted to acute inpatient rehabilitation at MD Anderson Cancer Center, 324 (76%) were discharged home, 72 (17%) went back to acute care service, 15 (4%) were sent to a skilled nursing facility, 9 (2%) were discharged

  7. Patients' Acceptance of the Use of Serious Games in Physical Rehabilitation in Morocco.

    PubMed

    Bonnechère, Bruno; Van Vooren, Mélissa; Jansen, Bart; Van Sint, Jan S; Rahmoun, Mohamed; Fourtassi, Maryam

    2017-10-01

    The aim of this study was to determine whether serious games especially customized for physical rehabilitation could be used in daily clinics with patients who are not familiar with informatics and/or new technologies and whether such a clinical approach would be culturally acceptable within a North African population to plan further clinical distribution if the hypothesis appears to be positive. Twenty-one patients participated in this study. Experiments were performed in the University Hospital Mohammed VI Oujda in Morocco. Patients were asked to perform physical rehabilitation exercises with dedicated serious games after their conventional therapy session. A questionnaire was used to evaluate patients' habits to rehabilitation exercises and satisfaction and expectation about the use of serious games for physical rehabilitation. The same problem of low participation in at-home exercises was found in Morocco compared to Europe and the United States: 60 (30)% of the exercises was performed by the patients in Morocco and 48 (28)% in Europe and the United States. Results of this study show that serious games are well accepted by the patients (100%) and that it can help during rehabilitation (90%). Most of the patients prefer exercises with games than conventional rehabilitation exercises. Even in a context of low education (participants in this study attended school until the age of 10 years old), and low access and knowledge about new technology and informatics, rehabilitation exercises within serious games seem to be an interesting option to motivate patients during rehabilitation with a physiotherapist. Such a system could be installed also at home to increase patient's participation.

  8. New Norcia Library Lecture: How Many Roads Must a Library Walk down?

    ERIC Educational Resources Information Center

    Missingham, Roxanne

    2012-01-01

    Libraries have welcomed the opportunity offered in the twenty-first century to place content on the roads and channels that are now available through the Internet to provide access to our rich and diverse collections. Amidst the enormous amount of information available the great collections sometimes are "dead ends" from a reader's point…

  9. Unofficial Road Building in the Brazilian Amazon: Dilemmas and Models for Road Governance

    NASA Technical Reports Server (NTRS)

    Perz, Stephen G.; Overdevest, Christine; Caldas, Marcellus M.; Walker, Robert T.; Arima, Eugenio Y.

    2007-01-01

    Unofficial roads form dense networks in landscapes, generating a litany of negative ecological outcomes, but unofficial roads in frontier areas are also instrumental in local livelihoods and community development. This trade-off poses dilemmas for the governance of unofficial roads. Unofficial road building in frontier areas of the Brazilian Amazon illustrates the challenges of 'road governance.' Both state-based and community based governance models exhibit important liabilities for governing unofficial roads. Whereas state-based governance has experienced difficulties in adapting to specific local contexts and interacting effectively with local interest groups, community-based governance has a mixed record owing to social inequalities and conflicts among local interest groups. A state-community hybrid model may offer more effective governance of unofficial road building by combining the oversight capacity of the state with locally grounded community management via participatory decision-making.

  10. 77 FR 8234 - National Institute on Disability and Rehabilitation Research-Disability and Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research-- Disability and Rehabilitation Research Projects and Centers Program, etc. AGENCY: Office of Special Education and...: National Institute on Disability and Rehabilitation Research-- Disability and Rehabilitation Research...

  11. Develop preliminary engineering design and study the benefits of providing an access to the Indiana toll road at State Road 327 near Orland, IN.

    DOT National Transportation Integrated Search

    2016-10-05

    A new toll road exit is proposed at the intersection of I-80/90 and SR 327 in Orland, : Indiana. The new exit is needed to facilitate travel for a proposed manufacturing plant to be : established on a 500-acre site east of SR 327 and south of I-80/90...

  12. Building the Case for Delivering Health Promotion Services within the Vocational Rehabilitation System

    ERIC Educational Resources Information Center

    Ipsen, Catherine; Seekins, Tom; Ravesloot, Craig

    2010-01-01

    Research studies report a negative relationship between employment and secondary conditions. Access to health promotion programs to manage secondary conditions, however, is limited for people with disabilities due to employment, financial, and insurance barriers. Vocational rehabilitation (VR) is one possible delivery point to overcome these…

  13. Fixed Route Accessible Bus Service in Connecticut : A Case Study

    DOT National Transportation Integrated Search

    1981-07-01

    U.S. Department of Transportation regulations implementing Section 504 of the Rehabilitation Act of 1973, require transit agencies to provide wheelchair accessibility on fixed-route bus service. The study is part of the series which included studies ...

  14. 78 FR 42868 - Final Priority; National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... for the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority...

  15. Wildlife friendly roads: the impacts of roads on wildlife in urban areas and potential remedies

    USGS Publications Warehouse

    Riley, Seth P D; Brown, Justin L.; Sikich, Jeff A.; Schoonmaker, Catherine M.; Boydston, Erin E.

    2014-01-01

    Roads are one of the most important factors affecting the ability of wildlife to live and move within an urban area. Roads physically replace wildlife habitat and often reduce habitat quality nearby, fragment the remaining habitat, and cause increased mortality through vehicle collisions. Much ecological research on roads has focused on whether animals are successfully crossing roads, or if the road is a barrier to wildlife movement, gene flow, or functional connectivity. Roads can alter survival and reproduction for wildlife, even among species such as birds that cross roads easily. Here we examine the suite of potential impacts of roads on wildlife, but we focus particularly on urban settings. We report on studies, both in the literature and from our own experience, that have addressed wildlife and roads in urban landscapes. Although road ecology is a growing field of study, relatively little of this research, and relatively few mitigation projects, have been done in urban landscapes. We also draw from the available science on road impacts in rural areas when urban case studies have not fully addressed key topics.

  16. Pulmonary Rehabilitation

    MedlinePlus

    ... as pulmonary hypertension and interstitial lung disease can benefit as well. What is Pulmonary Rehabilitation? Pulmonary rehabilitation is a program of education and exercise that helps you manage your breathing ...

  17. Osteoarthritis year in review: rehabilitation and outcomes.

    PubMed

    Davis, A M

    2012-03-01

    . In one study, there were larger effects in combined activity/participation than for activity alone for arthroscopic lavage compared to intraarticular steroid and, in a second study, the effect was larger for activity with an advanced pharmacy intervention whereas the physiotherapy intervention demonstrated a larger effect for activity/participation. Interventions of manual therapy for hip and knee OA provided limited evidence of effectiveness. These studies are of limited quality due to lack of blinding and disclosure of co-intervention. Tele-rehabilitation may be a viable option to improve access to rehabilitation post joint replacement for those in rural and remote areas. Data continue to support the need to include performance measures as well as patient-reported outcomes in evaluating outcomes in OA. Additionally, measures of participation should be considered as core outcomes. Copyright © 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  18. 78 FR 28543 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-15

    ... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... priority under the Rehabilitation Research and Training Center (RRTC) Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, this notice proposes a priority...

  19. 78 FR 26560 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-07

    ... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... priority for the Rehabilitation Research and Training Center (RRTC) Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, this notice proposes a priority...

  20. Online communication in a rehabilitation setting: Experiences of patients with chronic conditions using a web portal in Denmark.

    PubMed

    Cerdan, Jose; Catalan-Matamoros, Daniel; Berg, Sarah Warny

    2017-12-01

    To gain insight into the experiences of patients with long-term conditions enrolled in an online rehabilitation programme using a web portal. Danish outpatients were recruited from a rehabilitation department and were granted access to a web portal which included an online rehabilitation programme with key information, clinical advice, and self-management activities. After two weeks, patients were invited to participate in focus groups. A topic guide was used to explore this new online rehabilitation programme in relation to participants' experiences. Fourteen participants, ranging from 42 to 72 years old, were allocated into three focus groups. Participants mainly reported negative experiences by the following four themes: 'patients' experiences', 'technical aspects', 'areas for improvement', and 'digitalization added value'. Participants mainly reported negative experiences and suggested combining both face-to-face consultations with online care by user-friendly web portals. This will ensure a positive contribution from digital communication tools to rehabilitation. Patients' experiences should be considered in the design of web portals in rehabilitation which could help healthcare organizations when developing online rehabilitation programmes. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Three-Dimensional (3-D) Printing: A Cost-Effective Solution for Improving Global Accessibility to Prostheses.

    PubMed

    Silva, Kyle; Rand, Stephanie; Cancel, David; Chen, Yuxi; Kathirithamby, Rani; Stern, Michelle

    2015-12-01

    The lack of access to prostheses is a global problem, partially caused by the high cost associated with the current manufacturing process. Three-dimensional printing is gaining use in the medical field, and one such area is prosthetics. In addition to using cost-effective materials, this technology allows for rapid prototyping, making it an efficient solution for the development of affordable prostheses. If the rehabilitation medicine community embraces this novel technology, we can help alleviate the global disparity of access to prostheses. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  2. A GRASS GIS Semi-Stochastic Model for Evaluating the Probability of Landslides Impacting Road Networks in Collazzone, Central Italy

    NASA Astrophysics Data System (ADS)

    Taylor, Faith E.; Santangelo, Michele; Marchesini, Ivan; Malamud, Bruce D.

    2013-04-01

    During a landslide triggering event, the tens to thousands of landslides resulting from the trigger (e.g., earthquake, heavy rainfall) may block a number of sections of the road network, posing a risk to rescue efforts, logistics and accessibility to a region. Here, we present initial results from a semi-stochastic model we are developing to evaluate the probability of landslides intersecting a road network and the network-accessibility implications of this across a region. This was performed in the open source GRASS GIS software, where we took 'model' landslides and dropped them on a 79 km2 test area region in Collazzone, Umbria, Central Italy, with a given road network (major and minor roads, 404 km in length) and already determined landslide susceptibilities. Landslide areas (AL) were randomly selected from a three-parameter inverse gamma probability density function, consisting of a power-law decay of about -2.4 for medium and large values of AL and an exponential rollover for small values of AL; the rollover (maximum probability) occurs at about AL = 400 m.2 The number of landslide areas selected for each triggered event iteration was chosen to have an average density of 1 landslide km-2, i.e. 79 landslide areas chosen randomly for each iteration. Landslides were then 'dropped' over the region semi-stochastically: (i) random points were generated across the study region; (ii) based on the landslide susceptibility map, points were accepted/rejected based on the probability of a landslide occurring at that location. After a point was accepted, it was assigned a landslide area (AL) and length to width ratio. Landslide intersections with roads were then assessed and indices such as the location, number and size of road blockage recorded. The GRASS-GIS model was performed 1000 times in a Monte-Carlo type simulation. Initial results show that for a landslide triggering event of 1 landslide km-2 over a 79 km2 region with 404 km of road, the number of road blockages

  3. Cardiac rehabilitation

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000791.htm Cardiac rehabilitation To use the sharing features on this page, please enable JavaScript. Cardiac rehabilitation (rehab) is a program that helps you live ...

  4. Healing the wounds in the landscape-reclaiming gravel roads in conservation areas.

    PubMed

    Tarvainen, Oili; Tolvanen, Anne

    2016-07-01

    Reclaiming abandoned and unmaintained roads, built originally for forestry and mineral extraction, is an important part of ecological restoration, because the roads running through natural habitats cause fragmentation. The roads can be reclaimed in a passive way by blocking access to the road, but successful seedling recruitment may require additional management due to the physical constraints present at the road. We established a full factorial study to compare the effects of three road reclaiming measures, namely ripping, creation of safe sites by adding mulch and pine seed addition, on soil processes, recovery of understorey vegetation and seedling recruitment in three conservation areas in eastern Finland. We surveyed soil organic matter, frequency and cover of plant functional types, litter and mineral soil, and number of tree seedlings. The soil organic matter was, on average, 1.3-fold in the 50-cm-deep ripping treatment relative to unripped and 20-cm-deep ripping treatments. The germination and survival of deciduous seedlings and grass establishment were promoted by adding mulch. The addition of pine seeds counteracted the seed limitation and enhanced the regeneration of trees. The treatment combination consisting of ripping, adding mulch and pine seed addition enhanced the vegetation succession and tree-seedling recruitment most: the cover of grasses, herbs and ericaceous dwarf shrubs was 1.3-7.6-fold and the number of coniferous tree seedlings was 3.4-7.1-fold relative to the other treatment combinations. Differences between short-term (1-3 years) and longer-term (6 years) results indicate the need for a sufficient observation period in road reclamation studies.

  5. 24 CFR 1710.110 - Roads.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (4) Who is responsible for road maintenance? If the roads are to be maintained by a public authority... for maintaining the roads and that, if maintenance is not performed, the roads may soon deteriorate... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Roads. 1710.110 Section 1710.110...

  6. Client Aggression toward Rehabilitation Counselors Employed by State Vocational Rehabilitation Agencies

    ERIC Educational Resources Information Center

    Trice, April Lynette

    2011-01-01

    Through a series of interviews this transcendental phenomenological study explored how rehabilitation counselors employed by state vocational rehabilitation agencies experienced client aggression. More specifically, it examined the circumstances involved when client aggression manifested in the work lives of rehabilitation counselors. This study…

  7. Rural rehabilitation practice: perspectives of occupational therapists and physical therapists in British Columbia, Canada.

    PubMed

    Roots, Robin K; Brown, Helen; Bainbridge, Lesley; Li, Linda C

    2014-01-01

    Providing rehabilitation services to address the health needs of rural residents requires overcoming the challenges of geography, limited referral options and a shortage of occupational therapists (OTs) and physical therapists (PTs). However, little is known about how rehabilitation professionals in rural areas enact their practice to meet and overcome these challenges. To address this gap and contribute to enhancing health for rural residents, this study was designed to explore rural rehabilitation practice from the perspectives of OTs and PTs in rural British Columbia (BC). A purposive sample of OTs and PTs in rural communities (population <15 000) in northern BC was recruited for this qualitative study. Potential participants received an invitation mailed to workplaces and were selected to ensure a variety of work experiences, roles and practice settings. In semi-structured interviews, participants were asked to describe the skills and knowledge they perceived as unique to rural practice and strategies they used to overcome challenges. Guided by interpretive description, transcripts were analysed inductively using broad-level coding, and findings were collapsed into interpretive categories. Interpretations and implications for education, practice and policy were reviewed with participants to ensure relevance to rural practice. From interviews with 6 OTs and 13 PTs, serving a total of 15 rural communities, rehabilitation practice and participants' definition of health were understood to be substantially shaped by rurality or the contextual features of geography, determinants of health and access to services. Participants considered general practice 'a specialty' requiring advanced skills in assessment. They described 'stretching their role' and 'participating in, and partnerships with, community' as ways to overcome resource shortages. Reflective practice, networking and collaboration were deemed essential to maintaining competence. Rural clinical placements

  8. [In-patient (early) rehabilitation].

    PubMed

    Wallesch, Claus-W; Lautenschläger, Sindy

    2017-04-01

    It is difficult to develop the financing and hospital provision of interventions for early rehabilitation within the diagnosis-related group (DRG) system. In addition to a range of partially rehabilitative complex interventions, the system recognizes three main forms of early rehabilitative interventions: geriatric, neurological/neurosurgical, and interdisciplinary and others. In this article, the appropriate definitions and cost-effectiveness of these procedures are analyzed and compared. The early rehabilitative interventions are characterized by constant cooperation in the therapeutic team, especially neurological early rehabilitation through the incorporation of nursing as a therapeutic profession. Whereas geriatric and neurological early rehabilitation are reflected in the DRG system, the former provided in many general hospitals and the latter mainly in specialized institutions, interdisciplinary early rehabilitation has only occasionally been represented in the DRG system so far. If all acute in-patients who require early rehabilitation should receive such an intervention, an additional fee must be implemented for this this interdisciplinary service.

  9. Impact of daylight saving time on road traffic collision risk: a systematic review

    PubMed Central

    Carey, Rachel N; Sarma, Kiran M

    2017-01-01

    Background Bills have been put forward in the UK and Republic of Ireland proposing a move to Central European Time (CET). Proponents argue that such a change will have benefits for road safety, with daylight being shifted from the morning, when collision risk is lower, to the evening, when risk is higher. Studies examining the impact of daylight saving time (DST) on road traffic collision risk can help inform the debate on the potential road safety benefits of a move to CET. The objective of this systematic review was to examine the impact of DST on collision risk. Methods Major electronic databases were searched, with no restrictions as to date of publication (the last search was performed in January 2017). Access to unpublished reports was requested through an international expert group. Studies that provided a quantitative analysis of the effect of DST on road safety-related outcomes were included. The primary outcomes of interest were road traffic collisions, injuries and fatalities. Findings Twenty-four studies met the inclusion criteria. Seventeen examined the short-term impact of transitions around DST and 12 examined long-term effects. Findings from the short-term studies were inconsistent. The long-term findings suggested a positive effect of DST. However, this cannot be attributed solely to DST, as a range of road collision risk factors vary over time. Interpretation The evidence from this review cannot support or refute the assertion that a permanent shift in light from morning to evening will have a road safety benefit. PMID:28674131

  10. Inpatient rehabilitation diabetes consult service: a rehabilitation psychology approach to assessment and intervention.

    PubMed

    Schumann, Kristina P; Touradji, Pegah; Hill-Briggs, Felicia

    2010-11-01

    Diabetes clinical practice recommendations call for assessment and intervention on diabetes self-management during inpatient hospitalization. Although diabetes is prevalent in inpatient rehabilitation settings, diabetes self-management has not traditionally been a focus of inpatient rehabilitation psychology care. This is because diabetes is often a secondary diagnosis when an individual is admitted to rehabilitation for an acute event. The authors provide a rationale for a role for rehabilitation psychologists in assessing and intervening on the psychosocial, behavioral, and functional self-management needs of individuals with diabetes within the rehabilitation setting. The development of a rehabilitation psychology Inpatient Rehabilitation Diabetes Consultation Service is described. Theoretical and empirical bases for compilation of the assessment and intervention materials are provided. Format and implementation of the service on a university-affiliated inpatient rehabilitation unit is described, with special consideration given to professional issues faced by rehabilitation psychologists and teams. A flexible consultation model was implemented using a guided diabetes psychosocial assessment with brief educational handouts addressing selected key topics (i.e., hyperglycemia, hypoglycemia, blood sugar monitoring, nutrition, physical activity, medication, and, A1C and average blood sugar). The consultation service was feasible and well-accepted by treated individuals and the rehabilitation team. Rehabilitation psychologists are uniquely positioned to address the functional, psychosocial, and behavioral needs of individuals with diabetes. With further research to assess clinical outcomes, this approach may further address practice recommendations for inpatient diabetes care. Moreover, such a diabetes consultation model may be useful on an outpatient rehabilitation basis as well. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  11. 8. REINFORCED CONCRETE SLAB ROOF FROM NORTHWEST EDGE, ACCESS RAMP ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. REINFORCED CONCRETE SLAB ROOF FROM NORTHWEST EDGE, ACCESS RAMP IN FOREGROUND, VIEW TOWARDS SOUTHEAST. - Glenn L. Martin Company, Titan Missile Test Facilities, CaptiveTest Stand D-3, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  12. Telerehabilitation Technologies: Accessibility and Usability

    PubMed Central

    Pramuka, Michael; van Roosmalen, Linda

    2009-01-01

    In the fields of telehealth and telemedicine, phone and/or video technologies are key to the successful provision of services such as remote monitoring and visits. How do these technologies affect service accessibility, effectiveness, quality, and usefulness when applied to rehabilitation services in the field of telerehabilitation? To answer this question, we provide a overview of the complex network of available technologies and discuss how they link to rehabilitation applications, services, and practices as well as to the telerehabilitation end-user. This white paper will first present the numerous professional considerations that shape the use of technology in telerehabilitation service and set it somewhat apart from telemedicine. It will then provide an overview of concepts essential to usability analysis; present a summary of various telerehabilitation technologies and their strengths and limitations, and consider how the technologies interface with end users’ clinical needs for service accessibility, effectiveness, quality, and usefulness. The paper will highlight a conceptual framework (including task analyses and usability issues) that underlies a functional match between telerehabilitation technologies, clinical applications, and end-user capabilities for telerehabilitation purposes. Finally, we will discuss pragmatic issues related to user integration of telerehabilitation technology versus traditional face-to-face approaches. PMID:25945165

  13. [Acute Care Rehabilitation is the First Link in a Chain of Rehabilitation Interventions].

    PubMed

    Beyer, Joachim; Seidel, Egbert J

    2017-08-01

    An early, intensive rehabilitative therapy accelerates the recovery of the functions of patients. It contributes to a reduction in the complication rate as well as an improvement in physical and social functioning/participation in the long-term follow-up. Early rehabilitation must be strengthened on the basis of the existing structures: the creation and maintenance of adequately qualified early-stage rehabilitation facilities, at least in hospitals with priority and maximum supply contracts. Patients with long-term intensive care and polytrauma must be rehabilitated as soon as possible (intensive medical rehabilitation).Specialists in physical and rehabilitative medicine, rehabilitative geriatrists, neurologists, orthopaedists and accident surgeons and other regional physicians must cooperate in a targeted manner. Exclusion criteria using corresponding OPS codes must be canceled. Additional specialist physician groups (anesthetists and intensive care physicians, general practitioners, accident and thoracic surgeons, internists) must be sensitized to the importance of early rehabilitation.In the case of more than 500,000 hospital beds, 25,000 beds should be identified as age- and diagnosis-independent early-care beds in the country-specific bed-care plans. A cost-covering financing of the different, personal and cost-intensive early rehabilitation must be ensured. A phase model similar to the BAR guidelines for neurological-neurosurgical early rehabilitation is to be considered for other disease entities.In order to make the rehabilitation process as successful as possible, medical (acute) treatment, medical rehabilitation, occupational integration and social integration have to be understood as a holistic event and are effectively interrelated, as a continuous process which accompanies the entire disease phase-wise. For this purpose, a continuous case management or a rehabilitation guidance has to be established. © Georg Thieme Verlag KG Stuttgart · New York.

  14. A real time biofeedback using Kinect and Wii to improve gait for post-total knee replacement rehabilitation: a case study report.

    PubMed

    Levinger, Pazit; Zeina, Daniel; Teshome, Assefa K; Skinner, Elizabeth; Begg, Rezaul; Abbott, John Haxby

    2016-01-01

    This study aimed to develop a low-cost real-time biofeedback system to assist with rehabilitation for patients following total knee replacement (TKR) and to assess its feasibility of use in a post-TKR patient case study design with a comparison group. The biofeedback system consisted of Microsoft Kinect(TM) and Nintendo Wii balance board with a dedicated software. A six-week inpatient rehabilitation program was augmented by biofeedback and tested in a single patient following TKR. Three patients underwent a six weeks standard rehabilitation with no biofeedback and served as a control group. Gait, function and pain were assessed and compared before and after the rehabilitation. The biofeedback software incorporated real time visual feedback to correct limb alignment, movement pattern and weight distribution. Improvements in pain, function and quality of life were observed in both groups. The strong improvement in the knee moment pattern demonstrated in the case study indicates feasibility of the biofeedback-augmented intervention. This novel biofeedback software has used simple commercially accessible equipment that can be feasibly incorporated to augment a post-TKR rehabilitation program. Our preliminary results indicate the potential of this biofeedback-assisted rehabilitation to improve knee function during gait. Research is required to test this hypothesis. Implications for Rehabilitation The real-time biofeedback system developed integrated custom-made software and simple low-cost commercially accessible equipment such as Kinect and Wii board to provide augmented information during rehabilitation following TKR. The software incorporated key rehabilitation principles and visual feedback to correct alignment of the lower legs, pelvic and trunk as well as providing feedback on limbs weight distribution. The case study patient demonstrated greater improvement in their knee function where a more normal biphasic knee moment was achieved following the six

  15. Chief medical officer actions on information security in an Italian rehabilitation centre.

    PubMed

    Reni, Gianluigi; Molteni, Massimo; Arlotti, Stefano; Pinciroli, Francesco

    2004-03-31

    In a multi-speciality rehabilitation centre, where child neuropsychiatrists, neurologists, physical rehabilitators, psychologists, nurses, therapists and other health care professionals actively care for patients, the moment will arrive when information security takes high priority on the chief medical officer (CMO) agenda. This has happened at the La Nostra Famiglia Institution. Local push to high priority arose from several concurrent forces, like privacy both on the patient and on the doctor side, legal and ethical aspects. Recommendations on the protection of medical data require appropriate technical and organisational measures to be taken to protect personal data against unauthorised access, alterations or any other form of inappropriate processing. In the same time quick and easy access to patient information should be granted to authorised personnel to ensure proper and in time treatment of patients. A long lasting sequence of co-operative negotiation meetings between the CMO and the chief information officer (CIO) led to appropriate outline of policies. We developed a suitable and modular architecture for designing systems that can simultaneously manage an increasing number of healthcare actors, objects and related access levels taking into account temporal conditions. Actions for keeping the prototype in use on an everyday basis are directly taken by the CMO.

  16. Tele-rehabilitation using in-house wearable ankle rehabilitation robot.

    PubMed

    Jamwal, Prashant K; Hussain, Shahid; Mir-Nasiri, Nazim; Ghayesh, Mergen H; Xie, Sheng Q

    2018-01-01

    This article explores wide-ranging potential of the wearable ankle robot for in-house rehabilitation. The presented robot has been conceptualized following a brief analysis of the existing technologies, systems, and solutions for in-house physical ankle rehabilitation. Configuration design analysis and component selection for ankle robot have been discussed as part of the conceptual design. The complexities of human robot interaction are closely encountered while maneuvering a rehabilitation robot. We present a fuzzy logic-based controller to perform the required robot-assisted ankle rehabilitation treatment. Designs of visual haptic interfaces have also been discussed, which will make the treatment interesting, and the subject will be motivated to exert more and regain lost functions rapidly. The complex nature of web-based communication between user and remotely sitting physiotherapy staff has also been discussed. A high-level software architecture appended with robot ensures user-friendly operations. This software is made up of three important components: patient-related database, graphical user interface (GUI), and a library of exercises creating virtual reality-specifically developed for ankle rehabilitation.

  17. Sexual Recovery Following Prostate Cancer: Recommendations From 2 Established Canadian Sexual Rehabilitation Clinics.

    PubMed

    Elliott, Stacy; Matthew, Andrew

    2018-04-01

    Supportive sexual health care is much-needed adjuvant care to oncologic management for men with prostate cancer (PCa). To inspire the initiation of biopsychosocial sexual health programming where it does not exist and to inform program enhancement in existing sexual rehabilitation clinics (SRCs). This article reviews the combined 30-year experience of 2 well-established Canadian SRCs for men and their partners after PCa treatments, interwoven with empirical evidence. To comprehensively review the biopsychosocial approach to sexual health assessment of men with PCa and their partners to direct the practicalities of running a successful and sustainable SRC. A full description of the biomedical and psychosocial approaches, inclusive of comprehensive sexual function, the penile rehabilitation controversy, and other medical and relationship issues affecting sexual adjustment, is provided to highlight the relevance of proper assessment and follow-through for sexual adaptation and adjustment. 10 recommendations for a successful SRC are discussed, including the principles behind developing a sustainable business plan, staff acquisition and training, budget, integration of treatment and research priorities, respectful and multidisciplinary approaches to care, and suggestions of visit formats, protocols, and questionnaires. We recommend a phased approach of an SRC into usual care with the option to provide accessible and equitable care to patients not within proximal access of treating institutions. Sexual rehabilitation after treatment for PCa requires a complex treatment process. Providing sustainable sexual rehabilitation programming under the financially strained environment of the Canadian medical system is a challenge; therefore, to provide Canadian patients and their partners with comprehensive cancer care, they deserve a biopsychosocial approach combined with a creative and systematic implementation strategy. Elliott S, Matthew A. Sexual Recovery Following Prostate

  18. Upholding Accessibility Standards When Selecting Tech Tools

    ERIC Educational Resources Information Center

    Whetstone, Kimarie W.

    2017-01-01

    Research-supported guidelines to assist faculty with finding and evaluating online course tools and media that are accessible to learners taking online college courses in the United States are not generally available. The recent refresh to Section 508 of the Rehabilitation Act of 1973, as amended (29 U.S.C. § 794(d)) provides justification for…

  19. A Framework for Ethical Decision Making in the Rehabilitation of Patients with Anosognosia.

    PubMed

    Egbert, Anna Rita

    2017-01-01

    Currently, the number of patients diagnosed with impaired self-awareness of their own deficits after brain injury-anosognosia-is increasing. One reason is a growing understanding of this multifaceted phenomenon. Another is the development and accessibility of alternative measurements that allow more detailed diagnoses. Anosognosia can adversely affect successful rehabilitation, as often patients lack confidence in the need for treatment. Planning such treatment can become a complex process full of ethical dilemmas. To date, there is no systematic way to deal with different aspects of anosognosia rehabilitation planning. This is the first article to present a framework for ethical decision making in establishing rehabilitation plans that are focused on increasing patients' self-awareness of their own deficits after brain injury. It concentrates especially on addressing the ethical dilemmas that may arise, and describes stepwise procedures that can be applied to distinct theoretical approaches, as well as diagnostic and rehabilitation methods. To show the flexibility of the use of this framework, alternative approaches are discussed. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

  20. Road Infrastructure Safety Management in Poland

    NASA Astrophysics Data System (ADS)

    Budzynski, Marcin; Jamroz, Kazimierz; Kustra, Wojciech; Michalski, Lech; Gaca, Stanislaw

    2017-10-01

    The objective of road safety infrastructure management is to ensure that when roads are planned, designed, built and used road risks can be identified, assessed and mitigated. Road transport safety is significantly less developed than that of rail, water and air transport. The average individual risk of being a fatality in relation to the distance covered is thirty times higher in road transport that in the other modes. This is mainly because the different modes have a different approach to safety management and to the use of risk management methods and tools. In recent years Poland has had one of the European Union’s highest road death numbers. In 2016 there were 3026 fatalities on Polish roads with 40,766 injuries. Protecting road users from the risk of injury and death should be given top priority. While Poland’s national and regional road safety programmes address this problem and are instrumental in systematically reducing the number of casualties, the effects are far from the expectations. Modern approaches to safety focus on three integrated elements: infrastructure measures, safety management and safety culture. Due to its complexity, the process of road safety management requires modern tools to help with identifying road user risks, assess and evaluate the safety of road infrastructure and select effective measures to improve road safety. One possible tool for tackling this problem is the risk-based method for road infrastructure safety management. European Union Directive 2008/96/EC regulates and proposes a list of tools for managing road infrastructure safety. Road safety tools look at two criteria: the life cycle of a road structure and the process of risk management. Risk can be minimized through the application of the proposed interventions during design process as reasonable. The proposed methods of risk management bring together two stages: risk assessment and risk response occurring within the analyzed road structure (road network, road

  1. Road safety analysis on Achmad Yani frontage road Surabaya

    NASA Astrophysics Data System (ADS)

    Machsus; Prayogo, I.; Chomaedhi; Hayati, D. W.; Utanaka, A.

    2017-11-01

    This research discusses road safety analysis on the operation of frontage road on the west side of Achmad Yani Road Surabaya. This research began by conducting survey on secondary data of traffic accidents. In addition, primary data survey was conducted to obtain traffic data, geometric road data, and other supporting data at the study site along the west side frontage of Ahmad Yani Road Surabaya. Devices used in this research include camera, handy cam, speed gun, counters of vehicles, rolling meter, computer and others. In outline, the stages to conduct this research are divided into 4 stages, namely 1.the preparation stage, 2.data collection and processing, 3. analysis and discussion, and 4. conclusion. The results of this study showed that the accident characteristics of the frontage road are (i) 3 accidents occured per month, (ii) motorcycles was accounted for the largest proportion of accidents which amounted to 74.6 percent, (iii) there were 3 accident victims per month, and (iv) material losses per month worths 1.2 million. The accident rate in 2016 was 0.04 crashes per one million vehicle travels per kilometer, while during 2 months in 2017 it was 0.15 accidents per one million vehicle travels per kilometer. Black spot area of accident is located on Sta 2 + 800 to 2 + 900 which is in front of Graha Pena building and DBL Arena. The high rate of accidents is influenced by the speed of the vehicle which 85 percentile exceeds the speed limit of 40km per hour.

  2. Car manufacturers and global road safety: a word frequency analysis of road safety documents.

    PubMed

    Roberts, I; Wentz, R; Edwards, P

    2006-10-01

    The World Bank believes that the car manufacturers can make a valuable contribution to road safety in poor countries and has established the Global Road Safety Partnership (GRSP) for this purpose. However, some commentators are sceptical. The authors examined road safety policy documents to assess the extent of any bias. Word frequency analyses of road safety policy documents from the World Health Organization (WHO) and the GRSP. The relative occurrence of key road safety terms was quantified by calculating a word prevalence ratio with 95% confidence intervals. Terms for which there was a fourfold difference in prevalence between the documents were tabulated. Compared to WHO's World report on road traffic injury prevention, the GRSP road safety documents were substantially less likely to use the words speed, speed limits, child restraint, pedestrian, public transport, walking, and cycling, but substantially more likely to use the words school, campaign, driver training, and billboard. There are important differences in emphasis in road safety policy documents prepared by WHO and the GRSP. Vigilance is needed to ensure that the road safety interventions that the car industry supports are based on sound evidence of effectiveness.

  3. Vehicular road influence areas

    NASA Astrophysics Data System (ADS)

    Huertas, María E.; Huertas, José I.; Valencia, Alexander

    2017-02-01

    Vehicle operation over paved and unpaved roads is an emission source that significantly contributes to air pollution. Emissions are derived from vehicle exhaust pipes and re-suspension of particulate matter generated by wind erosion and tire to road surface interactions. Environmental authorities require a methodology to evaluate road impact areas, which enable managers to initiate counter-measures, particularly under circumstances where historic meteorological and/or air quality data is unavailable. The present study describes an analytical and experimental work developed to establish a simplified methodology to estimate the area influenced by vehicular roads. AERMOD was chosen to model pollutant dispersion generated by two roads of common attributes (straight road over flat terrain) under the effects of several arbitrary chosen weather conditions. The resulting pollutant concentration vs. Distance curves collapsed into a single curve when concentration and distance were expressed as dimensionless numbers and this curve can be described by a beta distribution function. This result implied that average concentration at a given distance was proportional to emission intensity and that it showed minor sensitivity to meteorological conditions. Therefore, road influence was defined by the area adjacent to the road limited by distance at which the beta distribution function equaled the limiting value specified by the national air quality standard for the pollutant under consideration.

  4. Stroke rehabilitation

    PubMed Central

    Bindawas, Saad M.; Vennu, Vishal S.

    2016-01-01

    Stroke is a major cause of death and other complications worldwide. In Saudi Arabia, stroke has become an emerging health issue leading to disability and death. However, stroke care including rehabilitation services, in Saudi Arabia lags behind developed countries. Stroke rehabilitation is an essential recovery option after stroke and should start as early as possible to avoid potential complications. The growing evidence on stroke rehabilitation effectiveness in different health care settings and outcome measures used widely are reviewed in this call to action paper. PMID:27744457

  5. Economic comparisons of haul road construction versus forwarding versus longer skid distances

    Treesearch

    Michael D. Erickson; Curt C. Hassler; Chris B. LeDoux

    1992-01-01

    There currently exists no set of basic guidelines for Appalachian loggers to use in the decision making process for selecting the best way to harvest a tract of timber. Specifically, guidelines are needed for deciding between the alternatives of constructing truck haul roads to access an area or other alternatives such as skidding or forwarding timber longer distances...

  6. Modeling spatial decisions with graph theory: logging roads and forest fragmentation in the Brazilian Amazon.

    PubMed

    Walker, Robert; Arima, Eugenio; Messina, Joe; Soares-Filho, Britaldo; Perz, Stephen; Vergara, Dante; Sales, Marcio; Pereira, Ritaumaria; Castro, Williams

    2013-01-01

    This article addresses the spatial decision-making of loggers and implications for forest fragmentation in the Amazon basin. It provides a behavioral explanation for fragmentation by modeling how loggers build road networks, typically abandoned upon removal of hardwoods. Logging road networks provide access to land, and the settlers who take advantage of them clear fields and pastures that accentuate their spatial signatures. In shaping agricultural activities, these networks organize emergent patterns of forest fragmentation, even though the loggers move elsewhere. The goal of the article is to explicate how loggers shape their road networks, in order to theoretically explain an important type of forest fragmentation found in the Amazon basin, particularly in Brazil. This is accomplished by adapting graph theory to represent the spatial decision-making of loggers, and by implementing computational algorithms that build graphs interpretable as logging road networks. The economic behavior of loggers is conceptualized as a profit maximization problem, and translated into spatial decision-making by establishing a formal correspondence between mathematical graphs and road networks. New computational approaches, adapted from operations research, are used to construct graphs and simulate spatial decision-making as a function of discount rates, land tenure, and topographic constraints. The algorithms employed bracket a range of behavioral settings appropriate for areas of terras de volutas, public lands that have not been set aside for environmental protection, indigenous peoples, or colonization. The simulation target sites are located in or near so-called Terra do Meio, once a major logging frontier in the lower Amazon Basin. Simulation networks are compared to empirical ones identified by remote sensing and then used to draw inferences about factors influencing the spatial behavior of loggers. Results overall suggest that Amazonia's logging road networks induce more

  7. GENERAL VIEW OF VEHICLE ACCESS PLATFORM CNORTH, HB3, FACING NORTHEAST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GENERAL VIEW OF VEHICLE ACCESS PLATFORM C-NORTH, HB-3, FACING NORTHEAST - Cape Canaveral Air Force Station, Launch Complex 39, Vehicle Assembly Building, VAB Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  8. GENERAL VIEW OF VEHICLE ACCESS PLATFORM ENORTH, HB3, FACING NORTH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GENERAL VIEW OF VEHICLE ACCESS PLATFORM E-NORTH, HB-3, FACING NORTH - Cape Canaveral Air Force Station, Launch Complex 39, Vehicle Assembly Building, VAB Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  9. GENERAL VIEW OF VEHICLE ACCESS PLATFORM ENORTH, HB3, FACING NORTHWEST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GENERAL VIEW OF VEHICLE ACCESS PLATFORM E-NORTH, HB-3, FACING NORTHWEST - Cape Canaveral Air Force Station, Launch Complex 39, Vehicle Assembly Building, VAB Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  10. GENERAL VIEW OF VEHICLE ACCESS PLATFORM DNORTH, HB3, FACING NORTHWEST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GENERAL VIEW OF VEHICLE ACCESS PLATFORM D-NORTH, HB-3, FACING NORTHWEST - Cape Canaveral Air Force Station, Launch Complex 39, Vehicle Assembly Building, VAB Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  11. GENERAL VIEW OF VEHICLE ACCESS PLATFORM BNORTH, HB3, FACING NORTH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GENERAL VIEW OF VEHICLE ACCESS PLATFORM B-NORTH, HB-3, FACING NORTH - Cape Canaveral Air Force Station, Launch Complex 39, Vehicle Assembly Building, VAB Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  12. GENERAL VIEW OF VEHICLE ACCESS PLATFORM DNORTH, HB3, FACING NORTH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GENERAL VIEW OF VEHICLE ACCESS PLATFORM D-NORTH, HB-3, FACING NORTH - Cape Canaveral Air Force Station, Launch Complex 39, Vehicle Assembly Building, VAB Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  13. GENERAL VIEW OF VEHICLE ACCESS PLATFORM BNORTH, HB3, FACING NORTHEAST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GENERAL VIEW OF VEHICLE ACCESS PLATFORM B-NORTH, HB-3, FACING NORTHEAST - Cape Canaveral Air Force Station, Launch Complex 39, Vehicle Assembly Building, VAB Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  14. GENERAL VIEW OF VEHICLE ACCESS PLATFORM CNORTH, HB3, FACING NORTHWEST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GENERAL VIEW OF VEHICLE ACCESS PLATFORM C-NORTH, HB-3, FACING NORTHWEST - Cape Canaveral Air Force Station, Launch Complex 39, Vehicle Assembly Building, VAB Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  15. Rehabilitation after stroke.

    PubMed

    Knecht, Stefan; Hesse, Stefan; Oster, Peter

    2011-09-01

    Stroke is becoming more common in Germany as the population ages. Its long-term sequelae can be alleviated by early reperfusion in stroke units and by complication management and functional restoration in early-rehabilitation and rehabilitation centers. Selective review of the literature. Successful rehabilitation depends on systematic treatment by an interdisciplinary team of experienced specialists. In the area of functional restoration, there has been major progress in our understanding of the physiology of learning, relearning, training, and neuroenhancement. There have also been advances in supportive pharmacotherapy and robot technology. Well-organized acute and intermediate rehabilitation after stroke can provide patients with the best functional results attainable on the basis of our current scientific understanding. Further experimental and clinical studies will be needed to expand our knowledge and improve the efficacy of rehabilitation.

  16. [Psychology in rehabilitation].

    PubMed

    Haag, G; Lucius, G

    1984-02-01

    The article gives an overview of the importance and potentialities of psychology in the context of rehabilitation, outlining, among others, the psychologist's various tasks and functions relative to diagnosis, counselling, and therapy in medical, education, vocational, and psychosocial rehabilitation. Theories describing psychosocial factors involved in the development of, and in coping with, disability are discussed. Further, psychological intervention approaches are set out, focussing on their particular relevance to rehabilitation. Special attention is given to the psychologist's position within the interdisciplinary team, as well as to possibilities for, and requirements of, professional training and further education in rehabilitation psychology. As the various subjects could not be dealth with exhaustively, the article includes numerous references for further reading and links up with subsequent five contributions dealing with the main theme of the present issue of Die Rehabilitation.

  17. On the road: workable solutions to the problems of roads and highways

    Treesearch

    Mary M. Rowland

    2004-01-01

    Fourteen authors, ranging from transportation specialists to ecologists, have collaborated to write this very useful compendium describing the newly minted discipline of "road ecology." The authors state that road ecology "uses the science of ecology and landscape ecology to explore, understand, and address the interactions of roads and vehicles with...

  18. 20. INTERIOR VIEW TO THE EAST OF THE ACCESS RAMP ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    20. INTERIOR VIEW TO THE EAST OF THE ACCESS RAMP TO THE HOT DISASSEMBLY AREA FROM THE COLD ASSEMBLY AREA. - Nevada Test Site, Reactor Maintenance Assembly & Dissassembly Facility, Area 25, Jackass Flats, Junction of Roads F & G, Mercury, Nye County, NV

  19. 10. REINFORCED CONCRETE SLAB ROOF FROM THE WESTERN EDGE, ACCESS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. REINFORCED CONCRETE SLAB ROOF FROM THE WESTERN EDGE, ACCESS RAMPS AT LEFT AND RIGHT, VIEW TOWARDS EAST. - Glenn L. Martin Company, Titan Missile Test Facilities, Captive Test Stand D-2, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  20. 10. REINFORCED CONCRETE SLAB ROOF FROM SOUTHEASTERN EDGE, ACCESS RAMPS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. REINFORCED CONCRETE SLAB ROOF FROM SOUTHEASTERN EDGE, ACCESS RAMPS AT LEFT AND RIGHT, VIEW TOWARDS NORTHWEST. - Glenn L. Martin Company, Titan Missile Test Facilities, Captive Test Stand D-1, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  1. Epidemiologic study of road traffic injuries by road user type characteristics and road environment in Iran: a community-based approach.

    PubMed

    Hatamabadi, Hamidreza; Vafaee, Reza; Hadadi, Mashyaneh; Abdalvand, Ali; Esnaashari, Hamidreza; Soori, Hamid

    2012-01-01

    Crash injuries in traffic accidents are affected by a variety of factors. In this study we analyzed road user type information based on different contributing factors. Data from all of the road traffic victims on a road extending from the east of the city of Tehran to Mazandaran province were included prospectively over a one-year period (May 2008 to May 2009). Data collected included the crash time, patient's age and sex, road user category, helmet or seat belt use, anatomical site of injury, Injury Severity Score (ISS), and mortality. Prevalence and cross-tabulations were included in the analysis. There were 433 patients, of whom 345 were hospitalized and 33 died either before or after arriving at the hospital. Sixty-nine percent of injured patients were vehicle occupants. Mean and median of ISS were higher for pedestrians, who accounted for 49 percent of the deaths. Head injury was the most common injury and injury to upper and lower extremities was the most common cause of admission. A significant difference in lower extremity injuries between vehicle occupants and nonoccupants was found. Sex and age group did not have a significant effect on mortality. Mortality was significantly higher in pedestrians (P < .001) when data were analyzed based on road user type. Because pedestrians are the most vulnerable road users, stricter legislation and law enforcement should be used to protect them. Greater protection can also be reached by holding effective public awareness campaigns on how to use different roads safely. On the other hand, because rear seat passengers are at the same risk for road traffic injuries as front seat passengers, employment of newer laws and preventive measures targeting this group of occupants can prevent many road traffic injuries (RTIs).

  2. Technology-assisted rehabilitation interventions following pediatric brain injury.

    PubMed

    Wade, Shari L; Narad, Megan E; Shultz, Emily L; Kurowski, Brad G; Miley, Aimee E; Aguilar, Jessica M; Adlam, Anna-Lynne R

    2018-04-01

    Following traumatic brain injury (TBI), children experience a variety of physical, motor, speech, and cognitive deficits that can have a long-term detrimental impact. The emergence and popularity of new technologies has led to research into the development of various apps, gaming systems, websites, and robotics that might be applied to rehabilitation. The objective of this narrative review was to describe the current literature regarding technologically-assisted interventions for the rehabilitation of motor, neurocognitive, behavioral, and family impairments following pediatric TBI. We conducted a series of searches for peer-reviewed manuscripts published between 2000 and 2017 that included a technology-assisted component in the domains of motor, language/communication, cognition, behavior, social competence/functioning, family, and academic/school-based functioning. Findings suggested several benefits of utilizing technology in TBI rehabilitation including facilitating engagement/adherence, increasing access to therapies, and improving generalizability across settings. There is fairly robust evidence regarding the efficacy of online family problem-solving therapy in improving behavior problems, executive functioning, and family functioning. There was less compelling, but still promising, evidence regarding the efficacy other technology for motor deficits, apps for social skills, and computerized programs for cognitive skills. Overall, many studies were limited in the rigor of their methodology due to small heterogeneous samples and lack of control groups. Technology-assisted interventions have the potential to enhance pediatric rehabilitation after TBI. Future research is needed to further support their efficacy with larger controlled trials and to identify characteristics of children who are most likely to benefit.

  3. Use of fatal real-life crashes to analyze a safe road transport system model, including the road user, the vehicle, and the road.

    PubMed

    Stigson, Helena; Krafft, Maria; Tingvall, Claes

    2008-10-01

    To evaluate if the Swedish Road Administration (SRA) model for a safe road transport system, which includes the interaction between the road user, the vehicle, and the road, could be used to classify fatal car crashes according to some safety indicators. Also, to present a development of the model to better identify system weakness. Real-life crashes with a fatal outcome were classified according to the vehicle's safety rating by Euro NCAP (European Road Assessment Programme) and fitment of ESC (Electronic Stability Control). For each crash, the road was also classified according to EuroRAP (European Road Assessment Programme) criteria, and human behavior in terms of speeding, seat belt use, and driving under the influence of alcohol. Each crash was compared with the model criteria, to identify components that might have contributed to fatal outcome. All fatal crashes where a car occupant was killed that occurred in Sweden during 2004 were included: in all, 215 crashes with 248 fatalities. The data were collected from the in-depth fatal crash data of the Swedish Road Administration (SRA). It was possible to classify 93% of the fatal car crashes according to the SRA model. A number of shortcomings in the criteria were identified since the model did not address rear-end or animal collisions or collisions with stationary/parked vehicles or trailers (18 out of 248 cases). Using the further developed model, it was possible to identify that most of the crashes occurred when two or all three components interacted (in 85 of the total 230 cases). Noncompliance with safety criteria for the road user, the vehicle, and the road led to fatal outcome in 43, 27, and 75 cases, respectively. The SRA model was found to be useful for classifying fatal crashes but needs to be further developed to identify how the components interact and thereby identify weaknesses in the road traffic system. This developed model might be a tool to systematically identify which of the components are

  4. Road boundary detection

    NASA Technical Reports Server (NTRS)

    Sowers, J.; Mehrotra, R.; Sethi, I. K.

    1989-01-01

    A method for extracting road boundaries using the monochrome image of a visual road scene is presented. The statistical information regarding the intensity levels present in the image along with some geometrical constraints concerning the road are the basics of this approach. Results and advantages of this technique compared to others are discussed. The major advantages of this technique, when compared to others, are its ability to process the image in only one pass, to limit the area searched in the image using only knowledge concerning the road geometry and previous boundary information, and dynamically adjust for inconsistencies in the located boundary information, all of which helps to increase the efficacy of this technique.

  5. Road building, land use and climate change: prospects for environmental governance in the Amazon.

    PubMed

    Perz, Stephen; Brilhante, Silvia; Brown, Foster; Caldas, Marcellus; Ikeda, Santos; Mendoza, Elsa; Overdevest, Christine; Reis, Vera; Reyes, Juan Fernando; Rojas, Daniel; Schmink, Marianne; Souza, Carlos; Walker, Robert

    2008-05-27

    Some coupled land-climate models predict a dieback of Amazon forest during the twenty-first century due to climate change, but human land use in the region has already reduced the forest cover. The causation behind land use is complex, and includes economic, institutional, political and demographic factors. Pre-eminent among these factors is road building, which facilitates human access to natural resources that beget forest fragmentation. While official government road projects have received considerable attention, unofficial road building by interest groups is expanding more rapidly, especially where official roads are being paved, yielding highly fragmented forest mosaics. Effective governance of natural resources in the Amazon requires a combination of state oversight and community participation in a 'hybrid' model of governance. The MAP Initiative in the southwestern Amazon provides an example of an innovative hybrid approach to environmental governance. It embodies a polycentric structure that includes government agencies, NGOs, universities and communities in a planning process that links scientific data to public deliberations in order to mitigate the effects of new infrastructure and climate change.

  6. Between suffering and hope: rehabilitation from urinary incontinence as an intervening component.

    PubMed

    Delarmelindo, Rita de Cássia Altino; Parada, Cristina Maria Garcia de Lima; Rodrigues, Rosalina Aparecida Partezani; Bocchi, Silvia Cristina Mangini

    2013-07-01

    This is a qualitative study seeking to understand Brazilian women's experience of urinary incontinence (UI) and design a representative theoretical model for the experience. Theoretical saturation occurred after analysis of the 18th non-directive interview in accordance with Grounded Theory. Two phenomena emerged: living with the challenges of UI and experiencing the hope and disappointment of rehabilitation from UI. Upon re-alignment of the components, the core category emerged, namely: between suffering and hope--rehabilitation from urinary incontinence as an intervening component. From the analysis in light of symbolic interactionism, pregnancy and vaginal birth were observed to be symbols of women's vulnerability to the suffering from living with the moral and physio-psychosocial challenges of UI. It is also inferred that the lack of consideration of the Unified Health System (SUS) in investing in the process of rehabilitation from UI may be having a negative effect on the incentive programs for promoting vaginal birth. Most of all, it reveals the ongoing suffering of women with UI, most of whom do not have access to rehabilitation due to the lack of programs geared to the real needs of these users of the Unified Health System.

  7. Is a rehabilitation treatment taxonomy the right answer to the rehabilitation black box?

    PubMed

    Cieza, Alarcos; Bickenbach, Jerome

    2014-01-01

    In this commentary on the development of an interventions taxonomy for medical rehabilitation, a rehabilitation treatment taxonomy (RTT), we acknowledge the authors' valuable contribution to rehabilitation science, and at the same time interrogate the assumption that a taxonomy has essential added value to address the challenge of rehabilitation's black box. The tripartite analytical structure of action of treatment, active ingredient, and mechanism of action, and not an RTT, is the key to addressing the rehabilitation black box. There is a need for clearly defined operationalized requirements of how the 3 components have to be expressed. We also recommend that this concerted effort be linked to all relevant stakeholders and all international endeavors that are pursuing a common goal of enhancing rehabilitation research. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. Evaluation of an internet-based aftercare program to improve vocational reintegration after inpatient medical rehabilitation: study protocol for a cluster-randomized controlled trial.

    PubMed

    Zwerenz, Rüdiger; Gerzymisch, Katharina; Edinger, Jens; Holme, Martin; Knickenberg, Rudolf J; Spörl-Dönch, Sieglinde; Kiwus, Ulrich; Beutel, Manfred E

    2013-01-25

    Mental disorders are the main reasons for rising proportions of premature pension in most high-income countries. Although inpatient medical rehabilitation has increasingly targeted work-related stress, there is still a lack of studies on the transfer of work-specific interventions into work contexts. Therefore, we plan to evaluate an online aftercare program aiming to improve vocational reintegration after medical rehabilitation. Vocationally strained patients (n = 800) aged between 18 and 59 years with private internet access are recruited in psychosomatic, orthopedic and cardiovascular rehabilitation clinics in Germany. During inpatient rehabilitation, participants in stress management group training are cluster-randomized to the intervention or control group. The intervention group (n = 400) is offered an internet-based aftercare with weekly writing tasks and therapeutic feedback, a patient forum, a self-test and relaxation exercises. The control group (n = 400) obtains regular e-mail reminders with links to publicly accessible information about stress management and coping. Assessments are conducted at the beginning of inpatient rehabilitation, the end of inpatient rehabilitation, the end of aftercare, and 9 months later. The primary outcome is a risk score for premature pension, measured by a screening questionnaire at follow-up. Secondary outcome measures include level of vocational stress, physical and mental health, and work capacity at follow-up. We expect the intervention group to stabilize the improvements achieved during inpatient rehabilitation concerning stress management and coping, resulting in an improved vocational reintegration. The study protocol demonstrates the features of internet-based aftercare in rehabilitation. International Standard Randomised Controlled Trial Number Register (ISRCTN:ISRCTN33957202).

  9. GENERAL VIEW OF NORTH VEHICLE ACCESS PLATFORMS, HB3, FACING NORTHEAST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GENERAL VIEW OF NORTH VEHICLE ACCESS PLATFORMS, HB-3, FACING NORTHEAST TOWARDS CEILING - Cape Canaveral Air Force Station, Launch Complex 39, Vehicle Assembly Building, VAB Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  10. GENERAL VIEW OF NORTH VEHICLE ACCESS PLATFORMS, HB3, FACING NORTH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GENERAL VIEW OF NORTH VEHICLE ACCESS PLATFORMS, HB-3, FACING NORTH TOWARDS FLOOR - Cape Canaveral Air Force Station, Launch Complex 39, Vehicle Assembly Building, VAB Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

  11. 78 FR 27208 - Applications for New Awards; Rehabilitation Services Administration-Centers for Independent Living

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-09

    ... DEPARTMENT OF EDUCATION Applications for New Awards; Rehabilitation Services Administration... Application Package: ED Pubs, U.S. Department of Education, P.O. Box 22207, Alexandria, VA 22304. Telephone... with disabilities can obtain a copy of the application package in an accessible format (e.g., braille...

  12. Evaluation of jointed reinforced concrete pavement rehabilitation on I-64 in the Richmond and Hampton Roads districts of Virginia.

    DOT National Transportation Integrated Search

    2009-01-01

    Beginning in 2004, the Virginia Department of Transportation (VDOT) undertook a series of pavement rehabilitation projects to address deficiencies in three sections of the I-64 corridor between Richmond and Newport News. I-64 serves as the primary av...

  13. 78 FR 66344 - Applications for New Awards; Rehabilitation Training: Rehabilitation Long-Term Training Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ...-Term Training Program--Vocational Rehabilitation Counseling AGENCY: Office of Special Education and...: Rehabilitation Long- Term Training Program--Vocational Rehabilitation Counseling Notice inviting applications for... in the priority area of rehabilitation counseling. Absolute Priority 2: This priority is from the...

  14. Road dust emissions from paved roads measured using different mobile systems.

    PubMed

    Pirjola, Liisa; Johansson, Christer; Kupiainen, Kaarle; Stojiljkovic, Ana; Karlsson, Hans; Hussein, Tareq

    2010-12-01

    Very few real-world measurements of road dust suspension have been performed to date. This study compares two different techniques (referred to as Sniffer and Emma) to measure road dust emissions. The main differences between the systems are the construction of the inlet, different instruments for recording particulate matter (PM) levels, and different loads on the wheel axes (the weight of Sniffer was much higher than that of Emma). Both systems showed substantial small-scale variations of emission levels along the road, likely depending on-road surface conditions. The variations observed correlated quite well, and the discrepancies are likely a result of variations in dust load on the road surface perpendicular to the driving direction that cause variations in the measurements depending on slightly different paths driven by the two vehicles. Both systems showed a substantial influence on the emission levels depending on the type of tire used. The summer tire showed much lower suspension than the winter tires (one nonstudded and one studded). However, the relative importance of the nonstudded versus studded tire was rather different. For the ratio of studded/nonstudded, Emma shows higher values on all road sections compared with Sniffer. Both techniques showed increased emission levels with increasing vehicle speed. When the speed increased from 50 to 80 km hr(-1), the relative concentrations increased by 30-170% depending on the tire type and dust load. However, for road sections that were very dirty, Sniffer showed a much higher relative increase in the emission level with the nonstudded tire. Sniffer's absolute concentrations were mostly higher than Emma's. Possible reasons for the differences are discussed in the paper. Both systems can be used for studying relative road dust emissions and for designing air quality management strategies.

  15. Web-based rehabilitation interventions for people with rheumatoid arthritis: A systematic review.

    PubMed

    Srikesavan, Cynthia; Bryer, Catherine; Ali, Usama; Williamson, Esther

    2018-01-01

    Background Rehabilitation approaches for people with rheumatoid arthritis include joint protection, exercises and self-management strategies. Health interventions delivered via the web have the potential to improve access to health services overcoming time constraints, physical limitations, and socioeconomic and geographic barriers. The objective of this review is to determine the effects of web-based rehabilitation interventions in adults with rheumatoid arthritis. Methods Randomised controlled trials that compared web-based rehabilitation interventions with usual care, waiting list, no treatment or another web-based intervention in adults with rheumatoid arthritis were included. The outcomes were pain, function, quality of life, self-efficacy, rheumatoid arthritis knowledge, physical activity and adverse effects. Methodological quality was assessed using the Cochrane Risk of Bias tool and quality of evidence with the Grading of Recommendations Assessment, Development and Evaluation approach. Results Six source documents from four trials ( n = 567) focusing on self-management, health information or physical activity were identified. The effects of web-based rehabilitation interventions on pain, function, quality of life, self-efficacy, rheumatoid arthritis knowledge and physical activity are uncertain because of the very low quality of evidence mostly from small single trials. Adverse effects were not reported. Conclusion Large, well-designed trials are needed to evaluate the clinical and cost-effectiveness of web-based rehabilitation interventions in rheumatoid arthritis.

  16. Road density

    EPA Pesticide Factsheets

    Road density is generally highly correlated with amount of developed land cover. High road densities usually indicate high levels of ecological disturbance. More information about these resources, including the variables used in this study, may be found here: https://edg.epa.gov/data/Public/ORD/NERL/ReVA/ReVA_Data.zip.

  17. [Rehabilitation in rheumatology].

    PubMed

    Luttosch, F; Baerwald, C

    2010-10-01

    Rehabilitation in rheumatology focuses on prevention of functional disorders of the musculoskeletal system, maintenance of working ability and prevention of care dependency. Drug treatment alone rarely results in long-term remission, therefore rehabilitative measures must be integrated into rheumatic care. Rehabilitative therapy in rheumatology includes physiotherapy, patient education and occupational therapy. Positive effects of physical therapy methods have been proven by various studies. Patient education and occupational therapy are important tools for stabilizing the course of the disease. To maintain positive rehabilitative results patients have to be involved in the selection of treatment measures and should take an active part in the long-term treatment process. Despite proven efficacy of physical measures there is evidence for a lack of utilization of rehabilitative therapy due to increasing cost pressure in the health care system which will further increase over time.

  18. Postacute Care in Cancer Rehabilitation.

    PubMed

    Guo, Ying; Fu, Jack B; Guo, Hong; Camp, Jennifer; Shin, Ki Y; Tu, Shi-Ming; Palmer, Lynn J; Yadav, Rajesh

    2017-02-01

    Acute care is usually associated with disease progression, treatments for cancer, and medical comorbidities. Patients with cancer may develop sudden functional deficits that require rehabilitation. Some of these patients benefit from acute rehabilitation, others benefit from subacute rehabilitation. After acute rehabilitation, continuous care for these patients has not been well described. Three studies are presented to demonstrate that cancer rehabilitation is a continuous process. Rehabilitation professionals should know how to detect fall risk, monitor symptoms, and render symptom management. Patients with cancer often require rehabilitation services during their entire disease trajectory. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Facilities Planning Guide for Special Education Programs: Planning Accessibility for the Handicapped in Public Schools.

    ERIC Educational Resources Information Center

    Brooks, Kenneth W.

    The guide details characteristics to provide architecturally accessible special education programs for handicapped students. Impetus for the accessibility movement is traced to legislation, including the Architectural Barriers Act and Sections 503 and 504 of the Rehabilitation Act of 1973. Planning features considered are the development of a…

  20. Powered off-road wheelchair for the transportation of tetraplegics along mountain trails.

    PubMed

    Antonelli, Michele Gabrio; Alleva, Stefano; Beomonte Zobel, Pierluigi; Durante, Francesco; Raparelli, Terenziano

    2017-12-08

    For off-road mobility, some manual or power assisted devices were conceived to be self-driven by paraplegics while for tetraplegics non power-assisted devices were conceived. These devices require one or more conductors who are subjected to a high physical demand thus potentially creating: precarious safety condition for the user an elevated physical demand of conductors could reduce the care and the attention to give to the user; the time of the outdoor adventure experience of the user could be limited. To address these issues, an innovative user-centered power assisted off-road wheelchair for the transportation of tetraplegics along mountain trails was developed. The device, structured like a trike, is driven by two healthy conductors; the user is placed in the middle of the frame. A movable seat provides for the transfer from the standard to the off-road wheelchair. An electrical motor, powered by a battery pack, provides for the actuation. All the design and prototype aspects, the control system and experimental tests are detailed. The prototype satisfies mechanical, safety and duration requirements. No physical demand while using the device and for the transfer of the user to the device was identified. Fun and engaging tests were carried out and all the participants were involved. Implications for Rehabilitation The device has the potential to enhance the quality of life of tetraplegics in terms of new life experiences. The device revealed the real possibility of a full recreational experience, an enhanced participation and a better social integration of tetraplegics.

  1. 77 FR 27035 - Rehabilitation Research and Training Center (RRTCs) on Vocational Rehabilitation (VR) and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-08

    ... Rehabilitation (VR) and Developing Strategies To Meet Employer Needs in Changing Economic Environments AGENCY...--Rehabilitation Research and Training Center (RRTCs) on Vocational Rehabilitation (VR) and Developing Strategies... Background The Rehabilitation Act authorizes the establishment of the State VR Services Program (VR Program...

  2. An emerging occupational rehabilitation system in the People's Republic of China.

    PubMed

    Tang, Dan; Chen, Gang; Xu, Yan-Wen; Hui-Lo, Karen Y L; Luo, Xiao-Yuan; Chan, Chetwyn C H

    2011-03-01

    China has become a major economic influence in Asia and globally. The country is in the position to further develop its workers' insurance and compensation system. This paper aims to introduce the existing workers' compensation policies, explain how these policies guide the operation of the occupational rehabilitation system for injured workers, and suggest ways to further develop an effective and sustainable system for the country. Major government policies and initiative documents and existing literature on occupational rehabilitation were critically reviewed. Shortfalls in our current system were identified and potential further development regimes were propose. Since 2004, China has implemented its national policy on providing timely and comprehensive rehabilitation and return-to-work interventions for workers who are injured at work. The three-tier medical and occupational rehabilitation system appears effective for enabling injured workers to access these services. Such a system is regarded as the most optimal for the country in spearheading the development of quality occupational rehabilitation services, and at the same time incorporating the existing expertise in acute medical care and rehabilitation within the public medical and health system. Problems encountered in the system can be classified under the culture, system and competence building aspects. The future workers' insurance and compensation system can probably put more emphasis on using bio-psychosocial and work disability prevention models in guiding its service development and delivery. Efforts need to be placed on building the competence of professionals in the system who provide services for injured workers. The empowerment of important stakeholders in the workers' insurance and compensation system and their inclusion in the planning of service delivery are crucial for developing a sustainable and effective system for China.

  3. Development, Implementation, and Evaluation of the Apollo Model of Pediatric Rehabilitation Service Delivery

    ERIC Educational Resources Information Center

    Camden, Chantal; Swaine, Bonnie; Tetreault, Sylvie; Bergeron, Sophie; Lambert, Carole

    2013-01-01

    This article presents the experience of a rehabilitation program that undertook the challenge to reorganize its services to address accessibility issues and improve service quality. The context in which the reorganization process occurred, along with the relevant literature justifying the need for a new service delivery model, and an historical…

  4. Impact of daylight saving time on road traffic collision risk: a systematic review.

    PubMed

    Carey, Rachel N; Sarma, Kiran M

    2017-07-02

    Bills have been put forward in the UK and Republic of Ireland proposing a move to Central European Time (CET). Proponents argue that such a change will have benefits for road safety, with daylight being shifted from the morning, when collision risk is lower, to the evening, when risk is higher. Studies examining the impact of daylight saving time (DST) on road traffic collision risk can help inform the debate on the potential road safety benefits of a move to CET. The objective of this systematic review was to examine the impact of DST on collision risk. Major electronic databases were searched, with no restrictions as to date of publication (the last search was performed in January 2017). Access to unpublished reports was requested through an international expert group. Studies that provided a quantitative analysis of the effect of DST on road safety-related outcomes were included. The primary outcomes of interest were road traffic collisions, injuries and fatalities. Twenty-four studies met the inclusion criteria. Seventeen examined the short-term impact of transitions around DST and 12 examined long-term effects. Findings from the short-term studies were inconsistent. The long-term findings suggested a positive effect of DST. However, this cannot be attributed solely to DST, as a range of road collision risk factors vary over time. The evidence from this review cannot support or refute the assertion that a permanent shift in light from morning to evening will have a road safety benefit. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Gravel roads management : volume 2, gravel roads management : implementation guide.

    DOT National Transportation Integrated Search

    2011-10-01

    This report establishes procedures for managing dirt and gravel roads, with a primary focus on smaller agencies, such as Wyoming counties, that must manage their roads with very limited resources. The report strives, first, to guide and assist smalle...

  6. Gravel roads management : volume 3, gravel roads management : programming guide.

    DOT National Transportation Integrated Search

    2010-10-01

    This report establishes procedures for managing dirt and gravel roads, with a primary focus on smaller agencies, such as Wyoming counties, that must manage their roads with very limited resources. The report strives, first, to guide and assist smalle...

  7. Service Providers Assessment of the Career Development Needs of Blind and Visually Impaired Students and Rehabilitation Clients and the Resources Available to Meet Those Needs.

    ERIC Educational Resources Information Center

    Bagley, Martha

    1985-01-01

    The article considers career development needs of blind and visually impaired individuals and discusses results of a survey of schoolteachers (grades K, three, six, nine, and 12), rehabilitation counselors, management staff of rehabilitation agencies, and agency administrators. Respondents cited the need for greater accessibility to career…

  8. Roads Near Streams

    EPA Pesticide Factsheets

    Roads are a source of auto related pollutants (e.g. gasoline, oil and other engine fluids). When roads are near streams, rain can wash these pollutants directly into the stream, harming both water and habitat quality. This metric measured the length of roads within 30 meters of a stream. More information about these resources, including the variables used in this study, may be found here: https://edg.epa.gov/data/Public/ORD/NERL/ReVA/ReVA_Data.zip.

  9. Responding to the World Health Organization Global Disability Action Plan in Egypt: A Technical Consultancy to develop a National Disability, Health and Rehabilitation Plan.

    PubMed

    Gutenbrunner, Christoph; Nugraha, Boya

    2018-04-18

    A technical consultation to develop a National Disability, Health and Rehabilitation Plan (NDHRP) for Egypt was carried out in 2015. Its overall goal was to improve health, functioning, well-being, quality of life, and participation of persons with disability in Egypt by supporting the Ministry of Health and Population and other stakeholders to improve access to health services and strengthen health-related rehabilitation services for all persons in need. The methodological steps of the technical consultation were as follows: collecting and reviewing accessible documents and data; site visits to state institutions, health and rehabilitation services; discussions with relevant stakeholders in rehabilitation, including persons with disability; drafting recommendations based on the principles of the World Report on Disability and the World Health Organization Global Disability Action Plan and the information collected; discussion with stakeholders in a workshop; and preparation of a final report. The development of a NDHRP was successful and led to recommendations with a good level of consensus among stakeholders in Egypt. The authors hope that the NDHRP will lead to improved rehabilitation service provision, and health and quality of life of persons with disability and chronic health conditions living in Egypt.

  10. Psychiatric rehabilitation education for physicians.

    PubMed

    Rudnick, Abraham; Eastwood, Diane

    2013-06-01

    As part of a rapidly spreading reform toward recovery-oriented services, mental health care systems are adopting Psychiatric/Psychosocial Rehabilitation (PSR). Accordingly, PSR education and training programs are now available and accessible. Although psychiatrists and sometimes other physicians (such as family physicians) provide important services to people with serious mental illnesses and may, therefore, need knowledge and skill in PSR, it seems that the medical profession has been slow to participate in PSR education. Based on our experience working in Canada as academic psychiatrists who are also Certified Psychiatric Rehabilitation Practitioners (CPRPs), we offer descriptions of several Canadian initiatives that involve physicians in PSR education. Multiple frameworks guide PSR education for physicians. First, guidance is provided by published PSR principles, such as the importance of self-determination (www.psrrpscanada.ca). Second, guidance is provided by adult education (andragogy) principles, emphasizing the importance of addressing attitudes in addition to knowledge and skills (Knowles, Holton, & Swanson, 2011). Third, guidance in Canada is provided by Canadian Medical Education Directives for Specialists (CanMEDS) principles, which delineate the multiple roles of physicians beyond that of medical expert (Frank, 2005) and have recently been adopted in Australia (Boyce, Spratt, Davies, & McEvoy, 2011). (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  11. Community-Based Rehabilitation to Improve Stroke Survivors' Rehabilitation Participation and Functional Recovery.

    PubMed

    Ru, Xiaojuan; Dai, Hong; Jiang, Bin; Li, Ninghua; Zhao, Xingquan; Hong, Zhen; He, Li; Wang, Wenzhi

    2017-07-01

    The aim of this study was to evaluate the effectiveness of a community-based rehabilitation appropriate technique (CRAT) intervention program in increasing rehabilitation participation and improving functional recovery of stroke survivors. This study followed a quasi-experimental design. In each of 5 centers servicing approximately 50,000 individuals, 2 communities were designated as either the intervention or control community. A CRAT intervention program, including 2-year rehabilitation education and 3-month CRAT treatment, was regularly implemented in the intervention communities, whereas there was no special intervention in the control community. Two sampling surveys, at baseline and after intervention, were administered to evaluate the rehabilitation activity undertaken. In intervention communities, stroke survivor's motor function, daily activity, and social activity were evaluated pretreatment and posttreatment, using the Fugl-Meyer Motor Function Assessment, Barthel index, and Social Functional Activities Questionnaire. The proportion of individuals participating in rehabilitation-related activity was increased significantly (P < 0.05) in intervention communities, as compared with control communities. In intervention communities, the patients' Fugl-Meyer Motor Function Assessment, Barthel index, and Social Functional Activities Questionnaire scores were significantly improved after rehabilitation (P < 0.05) across all ages and disease courses, except for the FAQ scores in patients younger than 50 years (P > 0.05). Community-based rehabilitation appropriate technique increases rehabilitation participation rates and enhances motor function, daily activity, and social activity of stroke survivors.

  12. Silk or Spandex : Chinas Problematic One Road, One Belt Plan to Expand its Economic Boundaries as Seen Through the Lens of American, British, and Japanese Experience

    DTIC Science & Technology

    2016-04-04

    Yahoo News Website, entry posted February 15, 2016, http://news.yahoo.com/first-silk-road-train-arrives-tehran-china- 134703954.html (accessed on...Intentionally left blank 85 Bibliography Agence France-Presse. “First ’Silk Road’ train arrives in Tehran from China,” Yahoo News

  13. Computer Assisted REhabilitation (CARE) Lab: A novel approach towards Pediatric Rehabilitation 2.0.

    PubMed

    Olivieri, Ivana; Meriggi, Paolo; Fedeli, Cristina; Brazzoli, Elena; Castagna, Anna; Roidi, Marina Luisa Rodocanachi; Angelini, Lucia

    2018-01-01

    Pediatric Rehabilitation therapists have always worked using a variety of off-the-shelf or custom-made objects and devices, more recently including computer based systems. These Information and Communication Technology (ICT) solutions vary widely in complexity, from easy-to-use interactive videogame consoles originally intended for entertainment purposes to sophisticated systems specifically developed for rehabilitation.This paper describes the principles underlying an innovative "Pediatric Rehabilitation 2.0" approach, based on the combination of suitable ICT solutions and traditional rehabilitation, which has been progressively refined while building up and using a computer-assisted rehabilitation laboratory. These principles are thus summarized in the acronym EPIQ, to account for the terms Ecological, Personalized, Interactive and Quantitative. The paper also presents the laboratory, which has been designed to meet the children's rehabilitation needs and to empower therapists in their work. The laboratory is equipped with commercial hardware and specially developed software called VITAMIN: a virtual reality platform for motor and cognitive rehabilitation.

  14. Cardiac Rehabilitation.

    ERIC Educational Resources Information Center

    Thoreson, Richard W.; And Others

    1981-01-01

    Describes rehabilitation implications associated with psychosocial factors, patient reaction, and family adjustment to coronary heart disease. Patient education and counseling must stress specific long-term care and follow-up and deal with family anxiety and depression. The rehabilitation counselor can help patients incorporate medical…

  15. Estimation of Road Friction Coefficient in Different Road Conditions Based on Vehicle Braking Dynamics

    NASA Astrophysics Data System (ADS)

    Zhao, You-Qun; Li, Hai-Qing; Lin, Fen; Wang, Jian; Ji, Xue-Wu

    2017-07-01

    The accurate estimation of road friction coefficient in the active safety control system has become increasingly prominent. Most previous studies on road friction estimation have only used vehicle longitudinal or lateral dynamics and often ignored the load transfer, which tends to cause inaccurate of the actual road friction coefficient. A novel method considering load transfer of front and rear axles is proposed to estimate road friction coefficient based on braking dynamic model of two-wheeled vehicle. Sliding mode control technique is used to build the ideal braking torque controller, which control target is to control the actual wheel slip ratio of front and rear wheels tracking the ideal wheel slip ratio. In order to eliminate the chattering problem of the sliding mode controller, integral switching surface is used to design the sliding mode surface. A second order linear extended state observer is designed to observe road friction coefficient based on wheel speed and braking torque of front and rear wheels. The proposed road friction coefficient estimation schemes are evaluated by simulation in ADAMS/Car. The results show that the estimated values can well agree with the actual values in different road conditions. The observer can estimate road friction coefficient exactly in real-time and resist external disturbance. The proposed research provides a novel method to estimate road friction coefficient with strong robustness and more accurate.

  16. Aural rehabilitation through music workshops for cochlear implant users.

    PubMed

    van Besouw, Rachel M; Nicholls, David R; Oliver, Benjamin R; Hodkinson, Sarah M; Grasmeder, Mary L

    2014-04-01

    It has been reported that after speech perception, music appreciation is the second most commonly expressed requirement among cochlear implant (CI) recipients. Certain features of music are known to be more readily accessible; however, provision of music rehabilitation for adult CI users is limited. A series of music workshops were organized to (1) enable attendees to explore which aspects of music they are able to perceive and appreciate; (2) raise awareness of listening strategies, technology, and rehabilitation resources for music; and (3) develop ideas, and prototype software, for inclusion in a music rehabilitation program. The therapeutic value of music workshops was concurrently investigated. A qualitative, longitudinal study was used. Two consultation meetings were held before a series of nine music workshops that occurred over a period of 5 mo. Five adult CI users participated in consultations before the workshops. Twenty-eight adult CI users from the South of England Cochlear Implant Centre attended at least one of the workshops. Participants could attend as many workshops as they wished. Each workshop lasted between 2 to 2.5 hr and included individual computer-based and group activities. Responses to open-ended questions were transcribed in the consultation meetings and used to develop workshop activities. A preworkshop survey was used to determine attendees' aspirations and expectations. Postworkshop surveys were used to qualitatively and quantitatively evaluate attendees' immediate reactions to the workshop content, software, and perceived benefits. A 2-month, postworkshop survey evaluated the longer-term impact of the workshops. Overall reaction to the workshops and prototype software was positive. All attendees indicated that they anticipated changing how they engaged with music as a result of the workshops, and data from the preworkshop and postworkshop surveys suggest a positive change in listening habits. The workshops proved to be an effective

  17. Geo-Hazards and Mountain Road Development in Nepal: Understanding the Science-Policy-Governance Interface

    NASA Astrophysics Data System (ADS)

    Dugar, Sumit; Dahal, Vaskar

    2015-04-01

    informed other road development schemes in Nepal. Geomorphological surveys and robust geo-hazard assessments that factor the spatial and temporal dimensions of the seismic, fluvial and sediment hazards along the road corridor are critical for sustainable development of mountain roads. However, scientific and technical research studies seldom inform mountain road development primarily due to lack of co-ordination between the respective government agencies, access to journal papers in developing countries and unwillingness to adopt novel interventions in rural road construction practices. These challenges are further exacerbated by weak governance and lack of proper policy enforcement that often leads to construction of poorly engineered roads, thereby increasing the risk of rural infrastructural damage from geo-hazards. Though there exists a disconnect between the science-policy-governance interface where information on geo-hazards is neglected in mountain road development due to lack of scientific research and government apathy, there is an opportunity to spur dialogue and sensitize these issues via trans-disciplinary approaches on disaster risk management.

  18. Music therapy in neurological rehabilitation settings.

    PubMed

    Galińska, Elżbieta

    2015-01-01

    The neurologic music therapy is a new scope of music therapy. Its techniques deal with dysfunctions resulting from diseases of the human nervous system. Music can be used as an alternative modality to access functions unavailable through non-musical stimulus. Processes in the brain activated by the influence of music can be generalized and transferred to non-musical functions. Therefore, in clinical practice, the translation of non-musical therapeutic exercises into analogous, isomorphic musical exercises is performed. They make use of the executive peculiarity of musical instruments and musical structures to prime, cue and coordinate movements. Among musical components, a repetitive rhythm plays a significant role. It regulates physiologic and behavioural functions through the mechanism of entrainment (synchronization of biological rhythms with musical rhythm based on acoustic resonance). It is especially relevant for patients with a deficient internal timing system in the brain. Additionally, regular rhythmic patterns facilitate memory encoding and decoding of non-musical information hence music is an efficient mnemonic tool. The music as a hierarchical, compound language of time, with its unique ability to access affective/motivational systems in the brain, provides time structures enhancing perception processes, mainly in the range of cognition, language and motor learning. It allows for emotional expression and improvement of the motivation for rehabilitation activities. The new technologies of rhythmic sensory stimulation (i.e. Binaural Beat Stimulation) or rhythmic music in combination with rhythmic light therapy appear. This multimodal forms of stimulation are used in the treatment of stroke, brain injury, dementia and other cognitive deficits. Clinical outcome studies provide evidence of the significant superiority of rehabilitation with music over the one without music.

  19. Conceptual design and analysis of roads and road construction machinery for initial lunar base operations

    NASA Technical Reports Server (NTRS)

    Sines, Jeffrey L.; Banks, Joel; Efatpenah, Keyanoush

    1990-01-01

    Recent developments have made it possible for scientists and engineers to consider returning to the Moon to build a manned lunar base. The base can be used to conduct scientific research, develop new space technology, and utilize the natural resources of the Moon. Areas of the base will be separated, connected by a system of roads that reduce the power requirements of vehicles traveling on them. Feasible road types for the lunar surface were analyzed and a road construction system was designed for initial lunar base operations. A model was also constructed to show the system configuration and key operating features. The alternate designs for the lunar road construction system were developed in four stages: analyze and select a road type; determine operations and machinery needed to produce the road; develop machinery configurations; and develop alternates for several machine components. A compacted lunar soil road was selected for initial lunar base operations. The only machinery required to produce this road were a grader and a compactor. The road construction system consists of a main drive unit which is used for propulsion, a detachable grader assembly, and a towed compactor.

  20. Virtual reality in the rehabilitation of people with intellectual disabilities: review.

    PubMed

    Standen, Penny J; Brown, David J

    2005-06-01

    Virtual reality (VR) possesses many qualities that give it rehabilitative potential for people with intellectual disabilities, both as an intervention and an assessment. It can provide a safe setting in which to practice skills that might carry too many risks in the real world. Unlike human tutors, computers are infinitely patient and consistent. Virtual worlds can be manipulated in ways the real world cannot be and can convey concepts without the use of language or other symbol systems. Published applications for this client group have all been as rehabilitative interventions. These are described in three groups: promoting skills for independent living, enhancing cognitive performance, and improving social skills. Five groups of studies are reviewed that utilize virtual technology to promote skills for independent living: grocery shopping, preparing food, orientation, road safety, and manufacturing skills. Fears that skills or habits learnt in a virtual setting would not transfer to the real world setting have not been supported by the available evidence, apart from those studies with people with autistic spectrum disorders. Future directions are in the development of more applications for independent living skills, exploring interventions for promoting motor and cognitive skills, and the developments of ecologically valid forms of assessment.

  1. Sleep habits and road traffic accident risk for Iranian occupational drivers.

    PubMed

    Ebrahimi, Mohammad Hossein; Sadeghi, Masoumeh; Dehghani, Mohsen; Niiat, Khosro Sadegh

    2015-01-01

    The aim of this study is to assess the sleep quality and sleep disorders (prevalence of obstructive sleep apnea and sleepiness) among occupational drivers in Iran and to determine which demographic factors and occupational habits are linked to road traffic accidents. In this analytic cross-sectional study 556 occupational road drivers from Shahroud city (in the northeast of Iran) participated, upon a prior verbal informed consent, during 2013-2014. The Pittsburgh Sleep Quality Index (PSQI) standard questionnaire that scored on 7 point scale, the 8-item Epworth Sleepiness Scale (ESS) questionnaire and the 8-question STOP-Bang questionnaire along with demographic information and occupational data were used. To explore the independent factors associated with odds of poor sleep quality and road accident, multiple logistic regression models were used. Prevalence of previous road accidents, sleepiness while driving, and obstructive sleep apnea scored ≥ 3 in the study, and drivers accounted for 23.8%, 29%, and 24.8%, respectively. The global mean score of sleep quality and excessive sleepiness score were 5.2 and 4.8, respectively. The main factors related to the odds of poor sleep quality were snoring (odds ratio (OR) = 2.34; 95% confidence interval (CI): 1.15-4.77), smoking (OR = 2.12; 95% CI: 1.15-3.97), and driving times in a day (OR = 1.12; 95% CI: 1.03-1.21). The Epworth Sleepiness Scale (OR = 1.13; 95% CI: 1.07-1.23) and suffering from apnea (OR = 4.89; 95% CI: 1.07-23.83) were the best predictors for odds (increased risk) of road accidents. A considerable proportion of Iranian drivers had records of road accidents; poor sleep quality, sleepiness while driving, and sleep disorder breathing (obstructive sleep apnea - OSA). Snoring, smoking, driving time in a day, excessive sleepiness, and presumably apnea increase the odds of poor sleep quality and road traffic accident for Iranian occupational drivers. This work is available in Open Access model and licensed under

  2. Stroke rehabilitation.

    PubMed

    Langhorne, Peter; Bernhardt, Julie; Kwakkel, Gert

    2011-05-14

    Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially beneficial treatment options for motor recovery of the arm include constraint-induced movement therapy and robotics. Promising interventions that could be beneficial to improve aspects of gait include fitness training, high-intensity therapy, and repetitive-task training. Repetitive-task training might also improve transfer functions. Occupational therapy can improve activities of daily living; however, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice and of novel therapies (eg, stem-cell therapy, repetitive transcranial magnetic stimulation, virtual reality, robotic therapies, and drug augmentation) are underway to inform future practice. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Geriatric Rehabilitation ('Alters-Rehabilitation'): The New Challenge for Social Medicine and Science.

    ERIC Educational Resources Information Center

    Barolin, G. S.

    1996-01-01

    This discussion of geriatric rehabilitation stresses the importance of holistic and permanent rehabilitation with a fluent transition from the acute phase to the rehabilitation phase under one specialist's care and in one institution. Recommendations include mixed age groups in one ward; systematic education of relatives; follow-up rehabilitation…

  4. 75 FR 21273 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-23

    ... Rehabilitation of Individuals Who are Mentally Ill. 84.129J Rehabilitation Psychology. 84.129P Specialized... Mentally Ill. 84.129J Rehabilitation 100,000 2 Psychology. 84.129P Specialized Personnel 100,000 3 for...

  5. Linkages between unpaved forest roads and streambed sediment: why context matters in directing road restoration

    USGS Publications Warehouse

    Al-Chokhachy, Robert K.; Black, Tom A.; Thomas, Cameron; Luce, Charlie H.; Rieman, Bruce; Cissel, Richard; Carlson, Anne; Hendrickson, Shane; Archer, Eric K.; Kershner, Jeffrey L.

    2016-01-01

    Unpaved forest roads remain a pervasive disturbance on public lands and mitigating sediment from road networks remains a priority for management agencies. Restoring roaded landscapes is becoming increasingly important for many native coldwater fishes that disproportionately rely on public lands for persistence. However, effectively targeting restoration opportunities requires a comprehensive understanding of the effects of roads across different ecosystems. Here, we combine a review and a field study to evaluate the status of knowledge supporting the conceptual framework linking unpaved forest roads with streambed sediment. Through our review, we specifically focused on those studies linking measures of the density of forest roads or sediment delivery with empirical streambed sediment measures. Our field study provides an example of a targeted effort of linking spatially explicit estimates of sediment production with measures of streambed sediment. Surprisingly, our review uncovered few studies (n = 8) that empirically tested the conceptual framework linking unpaved forest roads and streambed sediment, and the results varied considerably. Field results generally supported the conceptual model that unpaved forest roads can control streambed sediment quality, but demonstrated high-spatial variability in the effects of forest roads on streambed sediment and the need to address hotspots of sediment sources. The importance of context in the effects of forest roads is apparent in both our review and field data, suggesting the need for in situ studies to avoid misdirected restoration actions.

  6. The Language of Information Technology: Accessibility in the Information Society.

    ERIC Educational Resources Information Center

    Warmkessel, Marjorie M.

    The language of information technology is discussed, with a focus on accessibility in the information society. The metaphors of information technology as an "information superhighway" or "infobahn" are analyzed; limitations of the "road system" and developments of Internet systems are considered. The concept of…

  7. 2. View east of filtration bed building. Access bridge to ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. View east of filtration bed building. Access bridge to earth covering over reinforced concrete roof is at center right of photograph. - Lake Whitney Water Filtration Plant, Filtration Plant, South side of Armory Street between Edgehill Road & Whitney Avenue, Hamden, New Haven County, CT

  8. Selection for inpatient rehabilitation after severe stroke: what factors influence rehabilitation assessor decision-making?

    PubMed

    Hakkennes, Sharon; Hill, Keith D; Brock, Kim; Bernhardt, Julie; Churilov, Leonid

    2013-01-01

    This study aimed to identify factors that assessors considered important in decision-making regarding suitability for inpatient rehabilitation after acute severe stroke. Multi-site prospective observational cohort study. Consecutive acute, severe stroke patients and their assessors for inpatient rehabilitation. Rehabilitation assessors completed a questionnaire, rating the importance (10 point visual analogue scale) and direction (positive, negative or neutral) of 15 patient related and 2 organisational items potentially affecting their decision regarding patients' acceptance to rehabilitation. Of the 75 patients referred to rehabilitation and included in this study 61 (81.3%) were accepted for inpatient rehabilitation. The items considered to be most important in the decision to accept the patient for rehabilitation were pre-morbid cognition, pre-morbid mobility and pre-morbid communication. For those not accepted the most important items were current mobility, social support and current cognition. Factor analysis revealed 3 underlying factors, interpreted as post-stroke status, pre-morbid status, and social attributes, accounting for 61.8% of the total variance. All were independently associated with acceptance for rehabilitation (p < 0.05). This study highlights the importance of pre-morbid function and social factors in addition to post-stroke function in the decision making process for acceptance to rehabilitation following severe stroke. Future models for selection for rehabilitation should consider inclusion of these factors.

  9. The association of road safety knowledge and risk behaviour with paediatric road traffic injury in Guangzhou, China.

    PubMed

    Dong, Xiaomei; Peek-Asa, Corinne; Yang, Jingzhen; Wang, Shengyong; Chen, Xiongfei; Chi, Guibo; Ramirez, Marizen

    2011-02-01

    This study describes road traffic injuries among school-aged children in Guangzhou, China, and examines the effect of road safety knowledge and risk behaviours on road traffic injuries. A stratified cluster sample of 3747 children from six primary schools and six middle schools in Guangzhou, China, was surveyed. Data were collected on sociodemographic factors and road traffic injuries during the past year. Knowledge about road safety rules was assessed using a 14-item road safety knowledge index, and risky road safety behaviours were measured using a 25-item road safety behaviour index. A total of 403 (10.8%) students reported having at least one road traffic injury during the past 12 months. A high proportion of injuries was found among children who were boys, in primary school and from the suburbs. Bicycle-related injuries were the most common (46.0% of all injuries). Motor vehicle-related injuries had higher hospitalisation rates and worse psychological impact than bicycle or pedestrian injuries. Children with low and medium road safety knowledge had 1.5 to 3 times the odds of injury compared with students with high road safety knowledge. Students with high scores on the risky road behaviour index had twice the odds of injury (OR 2.04, 95% CI 1.47 to 2.84) compared with students with low scores. Better road safety knowledge and the avoidance of walking or cycling-related risk behaviours are protective factors for road traffic injuries among Chinese school children. More injury prevention programmes are needed to improve road safety knowledge and reduce risk behaviours.

  10. Wildland road removal: research needs

    Treesearch

    T. Adam Switalski; John A. Bissonette; Tom H. Deluca; Charles H. Luce; Mary Ann Madej

    2003-01-01

    Wildland road removal is a common practice across the U.S. and in some parts of Canada. The main types of road removal include ripping, stream crossing restoration, and full recontour. Road removal creates a short-term disturbance that may temporarily increase sediment loss. However, research and long-term monitoring have shown that road removal both reduces erosion...

  11. Configuration of Appalachian logging roads

    Treesearch

    John E. Baumgras; John E. Baumgras

    1971-01-01

    The configuration - the curvature and grade - of logging roads in southern Appalachia is seldom severe, according to a recent Forest Service study. To improve the efficiency of logging roads, we must first define the characteristics of these roads; and in this report we provide a quantitative description of the configuration of over 200 miles of logging roads.

  12. E-Texts for All (Even Lucy): Ebooks and Accessibility

    ERIC Educational Resources Information Center

    Booth, Char

    2010-01-01

    If digital literacy is exploding, the visually disabled are taking the shrapnel. The author wagers that most librarians consider themselves committed to accessibility and make individual and organizational efforts to comply with (and often exceed) the Americans with Disabilities Act (ADA) in their buildings and the Rehabilitation Act Section 508…

  13. Progressive transmission of road network

    NASA Astrophysics Data System (ADS)

    Ai, Bo; Ai, Tinghua; Tang, Xinming; Li, Zhen

    2009-10-01

    The progressive transmission of vector map data requires efficient multi-scale data model to process the data into hierarchical structure. This paper presents such a data structure of road network without redundancy of geometry for progressive transmission. For a given scale, the road network display has to settle two questions. One is which road objects to be represented and the other is what geometric details to be visualized for the selected roads. This paper combines the Töpfer law and the BLG-tree structure into a multi-scale representation matrix to answer simultaneously the above two questions. In the matrix, rows from top to bottom represent the roads in the sequence of descending classification of traffic and length, which can support the Töpfer law to retrieve the more important roads. In a row, columns record one road by a linear BLG-tree to provide good line graphics.

  14. Evaluation of an internet-based aftercare program to improve vocational reintegration after inpatient medical rehabilitation: study protocol for a cluster-randomized controlled trial

    PubMed Central

    2013-01-01

    Background Mental disorders are the main reasons for rising proportions of premature pension in most high-income countries. Although inpatient medical rehabilitation has increasingly targeted work-related stress, there is still a lack of studies on the transfer of work-specific interventions into work contexts. Therefore, we plan to evaluate an online aftercare program aiming to improve vocational reintegration after medical rehabilitation. Methods Vocationally strained patients (n = 800) aged between 18 and 59 years with private internet access are recruited in psychosomatic, orthopedic and cardiovascular rehabilitation clinics in Germany. During inpatient rehabilitation, participants in stress management group training are cluster-randomized to the intervention or control group. The intervention group (n = 400) is offered an internet-based aftercare with weekly writing tasks and therapeutic feedback, a patient forum, a self-test and relaxation exercises. The control group (n = 400) obtains regular e-mail reminders with links to publicly accessible information about stress management and coping. Assessments are conducted at the beginning of inpatient rehabilitation, the end of inpatient rehabilitation, the end of aftercare, and 9 months later. The primary outcome is a risk score for premature pension, measured by a screening questionnaire at follow-up. Secondary outcome measures include level of vocational stress, physical and mental health, and work capacity at follow-up. Discussion We expect the intervention group to stabilize the improvements achieved during inpatient rehabilitation concerning stress management and coping, resulting in an improved vocational reintegration. The study protocol demonstrates the features of internet-based aftercare in rehabilitation. Trial registration International Standard Randomised Controlled Trial Number Register (ISRCTN:ISRCTN33957202) PMID:23351836

  15. Road safety perspectives among employees of a multinational corporation in urban India: local context for global injury prevention.

    PubMed

    Jacoby, Sara F; Winston, Flaura K; Richmond, Therese S

    2017-12-01

    In rapidly developing economies, like urban India, where road traffic injury rates are among the world's highest, the corporate workplace offers a non-traditional venue for road safety interventions. In partnership with a major multinational corporation (MNC) with a large Indian workforce, this study aimed to elicit local employee perspectives on road safety to inform a global corporate health platform. The safety attitudes and behaviours of 75 employees were collected through self-report survey and focus groups in the MNC offices in Bangalore and Pune. Analysis of these data uncovered incongruity between employee knowledge of safety strategies and their enacted safety behaviours and identified local preference for interventions and policy-level actions. The methods modelled by this study offer a straightforward approach for eliciting employee perspective for local road safety interventions that fit within a global strategy to improve employee health. Study findings suggest that MNCs can employ a range of strategies to improve the road traffic safety of their employees in settings like urban India including: implementing corporate traffic safety policy, making local infrastructure changes to improve road and traffic conditions, advocating for road safety with government partners and providing employees with education and access to safety equipment and safe transportation options.

  16. Road safety and road traffic accidents in Saudi Arabia

    PubMed Central

    Mansuri, Farah A.; Al-Zalabani, Abdulmohsen H.; Zalat, Marwa M.; Qabshawi, Reem I.

    2015-01-01

    Objectives: To identify the changing trends and crucial preventive approaches to road traffic accidents (RTAs) adopted in the Kingdom of Saudi Arabia (KSA) over the last 2.5 decades, and to analyze aspects previously overlooked. Methods: This systematic review was based on evidence of RTAs in KSA. All articles published during the last 25 years on road traffic accident in KSA were analyzed. This study was carried out from December 2013 to May 2014 in the Department of Family and Community Medicine, Taibah University, Al-Madinah Al-Munawwarah, KSA. Results: Road traffic accidents accounted for 83.4% of all trauma admissions in 1984-1989, and no such overall trend was studied thereafter. The most frequently injured body regions as reported in the latest studies were head and neck, followed by upper and lower extremities, which was found to be opposite to that of the studies reported earlier. Hospital data showed an 8% non-significant increase in road accident mortalities in contrast to police records of a 27% significant reduction during the years 2005-2010. Excessive speeding was the most common cause reported in all recent and past studies. Conclusion: Disparity was common in the type of reporting of RTAs, outcome measures, and possible causes over a period of 2.5 decade. All research exclusively looked into the drivers’ faults. A sentinel surveillance of road crashes should be kept in place in the secondary and tertiary care hospitals for all regions of KSA. PMID:25828277

  17. 78 FR 29237 - Final Priority; National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-20

    ..., producing observational findings, and creating other sources of research-based information. This research... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... for the Disability and Rehabilitation Research Projects and Centers Program administered by the...

  18. Report of Accomplishments under the Airport Improvement Program.

    DTIC Science & Technology

    1982-09-30

    Acquire snow removal equipment; conduct City of Portland feasibility study. Portland International (PRIMARY) Presque Isle 01 $ 15,840 Airport Master Plan...update to terminal City of Presque Isle area plan). Northern Maine Regional (PRIMARY) Presque Isle 02 $ 118,869 Rehabilitate terminal access road...City of Presque Isle Northern Maine Regional (PRIMARY) Rockland 01 $ 40,252 Airport Master Plan (update). Knox County Knox County Regional (COMMERCIAL

  19. Impact of a multidisciplinary rehabilitation nutrition team on evaluating sarcopenia, cachexia and practice of rehabilitation nutrition.

    PubMed

    Kokura, Yoji; Wakabayashi, Hidetaka; Maeda, Keisuke; Nishioka, Shinta; Nakahara, Saori

    2017-01-01

    To determine whether the presence of a multidisciplinary rehabilitation nutrition team affects sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. A cross-sectional study using online questionnaire among members of the Japanese Association of Rehabilitation Nutrition (JARN) was conducted. Questions were related to sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. 677 (14.7%) questionnaires were analysed. 44.5% reported that their institution employed a rehabilitation nutrition team, 20.2% conducted rehabilitation nutrition rounds and 26.1% conducted rehabilitation nutrition meetings. A total of 51.7%, 69.7%, 69.0% and 17.8% measured muscle mass, muscle strength, physical function and cachexia, respectively. For those with a rehabilitation nutrition team, 63.5%, 80.7%, 82.4% and 22.9% measured muscle mass, muscle strength, physical function and cachexia, respectively, whereas 46.7%, 78.0% and 78.1% of the respondents reported implementation of nutrition planning strategies in consideration of energy accumulation, rehabilitation training in consideration of nutritional status and use of dietary supplements, respectively. Multivariate logistic regression analysis showed that the use of a rehabilitation nutrition team independently affected sarcopenia evaluation and practice of rehabilitation nutrition but not cachexia evaluation. The presence of a multidisciplinary rehabilitation nutrition team increased the frequency of sarcopenia evaluation and practice of rehabilitation nutrition. J. Med. Invest. 64: 140-145, February, 2017.

  20. 78 FR 34261 - Final Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-07

    ..., such as observational research or research toward the development of diagnostic or outcome assessment... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... for the Disability and Rehabilitation Research Projects and Centers Program administered by the...