Transportation Research Board

This study aimed to evaluate the effectiveness of work conditioning for injured workers with low back pain conditions relative to acute physical therapy. Episodes of injured workers with medium+ physical demand level (PDL) jobs leveraging acute workers' compensation physical therapy with (Acute+) or without (Acute) transition to work conditioning were considered. Analyses of covariance (ANCOVAs) compared visits and patient-reported outcomes (PROs) between Acute and Acute+ cohorts controlling for baseline factors, and χ 2 compared achievement of medium+ PDL capacity between cohorts. Most patients (81%) received only Acute PT. Between-group differences in visits were favorable to Acute, and PRO metrics were all favorable to Acute+ (all P < 0.001). Significantly more (80%) in the Acute+ cohort achieved medium+ PDL than Acute only (57%; P < 0.001). Acute+ increases utilization but yields significantly better PRO metrics.

Purpose: Palpation is a traditional physical exam tool used to screen for abdominal aorta aneurysm. The purpose of this study was to determine agreement and reliability of abdominal aorta palpation measurements compared to point of care ultrasound (POCUS) measurements by novice physical therapy examiners in healthy individuals. Methods: Fifty healthy subjects over age 18 participated (age 25.2 ± 3.4). Two novice physical therapy examiners, blinded to each other's findings, measured infrarenal abdominal aorta width using a two-finger palpation technique and with POCUS, using a Vscan Air™ handheld ultrasound device, in randomized order. Bland–Altman analysis and paired t-tests compared agreement between palpation and POCUS measurements. Twenty-five participants returned within a month to assess intrarater reliability. Results: POCUS abdominal aorta width measurements averaged 1.54 cm (SD = 0.21), whereas palpation measurements averaged 2.51 cm (SD = 1.07), with a mean difference of 0.97 cm (SD = 1.03; 95% CI [0.67, 1.26]; P &lt; .001). Palpation and POCUS measurements showed a positive correlation of 0.319 (P = .025); however, agreement decreased as aorta size increased. Intrarater reliability for POCUS had an intraclass correlation coefficient (ICC) of 0.58 (95% CI [0.25, 0.79]), and palpation showed intrarater reliability ICC of 0.59 (95% CI [0.25, 0.80]). Conclusions: Palpation overestimates infrarenal abdominal aorta width compared to POCUS in healthy individuals when performed by novice physical therapy examiners. While moderate agreement with POCUS exists, palpation accuracy decreases as aorta size increases, showing more variability. Further validation is needed in physical therapy examiners with more experience and in individuals with abdominal aortic aneurysm.

This study focused on improving light weight deflectometer (LWD) testing protocols and understanding material and equipment variability. The Indiana Department of Transportation (INDOT) adopted the LWD test for its efficiency and effectiveness in measuring soil stiffness, a crucial parameter for pavement structural layers. However, challenges remain for implementing LWD testing, particularly in small construction areas. There are also challenges with establishing standardized performance-related criteria for various subgrade treatments. To address these obstacles, this research aimed to develop maximum allowable deflections for compaction quality assurance without relying on site-specific test sections. A large-scale laboratory testing facility was established at the INDOT research center and equipped with advanced sensing systems and a sandbox for controlled testing environments. Finite element (FE) models simulate material behavior under LWD testing conditions by using the viscoelastic plastic model to predict realistic deflection basins for different materials. Initial findings suggest that Dynatest LWD equipment provides more reliable results compared to Zorn LWD equipment, based on FE simulations. This study underscored the need for standardized calculation protocols and aimed to refine LWD testing procedures, enhancing the durability and reliability of pavement structures across various construction scenarios.

This study proposes a new design called the continuous green-T median U-turn (CGT-MUT) interchange and evaluates its operational performance compared to three interchanges. The selected interchanges for comparison are the Superstreet, Single Point Diamond Interchange (SPDI), and the Synchronized interchange. The evaluation is based on a microsimulation environment created in VISSIM combined with ASC/3 Software-in-the-Loop signal controllers. The findings show that the CGT-MUT enhanced the network-wide and intersection-level operations regarding various measures of effectiveness. Additionally, while the CGT-MUT did not always outperform all the other designs in terms of the on-ramp turning traffic travel times, it outperformed the Superstreet and Synchronized in terms of the off-ramp turning traffic travel times and resulted in the least through traffic travel times for all the tested scenarios. Particularly, the CGT-MUT’s through travel times were 9% – 30%, 26% – 42%, and 13% – 38% less than those for the Superstreet, SPDI, and Synchronized interchanges, respectively.

Emotional distress is frequently experienced by mothers whose newborns are hospitalized in a neonatal intensive care unit (NICU). Among these women, there is a critical need for emotional support conveniently delivered at the newborn's point of care by a trusted and medically knowledgeable professional: a NICU nurse. One promising way to enhance in situ delivery of emotional care is to have a NICU nurse provide Listening Visits (LVs), a brief support intervention developed expressly for delivery by nurses to depressed postpartum women. This trial assessed the feasibility of having NICU nurses deliver LVs to emotionally distressed mothers of hospitalized newborns and compared depression outcomes in a small sample of participants randomized to LVs or usual care (UC). In this pilot randomized controlled trial, emotionally distressed mothers of hospitalized newborns were randomized to receive up to six LVs from a NICU nurse or UC from a NICU social worker. To assess change in depression symptoms, women were invited to complete the Inventory of Depression and Anxiety Symptoms-General Depression Scale at enrollment and 4 and 8 weeks post-enrollment. Depression symptoms declined over time for both groups, with no difference between the two groups. A post hoc analysis of reliable change found higher rates of improvement at the 4-week assessment among recipients of LVs than UC. NICU nurses successfully implemented LVs during this trial. Depression symptom scores did not significantly differ in the two groups posttreatment or at follow-up. Nevertheless, post hoc analyses indicated comparatively higher rates of clinical improvement immediately after LVs, suggesting the intervention can reduce maternal depression early on when women are most distressed.

An Automated Road Transportation Symposium (ARTS) breakout session entitled “Unscrambling the Automated Vehicle Policy Puzzle: AV Policy Development and Regulation under a New Normal” provided an overview of federal, state, and local policy. At the federal level, speakers discussed regulatory status, federal transportation policy points, and an industry prospective for federal action. During the second half of the breakout session, speakers provided perspectives and details about state and local efforts to design and implement AV systems that address societal goals, which include environmental benefits, reduced congestion, and improved mobility for all people.

Abstract In preparing for widespread deployment of automated vehicles and shared mobility, it is important to understand the role of connectivity. This chapter discusses the importance of connectivity from the perspective of OEMs, other private sector representatives, and federal, state, and local government agencies. Key findings are that all stakeholders see great value in increased connectivity and that it is politically feasible, unlike other means of increasing transportation capacity, such as building more roads or congestion pricing. However, it is very easy to get caught up in “shiny object syndrome” with connectivity and forget about the purpose of implementing it: the human who is the end user. A number of research questions are outlined at the end of this chapter.KeywordsAutomated vehiclesConnectivity

Few studies have examined and compared neonatal physicians' and nurses' attitudes toward palliative care. This comparative study sought to evaluate attitudes toward neonatal palliative care in neonatal nurses and physicians and identify associated facilitators and barriers. This comparative, cross-sectional study included 173 neonatal intensive care unit staff (149 neonatal nurses and 24 neonatal physicians) in 2 hospitals in Istanbul, Turkey. Data were collected using the Turkish version of the Neonatal Palliative Care Attitude Scale. The results of the study revealed 8 facilitators and 9 barriers to neonatal palliative care. Nurses were significantly more likely than physicians to agree that parents are informed about palliative care options in their unit ( P = .008), that caring for dying infants is traumatic ( P = .007), and that their willingness to provide palliative care is influenced by their personal attitudes toward death ( P = .015). This study demonstrates the importance of parents' active involvement in the palliative care process, the establishment of standard policies and guidelines, and the provision of vocational and in-service education programs to support palliative care. Initiatives to strengthen facilitators and mitigate barriers are needed to optimize the implementation of palliative care in NICUs.