My study offers a strategy to examine the effects of outdoor advertising on traffic safety. Innovations in the out-of-home advertising industry suggest the potential for outdoor advertising to increase driver distraction and therefore vehicle accident rates. Moreover, city planners need to understand how sign-free zones perform relativecompared to other areas and whether there is a safety rather conservational or aesthetic motivation for such planned zones. In addressing these issues, the present study uses panel data collected from the Massachusetts Departments of Transportation and Revenue and the American Community Survey on cities and towns in Massachusetts from 2008 to 2012 to assess whether off-premise advertising displays have a significant impact on vehicle accident rates. Ultimately, this study finds no evidence that sign density, or the number of signs per road mile, consistently impacts accident rates. However, the presence of signs in general significantly and adversely affects traffic safety, increasing collision rates. While this detected effect may be causal, it may also be indicative of differences in city-specific policies and environmental circumstances across Massachusetts cities with and without off-premise advertising signs.

Use of skilled care during antenatal visits and delivery is recommended to address the burden of maternal mortality. However there are few facility deliveries and insufficient knowledge of danger signs, especially in rural Tanzania.  The aim of this thesis was to explore the perceptions and challenges that the community faces while preparing for childbirth and to evaluate an intervention of the Home Based Life Saving Skills education programme on knowledge of danger signs, facility delivery and male involvement when delivered by rural community health workers in Tanzania. In Paper I, Focus Group Discussions explored the perceptions and challenges that the community encounters while preparing for childbirth. Structured questionnaires assessed men’s knowledge of danger signs and birth preparedness and complication readiness in Paper II. The effect of the Home Based Life Saving Skills education programme in the community was assessed with a before-and-after evaluation in two districts; one intervention and one comparison. Paper III assessed the effect of the programme on knowledge of danger signs and birth preparedness and facility delivery among women, while Paper IV evaluated its effect on male involvement. The community perceived that all births must be prepared for and that obstetric complication demands hospital care; hence skilled care was favoured. Men’s knowledge of danger signs was limited; only 12% were prepared for childbirth and complications. Preparedness was associated with knowledge of obstetric complications (AOR=1.4 95% CI 1.8 – 2.6). The intervention showed women utilizing antenatal care (four visits) significantly more (43.4 vs 67.8%) with a net effect of 25.3% (95% CI: 16.9 – 33.2; p < .0001). The use of facility delivery improved in the intervention area (75.6 vs 90.2%; p = 0.0002), but with no significant net effect 11.5% (95% CI: -5.1 – 39.6; p = 0.123) when comparing the two districts. Male involvement improved (39.2% vs 80.9%) with a net intervention effect of 41.1% (CI: 28.5 – 53.8; p < .0001). Improvements were demonstrated in men’s knowledge level, in escorting partners for antenatal care and delivery, making birth preparations, and shared decision-making. The intervention, in educating this rural community, is effective in improving knowledge, birth preparedness, male involvement and use of skilled care.

Language is the most common and crucial element newspapers apply to express meaning. Language is a system of linguistic signs combined by rules to create meaning. Newspapers use language, among other or sign systems (e.g. photographs, graphics, content and layout) to communicate. These systems support each other and perform as a unit to reflect a newspaper's character and function. South Africa has a diversity in language, culture, background and literacy levels and the media's target audiences differ significantly. The ways in which these systems are thus applied, diverge to satisfy the various needs of audiences. These needs include being informed, entertained, aesthetically pleased, emotionally involved and mobilized (persuaded). Audiences also seek a reflection of their values, views and cultures in the media. / Thesis (M.A. (Communication Studies))--North-West University, Potchefstroom Campus, 2007.

Bakgrund: Att tidigt upptäcka symtom på allvarlig klinisk försämring hos en patient är av stor vikt för att minska lidande och förhindra allvarliga komplikationer. För detta har flera skattningsinstrument utvecklats, däribland olika early warning score-system. Dessa har implementerats på flera håll i världen men det finns indikationer på att det brister i följsamheten till dessa. Syfte: Studiens syfte var att undersöka följsamheten till Early Warning Scores samt de faktorer som påverkar följsamheten. Metod: Studien genomfördes som en litteraturöversikt där 14 vetenskapliga artiklar inkluderades. Studierna hade kvantitativa, kvalitativa och blandade ansatser. Artiklarna söktes i databaserna PubMed, CINAHL och Web of Science. En innehållsanalys av studiernas resultat genomfördes och resultatet sammanställdes i ett antal kategorier. Resultat: Följsamheten visade sig vara högre till observationer av patientens vitalparametrar än till de åtgärdsriktlinjer som finns. Faktorer som påverkar följsamheten var sjuksköterskans kliniska erfarenhet, samarbete mellan professioner, bemanning, felkalkylering, dokumentation och rapportering. Konklusion: Följsamhet till EWS brister på många sätt och flera faktorer påverkar följsamheten. Faktorerna som påverkade följsamheten är sjuksköterskans kliniska erfarenhet, samarbete mellan professioner, felkalkylering, bemanning, dokumentation och rapportering. / Background: Early recognition of serious clinical deterioration is of great importance for minimizing suffering and serious adverse events. For early recognition, several physiological track and trigger systems have been developed, among them the early warning scores. These have been implemented in many places across the world but there is uncertainty about adherence to these systems. Aim: The aim of this study was to investigate adherence to Early warning score-systems and to evaluate what factors affect this adherence. Method: The study was conducted as a literature review including 14 articles with quantitative, qualitative and mixed-methods approaches. Searches were made in the PubMed, CINAHL and Web of Science databases. Content-analysis was used to identify themes. Results: Adherence seems higher to observations than to clinical responses. The main factors affecting adherence are the clinical experience of nurses, collaboration between professions, staffing, miscalculation, documentation and reporting. Conclusion: Adherence to EWS is lacking in many ways and several causes for this have been accounted for. Factors affecting adherence was the clinical experience of nurses, cooperation between professions, staffing, miscalculation, documentation and reporting.

Denna kvalitativa empiriska studie undersöker TAKK (Tecken som Alternativ och Kompletterande Kommunikation) som arbetssätt i en flerspråkig verksamhet. Forskningsfrågorna handlade om vilka erfarenheter och uppfattningar förskollärare har samt vilka möjligheter och svårigheter som framträder i användningen av TAKK. Studien använde sig av triangulering där intervjuer med förskollärare och observation i verksamheten kombinerades i datainsamlingen. Studien bygger på tre intervjuer samt observationer i verksamheten från fyra olika tillfällen. Studien utgår från ett sociokulturellt perspektiv och det empiriska materialet har hanterats utifrån ledorden; sortera, reducera och argumentera. Resultatet visar att TAKK är ett redskap för barn, pedagoger och vårdnadshavare att göra sig förstådd med. I resultatet framträder positiva förskollärare som ser TAKK som ett redskap till ett gemensamt språk och för kommunikation men som samtidigt önskar bättre förutsättningar för det arbete de vill kunna genomföra. Med medvetna pedagoger som får rätt förutsättningar med stöd och utbildningar från ledningsnivå så har TAKK stora möjligheter för barns kommunikation och språkutveckling. / This qualitative empiric study examines TAKK (Signs as an Alternative and Augmentative Communication) as a work method in a multilingual preschool. The purpose of the study is to examine what experience and perceptions preschool teachers have with TAKK and what possibilities and obstacles there might be when using TAKK. This study uses triangulation where interviews with preschool teacher has been combined with observations in the preschools. This study is based on three interviews and from preschool observations from four different occasions. The study is based on a sociocultural perspective and the empiric material handled from the watchwords; to sort, to reduce and to argue. The conclusion is that TAKK is a method to make yourself understood by children, teachers and parents. The results of this study show positive preschool teachers that sees TAKK as a method for making a mutual language and a tool for communication, but at the same time wishing for better pre-conditions for the work they want to do. With fully aware teachers that is offered the right conditions and education from the management of the preschools then TAKK has major possibilities for children’s communication- and language development.

The world is full of signs (symbols, signifiers). They guide us in supermarkets, on highways and in airports. They even guide us to the right bathroom. Signs have a huge impact if they are used as logos or in advertisements. Signs also help us when we read manuals or when we use a remote control. Signs are used everywhere. Signs render service as they are "applications of skills and knowledge for the benefit of another party" (Vargo and Lusch 2004, 2008). Like all offerings signs only render service if they are used in some way. This article will argue that the usage of signs depends on the practices they are embedded in. It is argued that signs do not gain their full meaning and do not serve or create any value unless they are embedded in practices. Since signs are explicit and practices mainly implicit they are both necessary to serve and more importantly to (co-)create value. Signs and practices are two sides of the same coin so both they (and their interrelation) have to be understood in order to offer a better service.

Title: Safety measures for hiking and cycling Objectives: The objective of this work is consistent and understandable description of the safety measures for hiking and cycling. Methods: The diploma thesis in the theoretical style is focused on searching for available sources and the research upon them, comparing of the sources and description of hiking and cycling, and listing the safety measures as well. Results: It was found that in selected works of Czech and foreign authors is sufficiently elaborated safety theme for tourism. The work describes hiking in adverse conditions behavior in nature and the recommended procedure for emergency situations. In works devoted to cycling is also carefully prepared technique bike riding, bike repair and care of him and recommendations for cycling gear. Furthermore, it was found that the cyclist applies rules to be respected, because the work contains a description of the rules and instructions on how to behave on the road and traffic. In work is also included historical development of both types of tourism, as well as the division between tourism and the inclusion of sport and physical activity universally. Keywords: tourism, tourist, cycling, routes, tourist signs, first aid

M.Ing. (Mechanical Engineering) / The purpose of this study was to investigate the accuracy of SOAP84-simulations of delay and percentage stops at isolated signalized intersections. In the application, capacity was distinguished in terms of lane configuration only. Results at the intersections showed SOAP overestimating both delay and percentage stops by as much as 100%. It is recommended that the same investigations be repeated with more accurate information on the capacity of the intersections.

Exclusive bus lanes and the Transit Signal Priority are often not effective in saturated peak-traffic conditions. An alternative way of providing priority for transit can be queue jumpers, which allows buses to bypass and then cut out in front of waiting queue by getting an early green signal. Utah Transit authority deployed Bus Rapid Transit system at Salt Lake County, Utah along W 3500 S. This research evaluates the impacts of queue jumpers with TSP on Bus Rapid Transit (BRT) and private vehicular traffic. Four VISSIM models were developed for analysis : Basic scenario, no TSP with queue jumpers, TSP with no queue jumbers, and TSP with queue jumpers. In TQ scenario travel time was reduced between 13.2-19.82% with respect to basic scenario. At the same time, travel time of private traffic increased very little 0.38-3.28%. Two TSP strategies : green extension and red truncation are implemented in this research work. / by R.M. Zahid Reza. / Thesis (M.S.C.S.)--Florida Atlantic University, 2012. / Includes bibliography. / Mode of access: World Wide Web. / System requirements: Adobe Reader.

Introdução: a coqueluche é uma doença causada pela Bordetella pertussis (BP), sendo mais frequente e grave em lactentes menores de um ano de idade. Com a introdução da vacina, houve redução na incidência mundial da doença, porém nos últimos 10 anos observa-se uma recrudescência. Pode apresentar-se de forma menos característica em lactentes, especialmente antes do final do esquema vacinal para o primeiro ano de vida. O quadro clínico, nesses pacientes, pode ser semelhante ao das infecções por vírus respiratórios (VR) que são os agentes etiológicos mais frequentes nas infecções de vias aéreas, nessa faixa etária. São necessários estudos que avaliem a importância da pesquisa de VR em lactentes com suspeita clínica de coqueluche. Objetivos: em lactentes com suspeita de coqueluche: identificar as prevalências de BP, VR e codetecções; analisar e comparar as características clínicas e a evolução, segundo a etiologia identificada e analisar o impacto do diagnóstico etiológico sobre o uso de macrolídeos. Métodos: estudo de coorte prospectivo, com crianças menores de um ano de idade, hospitalizadas com suspeita clínica de coqueluche entre junho de 2014 e junho de 2016 e submetidas à pesquisa etiológica para identificação de BP (\"swab\" de nasofaringe para cultura e/ou PCR) e pesquisa de VR (aspirado de nasofaringe para imunofluorescência indireta). Dados clínicos, demográficos e evolutivos foram coletados com o preenchimento de protocolo clínico-laboratorial padronizado. Resultados: no período de estudo foram analisados 59 lactentes. Em 18 (30,5%) houve identificação de BP, em 23 (39%) de algum vírus respiratório. Em quatro (7%), houve codetecção de BP e algum VR. O vírus mais frequentemente identificado foi o VSR (73%). As características com maior sensibilidade para o diagnóstico de infecção por BP foram tosse seguida de cianose e ser filho de mãe não vacinada com dTpa. Sibilos e desconforto respiratório apresentaram alta sensibilidade para a identificação de VR. Na análise bivariada apresentaram maior chance de infecção por BP: menor idade (OR = 1,86), ausência de febre (OR = 4,9), não ser vacinado para coqueluche (OR = 4,4), leucocitose superior a 20.000/mm3 (OR = 5,4), linfocitose superior a 10.000/mm3 (OR = 4,0) e de infecção por VR: sibilos (OR = 4,33). Após o ajuste para confundidores, os maiores preditores para BP de forma independente foram: ausência de sibilos (OR =5,7) e leucocitose superior a 20.000/mm3 (OR = 5,38). O número de pacientes com codetecção não permitiu a análise comparativa de gravidade com aqueles com agente único. Em apenas um paciente o resultado da pesquisa viral positiva resultou em suspensão de macrolídeo. Conclusão: além da BP, os VR também foram etiologias frequentes nos lactentes com suspeita clínica de coqueluche, além de casos de codetecção de BP e VR. Foram identificadas características clínicas/laboratoriais sugestivas, porém não patognomônicas das etiologias identificadas o que corrobora a necessidade da pesquisa etiológica para VR, nessa situação clínica / Introduction: Pertussis is a disease caused by Bordetella pertussis (BP), being more frequent and severe in infants less than one year old. After vaccine introduction, there was a reduction in the global incidence of the disease, but in the last ten years there was a resurgence. It may present less characteristically in infants, especially before the end of the vaccine scheme for the first year of life. The clinical picture in these patients may be similar to that of respiratory virus infections (VR), which are the most frequent etiologic agents in airway infections in this age group. Studies is necessary to evaluate the importance of RV research in infants with clinical suspicion of pertussis. Objectives: In infants with suspected pertussis: identify the prevalence of BP, VR and codetections; analyze and compare the clinical characteristics and evolution according to the identified etiology and analyze the impact of the etiological diagnosis on the use of macrolides. Methods: A prospective cohort study with children under one year of age hospitalized with suspected clinical pertussis between June 2014 and June 2016 and submitted to etiological research to identify BP (nasopharynx swab for culture and/or PCR) and VR (nasopharyngeal aspirate for indirect immunofluorescence). Clinical, demographic and evolution data were collected with the completion of a standardized clinical-laboratory protocol. Results: During the study period, 59 infants were analyzed. In 18 (30.5%) there was identification of BP, in 23 (39%) of some respiratory virus. In four (7%), there was BP detection and some RV. The virus most frequently identified was RSV (73%). The characteristics with greater sensitivity for the diagnosis of BP infection were cough followed by cyanosis and the mother\'s non-vaccinated dTpa. Wheezing and respiratory distress presented high sensitivity for RV identification. In the bivariate analysis they presented a greater chance of BP infection: lower age (OR = 1.86), absence of fever (OR = 4.9), not being vaccinated for pertussis (OR = 4.4), leukocytosis higher than 20,000/mm3 (OR = 5.4), lymphocytosis greater than 10,000/mm3 (OR = 4.0) and RV infection: wheezing (OR = 4.33). After adjustment for confounders, the largest predictors for BP independently were: no wheezing (OR = 5.7) and leukocytosis higher than 20,000/mm3 (OR = 5.38). The number of patients with codetection did not allow the comparative analysis of severity with those with single agent. In only one patient, the result of positive viral research resulted in macrolide suspension. Conclusion: In addition to BP, RVs were also frequent etiologies in infants with clinical suspicion of whooping cough, as well as cases of BP and VR codetection. Clinical/laboratory characteristics suggestive, but not pathognomonic, of the identified etiologies have been identified, which corroborates the need for etiological research for RV in this clinical situation