Offseason news.

Garage area.

The highlight of offseason improvements at the Indianapolis Motor Speedway was the construction of a new, state of the art garage area. Just days after the 1985 race, the old Gasoline Alley garage area, most of which had stood since the 1940s, was dismantled and demolished. Official groundbreaking for the new facility occurred on August 26, 1985. The new concrete garages increased to 96 units (up from 88), and each stall provided approximately 30% more working room than their predecessors. The green and white wooden barn doors were replaced with overhead steel garage doors, and the layout was changed from east-west to north-south. The access lanes were widened substantially, improving ingress and egress, improving drainage, and various vendor and support units were also part of the new complex. Lastly, a refueling complex was constructed in the southeast corner, including two underground tanks, one each for methanol and gasoline fuels. Most of the work was completed in April, however, some of the finishing touches were still being completed during the first week of on-track activity.  Though the new garages were universally praised for their increased space and function, they were criticized for lack of aesthetics, and for breaking tradition. The plain precast concrete walls resembled the cookie-cutter stadiums of the era that were largely criticized in baseball and football. The design was a sharp and striking contrast to the previous garage complex, which led some to call them overtly plain or "antiseptic." Changing the layout to north-south based was also a thinly-veiled attempt by the management to further scale back the oft-rowdy "Snakepit" area formerly located inside the turn one infield. The interiors were spacious and without walls (except those adjacent to the middle corridors), allowing teams the flexibility to erect partitions as they saw fit, as well as layout their work area however they desired. Lastly, the new complex greatly improved safety. The old wooden buildings were criticized as potential "fire traps," and management did not want a repeat of the devastating 1941 fire. The concrete construction was more fire-resistant, water spigots were provided in every stall, and the wider lanes provided easier fire escape.

Victory lane.

A new victory lane area was constructed for the 1986 race. From 1971-1985, the winner drove up the checkerboard ramps into the "horseshoe" area below the Master Control Tower. A hydraulic platform was now used, which was located in the actual pit area, in line with the pit stalls. The car would drive onto the platform, and it would raise into the air, and then slowly spin 360° for the fans to see the winner.  This victory lane was popular, but could only a hold a small number of people when raised. It would be used through 1993.

Television.

On August 19, 1985, after years of being shown tape delayed, ABC Sports signed an initial three-year deal to cover the Indianapolis 500 live flag-to-flag starting in 1986. Longtime anchor Jim McKay was moved to the host position, and play-by-play would be handled by Jim Lampley and Sam Posey.  The Daytona 500 had been shown live flag-to-flag on CBS since 1979, and ABC officials had wanted to do the same for Indianapolis for several years. ABC's landmark telecast was scheduled to feature 32 cameras, three RaceCams, and an hour-long live pre-race.

Team and driver changes.

Defending Indy 500 winner Danny Sullivan returned to Penske Racing, however, the rest of the team saw a shake-up from the previous year. Rick Mears returned to full-time driving. After his serious crash at Sanair in 1984, Mears only drove a partial schedule (ovals only) in 1985. Al Unser, Sr., who drove full-time for Penske in 1985, and won the 1985 CART championship, dropped to part-time. Unser would race only the three 500 milers (Indy, Michigan, and Pocono), along with Phoenix and Tamiami. Unser was assigned the duty of being the first driver to roll out the brand new PC-15/Ilmor Chevy Indy V-8 265A.  Kevin Cogan moved over from the Kraco Team to Patrick Racing. Cogan joined Emerson Fittipaldi to make the team a two-car effort. Fittipaldi's new livery for 1986 featured a new sponsor to the sport, Marlboro, which would become a big part of the sport for over two decades.  Bobby Rahal won three of the last six races of 1985, and finished third in the points. Despite a heavy crash at Michigan in August, and a testing crash in the fall at Indy, Rahal was hot off the finish of the 1985 season, returning with Truesports, and a favorite entering the season.

Borg-Warner Trophy.

For the month of May 1986, the Borg-Warner Trophy celebrated its 50th anniversary sporting a new look, featuring a brand new three-row base. The likeness of the 1986 race winner was going to fill the body of the trophy, and the new base was constructed in order to accommodate winners through 2003. On the base, the first square was filled with a gold likeness of the late Speedway president Tony Hulman. The base increased the height of the trophy to 55 inches, and the weight to about 95 pounds.

Practice and qualifying.

Practice – week 1.

Practice started on Opening Day, Saturday, May 3. Chip Ganassi earned the honor of first car on the track. Michael and Mario Andretti led the speed chart for the day, both over. On the second day of practice, the Andrettis continued their dominance, again posting the top two speeds.  On Tuesday, May 6, three single cars crashes marked the first incidents of the month. Danny Ongais, Herm Johnson, and Johnny Parsons all suffered single-car crashes in turn one, with Johnson's the most serious. Around 3:30 p.m., a piece of bodywork flew off Johnson's car in turn 1, which caused him to break into a hard spin. His car hit nearly head on into the retaining wall, and he suffered serious fractures to his feet and back.  Penske teammates Rick Mears and Danny Sullivan nudged the speeds up over by Wednesday, May 7, then the day ended early due to a rain shower. On Thursday, May 8, Emerson Fittipaldi joined them as the third driver over.  By Friday, May 9, the last practice session before pole day, seven drivers were over, with Mears still the fastest of the month at. The only incident of the day was a suspension failure and spin by Johnny Rutherford, but no wall contact resulted.

Pole Day time trials.

During the morning practice on Saturday, May 10, Rick Mears set an all-time unofficial track record, at. Later in the session, Michael Andretti and Bobby Rahal both broke the barrier. No incidents were reported.  Mario Andretti took the honor of first-in-the-field, with a qualifying run of. Three cars later, defending champion Danny Sullivan took the provisional pole position with a new track record of. The speed did not hold up long, as less than an hour later, Rick Mears blistered the track with a first lap of and a four lap average of. Mears' one- and four- lap track records would stand for two years.  Michael Andretti squeezed himself into the front row, with a run of, faster than his father Mario. Emerson Fittipaldi ran 2 laps over, but a flat tire slowed his average to just over. Bobby Rahal managed one lap over, and qualified 4th.  With about 10 minutes to go, A. J. Foyt lined up to make an attempt, but his car failed technical inspection, and he was sidelined for the day. After qualifying was over, the cars of Raul Boesel and Dick Simon, both of the same team, were disqualified for faulty pop-off valve fitting.

Second day time trials.

After missing out on a qualifying attempt on pole day, A. J. Foyt took to the track on Sunday, May 11 to qualify for his 29th career Indy 500. He posted the 5th fastest speed in the field, but since he was a second day qualifier, he lined up deep in the field.  Raul Boesel re-qualified his machine, after being disqualified a day earlier. At the close of the day, the field was filled to 28 cars.

Practice – week 2.

Rain delayed the opening of practice on Monday, May 12, and only 21 cars took laps Tuesday (May 13). Both days saw light activity, and the biggest news came off-the-track. Two-time winner Gordon Johncock planned to end a one-year retirement, and purchase a back-up car from Penske. His funding fell through at the last minute, and he was forced to sit out the race.  On Tuesday, May 14, Mario Andretti was practicing his qualified car. A suspension piece failed, and he crashed hard into the turn 3 wall. Newman/Haas Racing would spend the next several days trying to make repairs, but the car's tub was rendered a total loss. Later in the week, Andretti started practicing his back-up car, which the team announced he would be driving on race day.  The remainder of the week saw sparse track activity. Most cars on the track belonged to yet-unqualified drivers. Thursday, May 15 was almost a complete wash out due to a thunderstorm.

Day 3 time trials.

Despite threatening weather for the next two days, the third day of qualifying saw only four additional cars added to the field. Jim Crawford was the fastest of the day, over. Dick Simon, who was disqualified the previous weekend, put his car back into the field with a speed of.  The day ended with 1 position left vacant in the field.

Bump Day time trials.

As many as 12 cars started the day with hopes to make the field on the final day of time trials. Rain kept the track closed until 3 p.m., with qualifying finally getting underway at 4 p.m. By late afternoon, however, several cars were pulled out of line and chose not to make an attempt.  George Snider went out first in an A. J. Foyt back-up car, and filled the field to 33 cars. That placed Dick Simon on the bubble as the slowest car in the field. After a wave-off by Steve Chassey, Gary Bettenhausen took to the track, found some much sought after speed, and bumped his way into the field with ease.  With Geoff Brabham on the bubble, and with rain approaching, Rick Miaskiewicz was the next car out. His first two laps were not nearly fast enough, and his team waved him off. That gave Derek Daly just enough time to get out on the track. His first two laps were fast enough to bump Brabham, but as he was completing his second lap, the skies poured rain, and the run was negated.  Geoff Brabham held on as the slowest car in the field, while Dick Simon, the only car bumped, stood as the first alternate. Qualifying for the day lasted less than 45 minutes.

Carburetion Day.

On Thursday, May 23, the final scheduled practice session was held. All 33 qualified cars except Phil Krueger took practice laps. At 11:43 a.m., a major crash occurred. A brake rotor on Dennis Firestone's car exploded, blowing his left rear tire. He spun wildly out of turn four, collecting the car of Roberto Moreno. Both cars spun into the inside wall, and Firestone slammed into the pit-entrance barrier, splitting the car in half. Moreno continued to spin through the pits, running into the back of George Snider's car, and crashing into the parked car of Josele Garza.  None of the drivers were seriously injured, however, Firestone's car was damaged beyond repair. The following day, Firestone's car was withdrawn from the field. George Snider and Roberto Moreno announced they would be driving back-up cars in the race. Both cars moved to the back of the grid. After Firestone withdrew, the first alternate Dick Simon was awarded the 33rd starting position.  Rick Mears led the speed chart for the afternoon, with a hand-timed lap of. Later in the day, Penske Racing and driver Danny Sullivan won the annual Miller Indy Pit Stop Contest. Sullivan's team defeated the Truesports team (Bobby Rahal) in the final round to win the event for the second year in a row.

Rain delay.

Sunday, May 25.

The race was scheduled to be held Sunday, May 25. Despite a forecast of only a 15% chance of precipitation, race morning saw overcast skies and steady rain. Track drying efforts began around 10:45 a.m. EST. The track was close to dry, and spectators began filing into their seats. The cars were then wheeled to the pits, in preparations for a start. At 1:15 p.m., however, the rain resumed, and threatened to wash out the entire day. The rain stopped, and track drying efforts started a second time. The rain returned once more, and at 3:35 p.m., officials rescheduled the race for Monday. During the delay, ABC-TV diverted its programming for several minutes in favor of live coverage of Hands Across America.  Grim memories of the tragic 1973 race were still in many people's minds, and all involved were determined to make certain the race would not be hastily put on in a rushed, last-minute, fashion. In addition, officials were uncommitted on how late they would permit a start, and if they would aim for a 101-lap race (the minimum distance for the event to be official), or insist on adequate time for a full 200-lap race before sunset. The weather forecast for Monday (80% chance of rain) was yet another concern.

Monday, May 26.

On Monday, May 26, there was no chance to hold the race, as it rained all day. The infield turned into a sea of mud, and most of the spectators had since departed, going home to their jobs. Authorities estimated Monday's attendance at a paltry 5,800 spectators. Those who did arrive merely milled around, as most of the infield was impassable, concession stands were out of food, and souvenir tents were empty and abandoned. Some visited the Speedway museum.  At 3:20 p.m., officials announced that the race was going to be postponed, but did not yet announce the date or time to which it would be rescheduled. Unsubstantiated rumors even circulated about canceling the race outright. ABC television was scheduled to cover the race live for the first time, but did not commit to live coverage on Tuesday. Track officials were faced with the possibility of running the race on Tuesday in front of empty grandstands, and without live TV coverage. Weather forecasts for Tuesday and Wednesday were not promising, a substantial amount of the track staff was unavailable, and the sloppy conditions made parts of the facility impassable. Around 6 p.m. on Monday evening, a deal had been struck to reschedule the race for Saturday, May 31.

Mid-week.

During the week, teams spent time resting and relaxing, while others prepared for the next race at Milwaukee. Track crews worked diligently to clean up the infield, and make it passable for Saturday. As a result of the postponement, a special 30-minute practice session was arranged on Friday, May 30. Participants were held to a speed limit, and it served mostly as an oil leak check exercise. Some drivers, including polesitter Rick Mears, as well as Bobby Rahal, did not even participate. The five-day delay wound up being a popular choice by nearly all of the participants. It allowed them to unwind, and regroup for race day without the uncertainty that was looming over them of when the race would start.  For the weekend, the Rex Mays 200 at Milwaukee, originally scheduled for Sunday June 1, was pushed back one week to accommodate the Indy rain delay. The 1986 race marked the first time since 1973 that the race was pushed to another day, and the first time since 1915 that 'not a single wheel had turned' all weekend because of rain. It also marked the first time since 1967 the race was held May 31; until 1971, when the race was always held on May 30, if that day was a Sunday, it was held the ensuing Monday, May 31.

Race summary.

Start.

Saturday, May 31 saw sunny skies and temperatures in the low 80s. Traditional pre-race ceremonies were retooled slightly, with some replacement performers. The Purdue band was absent, while Robert McFarland, scheduled to sing "Back Home Again in Indiana", had departed and was replaced by John S. Davies, the artist-in-residence at the Indianapolis Opera. A smaller balloon spectacle was also hastily arranged, after all of the original balloons had lost their helium by Monday afternoon. An army band from Fort Benjamin Harrison was brought in to accompany the performances, and to perform "Taps." Mary F. Hulman gave the starting command just minutes before 11 a.m., and the field pulled away for the parade and pace laps.  On the final pace lap, Tom Sneva veered off-course at the exit of turn 2. Further down the backstretch, a massive smoke bomb was set off by some unruly spectators. The yellow flag was displayed, and the start was waved off. The next time by, the field was red flagged, and halted on the frontstretch. Sneva's crash was cleaned up, but it was determined that the field had burned an unnecessary four laps of fuel. A decision was made to replenish each of the 32 remaining cars' pitside fuel tanks with 3 gallons of methanol. The red flag wound up delaying the start by over a half-hour.  At 11:34 a.m., Tony George gave the command to restart the engines, and the field assembled for two pace laps. The field was straggling through the fourth turn to take the green, and Michael Andretti jumped into the lead from the outside of the front row. He set a new all-time record for the first lap at, the first time the opening lap was run over. After a postponement of six days, and after another half hour delay due to the Sneva crash, the race was finally underway.

First half.

After charging from the 30th starting position, Mario Andretti's day was short-lived. On the 15th lap, he brought out the yellow when he stalled in turn three with an ignition problem. Michael Andretti set the early pace, leading the first 42 laps. Mario later returned to the track, but his car lasted only four additional laps, and he placed 32nd.  The first half of the race saw record average speed, with only two yellows for 10 laps, and no major incidents. The second yellow on lap 52 came out for debris when Michael Andretti lost a mirror. Rick Mears came to the lead by lap 49, and held it until the next round of pit stops. On lap 83, Bobby Rahal took the lead for 19 laps, and led at the halfway point.

Second half.

Johnny Parsons spun out of turn two on lap 102, and came to a stop along the inside wall. The car suffered minor damage, and Parsons was uninjured. After another long stretch of green, Rich Vogler crashed in turn 3 on lap 135.  On the 135th lap, Rahal (1st) and Cogan (2nd) pitted under caution. Rahal's team nearly made a serious error, and did not change the left-front tire (it had not been changed yet in the race). Rahal had to pit once again the next time around to correct the oversight. Since the field was under caution, the consequences were not quite as serious, but he still fell from 1st to 4th.  On the restart, Rick Mears resumed as the leader. Short-pitting due to poor handling, 4th place Michael Andretti was the first of the leaders to pit again (on lap 163). Mears led all the way until his final scheduled pit stop on lap 165. Moments later Roberto Moreno brought out the caution by stalling in turn four. After Rahal and Cogan cycled through their final planned stops on lap 166, Mears again found himself up front. Michael Andretti (at the tail-end of the lead lap in 4th place) actually led the field behind the pace car as the field went back to green with 31 laps to go.

Finish.

With 14 laps to go, Rick Mears led Bobby Rahal and Kevin Cogan. Fourth place Michael Andretti was still clinging on to the tail-end of the lead lap, just ahead of Mears. As the leaders approached traffic, Rahal looked to pass Mears for the lead. Down the backstretch, Rahal took the lead and headed towards turn 3. Cogan passed Mears on the outside of turn four and took second place. Down the frontstretch, Rahal was caught up behind the lap car of Randy Lanier. Cogan diced back and forth, and slipped by Rahal going into turn one.  With then 13 laps to go, Cogan suddenly pulled out to a sizable 3-second lead. Cogan's car was visibly loose in the turns, and on several occasions nearly clipped the outside wall in turn 2. With 7 laps to go, fourth place Michael Andretti ducked into the pit area for a splash of fuel. On lap 194, Arie Luyendyk who was running 11th, spun exiting turn four. His car whipped around and lightly tagged the inside wall near the entrance of the pits. The yellow flag came out, and the field was bunched up behind the pace car.  Safety crews were able to clean up the incident quickly. Cogan led, with Rahal second, and Mears third, all together on the track. With 21⁄2 laps to go, the lights on the pace car were turned off, signifying that the field was ready to go back to green. Cogan, Rahal, and Mears picked up the pace in the north chute, and came out of turn four for a restart and two laps to go. Rahal got the jump on Cogan out of turn four, and took the lead mid-way down the frontstretch. Rahal led at the line, and dove in front of Cogan in turn one.  Down the backstretch, Rahal pulled to over a 1-second lead, and Mears set up to pass Cogan in turn three. Cogan held off the challenge, as Rahal took the white flag. Rahal's speed on the 199th lap was a noteworthy. Rahal pulled out to a 1.4 second advantage, and won his first Indianapolis 500. Cogan and Mears finished second and third, in what was the closest three-car finish to date. Rahal's final lap was an all-time record, the fastest race lap to-date in Indy 500 competition.  Rahal completed the in 2 hours, 55 minutes, 43.470 seconds; becoming the first driver to complete the Indianapolis 500 in less than three hours. His average speed of 170.722 broke Rick Mears' 1984 record. Rahal later claimed his fuel light had come on during the final lap, and a post-race inspection showed that only two gallons of methanol fuel remained in his tank.

Post race.

The race celebration was emotional for the Truesports team, in that owner Jim Trueman was stricken with cancer. Visibly frail and lacking strength, he managed to arrive in victory lane to celebrate with his driver Bobby Rahal: as the race ended, he reportedly told ABC reporter Jack Arute, "I can go now". Due to the rain delay, the traditional victory banquet was canceled. A makeshift victory luncheon was held in its place on Sunday June 1 at the Speedway Motel. The top three finishers were invited to the private reception. Later, Rahal's crew celebrated with a lunch at the nearby Red Lobster.  The city of Columbus held a victory celebration downtown on June 5. Over 300 Red Roof Inn employees took part in a parade down Broad Street. Trueman was too sick to attend. On June 11, Trueman succumbed to his illness, at the age of 51.  Rahal and the Truesports team rode the wave of success to five additional wins during the CART season, and clinched the 1986 CART championship. The team made it back-to-back titles by winning the 1987 CART championship as well.  Kevin Cogan suffered through his second major disappointment at Indy, following the misfortunes of 1982. Despite winning the season opener at Phoenix, he faded as a contender during the season.

Broadcasting.

Radio.

The race was carried live on the IMS Radio Network. Paul Page served as the chief announcer for the tenth year. It was Page's thirteenth year overall as part of the network crew. Lou Palmer reported from victory lane. Bobby Unser, Page's frequent booth partner on NBC Sports, joined the broadcast for the first and only time as "driver expert."  Ron Carrell and Jerry Baker swapped places, with Carrell moving to the north pits (where he remained until 1990) and Baker moving to the high profile Turn 1 location. Baker has remained in that location until 2017 (except 2010 and 2013 when it was vacant) as he would depart the crew and join the public address crew for 2018 when it was decided that Turn 1 would not be used in 2018 but due to a new broadcast booth debuting in 2019 named after Sid Collins, Turn 1's broadcasting location would be reinstated.. Gary Gerould (one of Page's NBC colleagues), made his first appearance as a pit reporter, sharing duties in the south pits with Lou Palmer.  Luke Walton reprised his traditional duty of introducing the starting command during the pre-race, however, he did not have an active role during the race.

Television.

The race was carried in the United States on ABC Sports on live, flag-to-flag coverage for the first time. Jim McKay moved to the host position, while Jim Lampley served as announcer.  The initial live broadcast set for Sunday, May 25 was rained out. The telecast was filled with interviews, talk, and highlights of previous races. The broadcast returned on Saturday, May 31 for the live coverage of the race.  Three pit reporters served on the crew, joined by Donna de Varona, who was slated to serve as a roving reporter, conducting interviews and other features. However, she appeared only on the original Sunday telecast, and did not return on Saturday. Dr. Joe Randolph was also announced as part of the team, slated to report from the medical center, but he never appears on-air.  Three RaceCams were used (none were utilized in 1985), with defending champion Danny Sullivan the highest-profile driver to feature one. For the first time, the broadcast carried all of the pre-race ceremonies live, although they omitted coverage of the invocation.  The broadcast has re-aired numerous times on ESPN Classic since the mid-2000s.

Quotes.

Paul Page described the finish of IMS Radio Network: Kevin Cogan responding to Sam Posey for an in-race radio interview with only 3 laps to go: Sam Posey on ABC-TV after being snubbed by Kevin Cogan:

The 70th Indianapolis 500 was held at the Indianapolis Motor Speedway in Speedway, Indiana on Saturday, May 31, 1986. After being rained out on May 25–26, the race was rescheduled for the following weekend. Bobby Rahal was the winner, becoming the first driver in Indy history to complete the in less than three hours.

Les 500 miles d'Indianapolis 1986, organisés exceptionnellement le samedi sur l'Indianapolis Motor Speedway, ont été remportés par le pilote américain Bobby Rahal sur une March-Cosworth.


The six stages of Cass' model.

Identity confusion.

In the first stage, "identity confusion", the person is amazed to think of themselves as a gay person. "Could I be gay?" This stage begins with the person's first awareness of gay or lesbian thoughts, feelings, and attractions. The people typically feel confused and experience turmoil.  To the question "Who am I?", the answers can be acceptance, psychological self-denial and repression, or rejection.  Possible responses can be: to avoid information about lesbians and gays; inhibited behavior; self-denial of homosexuality ("experimenting", "an accident", "just drunk", "just looking"). Men often keep emotional involvement separated from sexual contact; women often have deep, strongly emotional but non-sexual relationships.  The possible needs can be: the person may explore internal positive and negative judgments. Will be allowed to be uncertain regarding sexual identity. May find support in knowing that sexual behavior occurs along a spectrum. May receive permission and encouragement to explore sexual identity as a normal experience (like career identity and social identity).

Identity comparison.

The second stage is called "identity comparison". In this stage, the person accepts the possibility of being gay or lesbian and examines the wider implications of that tentative commitment. "Maybe this does apply to me." The self-alienation becomes isolation. The task is to deal with the social alienation.  Possible responses can be: the person may begin to grieve for losses and the things they give up by embracing their sexual orientation (marriage, children). They may compartmentalize their own sexuality—accept lesbian/gay definition of behavior but maintain "heterosexual" identity. Tells oneself, "It's only temporary"; "I'm just in love with this particular woman/man"; etc.  The possible needs can be: will be very important that the person develops own definitions. Will need information about sexual identity, lesbian, gay community resources, encouragement to talk about loss of heterosexual life expectations. May be permitted to keep some "heterosexual" identity (as "not an all or none" issue).

Identity tolerance.

In the third stage, "identity tolerance", the person comes to the understanding they are "not the only one".  The person acknowledges they are likely gay or lesbian and seeks out other gay and lesbian people to combat feelings of isolation. Increased commitment to being lesbian or gay. The task is to decrease social alienation by seeking out lesbians and gays.  Possible responses can be: beginning to have language to talk and think about the issue. Recognition that being lesbian or gay does not preclude other options. Accentuate difference between self and heterosexuals. Seek out lesbian and gay culture (positive contact leads to more positive sense of self, negative contact leads to devaluation of the culture, stops growth). The person may try out variety of stereotypical roles.  The possible needs can be: to be supported in exploring own shame feelings derived from heterosexism, as well as internalized homophobia. Receive support in finding positive lesbian, gay community connections. It is particularly important for the person to know community resources. There are many ways you can get support. Examples include LGBQT clubs, organizations for the gay.

Identity acceptance.

The "identity acceptance" stage means the person accepts themselves. "I will be okay." The person attaches a positive connotation to their gay or lesbian identity and accepts rather than tolerates it. There is continuing and increased contact with the gay and lesbian culture. The task is to deal with inner tension of no longer subscribing to society's norm, attempt to bring congruence between private and public view of self.  Possible responses can be: accepts gay or lesbian self-identification. May compartmentalize "gay life". Maintain less and less contact with heterosexual community. Attempt to "fit in" and "not make waves" within the gay and lesbian community. Begin some selective disclosures of sexual identity. More social coming out; more comfortable being seen with groups of men or women that are identified as "gay". More realistic evaluation of situation.  The possible needs can be: continue exploring grief and loss of heterosexual life expectation, continue exploring internalized homophobia (learned shame from heterosexist society). Find support in making decisions about where, when, and to whom to disclose.

Identity pride.

In the "identity pride" stage, sometimes the coming out of the closet arrives, and the main thinking is "I've got to let people know who I am!" The person divides the world into heterosexuals and homosexuals, and is immersed in gay and lesbian culture while minimizing contact with heterosexuals. Us-them quality to political/social viewpoint. The task is to deal with the incongruent views of heterosexuals.  Possible responses include: splits world into "gay" (good) and "straight" (bad)—experiences disclosure crises with heterosexuals as they are less willing to "blend in"—identify gay culture as sole source of support, acquiring all gay friends, business connections, social connections.  The possible needs can be: to receive support for exploring anger issues, to find support for exploring issues of heterosexism, to develop skills for coping with reactions and responses to disclosure to sexual identity, and to resist being defensive.

Identity synthesis.

The last stage in Cass' model is "identity synthesis": the person integrates their sexual identity with all other aspects of self, and sexual orientation becomes "only one aspect" of self rather than the entire identity.  The task is to integrate gay and lesbian identity so that instead of being the identity, it is an aspect of self.  Possible responses can be: continues to be angry at heterosexism, but with decreased intensity, or allows trust of others to increase and build. Gay and lesbian identity is integrated with all aspects of "self". The person feels "all right" to move out into the community and not simply define space according to sexual orientation. This is a normal feeling.

Criticisms of the model.

Joanne Kaufman and Cathryn Johnson have argued that based upon more recent research, this model is less valid today than it was at its inception for several reasons:

The Cass identity model is one of the fundamental theories of gay and lesbian identity development, developed in 1979 by Vivienne Cass. This model was one of the first to treat gay people as normal in a heterosexist society and in a climate of homophobia instead of treating homosexuality itself as a problem. Cass described a process of six stages of gay and lesbian identity development. While these stages are sequential, some people might revisit stages at different points in their lives.

Le modèle d'identité de Cass est un modèle du développement de l'identité et du "coming out" gay et lesbien, présenté en 1979 par la psychologue australienne Vivienne Cass. Dans le cadre de ce modèle, la construction de l'identité homosexuelle passe par six étapes successives : la confusion, la comparaison, la tolérance, l'acceptation, la fierté et finalement la synthèse.


History.

The fixed-blade utility knife was developed some 500,000 years ago, when human ancestors began to make stone knives. These knives were general-purpose tools, designed for cutting and shaping wooden implements, scraping hides, preparing food, and for other utilitarian purposes.  By the 19th century the fixed-blade utility knife had evolved into a steel-bladed outdoors field knife capable of butchering game, cutting wood, and preparing campfires and meals. With the invention of the backspring, pocket-size utility knives were introduced with folding blades and other folding tools designed to increase the utility of the overall design. The folding pocketknife and utility tool is typified by the "Camper" or "Boy Scout" pocketknife, the U.S. folding utility knife, the Swiss Army Knife, and by multi-tools fitted with knife blades. The development of stronger locking blade mechanisms for folding knives—as with the Spanish navaja, the Opinel, and the Buck 110 Folding Hunter—significantly increased the utility of such knives when employed for heavy-duty tasks such as preparing game or cutting through dense or tough materials.

Contemporary utility knives.

The fixed or folding blade utility knife is popular for both indoor and outdoor use. One of the most popular types of workplace utility knife is the retractable or folding utility knife (also known as a "Stanley knife", "box cutter", "X-Acto knife", or by various other names). These types of utility knives are designed as multi-purpose cutting tools for use in a variety of trades and crafts. Designed to be lightweight and easy to carry and use, utility knives are commonly used in factories, warehouses, construction projects, and other situations where a tool is routinely needed to mark cut lines, trim plastic or wood materials, or to cut tape, cord, strapping, cardboard, or other packaging material.

Names.

In British, Australian and New Zealand English, along with Dutch and Austrian German, a utility knife frequently used in the construction industry is known as a "Stanley knife". This name is a generic trademark named after Stanley Works, a manufacturer of such knives. In Israel and Switzerland, these knives are known as "Japanese knives". In Brazil they are known as "estiletes" or "cortadores Olfa" (the latter, being another genericised trademark). In Portugal and Canada they are also known as "X-Acto" (yet another genericised trademark). In India, the Philippines, France, Iraq, Italy, Egypt, and Germany, they are simply called "cutter". In the Flemish region of Belgium it is called "cuttermes(je)" (cutter knife). In general Spanish, they are known as "cortaplumas" (penknife, when it comes to folding blades); in Spain, Mexico, and Costa Rica, they are colloquially known as "cutters"; in Argentina and Uruguay the segmented fixed-blade knives are known as "Trinchetas". In Turkey, they are known as "maket bıçağı" (which literally translates as "model knife").  Other names for the tool are "box cutter" or "boxcutter", "razor blade knife", "razor knife", "carpet knife", "pen knife", "stationery knife", "sheetrock knife", or "drywall knife".

Design.

Utility knives may use fixed, folding, or retractable or replaceable blades, and come in a wide variety of lengths and styles suited to the particular set of tasks they are designed to perform. Thus, an outdoors utility knife suited for camping or hunting might use a broad fixed blade, while a utility knife designed for the construction industry might feature a replaceable utility or razor blade for cutting packaging, cutting shingles, marking cut lines, or scraping paint.

Fixed blade utility knife.

Large fixed-blade utility knives are most often employed in an outdoors context, such as fishing, camping, or hunting. Outdoor utility knives typically feature sturdy blades from in length, with edge geometry designed to resist chipping and breakage.  The term "utility knife" may also refer to small fixed-blade knives used for crafts, model-making and other artisanal projects. These small knives feature light-duty blades best suited for cutting thin, lightweight materials. The small, thin blade and specialized handle permit cuts requiring a high degree of precision and control.

Workplace utility knives.

The largest construction or workplace utility knives typically feature retractable and replaceable blades, made of either die-cast metal or molded plastic. Some use standard razor blades, others specialized double-ended utility blades. The user can adjust how far the blade extends from the handle, so that, for example, the knife can be used to cut the tape sealing a package without damaging the contents of the package. When the blade becomes dull, it can be quickly reversed or switched for a new one. Spare or used blades are stored in the hollow handle of some models, and can be accessed by removing a screw and opening the handle. Other models feature a quick-change mechanism that allows replacing the blade without tools, as well as a flip-out blade storage tray. The blades for this type of utility knife come in both double- and single-ended versions, and are interchangeable with many, but not all, of the later copies. Specialized blades also exist for cutting string, linoleum, and other materials. Another style is a snap-off utility knife that contains a long, segmented blade that slides out from it. As the endmost edge becomes dull, it can be broken off the remaining blade, exposing the next section, which is sharp and ready for use. The snapping is best accomplished with a blade snapper that is often built-in, or a pair of pliers, and the break occurs at the score lines, where the metal is thinnest. When all of the individual segments are used, the knife may be thrown away, or, more often, refilled with a replacement blade. This design was introduced by Japanese manufacturer Olfa Corporation in 1956 as the world's first snap-off blade and was inspired from analyzing the sharp cutting edge produced when glass is broken and how pieces of a chocolate bar break into segments. The sharp cutting edge on these knives is not on the edge where the blade is snapped off; rather one long edge of the whole blade is sharpened, and there are scored diagonal breakoff lines at intervals down the blade. Thus each snapped-off piece is roughly a parallelogram, with each long edge being a breaking edge, and one or both of the short ends being a sharpened edge. Another utility knife often used for cutting open boxes consists of a simple sleeve around a rectangular handle into which single-edge utility blades can be inserted. The sleeve slides up and down on the handle, holding the blade in place during use and covering the blade when not in use. The blade holder may either retract or fold into the handle, much like a folding-blade pocketknife. The blade holder is designed to expose just enough edge to cut through one layer of corrugated fibreboard, to minimize chances of damaging contents of cardboard boxes.

Use as weapon.

Most utility knives are not well suited to use as offensive weapons, with the exception of some outdoor-type utility knives employing longer blades. However, even small razor-blade type utility knives may sometimes find use as slashing weapons. The 9-11 commission report stated passengers in cell phone calls reported knives or "box-cutters" were used as weapons (also Mace or a bomb) in hi-jacking airplanes in the September 11, 2001 terrorist attacks against the United States, though the exact design of the knives used is unknown. Two of the hijackers were known to have purchased Leatherman knives, which feature a 4" slip-joint blade which were not prohibited on U.S. flights at the time. Those knives were not found in the possessions the two hijackers left behind. Similar cutters, including paper cutters, have also been known to be used as a lethal weapon.  Small work-type utility knives have also been used to commit robbery and other crimes. In June 2004, a Japanese student was slashed to death with a segmented-type utility knife.  In the United Kingdom, the law was changed (effective 1 October 2007) to raise the age limit for purchasing knives, including utility knives, from 16 to 18.

A utility knife, sometimes generically called a Stanley knife, is a knife used for general or utility purposes. The utility knife was originally a fixed blade knife with a cutting edge suitable for general work such as cutting hides and cordage, scraping hides, butchering animals, cleaning fish, and other tasks. Craft knives are tools mostly used for crafts. Today, the term "utility knife" also includes small folding or retractable-blade knives suited for use in the general workplace or in the construction industry.

Un couteau à lame rétractable, cutter ou stylet est un outil qui permet de couper des matériaux fins et peu résistants. Il est en général muni d'une lame mobile qui est masquée lorsque l'objet n'est pas utilisé (pour plus de sécurité). On l'appelle également Exacto ou couteau OLFA en référence aux marques de commerce des outils du genre. Le mot tranchet, qui désigne un outil similaire mais très spécifique, a été utilisé mais n'est pas entré dans l'usage courant.


Properties.

The principal invariants do not change with rotations of the coordinate system (they are objective, or in more modern terminology, satisfy the principle of material frame-indifference) and any function of the principal invariants is also objective.

Calculation of the invariants of rank two tensors.

In a majority of engineering applications, the principal invariants of (rank two) tensors of dimension three are sought, such as those for the right Cauchy-Green deformation tensor.

Principal invariants.

For such tensors the principal invariants are given by: For symmetric tensors these definitions are reduced. The correspondence between the principal invariants and the characteristic polynomial of a tensor, in tandem with the Cayley–Hamilton theorem reveals that where formula_3 is the second-order identity tensor.

Main invariants.

In addition to the principal invariants listed above, it is also possible to introduce the notion of main invariants which are functions of the principal invariants above.

Mixed invariants.

Furthermore, mixed invariants between pairs of rank two tensors may also be defined.

Calculation of the invariants of rank two tensors of higher dimension.

These may be extracted by evaluating the characteristic polynomial directly, using the Faddeev-LeVerrier algorithm for example.

Calculation of the invariants of higher order tensors.

The invariants of rank three, four, and higher order tensors may also be determined.

Engineering applications.

A scalar function formula_9 that depends entirely on the principal invariants of a tensor is objective, i.e., independent from rotations of the coordinate system. This property is commonly used in formulating closed-form expressions for the strain energy density, or Helmholtz free energy, of a nonlinear material possessing isotropic symmetry.  This technique was first introduced into isotropic turbulence by Howard P. Robertson in 1940 where he was able to derive Kármán–Howarth equation from the invariant principle. George Batchelor and Subrahmanyan Chandrasekhar exploited this technique and developed an extended treatment for axisymmetric turbulence.

In mathematics, in the fields of multilinear algebra and representation theory, the principal invariants of the second rank tensor formula_1 are the coefficients of the characteristic polynomial

En algèbre linéaire, un invariant de similitude est une quantité qu'on peut associer à toute matrice carrée (à coefficients dans un corps commutatif fixé "K"), telle que pour deux matrices semblables cette quantité soit toujours la même. Des exemples d'invariants de similitude sont la taille de la matrice, sa trace, son déterminant, son polynôme caractéristique (dont on peut déduire les trois invariants précédents), ou encore son polynôme minimal. Du fait de cette invariance, une telle quantité peut aussi être associée à tout endomorphisme d'un espace vectoriel de dimension finie, en utilisant sa matrice dans une base quelconque de l'espace.


Overview.

The CCX was unveiled at the 2006 Geneva Motor Show, sporting body modifications to meet US vehicle regulations and a new in-house developed 4.7L twin supercharged V8 engine capable of generating a maximum power output of at 7,000 rpm and of torque at 5,500 rpm while running on 91 octane gasoline.

Powertrain.

The new engine is of all aluminium construction made out of 356 aluminium with a T7 heat treatment to further enhance block integrity and cylinder bore chill during casting. Specifically created and cast for Koenigsegg by Grainger & Worrall, a casting specialist with F1 experience in drivetrain components, the engine was built, assembled and tested at their Ängelholm production plant. The engine is lubricated with a dry sump system with a separate oil pump and the pistons are cooled by means of an internal cooler that sprays oil onto them in order to run high cylinder pressure with 91 octane fuel making it capable of in combined cycle and in highway travel. Available transmissions are a CIMA 6-speed manual and a 6-speed sequential manual transmission. Power is fed to the wheels through a torque-sensitive limited slip differential.

Body.

The chassis is made from carbon fibre reinforced with kevlar and aluminium honeycomb like the previous models. While the body keeps the targa top body style and the dihedral synchro-helix actuation doors, it is completely reworked. There is a new front bumper design, enhanced brake cooling, fog lamps, US patented head lamps, a new fresh air intake on the bonnet that acts as ram air booster, air intakes behind the front wheels to enhance airflow and a glass window over the engine.  The CCX has frontal area of and a., with a CdA of. It also has a flat underside with venturi tunnels at the rear and an optional rear spoiler to improve downforce. At there is of downforce over the front axle and over the rear. The car is longer to comply with the US rear impact regulations and to free space around the rear muffler. On the interior, there is of extra headroom as well as specifically designed Sparco carbon fibre seats.

Wheels and brakes.

First in the industry carbon fibre wheels are optional equipment, lighter than the standard forged alloy "telephone-dial" wheels, both using centre locking nuts. Diameter is 19 inches at the front and 20 inches at the rear equipped with 255/35 Y19 front, 335/30 Y20 rear Michelin Pilot Sport 2 tyres, 8 piston caliper carbon ceramic brakes measuring in diameter at the front and 6 piston caliper at the rear are optional, saving another of unsprung weight.

Variants.

CCXR.

The CCXR is a more "environmentally friendly" version of the CCX, powered by the same engine, but converted to use E85 and E100 ethanol fuel, as well as standard 98 octane petrol. The CCXR required modified fuel injectors, upgraded fuel lines and piston rings, and a higher boost setting on the superchargers. In standard form, bodywork of the CCXR features heavily optimized aerodynamics, along with optional diffusers to enhance airflow, including an optional front splitter with an aerodynamic nolder. When run on ethanol, the power increases to at 7000 rpm and of torque at 5600 rpm. This is a direct result of the cooling properties of ethanol in the engine's combustion chambers along with the added boost, made possible by ethanol's higher octane rating when compared to gasoline. Due to the lower specific energy content of ethanol, the CCXR burns slightly more fuel than the CCX with a combined fuel consumption of under the EU cycle.  In March 2009 the CCXR was chosen by "Forbes" as one of the ten most beautiful cars in history.

CCX Edition, CCXR Edition, CCXR Special Edition.

At the 2008 Geneva Motor Show, Koenigsegg presented two special edition models, the CCX Edition and the CCXR Edition, both fitted with a remapped, 4.8 L twin-supercharged V8 engine and limited to 2 and 4 units respectively. The modifications to the engine increase the power of the CCX Edition to on normal gasoline and of torque while the CCXR Edition ratings remained unchanged over the CCXR.  The Edition models are more track oriented compared to the standard models, being equipped with stiffer springs and anti-roll bars, new dampers and a lowered chassis, a bare carbon body, unique 11 spoke aluminium wheels with a unique rear wing, and a larger front splitter and side winglets, all of which make the car capable of producing of downforce at. The interior is also reworked and features; colour matched leather carpets, Koenigsegg Edition side step plates and Edition chronograph instrument cluster. All other extra equipment for the Koenigsegg CCX and CCXR Edition comes as standard which include optional carbon fibre wheels, a rearview camera, Satnav or Bluetooth, amplifiers, and a complete Inconell exhaust system.  Later, Koenigsegg also built 2 CCXR Special Edition cars which when compared to the old CCXR Edition had equipped with the double F1 wing, a revised aero package with a unique and larger front splitter and side winglets, wheel vents on top of the body, as well as Koenigsegg’s first F1 Paddleshift system.

CCXR Trevita.

The CCXR Trevita is a limited edition of the Koenigsegg CCXR featuring a diamond weave carbon fibre finish. "Trevita" is an abbreviation in Swedish and translates into "three whites". The Koenigsegg Proprietary Diamond Weave, fully developed by Koenigsegg, is a new and unique method to manufacture the carbon fibre used for the CCXR Trevita. By utilising this new and unique method, Koenigsegg managed to coat the fibres with a diamond finish. The fibre treatment is conducted carefully in small quantities, prior to further processing the pre-production material.  Initially, three CCXR Trevitas were planned to be produced, however, because of the complexity to make the special diamond weave carbon-fibre, only 2 were ever made, making it one of the rarest vehicles manufactured by Koenigsegg. Both cars featured the Koenigsegg Shimmering Diamond Weave bodywork, twin-deck carbon fibre rear wing, inconel exhaust system, carbon ceramic brakes with ABS, airbags, F1 paddle-shift gearbox, chrono instrument cluster, infotainment system, tire monitoring system and a hydraulic lifting system. The Trevita is also one of the most expensive sports cars, costing US$4.8 million. One was owned by boxer Floyd Mayweather until it was sold in 2017 for 2.6 million dollars.

Motorsport.

In order to compete in the FIA GT Championship Koenigsegg created the CCGT race car, based on the production CC model range; making its debut appearance at the 2007 Geneva Motor Show and built to comply with the ACO and FIA regulations for the GT1 class.  The CCGT's engine is based on the unit used in the Koenigsegg CCX with the superchargers removed and the capacity increased to 5.0 L to compensate for the loss of power. The CCGT had over 600 kg downforce and over 600 hp normally aspirated, racing restricted hp. Due to the already lightweight construction of the road-going model it was based on, the weight was easily reduced under the minimum, which means that the Ballast can be placed optimally in order to meet the mandatory weight.  As the car neared completion, the FIA GT1 regulations were suddenly changed, according to the altered regulations, there had to be a minimum of 350 road cars produced per year of the model that was to compete, something that Koenigsegg was unable to achieve, prohibiting the CCGT from racing.

Production.

The CCX was produced between 2006 and 2010 and the total production amounted to 49 cars (30 CCX, 9 CCXR, 6 CCX/CCXR Edition, 2 CCXR Special Edition and 2 CCXR Trevita). One of them was a CCX used for Crash tests and the other was a CCXR which is still a factory test car. Some CCX cars have later been upgraded to CCXR-specifications.

Awards and recognition.

In 2007, the CCX was the fastest car to complete Top Gear's Power Lap with a time of 1:17.6 (until it was beaten by the Ascari A10 with a time of 1:17.3). The car originally lapped the circuit in 1:20.4, but was then fitted with an optional rear wing to provide downforce after The Stig spun it off the track at 130 mph due to a power steering failure. The Stig purportedly recommended this modification, predicting that the car would then be the fastest ever round "Top Gear"<nowiki>'</nowiki>s track but Koenigsegg later stated that the improvement was due to adjustments to the chassis and suspension settings and not the addition of the rear spoiler. Despite this, the Stig's spoiler-idea remained the credited reason for the improved lap time. The name of the car on the lap board as "Koeniggggsenisseggsegnignigsegigiseg CCX2 with the Top Gear wing", reportedly because none of the Top Gear Presenters knew how to spell Koenigsegg, and also poking fun at the long and hard pronunciation of the manufacturer's name.

The Koenigsegg CCX is a mid-engine sports car manufactured by Swedish automotive manufacturer Koenigsegg Automotive AB. The project began with the aim of making a global car, designed and engineered to comply with global safety and environment regulations, particularly to enter the United States car market. To sell cars in the US, many alterations were made to the design of the CCR; the previously used Ford Modular engine was replaced by an in-house developed Koenigsegg engine designed to run on 91 octane fuel, readily available in the United States, and to meet the Californian emission standards.

La Koenigsegg CCX est une supercar produite par Koenigsegg, en Suède, sous forme de roadster ou de coupé. Elle est dotée d'un moteur en position centrale arrière. Le modèle a été remanié pour pouvoir satisfaire aux exigences américaines.


Signs and symptoms.

Iron-deficiency anemia may be present without a person experiencing symptoms. If symptomatic, patients may present with the sign of pallor (reduced oxyhemoglobin in skin or mucous membranes), and the symptoms of fatigue, lightheadedness, decreased exercise tolerance, headache, and weakness. None of these symptoms (or any of the others below) are sensitive or specific. The symptom most suggestive of iron deficiency anemia in children is pallor of mucous membranes (primarily the conjunctiva). Even so, a large study showed that pallor of the mucous membranes is only 28% sensitive and 87% specific (with high predictive value) in distinguishing children with anemia (defined as hemoglobin < 11.0 g/dl) and 49% sensitive and 79% specific in distinguishing severe anemia (hemoglobin < 7.0 g/dl). Thus, this sign is reasonably predictive when present, but not helpful when absent, as only one-third to one-half of children who are anemic (depending on severity) will show pallor.  Iron deficiency anemia tends to develop slowly; therefore the body has time to adapt, and the disease often goes unrecognized for some time. In severe cases, shortness of breath can occur. Pica may also develop; of which consumption of ice, known as pagophagia, has been suggested to be the most specific for iron deficiency anemia.  Other possible symptoms and signs of iron-deficiency anemia include:

Child development.

Iron-deficiency anemia is associated with poor neurological development, including decreased learning ability and altered motor functions. This is because iron deficiency impacts the development of the cells of the brain called neurons. When the body is low on iron, the red blood cells get priority on iron and it is shifted away from the neurons of the brain. Exact causation has not been established, but there is a possible long-term impact from these neurological issues.

Cause.

A diagnosis of iron-deficiency anemia requires further investigation into its cause. It can be caused by increased iron demand, increased iron loss, or decreased iron intake. Increased iron demand often occurs during periods of growth, such as in children and pregnant women. For example, during stages of rapid growth, babies and adolescents may outpace their dietary intake of iron which can result in deficiency in the absence of disease or a grossly abnormal diet. Iron loss is typically from blood loss. One example of blood loss is by chronic gastrointestinal blood loss, which could be linked to a possible cancer. In women of childbearing age, heavy menstrual periods can be a source of blood loss causing iron-deficiency anemia. People who do not consume much iron in their diet, such as vegans or vegetarians, are also at increased risk of developing iron deficiency anemia.

Parasitic disease.

The leading cause of iron-deficiency anemia worldwide is a parasitic disease known as a helminthiasis caused by infestation with parasitic worms (helminths); specifically, hookworms. The hookworms most commonly responsible for causing iron-deficiency anemia include "Ancylostoma duodenale", "Ancylostoma ceylanicum", and "Necator americanus". The World Health Organization estimates that approximately two billion people are infected with soil-transmitted helminths worldwide. Parasitic worms cause both inflammation and chronic blood loss by binding to a human's small-intestinal mucosa, and through their means of feeding and degradation, they can ultimately cause iron-deficiency anemia.

Blood loss.

Red blood cells contain iron, so blood loss also leads to a loss of iron. There are several causes of blood loss including menstrual bleeding, gastrointestinal bleeding, stomach ulcers, and bleeding disorders. The bleeding may occur quickly or slowly. Slow, chronic blood loss within the body — such as from a peptic ulcer, angiodysplasia, inflammatory bowel disease, a colon polyp or gastrointestinal cancer (e.g., colon cancer)— can cause iron-deficiency anemia.

Menstrual bleeding.

Menstrual bleeding is a common cause of iron deficiency anemia in women of child-bearing age. Women with menorrhagia (heavy menstrual periods) are at risk of iron-deficiency anemia because they are at higher-than-normal risk of losing a larger amount blood during menstruation than is replaced in their diet. Most women lose about 40 mL of blood per cycle. Iron is lost with the blood. Some birth control methods, such as pills and IUDs, may decrease the amount of blood, therefore iron lost during a menstrual cycle. Intermittent iron supplementation may be as effective a treatment in these cases as daily supplements and reduce some of the adverse effects of long term daily supplements.

Gastrointestinal bleeding.

The most common cause of iron deficiency anemia in men and post-menopausal women is gastrointestinal bleeding. There are many sources of gastrointestinal tract bleeding including the stomach, esophagus, small intestine, and the large intestine(colon). Gastrointestinal bleeding can result from regular use of some groups of medication, such as non-steroidal anti-inflammatory drugs (e.g. aspirin), as well as antiplatelets such as clopidogrel and anticoagulants such as warfarin; however, these are required in some patients, especially those with states causing a tendency to form blood clots. Colon cancer is another potential cause gastrointestinal bleeding, thus iron deficiency anemia. Typically colon cancer occurs in older individuals In addition, some bleeding disorders can cause gastrointestinal bleeding. Two examples of bleeding disorders are von Willebrand disease and polycythemia vera.

Diet.

The body normally gets the iron it requires from foods. If a person consumes too little iron, or iron that is poorly absorbed (non-heme iron), they can become iron deficient over time. Examples of iron-rich foods include meat, eggs, leafy green vegetables and iron-fortified foods. For proper growth and development, infants and children need iron from their diet. For children, a high intake of cow's milk is associated with an increased risk of iron-deficiency anemia. Other risk factors for iron-deficiency anemia include low meat intake and low intake of iron-fortified products.  The National Academy of Medicine updated Estimated Average Requirements and Recommended Dietary Allowances in 2001. The current EAR for iron for women ages 14–18 is 7.9 mg/day, 8.1 for ages 19–50 and 5.0 thereafter (post menopause). For men the EAR is 6.0 mg/day for ages 19 and up. The Recommended Dietary Allowance is 15.0 mg/day for women ages 15–18, 18.0 for 19–50 and 8.0 thereafter. For men, 8.0 mg/day for ages 19 and up. (Recommended Dietary Allowances are higher than Estimated Average Requirements so as to identify amounts that will cover people with higher than average requirements.) The Recommended Dietary Allowance for pregnancy is 27 mg/day, and for lactation, 9 mg/day. For children ages 1–3 years it is 7 mg/day, 10 for ages 4–8 and 8 for ages 9–13. The European Food Safety Authority refers to the collective set of information as Dietary Reference Values, with Population Reference Intakes instead of Recommended Dietary Allowances, and Average Requirements instead of Estimated Average Requirements. For women the Population Reference Intake is 13 mg/day ages 15–17 years, 16 mg/day for women ages 18 and up who are premenopausal and 11 mg/day postmenopausal. For pregnancy and lactation, 16 mg/day. For men the Population Reference Intake is 11 mg/day ages 15 and older. For children ages 1 to 14 the Population Reference Intake increases from 7 to 11 mg/day. The Population Reference Intakes are higher than the US Recommended Dietary Allowances, with the exception of pregnancy.

Iron malabsorption.

Iron from food is absorbed into the bloodstream in the small intestine, primarily in the duodenum. Iron malabsorption is a less common cause of iron-deficiency anemia, but many gastrointestinal disorders can reduce the body's ability to absorb iron. There are different mechanisms that may be present.  In celiac disease, abnormal changes in the structure of the duodenum can decrease iron absorption. Abnormalities or surgical removal of the stomach can also lead to malabsorption by altering the acidic environment needed for iron to be converted into its absorbable form. If there is insufficient production of hydrochloric acid in the stomach, hypochlorhydria/achlorhydria can occur (often due to chronic H. pylori infections or long-term proton-pump inhibitor therapy), inhibiting the conversion of ferric iron to the absorbable ferrous iron.  Bariatric surgery is associated with an increased risk of iron deficiency anemia due to malabsorption of iron. During a Roux-en-Y anastamosis, which is commonly performed for weight management and diabetes control, the stomach is made into a small pouch and this is connected directly to the small intestines further downstream (bypassing the duodenum as a site of digestion). About 17-45% of people develop iron deficiency after a Roux-en-Y gastric bypass.

Pregnant women.

Without iron supplementation, iron-deficiency anemia occurs in many pregnant women because their iron stores need to serve their own increased blood volume, as well as be a source of hemoglobin for the growing baby and for placental development. Other less common causes are intravascular hemolysis and hemoglobinuria. Iron deficiency in pregnancy appears to cause long-term and irreversible cognitive problems in the baby.  Iron deficiency affects maternal well-being by increasing risks for infections and complications during pregnancy. Some of these complications include pre-eclampsia, bleeding problems, and perinatal infections. Pregnancies where iron deficiency is present can lead to improper development of fetal tissues. Oral iron supplementation during the early stages of pregnancy is suggested to decrease the adverse effects of iron-deficiency anemia throughout pregnancy and to decrease the negative impact that iron deficiency has on fetal growth. Iron deficiency can lead to premature labor and to problems with neural functioning, including delays in language and motor development in the infant.  Some studies show that women pregnant during their teenage years can be at greater risk of iron-deficiency anemia due to an already increased need for iron and other nutrients during adolescent growth spurts.

Children.

Babies are at increased risk of developing iron deficiency anemia due to their rapid growth. Their need for iron is greater than they are getting in their diet. Babies are born with iron stores; however, these iron stores typically run out by 4–6 months of age. In addition, infants who are given cow's milk too early can develop anemia due to gastrointestinal blood loss.  Children who are at risk for iron-deficiency anemia include:

Blood donation.

Frequent blood donors are also at risk for developing iron deficiency anemia. When whole blood is donated, approximately 200 mg of iron is also lost from the body. The blood bank screens people for anemia before drawing blood for donation. If the patient has anemia, blood is not drawn. Less iron is lost if the person is donating platelets or white blood cells.

Hepcidin.

Decreased levels of serum and urine hepcidin are early indicators of iron deficiency. Hepcidin concentrations are also connected to the complex relationship between malaria and iron deficiency.

Mechanism.

Anemia can result from significant iron deficiency. When the body has sufficient iron to meet its needs (functional iron), the remainder is stored for later use in cells, mostly in the bone marrow and liver. These stores are called ferritin complexes and are part of the human (and other animals) iron metabolism systems. Men store about 3.5 g of iron in their body, and women store about 2.5 g.  Hepcidin is a peptide hormone produced in the liver that is responsible for regulating iron levels in the body. Hepcidin decreases the amount of iron available for erythropoesis (red blood cell production). Hepcidin binds to and induces the degradation of ferroportin, which is responsible for exporting iron from cells and mobilizing it to the bloodstream. Conditions such as high levels of erythropoesis, iron deficiency and tissue hypoxia inhibit hepcidin expression. Whereas systemic infection or inflammation (especially involving the cytokine IL-6) or increased circulating iron levels inhibit hepcidin expression.  Iron is a mineral that is important in the formation of red blood cells in the body, particularly as a critical component of hemoglobin. About 70% of the iron found in the body is bound to hemoglobin. Iron is primarily absorbed in the small intestine, in particular the duodenum and jejunum. Certain factors increase or decrease absorption of iron. For example, taking Vitamin C with a source of iron is known to increase absorption. Some medications such as tetracyclines and antacids can decrease absorption of iron. After being absorbed in the small intestine, iron travels through blood, bound to transferrin, and eventually ends up in the bone marrow, where it is involved in red blood cell formation. When red blood cells are degraded, the iron is recycled by the body and stored.  When the amount of iron needed by the body exceeds the amount of iron that is readily available, the body can use iron stores (ferritin) for a period of time, and red blood cell formation continues normally. However, as these stores continue to be used, iron is eventually depleted to the point that red blood cell formation is abnormal. Ultimately, anemia ensues, which by definition is a hemoglobin lab value below normal limits.

Diagnosis.

Conventionally, a definitive diagnosis requires a demonstration of depleted body iron stores obtained by bone marrow aspiration, with the marrow stained for iron. However, with the availability of reliable blood tests that can be more readily collected for iron-deficiency anemia diagnosis, a bone marrow aspiration is usually not obtained. Furthermore, a study published April 2009 questions the value of stainable bone marrow iron following parenteral iron therapy. Once iron deficiency anemia is confirmed, gastrointestinal blood loss is presumed to be the cause until proven otherwise since it can be caused by an otherwise asymptomatic colon cancer. Initial evaluation must include esophagogastroduodenoscopy and colonoscopy to evaluate for cancer or bleeding of the gastrointestinal tract.  A thorough medical history is important to the diagnosis of iron-deficiency anemia. The history can help to differentiate common causes of the condition such as a menstruation in woman or the presence of blood in the stool. A travel history to areas in which hookworms and whipworms are endemic may also be helpful in guiding certain stool tests for parasites or their eggs. Although symptoms can play a role in identifying iron-deficiency anemia, they are often vague, which may limit their contribution to determining the diagnosis.

Blood tests.

Anemia is often discovered by routine blood tests. A sufficiently low hemoglobin by definition makes the diagnosis of anemia, and a low hematocrit value is also characteristic of anemia. Further studies will be undertaken to determine the anemia's cause. If the anemia is due to iron deficiency, one of the first abnormal values to be noted on a complete blood count, as the body's iron stores begin to be depleted, will be a high red blood cell distribution width, reflecting an increased variability in the size of red blood cells.  A low mean corpuscular volume also appears during the course of body iron depletion. It indicates a high number of abnormally small red blood cells. A low mean corpuscular volume, a low mean corpuscular hemoglobin or mean corpuscular hemoglobin concentration, and the corresponding appearance of red blood cells on visual examination of a peripheral blood smear narrows the problem to a microcytic anemia (literally, a small red blood cell anemia).  The blood smear of a person with iron-deficiency anemia shows many hypochromic (pale, relatively colorless) and small red blood cells, and may also show poikilocytosis (variation in shape) and anisocytosis (variation in size). Target cells may also be seen. With more severe iron-deficiency anemia, the peripheral blood smear may show hypochromic, pencil-shaped cells and, occasionally, small numbers of nucleated red blood cells. The platelet count may be slightly above the high limit of normal in iron-deficiency anemia (termed a mild thrombocytosis), but severe cases can present with thrombocytopenia (low platelet count).  Iron-deficiency anemia is confirmed by tests that include serum ferritin, serum iron level, serum transferrin, and total iron binding capacity. A low serum ferritin is most commonly found. However, serum ferritin can be elevated by any type of chronic inflammation and thus is not consistently decreased in iron-deficiency anemia. Serum iron levels may be measured, but serum iron concentration is not as reliable as the measurement of both serum iron and serum iron-binding protein levels. The percentage of iron saturation (or transferrin saturation index or percent) can be measured by dividing the level of serum iron by total iron binding capacity and is a value that can help to confirm the diagnosis of iron-deficiency anemia; however, other conditions must also be considered, including other types of anemia.  Another finding that can be used is the level of red blood cell distribution width. During haemoglobin synthesis, trace amounts of zinc will be incorporated into protoporphyrin in the place of iron which is lacking. Protoporphyrin can be separated from its zinc moiety and measured as free erythrocyte protoporphyrin, providing an indirect measurement of the zinc-protoporphyrin complex. The level of free erythrocyte protoporphyrin is expressed in either μg/dl of whole blood or μg/dl of red blood cells. An iron insufficiency in the bone marrow can be detected very early by a rise in free erythrocyte protoporphyrin.  Further testing may be necessary to differentiate iron-deficiency anemia from other disorders, such as thalassemia minor. It is very important not to treat people with thalassemia with an iron supplement, as this can lead to hemochromatosis. A hemoglobin electrophoresis provides useful evidence for distinguishing these two conditions, along with iron studies.

Screening.

It is unclear if screening pregnant women for iron-deficiency anemia during pregnancy improves outcomes in the United States. The same holds true for screening children who are 6 to 24 months old. Even so, screening is a Level B recommendation suggested by the US Preventative Services Task Force in pregnant women without symptoms and in infants considered high risk. Screening is done with either a hemoglobin or hematocrit lab test.

Treatment.

Treatment should take into account the cause and severity of the condition. If the iron-deficiency anemia is a result of blood loss or another underlying cause, treatment is geared toward addressing the underlying cause. Most cases of iron deficiency anemia are treated with oral iron supplements. In severe acute cases, treatment measures are taken for immediate management in the interim, such as blood transfusions or intravenous iron.  For less severe cases, treatment of iron-deficiency anemia includes dietary changes to incorporate iron-rich foods into regular oral intake and oral iron supplementation. Foods rich in ascorbic acid (vitamin C) can also be beneficial, since ascorbic acid enhances iron absorption. Oral iron supplements are available in multiple forms. Some are in the form of pills and some are drops for children. Most forms of oral iron replacement therapy are absorbed well by the small intestine; however, there are certain preparations of iron supplements that are designed for longer release in the small intestine than other preparations. Oral iron supplements are best taken up by the body on an empty stomach because food can decrease the amount of iron absorbed from the small intestine. The dosing of oral iron replacement therapy is as much as 100-200 mg per day in adults and 3-6 mg per kilogram in children. This is generally spread out as 3-4 pills taken throughout the day. The various forms of treatment are not without possible adverse side effects. Iron supplementation by mouth commonly causes negative gastrointestinal effects, including constipation, nausea, vomiting, metallic taste to the oral iron and dark colored stools. Constipation is reported by 15-20% of patients taking oral iron therapy. Preparations of iron therapy that take longer to be absorbed by the small intestine (extended release iron therapy) are less likely to cause constipation. It can take six months to one year to get blood levels of iron up to a normal range and provide the body with iron stores. Oral iron replacement may not be effective in cases of iron deficiency due to malabsorption, such as celiac disease, inflammatory bowel disease, or H. pylori infection; these cases would require treatment of the underlying disease to increase oral absorption or intravenous iron replacement.  As iron-deficiency anemia becomes more severe, if the anemia does not respond to oral treatments, or if the treated person does not tolerate oral iron supplementation, then other measures may become necessary. Two options are intravenous iron injections and blood transfusion. Intravenous can be for people who do not tolerate oral iron, who are unlikely to respond to oral iron, or who require iron on a long-term basis. For example, people receiving dialysis treatment who are also getting erythropoietin or another erythropoiesis-stimulating agent are given parenteral iron, which helps the body respond to the erythropoietin agents to produce red blood cells.  Intravenous iron can induce an allergic response that can be as serious as anaphylaxis, although different formulations have decreased the likelihood of this adverse effect. In certain cases intravenous iron is both safer and more effective than the oral route. For patients with severe anemia such as from blood loss, or who have severe symptoms such as cardiovascular instability, a blood transfusion may be considered.

Epidemiology.

A moderate degree of iron-deficiency anemia affects approximately 610 million people worldwide or 8.8% of the population. It is slightly more common in females (9.9%) than males (7.8%). Up to 15% of children ages 1–3 years have iron deficiency anemia. Mild iron deficiency anemia affects another 375 million. Iron deficiency affects up to 52% of pregnant women worldwide.  The prevalence of iron deficiency as a cause of anemia varies among countries; in the groups in which anemia is most common, including young children and a subset of non-pregnant women, iron deficiency accounts for a fraction of anemia cases in these groups (25% and 37%, respectively). Iron deficiency is common in pregnant women.  Within the United States, iron-deficiency anemia affects about 2% of adult males, 10.5% of Caucasian women, and 20% of African-American and Mexican-American women.  A map provides a country-by-country listing of what nutrients are fortified into specified foods. Some of the Sub-Saharan countries shown in the deaths from iron-deficiency anemia map from 2012 are as of 2018 fortifying foods with iron.

Iron-deficiency anemia is anemia caused by a lack of iron. Anemia is defined as a decrease in the number of red blood cells or the amount of hemoglobin in the blood. When onset is slow, symptoms are often vague such as feeling tired, weak, short of breath, or having decreased ability to exercise. Anemia that comes on quickly often has more severe symptoms, including: confusion, feeling like one is going to pass out or increased thirst. Anemia is typically significant before a person becomes noticeably pale. Children with iron deficiency anemia may have problems with growth and development. There may be additional symptoms depending on the underlying cause. Iron-deficiency anemia is caused by blood loss, insufficient dietary intake, or poor absorption of iron from food. Sources of blood loss can include heavy periods, childbirth, uterine fibroids, stomach ulcers, colon cancer, and urinary tract bleeding. Poor absorption of iron from food may occur as a result of an intestinal disorder such as inflammatory bowel disease or celiac disease, or surgery such as a gastric bypass. In the developing world, parasitic worms, malaria, and HIV/AIDS increase the risk of iron deficiency anemia. Diagnosis is confirmed by blood tests. Iron deficiency anemia can be prevented by eating a diet containing sufficient amounts of iron or by iron supplementation. Foods high in iron include meat, nuts, spinach, and foods made with iron-fortified flour. Treatment may include dietary changes and dealing with underlying causes, for example medical treatment for parasites or surgery for ulcers. Iron supplements and vitamin C may be recommended. Severe cases may be treated with blood transfusions or iron injections. Iron-deficiency anemia affected about 1.48 billion people in 2015. A lack of dietary iron is estimated to cause approximately half of all anemia cases globally. Women and young children are most commonly affected. In 2015, anemia due to iron deficiency resulted in about 54,000 deaths – down from 213,000 deaths in 1990.

Une anémie ferriprive ou anémie par carence martiale (en anglais, "iron deficiency anemia" ou "IDA") est une anémie due à une carence des réserves en fer de l'organisme. Il s'agit d'une situation fréquente en médecine.


History.

Near the start of the 18th century, a large number of sea vessels appeared using the ship's wheel design, but historians are unclear when that approach to steering was first used. The first automobiles were steered with a tiller, but in 1894, Alfred Vacheron took part in the Paris–Rouen race with a Panhard 4 hp model which he had fitted with a steering wheel. That is believed to be one of the earliest employments of the principle.  From 1898, the Panhard et Levassor cars were equipped as standard with steering wheels. Charles Rolls introduced the first car in Britain fitted with a steering wheel when he imported a 6 hp Panhard from France in 1898. Arthur Constantin Krebs replaced the tiller with an inclined steering wheel for the Panhard car he designed for the 1898 Paris–Amsterdam–Paris race which ran 7–13 July 1898.  In 1898, Thomas B. Jeffery and his son, Charles T. Jeffery, developed two advanced experimental cars featuring a front-mounted engine, as well as a steering wheel that was mounted on the left-hand side. However, the early automaker adopted a more "conventional" rear-engine and tiller-steering layout for its first mass-produced Ramblers in 1902. The following year, the Rambler Model E was largely unchanged, except that it came equipped with a tiller early in the year, but with a steering wheel by the end of 1903. By 1904, all Ramblers featured steering wheels. Within a decade, the steering wheel had entirely replaced the tiller in automobiles.  At the insistence of Thomas B. Jeffery, the position of the driver was also moved to the left-hand side of the car during the 1903 Rambler production. Most other car makers began offering cars with left-hand drive in 1910. Soon after, most cars in the U.S. converted to left hand drive.

Passenger cars.

Steering wheels for passenger automobiles are generally circular, and are mounted to the steering column by a hub connected to the outer ring of the steering wheel by one or more spokes (single spoke wheels being a rather rare exception). Other types of vehicles may use the circular design, a butterfly shape, or some other shape. In countries where cars must drive on the left side of the road, the steering wheel is typically on the right side of the car (right-hand drive or RHD); the converse applies in countries where cars drive on the right side of the road (left-hand drive or LHD).  In addition to its use in steering, the steering wheel is the usual location for a button to activate the car's horn. Modern automobiles may have other controls, such as cruise control, audio system and telephone controls, as well as paddle shifters, built into the steering wheel to minimize the extent to which the driver must take their hands off the wheel.  The steering wheels were rigid and mounted on non-collapsible steering columns. This arrangement increased the risk of impaling the driver in case of a severe crash. The first collapsible steering column was invented in 1934 but was never successfully marketed. By 1956, Ford came out with a safety steering wheel that was set high above the post with spokes that would flex, but the column was still rigid. In 1968, United States regulations (FMVSS Standard No. 204) were implemented concerning the acceptable rearward movement of the steering wheel in case of crash. Collapsible steering columns were required to meet that standard.  Power steering gives the driver an easier means by which the steering of a car can be accomplished. Modern power steering has almost universally relied on a hydraulic system, although electrical systems are steadily replacing this technology. Mechanical power steering systems (e.g., Studebaker, 1952) have been invented, but their weight and complexity negate the benefits that they provide.  While other methods of steering passenger cars have resulted from experiments, for example the "wrist-twist" steering of the 1965 Mercury Park Lane concept car was controlled by two rings, none have yet been deployed as successfully as the conventional large steering wheel.  Passenger automobile regulations implemented by the U.S. Department of Transportation required the locking of steering wheel rotation (or transmission locked in "park") to hinder motor vehicle theft; in most vehicles, this is accomplished when the ignition key is removed from the ignition lock. See steering lock.

Other designs.

The driver's seat, and therefore the steering wheel, is centrally located on certain high-performance sports cars, such as the McLaren F1, and in the majority of single-seat racing cars.  As a driver may have his hands on the steering wheel for hours at a time these are designed with ergonomics in mind. However, the most important concern is that the driver can effectively convey torque to the steering system; this is especially important in vehicles without power steering or in the rare event of a loss of steering assist. A typical design for circular steering wheels is a steel or magnesium rim with a plastic or rubberized grip molded over and around it. Some drivers purchase vinyl or textile steering wheel covers to enhance grip or comfort, or simply as decoration. Another device used to make steering easier is the brodie knob.  A similar device in aircraft is the yoke. Water vessels not steered from a stern-mounted tiller are directed with the ship's wheel, which may have inspired the concept of the steering wheel. The steering wheel is better than other user interfaces and has persisted because driving requires precise feedback that only comes from a large interface.  Early Formula One cars used steering wheels taken directly from road cars. They were normally made from wood (necessitating the use of driving gloves), and in the absence of packaging constraints they tended to be made as large a diameter as possible, to reduce the effort needed to turn. As cars grew progressively lower and cockpits narrower throughout the 1960s and 1970s, steering wheels became smaller, so as to fit into the more compact space available.

Spokes in steering wheel.

The number of spokes in the steering wheel has continuously changed. Most early cars had four-spoke steering wheels.  A Banjo Steering Wheel was an option on many early automobiles. Banjo Wheels predate power steering. The wire spokes were a buffer or absorber between the driver's hands and the drum of the road. Most were 3 or 4 spokes made of four or five wires in each spoke, hence the name "Banjo".

Usage.

The steering wheel should be used with strategic movements of the hand and wrist in spinning motions. Caution and care should be used to ensure safety of the extremities. The constant motions used must be performed with caution. "Proper posture of the hand-arm system while using hand tools is very important. As a rule the wrist should not be bent, but must be kept straight to avoid overexertion of such tissues as tendons and tendon sheaths and compression of nerves and blood vessels."  The act of turning the steering wheel while the vehicle is stationary is called dry steering. It is generally advised to avoid dry steering as it puts strain on the steering mechanism and causes undue wear of the tires.

Buttons and controls on the steering wheel.

The first button added to the steering wheel was a switch to activate the car's electric horn. Traditionally located on the steering wheel hub or center pad, the horn switch was sometimes placed on the spokes or activated via a decorative horn ring which obviated the necessity to move a hand away from the rim. Electrical connections are made via a slip ring. A further development, the Rim Blow steering wheel, integrated the horn switch into the steering wheel rim.  In 1966, Ford offered the Highway Pilot Speed Control Option, with steering wheel pad mounted rocker switches, on its Thunderbird. Uniquely, the Thunderbird also lightly applied the brakes and illuminated the stop lamps when the Retard was continuously depressed with the cruise control on, but not engaged.  In 1974, Lincoln added two rocker switches on the steering wheel to activate various cruise control functions on the Continental and Continental Mark IV. In 1988, Pontiac offered a steering wheel with 12 buttons controlling various audio functions on the Trans-Am, 6000 STE and Bonneville.  In the 1990s, a proliferation of new buttons began to appear on automobile steering wheels. Remote or alternate adjustments could include vehicle audio, telephone, and voice control navigation. Often scroll wheels or buttons are used to set volume levels or page through menus, change radio stations or audio tracks. These controls can use universal interfaces, wired or wirelessly.

Gaming imitations.

Game controllers are available for arcade cabinets, personal computers, and console games are designed to look and feel like a steering wheel and intended for use in racing games. The least expensive units are paddle controllers with a larger wheel, but many gaming wheels also employ force feedback to simulate the tactile feedback a real driver feels from a steering wheel.

A steering wheel (also called a driving wheel or a hand wheel) is a type of steering control in vehicles.

Dans une automobile, le volant est la pièce mécanique permettant au conducteur de choisir la direction du véhicule. Le volant fait donc partie du mécanisme de direction du véhicule. Il fut introduit pour la première fois en 1894, dans l'épreuve Paris-Rouen, par M. Alfred Vacheron et son numéro 24.