Life cycle assessment of roads: Exploring research trends and harmonization challenges.

The transparency, heterogeneity and hypotheses considered in the calculation of the environmental impacts of roads are still barriers to the identification of low-carbon solutions. To overcome this problem, this study presents an analysis of 94 papers obtained in a systematic literature review of the Scopus, Science Direct, Mendeley, Springer Link, and Web of Science databases. From a total of 417 road case studies, only 18% were found to be fully transparent, reproducible, and likely to present reliable results. The road design parameters of the speed limit were provided in 11% of the cases, and the average annual daily traffic data were provided in 42%. Limited data were found for the dimensions of road elements such as the number (77%) and width of lanes (33%), shoulders (15%), footpaths (5%), berms (1%) and foreslope (4%). The source of the life cycle inventory was presented in 57% of the case studies, impact assessment method was indicated in 22%, and the software utilized was listed in 50%. A lack of information was noted in the description of the types of materials employed in road projects. In addition, the large heterogeneity in the definitions of the functional unit, system boundary and in the reference study period of repair, replacement, rehabilitation or end-of-life for both flexible and rigid pavement does not support the identification of the most environmentally friendly solutions. Based on the results of the analysis, several recommendations for design parameters and life cycle assessment aspects are proposed to support a harmonized calculation of the environmental impacts of road projects.

Survey of physician fellows in adolescent medicine, 1979-1984.

A national survey of physician fellows in adolescent medicine, a sequel to the 1974-1979 survey, was conducted in 1984. Fifty-one listed programs were identified; 48 directors responded. Two hundred twelve fellows were identified (111 one-year, 101 two-year); 151 (71%) returned the questionnaire. Eighty-six percent had a pediatric residency. Current or projected professional responsibilities were 36% full-time academic, 35% mixture of academic/private practice, and 29% private practice. Forty percent were spending 75-100% of their time in adolescent medicine. Recommended changes for their fellowship included more emphasis on research (34%), more inpatient care (18%), more experience in sports medicine/orthopedics (13%), more psychosocial training (12%), and more structured education (12%). Responses as to whether the objective was fully met in each of 18 different content areas showed 60-96% satisfaction in 12 areas but only 23-34% satisfaction in six (developing a research project, participating in a critical assessment of the literature, diagnosing/managing sports medicine, developmental disability, substance abuse problems, and managing pregnancy). Significant differences (p less than 0.05 or less than 0.01) between 1979-1984 fellows compared with the 1974-1979 group included more females, two-year fellows, and fellows in private practice and less fellows in full-time academic work or spending a majority of time in adolescent medicine. These results especially indicate that there are more programs and fellows, more two-year fellows, and suggest more satisfaction with the training experience.

Issues in fertility control for mentally retarded female adolescents: I. Sexual activity, sexual abuse, and contraception.

Little information is available about sexual activity, sexual assault, and contraceptive use among mentally retarded adolescents. The experience in these areas among 87 mentally retarded females is reviewed. (A companion paper focuses on these patients' parental attitudes toward sterilization.) All subjects attended a multiservice adolescent clinic with a large developmentally disabled patient group. Charts were reviewed and 69 parents were interviewed. The patients had an age range from 11 to 23 years (mean 16.7). Forty-one subjects were mildly retarded (IQ 55 to 69), 23 were moderately retarded (IQ 41 to 54), and 23 were severely retarded (IQ less than 41). Half of the mildly retarded had had sexual intercourse, a proportion comparable to the general adolescent population. Thirty-two percent of the moderately retarded and nine percent of the severely retarded adolescents had had intercourse. One third of the mildly retarded and one fourth of the moderately retarded adolescents had been victims of rape or incest. Continued sexual activity correlated with sexual abuse, but the majority of victims had no prior or subsequent evidence of intercourse. Forty-two subjects (48%) had used contraception at some time; intrauterine devices and injectable medroxyprogesterone acetate were preferred to oral contraceptives. Six of the 14 patients (43%) who continued sexual activity became pregnant, suggesting that currently available contraception is not providing sufficient protection.

Issues in fertility control for mentally retarded female adolescents: II. Parental attitudes toward sterilization.

Knowledge of the issues involving sterilization for mentally retarded adolescents is limited. Data were obtained from 69 interviewed parents whose mentally retarded daughters were attending the Cincinnati Adolescent Clinic. (A companion paper focuses on the experience of these girls with sexual activity, sexual abuse, and contraceptive use.) Forty-six percent of the parents had considered sterilization for their daughters. Twenty-six percent were still seeking the operation. Interest in sterilization especially correlated with increased severity of retardation (P less than .005) and with difficulty teaching menstrual hygiene (P less than .005). Parents of mildly retarded females sought tubal ligation, and those with severely retarded daughters chose hysterectomy and stressed their concern about menstrual management. Eighty-five percent of the parents favored a state statute that would enable sterilization under certain conditions and limitations. In general, few parents supported either an extremely restrictive or permissive position about sterilization.