Field Triage Decision Scheme: The National Trauma Triage Protocol

Centers for Disease Control (CDC) Podcasts

In this podcast, Dr. Richard C. Hunt, Director of CDC's Division of Injury Response, provides an overview on the development process and scientific basis for the revised field triage guidelines published in the MMWR Recommendations and Report: Guidelines for Field Triage of Injured Patients, Recommendations of the National Expert Panel on Field Triage.

Do prehospital providers and emergency nurses agree on triage assignment?

DEFF Research Database (Denmark)

Skjøt-Arkil, Helene; Pontoppidan, Louise L; Laursen, Jens O

2018-01-01

OBJECTIVES: The aim of this study was to investigate the agreement on triage level between prehospital providers and emergency department (ED) nurses in clinical practice when using the same triage system. The objectives were as follows: (a) What is the agreement of triage between prehospital...... providers and ED nurses, when using Danish Emergency Process Triage (DEPT) correctly? (b) Which part of the triage process yields the highest agreement regarding the final triage? METHODS: The study was a prospective and observational efficacy study. Patients transported to the ED by ambulances were...... included. They were triaged by prehospital providers while being transported by ambulance to the ED, and by ED nurses upon arrival. Triage was done using the DEPT - a five-level triage system based on vital signs and a presenting complaint algorithm. An agreement analysis was performed. RESULTS: DEPT...

The introduction of a midwife-led obstetric triage system into a regional referral hospital in Ghana.

Science.gov (United States)

Floyd, Liz; Bryce, Fiona; Ramaswamy, Rohit; Olufolabi, Adeyemi; Srofenyoh, Emmanuel; Goodman, David; Pearson, Nancy; Morgan, Kerry; Tetteh, Cecilia; Ahwireng, Victoria; Owen, Medge

2018-06-01

to introduce and embed a midwife-led obstetric triage system in a busy labour ward in Accra, Ghana to improve the quality of care and to reduce delay. the study utilized a participatory action research design. Local staff participated in baseline data collection, the triage training course design and delivery, and post-training monitoring and evaluation. a regional referral hospital in Accra, Ghana undertaking 11,032 deliveries in 2012. all midwives and medical staff. measurements included maternal health outcomes, observations of labour ward activity, structured assessments of midwife actions during admission, waiting times, focus group discussions, and learning needs assessments which informed the course content. During training, two quality improvement tools were developed; coloured risk acuity wristbands and a one page triage assessment form. Participants measured compliance and accuracy in the use of these tools following course completion. initially, no formal triage system was in place. The environment was chaotic with poor compliance to existing protocols. Sixty-two midwives received triage training between 2013 and 2014. Two Triage Champions became responsible for triage implementation, monitoring and further training. Following training, the 'in-charge' midwives recorded a cumulative average of 83.4% of women wearing coloured wristbands. A separate audit by the Triage Champions found that 495/535 (93%) of the wristbands were correctly applied based on the diagnosis. Quarterly monitoring of the triage assessment forms by Kybele trainers, showed that 92% recorded the risk acuity colour, 85% a 'working diagnosis' and 82% a 'plan.' Median (interquartile range) waiting times were reduced from 40 (15-100) to 29 (11-60) minutes (p = 007). Twenty of 25 of the staff reported that the wristbands were helpful. an interactive triage training course led to the development of a triage assessment form and the use of coloured patient wristbands which resulted in delay

Contemporary Obstetric Triage.

Science.gov (United States)

Sandy, Edward Allen; Kaminski, Robert; Simhan, Hygriv; Beigi, Richard

2016-03-01

The role of obstetric triage in the care of pregnant women has expanded significantly. Factors driving this change include the Emergency Medical Treatment and Active Labor Act, improved methods of testing for fetal well-being, increasing litigation risk, and changes in resident duty hour guidelines. The contemporary obstetric triage facility must have processes in place to provide a medical screening examination that complies with regulatory statues while considering both the facility's maternal level of care and available resources. This review examines the history of the development of obstetric triage, current considerations in a contemporary obstetric triage paradigm, and future areas for consideration. An example of a contemporary obstetric triage program at an academic medical center is presented. A successful contemporary obstetric triage paradigm is one that addresses the questions of "sick or not sick" and "labor or no labor," for every obstetric patient that presents for care. Failure to do so risks poor patient outcome, poor patient satisfaction, adverse litigation outcome, regulatory scrutiny, and exclusion from federal payment programs. Understanding the role of contemporary obstetric triage in the current health care environment is important for both providers and health care leadership. This study is for obstetricians and gynecologists as well as family physicians. After completing this activity, the learner should be better able to understand the scope of a medical screening examination within the context of contemporary obstetric triage; understand how a facility's level of maternal care influences clinical decision making in a contemporary obstetric triage setting; and understand the considerations necessary for the systematic evaluation of the 2 basic contemporary obstetric questions, "sick or not sick?" and "labor or no labor?"

Field Triage Decision Scheme: The National Trauma Triage Protocol

Centers for Disease Control (CDC) Podcasts

2009-01-22

In this podcast, Dr. Richard C. Hunt, Director of CDC's Division of Injury Response, provides an overview on the development process and scientific basis for the revised field triage guidelines published in the MMWR Recommendations and Report: Guidelines for Field Triage of Injured Patients, Recommendations of the National Expert Panel on Field Triage.  Created: 1/22/2009 by National Center for Injury Prevention and Control (NCIPC), Division of Injury Response (DIR).   Date Released: 1/22/2009.

Level I center triage and mass casualties.

Science.gov (United States)

Hoey, Brian A; Schwab, C William

2004-05-01

The world has been marked by a recent series of high-profile terrorist attacks, including the attack of September 11, 2001, in New York City. Similar to natural disasters, these attacks often result in a large number of casualties necessitating triage strategies. The end of the twentieth century was marked by the development of trauma systems in the United States and abroad. By their very nature, trauma centers are best equipped to handle mass casualties resulting from natural and manmade disasters. Triage assessment tools and scoring systems have evolved to facilitate this triage process and to potentially reduce the morbidity and mortality associated with these events.

A lean case study in an oncological hospital: implementation of a telephone triage system in the emergency service

Directory of Open Access Journals (Sweden)

Crespo de Carvalho J

2013-12-01

Full Text Available José Crespo de Carvalho,1 Madalena Ramos,1 Carina Paixão2 1Business School, University Institute of Lisbon, Lisbon, Portugal; 2Instituto Português de Oncologia, Lisbon, Portugal Abstract: Lean practices and thinking have increased substantially in the last few years. Applications of lean practices to health care are found worldwide. Despite that, new contributions are required because the application of lean thinking to hospitals has a long way to go. Lean practices and thinking do not include, in the literature or practice programs, any references to triage systems in health care units. The common triage systems require physical presence, but there are alternative methods to avoid the need to move patients: these alternative triage systems, given their characteristics, may be included in the spectrum of lean practices. Currently, patients that are already known to suffer from cancer are encouraged to go to hospital (public or private, with an oncological focus when facing side effects from chemotherapy or radiation treatments; they are then submitted to a triage system (present themselves to the hospital for examination. The authors of this paper propose the introduction of telephone or email triage for impaired patients as a valid substitute for moving them physically, thereby often avoiding several unnecessary moves. This approach has, in fact, characteristics similar to a lean practice in that it reduces costs and maintains, if done properly, the overall service offered. The proposed 'remote' triage emerged from the results of a large survey sent to patients and also as the outcome of a set of semistructured interviews conducted with hospital nurses. With the results they obtained, the authors felt comfortable proposing this approach both to public and private hospitals, because the study was conducted in the most important, largest, and best-known oncological unit in Spain. As a final result, the health care unit studied is now taking

Addressing the third delay: implementing a novel obstetric triage system in Ghana.

Science.gov (United States)

Goodman, David M; Srofenyoh, Emmanuel K; Ramaswamy, Rohit; Bryce, Fiona; Floyd, Liz; Olufolabi, Adeyemi; Tetteh, Cecilia; Owen, Medge D

2018-01-01

Institutional delivery has been proposed as a method for reducing maternal morbidity and mortality, but little is known about how referral hospitals in low-resource settings can best manage the expected influx of patients. In this study, we assess the impact of an obstetric triage improvement programme on reducing hospital-based delay in a referral hospital in Accra, Ghana. An Active Implementation Framework is used to describe a 5-year intervention to introduce and monitor obstetric triage capabilities. Baseline data, collected from September to November 2012, revealed significant delays in patient assessment on arrival. A triage training course and monitoring of quality improvement tools occurred in 2013 and 2014. Implementation barriers led to the construction of a free-standing obstetric triage pavilion, opened January 2015, with dedicated midwives. Data were collected at three time intervals following the triage pavilion opening and compared with baseline including: referral indications, patient and labour characteristics, waiting time from arrival to assessment and the documentation of a care plan. An obstetric triage improvement programme reduced the median (IQR) patient waiting time from facility arrival to first assessment by a midwife from 40 min (15-100) to 5 min (2-6) (p<0.001) over the 5-year intervention. The triage pavilion enhanced performance resulting in the elimination of previous delays associated with the time of admission and disease acuity. Care plan documentation increased from 51% to 96%. Obstetric triage, when properly implemented, reduced delay in a busy, low-resource hospital. The implementation process was sustained under local leadership during transition to a new hospital.

The Copenhagen Triage Algorithm

DEFF Research Database (Denmark)

Hasselbalch, Rasmus Bo; Plesner, Louis Lind; Pries-Heje, Mia

2016-01-01

is non-inferior to an existing triage model in a prospective randomized trial. METHODS: The Copenhagen Triage Algorithm (CTA) study is a prospective two-center, cluster-randomized, cross-over, non-inferiority trial comparing CTA to the Danish Emergency Process Triage (DEPT). We include patients ≥16 years...

Short-term predictive capacity of two different triage systems in patients with acute heart failure: TRICA-EAHFE study.

Science.gov (United States)

Miró, Òscar; Tost, Josep; Herrero, Pablo; Jacob, Javier; Martín-Sánchez, Francisco Javier; Gil, Víctor; Fernández-Pérez, Cristina; Escoda, Rosa; Llorens, Pere

2016-12-01

To evaluate whether prioritization of patients with acute heart failure (AHF) in the Andorran Triage Model/Spanish Triage System (MAT/SET) and the Manchester Triage System (MTS) also allows the identification of different profiles of outcome and prognosis and determine whether either system has a better predictive capacity of outcomes. Patients with AHF included in the Spanish EAHFE registry from hospitals using the MAT/SET or MTS were selected and divided according to the triage system used. Outcome variables included hospital admission, length of stay, death during admission, 3, 7, and 30-day all-cause mortality, and emergency department (ED) reconsultation at 30 days. The results were compared according to the level of priority and the triage system used. We included 3837 patients (MAT/SET=2474; MTS=1363) classified as follows: 4.0% level 1; 34.7% level 2; 55.1% level 3; and 6.3% levels 4-5. Both systems associated greater priority with higher rates of admission and mortality; the MTS associated greater priority with greater ED reconsultation and the MAT/SET found greater priority to be associated with less ED reconsultation. The discriminative capacity of the two scales for adverse outcomes was statistically significant, albeit poor, for almost all the outcome events and it was of scarce clinical relevance (Area under the curve of the receiver operating characteristic between 0.458 and 0.661). The prediction of the outcome of patients with AHF determined with the MAT/SET or MTS showed scarce differences between the two systems, and their discriminative capacity does not seem to be clinically relevant.

Dental triage Hydebank Wood Prison and young offenders centre, Belfast.

Science.gov (United States)

Gray, R; Fawcett, T

2014-05-01

The aim of this study was to devise and test a triage protocol to prioritise patients' dental needs in a prison environment. Secondary aims were to include in the triage process oral health promotion and information about accessing prison dental services. Also to work collaboratively with the prison staff to improve referrals to the dental services. The triage system was devised to have three strands: (1) an oral health assessment conducted by the dental nurse during the induction process for each new prisoner; (2) a simple oral health examination conducted in monthly screening clinics; (3) the prioritisation of referrals from prison landing staff using the prisons computer system PRISM. The triage was evaluated by assessing the first 100 patients' records with regard to the prioritisation of the triage category at the time of the clinical dental examination. Of the 100 patients triaged 95% were prioritised into the correct triage category. Seventy-two percent of patients were seen in the appropriate timeframe. Referral patterns from prison landing staff were improved along with interdisciplinary working in the prison. All new prisoners were seen within 72 hours of committal and received oral health advice and information on accessing dental services. This is the first triage system to be introduced into Hydebank Wood Prison, facilitating a targeted approach to dental care. It has improved access to the prison dental services; introduced oral health advice and information into the regular prison healthcare structure; and improved the efficiency of the clinical dental sessions. It is hoped to strategically address problems with waiting times and inequity in service utilisation.

Triage and mortality in 2875 consecutive trauma patients

DEFF Research Database (Denmark)

Meisler, Rikke; Thomsen, A B; Abildstrøm, H

2010-01-01

Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European trauma patients, with focus on triage.......Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European trauma patients, with focus on triage....

Risk Analysis for Environmental Health Triage

International Nuclear Information System (INIS)

Bogen, K T

2005-01-01

The Homeland Security Act mandates development of a national, risk-based system to support planning for, response to and recovery from emergency situations involving large-scale toxic exposures. To prepare for and manage consequences effectively, planners and responders need not only to identify zones of potentially elevated individual risk, but also to predict expected casualties. Emergency response support systems now define ''consequences'' by mapping areas in which toxic chemical concentrations do or may exceed Acute Exposure Guideline Levels (AEGLs) or similar guidelines. However, because AEGLs do not estimate expected risks, current unqualified claims that such maps support consequence management are misleading. Intentionally protective, AEGLs incorporate various safety/uncertainty factors depending on scope and quality of chemical-specific toxicity data. Some of these factors are irrelevant, and others need to be modified, whenever resource constraints or exposure-scenario complexities require responders to make critical trade-off (triage) decisions in order to minimize expected casualties. AEGL-exceedance zones cannot consistently be aggregated, compared, or used to calculate expected casualties, and so may seriously misguide emergency response triage decisions. Methods and tools well established and readily available to support environmental health protection are not yet developed for chemically related environmental health triage. Effective triage decisions involving chemical risks require a new assessment approach that focuses on best estimates of likely casualties, rather than on upper plausible bounds of individual risk. If risk-based consequence management is to become a reality, federal agencies tasked with supporting emergency response must actively coordinate to foster new methods that can support effective environmental health triage

[Emergency department triage: independent nursing intervention?].

Science.gov (United States)

Corujo Fontes, Sergio José

2014-03-01

The branch hospital triage aimed at, as well as exercised by nurses, has evolved to meet their needs to organize and make visible the nurses' duties. However, it is still not properly considered as independent nursing intervention. Evidencing practice triage nurse in hospital as experienced by their protagonists disclosed the possible causes of this paradoxical competence. In a sample of 41 nurses, of the 52 possible with previous experience in hospital triage in the Emergency Department of the Hospital General Dr. José Molina Orosa in Lanzarote, the nurses themselves carried out an opinion survey that group together statements about different aspects of the triaje nurse. In its results, 65.8% of those polled thought the triaje nursing training to be deficient and even though nearly half 48.7%, was considered competent to decide the level of emergency, 46.3% disagreed to take this task part of their duty. It is conclusive that the training received in hospital triage, regulated and sustained, is deficient, that is the main reason why professionals have their doubts to take on an activity they are not familiar with. Triage systems do not record the entire outcome of the nursing work and nursing methodology does not seem to be quite indicative for this task.

Diagnostic performance and system delay using telemedicine for prehospital diagnosis in triaging and teatment of STEMI

DEFF Research Database (Denmark)

Rasmussen, Martin Bøhme; Frost, Lars; Stengaard, Carsten

2014-01-01

diagnoses established by telemedicine confirmed on hospital arrival, and we determined system delay in patients diagnosed before hospital arrival and triaged directly to the catheterisation laboratory. Methods: Design: Population-based follow-up study. Setting: Central Denmark Region. Participants: 15 992...... patients diagnosed using telemedicine. Results: During the study period, a tentative diagnosis of STEMI was established in 1061 patients, of whom 919 were triaged directly to the PCI centre. In 771 (84%) patients, a diagnosis of STEMI was confirmed. Patients transported ... living telemedicine for prehospital diagnosis and triage of patients directly to the catheter laboratory is feasible and allows 89% of patients living up to 95 km from the invasive centre to be treated...

Evaluation of the on-site immunoassay drug-screening device Triage-TOX in routine forensic autopsy.

Science.gov (United States)

Tominaga, Mariko; Michiue, Tomomi; Maeda, Hitoshi

2015-11-01

Instrumental identification of drugs with quantification is essential in forensic toxicology, while on-site immunoassay urinalysis drug-screening devices conveniently provide preliminary information when adequately used. However, suitable or sufficient urine specimens are not always available. The present study evaluated the efficacy of a new on-site immunoassay drug-screening device Triage-TOX (Alere Inc., San Diego, CA, USA), which has recently been developed to provide objective data on the one-step automated processor, using 51 urine and 19 pericardial fluid samples from 66 forensic autopsy cases, compared with Triage-Drug of Abuse (DOA) and Monitect-9. For benzodiazepines, the positive predictive value and specificity of Triage-TOX were higher than those of Triage-DOA; however, sensitivity was higher with Monitect-9, despite frequent false-positives. The results for the other drugs with the three devices also included a few false-negatives and false-positives. These observations indicate the applicability of Triage-TOX in preliminary drug screening using urine or alternative materials in routine forensic autopsy, when a possible false-negative is considered, especially for benzodiazepines, providing objective information; however, the combined use of another device such as Monitect-9 can help minimize misinterpretation prior to instrumental analysis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Evidence-based Effective Triage Operation During Disaster: Application of Human-trajectory Data to Triage Drill Sessions.

Science.gov (United States)

Ohta, Shoichi; Yoda, Ikushi; Takeda, Munekazu; Kuroshima, Satomi; Uchida, Kotaro; Kawai, Kentaro; Yukioka, Tetsuo

2015-02-01

Though many governmental and nongovernmental efforts for disaster prevention have been sought throughout Japan since the Great East Japan Earthquake on March 11, 2011, most of the preparation efforts for disasters have been based more on structural and conventionalized regulations than on scientific and objective grounds. Problem There has been a lack of scientific knowledge for space utilization for triage posts in disaster drill sessions. This report addresses how participants occupy and make use of the space within a triage post in terms of areas of use and occupied time. The trajectories of human movement by using Ubiquitous Stereo Vision (USV) cameras during two emergency drill sessions held in 2012 in a large commercial building have been measured. The USV cameras collect each participant's travel distance and the wait time before, during, and after undergoing triage. The correlation between the wait time and the space utilization of patients at a triage post has been analyzed. In the first session, there were some spaces not entirely used. This was caused largely by a patient who arrived earlier than others and lingered in the middle area, which caused the later arrivals to crowd the entrance area. On the other hand, in the second session, the area was used in a more evenly-distributed manner. This is mainly because the earlier arrivals were guided to the back space of the triage post (ie, the opposite side of the entrance), and the late arrivals were also guided to the front half, which was not occupied by anyone. As a result, the entire space was effectively utilized without crowding the entrance. This study has shown that this system could measure people's arrival times and the speed of their movements at the triage post, as well as where they are placed until they receive triage. Space utilization can be improved by efficiently planning and controlling the positioning of arriving patients. Based on the results, it has been suggested that for triage

No Child Overlooked: Mental Health Triage in the Schools

Science.gov (United States)

Wilson, F. Robert; Tang, Mei; Schiller, Kelly; Sebera, Kerry

2009-01-01

Mental health problems among children in schools are on the increase. To exercise due diligence in their responsibility to monitor and promote mental health among our nation's children, school counselors may learn from triage systems employed in hospitals, clinics, and mental health centers. The School Counselor's Triage Model provides school…

How Triage Nurses Use Discretion: a Literature Review

Directory of Open Access Journals (Sweden)

Lars Emil Fagernes Johannessen

2016-02-01

Full Text Available Discretion is quintessential for professional work. This review aims to understand how nurses use discretion when they perform urgency assessments in emergency departments with formalised triage systems—systems that are intended to reduce nurses’ use of discretion. Because little research has dealt explicitly with this topic, this review addresses the discretionary aspects of triage by reinterpreting qualitative studies of how triage nurses perform urgency assessments. The review shows (a how inexhaustive guidelines and a hectic work environment are factors that necessitate nurses’ use of discretion and (b how nurses reason within this discretionary space by relying on their experience and intuition, judging patients according to criteria such as appropriateness and believability, and creating urgency ratings together with their patients. The review also offers a synthesis of the findings’ discretionary aspects and suggests a new interactionist dimension of discretion.Keywords: Triage, discretion, emergency department, meta-ethnography, review, decision-making

Testing the START Triage Protocol: Can It Improve the Ability of Nonmedical Personnel to Better Triage Patients During Disasters and Mass Casualties Incidents ?

Science.gov (United States)

Badiali, Stefano; Giugni, Aimone; Marcis, Lucia

2017-06-01

START (Simple Triage and Rapid Treatment) triage is a tool that is available even to nonmedical rescue personnel in case of a disaster or mass casualty incident (MCI). In Italy, no data are available on whether application of the START protocol could improve patient outcomes during a disaster or MCI. We aimed to address whether "last-minute" START training of nonmedical personnel during a disaster or MCI would result in more effective triage of patients. In this case-control study, 400 nonmedical ambulance crew members were randomly assigned to a non-START or a START group (200 per group). The START group received last-minute START training. Each group examined 6000 patients, obtained from the Emergo Train System (ETS Italy, Bologna, Italy) victims database, and assigned patients a triage code (black-red-yellow-green) along with a reason for the assignment. Each rescuer triaged 30 patients within a 30-minute time frame. Results were analyzed according to Fisher's exact test for a P valueSTART group completed the evaluations in 15 minutes, whereas the non-START group took 30 minutes. The START group correctly triaged 94.2% of their patients, as opposed to 59.83% of the non-START group (PSTART group versus 13.67% and 26.5% for the non-START group. The non-START group had 458 "preventable deaths" on 6000 cases because of incorrect triage, whereas the START group had 91. Even a "last-minute" training on the START triage protocol allows nonmedical personnel to better identify and triage the victims of a disaster or MCI, resulting in more effective and efficient medical intervention. (Disaster Med Public Health Preparedness. 2017;11:305-309).

Information technology systems for critical care triage and medical response during an influenza pandemic: a review of current systems.

Science.gov (United States)

Bandayrel, Kristofer; Lapinsky, Stephen; Christian, Michael

2013-06-01

To assess local, state, federal, and global pandemic influenza preparedness by identifying pandemic plans at the local, state, federal, and global levels, and to identify any information technology (IT) systems in these plans to support critical care triage during an influenza pandemic in the Canadian province of Ontario. The authors used advanced MEDLINE and Google search strategies and conducted a comprehensive review of key pandemic influenza Web sites. Descriptive data extraction and analysis for IT systems were conducted on all of the included pandemic plans. A total of 155 pandemic influenza plans were reviewed: 29 local, 62 state, 63 federal, and 1 global. We found 70 plans that examined IT systems (10 local, 33 state, 26 federal, 1 global), and 85 that did not (19 local, 29 state, 37 federal). Of the 70 plans, 64 described surveillance systems (10 local, 32 state, 21 federal, 1 global), 2 described patient data collection systems (1 state, 1 federal); 4 described other types of IT systems (4 federal), and none were intended for triage. Although several pandemic plans have been drafted, the majority are high-level general documents that do not describe IT systems. The plans that discuss IT systems focus strongly on surveillance, which fails to recognize the needs of a health care system responding to an influenza pandemic. The best examples of the types of IT systems to guide decision making during a pandemic were found in the Kansas and the Czech Republic pandemic plans, because these systems were designed to collect both patient and surveillance data. Although Ontario has yet to develop such an IT system, several IT systems are in place that could be leveraged to support critical care triage and medical response during an influenza pandemic.

The design and implementation of an obstetric triage system for unscheduled pregnancy related attendances: a mixed methods evaluation.

Science.gov (United States)

Kenyon, Sara; Hewison, Alistair; Dann, Sophie-Anna; Easterbrook, Jolene; Hamilton-Giachritsis, Catherine; Beckmann, April; Johns, Nina

2017-09-18

No standardised system of triage exists in Maternity Care and local audit identified this to be problematic. We designed, implemented and evaluated an Obstetric Triage System in a large UK maternity unit. This includes a standard clinical triage assessment by a midwife, within 15 min of attendance, leading to assignment to a category of clinical urgency (on a 4-category scale). This guides timing of subsequent standardised immediate care for the eight most common reasons for attendance. A training programme was integral to the introduction. A mixed methods evaluation was conducted. A structured audit of 994 sets of maternity notes before and after implementation identified the number of women seen within 15 min of attendance. Secondary measures reviewed included time to subsequent care and attendance. An inter-operator reliability study using scenarios was completed by midwives. A focus group and two questionnaire studies were undertaken to explore midwives' views of the system and to evaluate the training. In addition a national postal survey of practice in UK maternity units was undertaken in 2015. The structured audit of 974/992 (98%) of notes demonstrated an increase in the number of women seen within 15 min of attendance from 39% before implementation to 54% afterwards (RR (95% CI) 1.4 (1.2, 1.7) p = reliability (ICC 0.961 (95% CI 0.91-0.99)) was demonstrated with breakdown showing consistently good rates. Thematic analysis of focus group data (n = 12) informed the development of the questionnaire which was sent to all appropriate midwives. The response rate was 53/79 (67%) and the midwives reported that the new system helped them manage the department and improved safety. The National Survey (response rate 85/135 [63%]) demonstrated wide variation in where women are seen and staffing models in place. The majority of units 69/85 (81%) did not use a triage system based on clinical assessment to prioritise care. This obstetric triage system has excellent

The RABiT: a rapid automated biodosimetry tool for radiological triage. II. Technological developments.

Science.gov (United States)

Garty, Guy; Chen, Youhua; Turner, Helen C; Zhang, Jian; Lyulko, Oleksandra V; Bertucci, Antonella; Xu, Yanping; Wang, Hongliang; Simaan, Nabil; Randers-Pehrson, Gerhard; Lawrence Yao, Y; Brenner, David J

2011-08-01

Over the past five years the Center for Minimally Invasive Radiation Biodosimetry at Columbia University has developed the Rapid Automated Biodosimetry Tool (RABiT), a completely automated, ultra-high throughput biodosimetry workstation. This paper describes recent upgrades and reliability testing of the RABiT. The RABiT analyses fingerstick-derived blood samples to estimate past radiation exposure or to identify individuals exposed above or below a cut-off dose. Through automated robotics, lymphocytes are extracted from fingerstick blood samples into filter-bottomed multi-well plates. Depending on the time since exposure, the RABiT scores either micronuclei or phosphorylation of the histone H2AX, in an automated robotic system, using filter-bottomed multi-well plates. Following lymphocyte culturing, fixation and staining, the filter bottoms are removed from the multi-well plates and sealed prior to automated high-speed imaging. Image analysis is performed online using dedicated image processing hardware. Both the sealed filters and the images are archived. We have developed a new robotic system for lymphocyte processing, making use of an upgraded laser power and parallel processing of four capillaries at once. This system has allowed acceleration of lymphocyte isolation, the main bottleneck of the RABiT operation, from 12 to 2 sec/sample. Reliability tests have been performed on all robotic subsystems. Parallel handling of multiple samples through the use of dedicated, purpose-built, robotics and high speed imaging allows analysis of up to 30,000 samples per day.

Open access phone triage for veterans with suspected malignant pleural mesothelioma.

Science.gov (United States)

Siegert, Charles Jeff; Fisichella, Piero Marco; Moseley, Jennifer M; Shoni, Melina; Lebenthal, Abraham

2017-01-01

Phone triaging patients with suspected malignant pleural mesothelioma (MPM) within the Veterans Healthcare Administration (VHA) system offers a model for rapid, expert guided evaluation for patients with rare and treatable diseases within a national integrated healthcare system. To assess feasibility of national open access telephone triage using evidence-based treatment recommendations for patients with MPM, measure timelines of the triage and referral process and record the impact on "intent to treat" for patients using our service. A retrospective study. The main outcome measures were: (1) ability to perform long distance phone triage, (2) to assess the speed of access to a mesothelioma surgical specialist for patients throughout the entire VHA, and (3) to determine if access to a specialist would alter the plan of care. Sixty veterans were screened by our phone triage program, 38 traveled an average of 997 miles to VA Boston Healthcare system. On average, 14 d elapsed from initial phone contact until the patient was physically evaluated in our general thoracic clinic in Boston. The treatment plan was altered for 71% of patients evaluated at VA Boston Healthcare system based on 2012 International Mesothelioma Interest Group guidelines. Our initial experience demonstrates that in-network centralized care for Veterans with MPM is feasible within the VHA. National open access phone triage improves access to expert surgical advice and can be delivered in a timely manner for Veterans using our service. Guideline-based treatment recommendations ("intent to treat") changed the therapeutic course for the majority of patients who used our service. Copyright © 2016 Elsevier Inc. All rights reserved.

The introduction of the Manchester triage scale to an emergency department in the Republic of Ireland.

LENUS (Irish Health Repository)

Cronin, J G

2012-02-03

Triage is an integral part of the modern emergency department. The use of a recognised triage system has many advantages for the emergency department including reference to a recognised decision-making structure and support in the form of a professionally accepted and validated system. As part of a programme of internal change the Manchester triage system (MTS) was introduced to an emergency department in the Republic of Ireland. This article outlines the introduction of this method of triage and cites the domestic and international drivers of the change.

Sample tracking in an automated cytogenetic biodosimetry laboratory for radiation mass casualties

International Nuclear Information System (INIS)

Martin, P.R.; Berdychevski, R.E.; Subramanian, U.; Blakely, W.F.; Prasanna, P.G.S.

2007-01-01

Chromosome-aberration-based dicentric assay is expected to be used after mass-casualty life-threatening radiation exposures to assess radiation dose to individuals. This will require processing of a large number of samples for individual dose assessment and clinical triage to aid treatment decisions. We have established an automated, high-throughput, cytogenetic biodosimetry laboratory to process a large number of samples for conducting the dicentric assay using peripheral blood from exposed individuals according to internationally accepted laboratory protocols (i.e., within days following radiation exposures). The components of an automated cytogenetic biodosimetry laboratory include blood collection kits for sample shipment, a cell viability analyzer, a robotic liquid handler, an automated metaphase harvester, a metaphase spreader, high-throughput slide stainer and coverslipper, a high-throughput metaphase finder, multiple satellite chromosome-aberration analysis systems, and a computerized sample-tracking system. Laboratory automation using commercially available, off-the-shelf technologies, customized technology integration, and implementation of a laboratory information management system (LIMS) for cytogenetic analysis will significantly increase throughput. This paper focuses on our efforts to eliminate data-transcription errors, increase efficiency, and maintain samples' positive chain-of-custody by sample tracking during sample processing and data analysis. This sample-tracking system represents a 'beta' version, which can be modeled elsewhere in a cytogenetic biodosimetry laboratory, and includes a customized LIMS with a central server, personal computer workstations, barcode printers, fixed station and wireless hand-held devices to scan barcodes at various critical steps, and data transmission over a private intra-laboratory computer network. Our studies will improve diagnostic biodosimetry response, aid confirmation of clinical triage, and medical

Sample tracking in an automated cytogenetic biodosimetry laboratory for radiation mass casualties

Energy Technology Data Exchange (ETDEWEB)

Martin, P.R.; Berdychevski, R.E.; Subramanian, U.; Blakely, W.F. [Armed Forces Radiobiology Research Institute, Uniformed Services University of Health Sciences, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603 (United States); Prasanna, P.G.S. [Armed Forces Radiobiology Research Institute, Uniformed Services University of Health Sciences, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603 (United States)], E-mail: prasanna@afrri.usuhs.mil

2007-07-15

Chromosome-aberration-based dicentric assay is expected to be used after mass-casualty life-threatening radiation exposures to assess radiation dose to individuals. This will require processing of a large number of samples for individual dose assessment and clinical triage to aid treatment decisions. We have established an automated, high-throughput, cytogenetic biodosimetry laboratory to process a large number of samples for conducting the dicentric assay using peripheral blood from exposed individuals according to internationally accepted laboratory protocols (i.e., within days following radiation exposures). The components of an automated cytogenetic biodosimetry laboratory include blood collection kits for sample shipment, a cell viability analyzer, a robotic liquid handler, an automated metaphase harvester, a metaphase spreader, high-throughput slide stainer and coverslipper, a high-throughput metaphase finder, multiple satellite chromosome-aberration analysis systems, and a computerized sample-tracking system. Laboratory automation using commercially available, off-the-shelf technologies, customized technology integration, and implementation of a laboratory information management system (LIMS) for cytogenetic analysis will significantly increase throughput. This paper focuses on our efforts to eliminate data-transcription errors, increase efficiency, and maintain samples' positive chain-of-custody by sample tracking during sample processing and data analysis. This sample-tracking system represents a 'beta' version, which can be modeled elsewhere in a cytogenetic biodosimetry laboratory, and includes a customized LIMS with a central server, personal computer workstations, barcode printers, fixed station and wireless hand-held devices to scan barcodes at various critical steps, and data transmission over a private intra-laboratory computer network. Our studies will improve diagnostic biodosimetry response, aid confirmation of clinical triage, and

Nurses' and doctors' perceptions regarding the implementation of a triage system in an emergency unit in South Africa

Directory of Open Access Journals (Sweden)

Jean E. Augustyn

2009-09-01

Opsomming Triage assessering van pasiënte met hulle aankoms by ‘n ongeluk/noodeenheid is ‘n noodsaaklike funksie van noodsorgvoorsiening, en is ‘n koste-effektiewe en tydbesparende onderneming. Hierdie studie het die persepsies van dokters en verpleegkundiges ondersoek betreffende die implementering van die Cape Triage Score in een noodeenheid. Die uitdagings wat ervaar is voor die implementering van die Cape Triage Score, die rolle en kernvaardighede van die triage verpleegkundige asook die swak en sterk punte van die Cape Triage Score is aangespreek. In hierdie beskrywende, kwantitatiewe en verkennende studie het 15 verpleegkundiges en dokters vraelyste voltooi. Uitdagings het verminder en die prioritisering van die pasiënte het verbeter na die implementering van die Cape Triage Score. Ander sterk punte van die stelsel het ingesluit dat die triage verpleegkundige die pasiënte geprioritiseer het, nie die ontvangsdame of die administratiewe personeel nie, en verpleegkundiges kon voorlopige ondersoeke doen sonder om op doktersbevele te wag. Die swakhede van die geïmplementeerde Cape Triage Score het ingesluit dat dit nog nie ten volle 100% van die tyd gefunksioneer het nie, en dat dit moeilik was om triage gedurende spitstye te handhaaf as gevolg van ‘n tekort aan verpleegkundiges. Die aanbevelings het ingesluit dat bestuur oortuig moet word van die voordele van die stelsel, verpleegkundiges triage funksies op ‘n rotasiebasis moet uitvoer, meer verpleegkundiges beskikbaar moet wees gedurende spitstye; en dat administratiewe en ontvangspersoneel ook georiënteer moet word ten opsigte van die triage stelsel.

Recent advances in medical device triage technologies for chemical, biological, radiological, and nuclear events.

Science.gov (United States)

Lansdowne, Krystal; Scully, Christopher G; Galeotti, Loriano; Schwartz, Suzanne; Marcozzi, David; Strauss, David G

2015-06-01

In 2010, the US Food and Drug Administration (Silver Spring, Maryland USA) created the Medical Countermeasures Initiative with the mission of development and promoting medical countermeasures that would be needed to protect the nation from identified, high-priority chemical, biological, radiological, or nuclear (CBRN) threats and emerging infectious diseases. The aim of this review was to promote regulatory science research of medical devices and to analyze how the devices can be employed in different CBRN scenarios. Triage in CBRN scenarios presents unique challenges for first responders because the effects of CBRN agents and the clinical presentations of casualties at each triage stage can vary. The uniqueness of a CBRN event can render standard patient monitoring medical device and conventional triage algorithms ineffective. Despite the challenges, there have been recent advances in CBRN triage technology that include: novel technologies; mobile medical applications ("medical apps") for CBRN disasters; electronic triage tags, such as eTriage; diagnostic field devices, such as the Joint Biological Agent Identification System; and decision support systems, such as the Chemical Hazards Emergency Medical Management Intelligent Syndromes Tool (CHEMM-IST). Further research and medical device validation can help to advance prehospital triage technology for CBRN events.

Triage level assignment and nurse characteristics and experience.

Science.gov (United States)

Gómez-Angelats, Elisenda; Miró, Òscar; Bragulat Baur, Ernesto; Antolín Santaliestra, Alberto; Sánchez Sánchez, Miquel

2018-06-01

To study the relation between nursing staff demographics and experience and their assignment of triage level in the emergency department. One-year retrospective observational study in the triage area of a tertiary care urban university hospital that applies the Andorran-Spanish triage model. Variables studied were age, gender, nursing experience, triage experience, shift, usual level of emergency work the nurse undertakes, number of triage decisions made, and percentage of patients assigned to each level. Fifty nurses (5 men, 45 women) with a mean (SD) age of 45 (9) years triaged 67 803 patients during the year. Nurses classified more patients in level 5 on the morning shift (7.9%) than on the afternoon shift (5.5%) (P=.003). The difference in the rate of level-5 triage classification became significant when nurses were older (β = 0.092, P=.037) and experience was greater (β = 0.103, P=.017). The number of triages recorded by a nurse was significantly and directly related to the percentage of patients assigned to level 3 (β = 0.003, P=.006) and inversely related to the percentages assigned to level 4 (β = -0.002, P=.008) and level 5 (β = -0.001, P=.017). We found that triage level assignments were related to age, experience, shift, and total number of patients triaged by a nurse.

2 Major incident triage and the implementation of a new triage tool, the MPTT-24.

Science.gov (United States)

Vassallo, James; Smith, Jason

2017-12-01

Over the last decade, a number of European cities including London, have witnessed high profile terrorist attacks resulting in major incidents with large numbers of casualties. Triage, the process of categorising casualties on the basis of their clinical acuity, is a key principle in the effective management of major incidents.The Modified Physiological Triage Tool (MPTT) is a recently developed primary triage tool which in comparison to existing triage tools, including the 2013 UK NARU Sieve, demonstrates the greatest sensitivity at predicting need for life-saving intervention (LSI) within both military and civilian populations.To improve the applicability and usability of the MPTT we increased the upper respiratory rate threshold to 24 breaths per minute (MPTT-24), to make it divisible by four, and included an assessment of external catastrophic haemorrhage. The aim of this study was to conduct a feasibility analysis of the proposed MPTT-24 (figure 1).emermed;34/12/A860-b/F1F1F1Figure 1MPTT-24 METHODS: A retrospective review of the Joint Theatre Trauma Registry (JTTR) and Trauma Audit Research Network (TARN) databases was performed for all adult ( > 18 years) patients presenting between 2006-2013 (JTTR) and 2014 (TARN). Patients were defined as priority one (P1) if they had received one or more life-saving interventions.Using first recorded hospital physiology, patients were categorised as P1 or not-P1 by existing triage tools and both MPTT and MPTT-24. Performance characteristics were evaluated using sensitivity, specificity, under and over-triage with a McNemar test to determine statistical significance. Basic study characteristics are shown in Table 1. Both the MPTT and MPTT-24 outperformed all existing triage methods with a statistically significant (p<0.001) absolute reduction of between 25.5%-29.5% in under-triage when compared to existing UK civilian methods (NARU Sieve). In both populations the MPTT-24 demonstrated an absolute reduction in sensitivity

Mental health triage in emergency medicine.

Science.gov (United States)

Smart, D; Pollard, C; Walpole, B

1999-02-01

The aim of this study was to: (i) develop a triage scale consistent with the National Triage Scale (NTS) for patients with mental health problems attending emergency departments; and (ii) to reduce emergency waiting times, transit times and improve skills assessing mental health problems. We developed a Mental Health Triage Scale (MHTS) consistent with the NTS. The MHTS was then implemented using a structured education package, and evaluated from March to August 1994. Further evaluation occurred after 2 years. A four-tiered MHTS was produced: category 2, violent, aggressive or suicidal, danger to self or others or with police escort; category 3, very distressed or psychotic, likely to deteriorate, situational crisis, danger to self or others; category 4, long-standing semi-urgent mental health disorder, supporting agency present; and category 5, long-standing non-acute mental health disorder, no support agency present. Patients with illness, injury or self-harm were triaged using combined mental health and medical information. Mean emergency waiting times and transit times were reduced. More consistent triaging for mental health patients occurred, and more consistent admission rates by urgency. Reduced mental health 'did not waits' showed improved customer satisfaction. Mental Health Triage Scale was considered appropriate by liaison psychiatry and its use has continued at 2 years follow-up. A systematic approach to mental health triaging produced a workable scale, reduced waiting times, transit times, and provided effective and consistent integration of mental health patients into a general emergency department.

Observer agreement of the Manchester Triage System and the Emergency Severity Index: a simulation study

NARCIS (Netherlands)

Storm-Versloot, M. N.; Ubbink, D. T.; Chin a Choi, V.; Luitse, J. S. K.

2009-01-01

Objectives: To compare inter and intra-observer agreement of the Manchester Triage System (MTS) and the Emergency Severity Index (ESI). Methods: 50 representative emergency department (ED) scenarios derived from actual cases were presented to 18 ED nurses from three different hospitals. Eight of

Effect of self-triage on waiting times at a walk-in sexual health clinic.

Science.gov (United States)

Hitchings, Samantha; Barter, Janet

2009-10-01

Lengthy waiting times can be a major problem in walk-in sexual health clinics. They are stressful for both patients and staff and may lead to clients with significant health issues leaving the department before being seen by a clinician. A self-triage system may help reduce waiting times and duplication of work, improve patient pathways and decrease wasted visits. This paper describes implementation of a self-triage system in two busy sexual and reproductive health clinics. Patients were asked to complete a self-assessment form on registration to determine the reason for attendance. This then enabled patients to be directed to the most appropriate specialist or clinical service. The benefits of this approach were determined by measuring patient waiting times, reduction in unnecessary specialist review together with patient acceptability as tested by a patient satisfaction survey. The ease of comprehension of the triage form was also assessed by an independent readers' panel. A total of 193 patients were recruited over a 4-month period from November 2004 to February 2005. Patients from the November and December clinics were assigned to the 'traditional treatment' arm, with patients at subsequent clinics being assigned to the 'self-triage' system. Waiting times were collected by the receptionist and clinic staff. Ninety six patients followed the traditional route, 97 the new self-triage system. Sixty-nine (35.8%) patients completed the satisfaction survey. The self-triage system significantly reduced waiting time from 40 (22, 60) to 23 (10, 40) minutes [results expressed as median (interquartile range)]. There was a non-significant reduction in the proportion of patients seeing two clinicians from 21% to 13% (p = 0.17). Satisfaction levels were not significantly altered (95% compared to 97% satisfied, p = 0.64). The readers' panel found the triage form both easy to understand and to complete. Self-triage can effectively reduce clinic waiting times and allow better

Clinical decision support improves quality of telephone triage documentation--an analysis of triage documentation before and after computerized clinical decision support.

Science.gov (United States)

North, Frederick; Richards, Debra D; Bremseth, Kimberly A; Lee, Mary R; Cox, Debra L; Varkey, Prathibha; Stroebel, Robert J

2014-03-20

Clinical decision support (CDS) has been shown to be effective in improving medical safety and quality but there is little information on how telephone triage benefits from CDS. The aim of our study was to compare triage documentation quality associated with the use of a clinical decision support tool, ExpertRN©. We examined 50 triage documents before and after a CDS tool was used in nursing triage. To control for the effects of CDS training we had an additional control group of triage documents created by nurses who were trained in the CDS tool, but who did not use it in selected notes. The CDS intervention cohort of triage notes was compared to both the pre-CDS notes and the CDS trained (but not using CDS) cohort. Cohorts were compared using the documentation standards of the American Academy of Ambulatory Care Nursing (AAACN). We also compared triage note content (documentation of associated positive and negative features relating to the symptoms, self-care instructions, and warning signs to watch for), and documentation defects pertinent to triage safety. Three of five AAACN documentation standards were significantly improved with CDS. There was a mean of 36.7 symptom features documented in triage notes for the CDS group but only 10.7 symptom features in the pre-CDS cohort (p < 0.0001) and 10.2 for the cohort that was CDS-trained but not using CDS (p < 0.0001). The difference between the mean of 10.2 symptom features documented in the pre-CDS and the mean of 10.7 symptom features documented in the CDS-trained but not using was not statistically significant (p = 0.68). CDS significantly improves triage note documentation quality. CDS-aided triage notes had significantly more information about symptoms, warning signs and self-care. The changes in triage documentation appeared to be the result of the CDS alone and not due to any CDS training that came with the CDS intervention. Although this study shows that CDS can improve documentation, further study is needed

World-wide distribution automation systems

International Nuclear Information System (INIS)

Devaney, T.M.

1994-01-01

A worldwide power distribution automation system is outlined. Distribution automation is defined and the status of utility automation is discussed. Other topics discussed include a distribution management system, substation feeder, and customer functions, potential benefits, automation costs, planning and engineering considerations, automation trends, databases, system operation, computer modeling of system, and distribution management systems

Identifying the core competencies of mental health telephone triage.

Science.gov (United States)

Sands, Natisha; Elsom, Stephen; Gerdtz, Marie; Henderson, Kathryn; Keppich-Arnold, Sandra; Droste, Nicolas; Prematunga, Roshani K; Wereta, Zewdu W

2013-11-01

The primary aim of this study was to identify the core competencies of mental health telephone triage, including key role tasks, skills, knowledge and responsibilities, in which clinicians are required to be competent to perform safe and effective triage. Recent global trends indicate an increased reliance on telephone-based health services to facilitate access to health care across large populations. The trend towards telephone-based health services has also extended to mental health settings, evidenced by the growing number of mental health telephone triage services providing 24-hour access to specialist mental health assessment and treatment. Mental health telephone triage services are critical to the early identification of mental health problems and the provision of timely, appropriate interventions. In spite of the rapid growth in mental health telephone triage and the important role these services play in the assessment and management of mental illness and related risks, there has been very little research investigating this area of practice. An observational design was employed to address the research aims. Structured observations (using dual wireless headphones) were undertaken on 197 occasions of mental health telephone triage over a three-month period from January to March 2011. The research identified seven core areas of mental health telephone triage practice in which clinicians are required to be competent in to perform effective mental health telephone triage, including opening the call; performing mental status examination; risk assessment; planning and action; termination of call; referral and reporting; and documentation. The findings of this research contribute to the evidence base for mental health telephone triage by articulating the core competencies for practice. The mental health telephone triage competencies identified in this research may be used to define an evidence-based framework for mental health telephone triage practice that aims to

An automated, broad-based, near real-time public health surveillance system using presentations to hospital Emergency Departments in New South Wales, Australia

Directory of Open Access Journals (Sweden)

Chiu Clayton

2005-12-01

Full Text Available Abstract Background In a climate of concern over bioterrorism threats and emergent diseases, public health authorities are trialling more timely surveillance systems. The 2003 Rugby World Cup (RWC provided an opportunity to test the viability of a near real-time syndromic surveillance system in metropolitan Sydney, Australia. We describe the development and early results of this largely automated system that used data routinely collected in Emergency Departments (EDs. Methods Twelve of 49 EDs in the Sydney metropolitan area automatically transmitted surveillance data from their existing information systems to a central database in near real-time. Information captured for each ED visit included patient demographic details, presenting problem and nursing assessment entered as free-text at triage time, physician-assigned provisional diagnosis codes, and status at departure from the ED. Both diagnoses from the EDs and triage text were used to assign syndrome categories. The text information was automatically classified into one or more of 26 syndrome categories using automated "naïve Bayes" text categorisation techniques. Automated processes were used to analyse both diagnosis and free text-based syndrome data and to produce web-based statistical summaries for daily review. An adjusted cumulative sum (cusum was used to assess the statistical significance of trends. Results During the RWC the system did not identify any major public health threats associated with the tournament, mass gatherings or the influx of visitors. This was consistent with evidence from other sources, although two known outbreaks were already in progress before the tournament. Limited baseline in early monitoring prevented the system from automatically identifying these ongoing outbreaks. Data capture was invisible to clinical staff in EDs and did not add to their workload. Conclusion We have demonstrated the feasibility and potential utility of syndromic surveillance using

Mixed Methods Approach for Measuring the Impact of Video Telehealth on Outpatient Clinic Triage Nurse Workflow

Science.gov (United States)

Cady, Rhonda G.; Finkelstein, Stanley M.

2015-01-01

Nurse-delivered telephone triage is a common component of outpatient clinic settings. Adding new communication technology to clinic triage has the potential to not only transform the triage process, but also alter triage workflow. Evaluating the impact of new technology on an existing workflow is paramount to maximizing efficiency of the delivery system. This study investigated triage nurse workflow before and after the implementation of video telehealth using a sequential mixed methods protocol that combined ethnography and time-motion study to provide a robust analysis of the implementation environment. Outpatient clinic triage using video telehealth required significantly more time than telephone triage, indicating a reduction in nurse efficiency. Despite the increased time needed to conduct video telehealth, nurses consistently rated it useful in providing triage. Interpretive analysis of the qualitative and quantitative data suggests the increased depth and breadth of data available during video triage alters the assessment triage nurses provide physicians. This in turn could impact the time physicians spend formulating a diagnosis and treatment plan. While the immediate impact of video telehealth is a reduction in triage nurse efficiency, what is unknown is the impact of video telehealth on physician and overall clinic efficiency. Future studies should address this area. PMID:24080753

Cost Effectiveness of Field Trauma Triage among Injured Adults Served by Emergency Medical Services

Science.gov (United States)

Newgard, Craig D; Yang, Zhuo; Nishijima, Daniel; McConnell, K John; Trent, Stacy; Holmes, James F; Daya, Mohamud; Mann, N Clay; Hsia, Renee Y; Rea, Tom; Wang, N Ewen; Staudenmayer, Kristan; Delgado, M Kit

2016-01-01

Background The American College of Surgeons Committee on Trauma sets national targets for the accuracy of field trauma triage at ≥ 95% sensitivity and ≥ 65% specificity, yet the cost-effectiveness of realizing these goals is unknown. We evaluated the cost-effectiveness of current field trauma triage practices compared to triage strategies consistent with the national targets. Study Design This was a cost-effectiveness analysis using data from 79,937 injured adults transported by 48 emergency medical services (EMS) agencies to 105 trauma and non-trauma hospitals in 6 regions of the Western U.S. from 2006 through 2008. Incremental differences in survival, quality adjusted life years (QALYs), costs, and the incremental cost-effectiveness ratio (ICER; costs per QALY gained) were estimated for each triage strategy over a 1-year and lifetime horizon using a decision analytic Markov model. We considered an ICER threshold of less than $100,000 to be cost-effective. Results For these 6 regions, a high sensitivity triage strategy consistent with national trauma policy (sensitivity 98.6%, specificity 17.1%) would cost $1,317,333 per QALY gained, while current triage practices (sensitivity 87.2%, specificity 64.0%) cost $88,000 per QALY gained compared to a moderate sensitivity strategy (sensitivity 71.2%, specificity 66.5%). Refining EMS transport patterns by triage status improved cost-effectiveness. At the trauma system level, a high-sensitivity triage strategy would save 3.7 additional lives per year at a 1-year cost of $8.78 million, while a moderate sensitivity approach would cost 5.2 additional lives and save $781,616 each year. Conclusions A high-sensitivity approach to field triage consistent with national trauma policy is not cost effective. The most cost effective approach to field triage appears closely tied to triage specificity and adherence to triage-based EMS transport practices. PMID:27178369

Accuracy of prehospital triage protocols in selecting severely injured patients: A systematic review.

Science.gov (United States)

van Rein, Eveline A J; Houwert, R Marijn; Gunning, Amy C; Lichtveld, Rob A; Leenen, Luke P H; van Heijl, Mark

2017-08-01

Prehospital trauma triage ensures proper transport of patients at risk of severe injury to hospitals with an appropriate corresponding level of trauma care. Incorrect triage results in undertriage and overtriage. The American College of Surgeons Committee on Trauma recommends an undertriage rate below 5% and an overtriage rate below 50% for prehospital trauma triage protocols. To find the most accurate prehospital trauma triage protocol, a clear overview of all currently available protocols and corresponding outcomes is necessary. The aim of this systematic review was to evaluate the current literature on all available prehospital trauma triage protocols and determine accuracy of protocol-based triage quality in terms of sensitivity and specificity. A search of Pubmed, Embase, and Cochrane Library databases was performed to identify all studies describing prehospital trauma triage protocols before November 2016. The search terms included "trauma," "trauma center," or "trauma system" combined with "triage," "undertriage," or "overtriage." All studies describing protocol-based triage quality were reviewed. To assess the quality of these type of studies, a new critical appraisal tool was developed. In this review, 21 articles were included with numbers of patients ranging from 130 to over 1 million. Significant predictors for severe injury were: vital signs, suspicion of certain anatomic injuries, mechanism of injury, and age. Sensitivity ranged from 10% to 100%; specificity from 9% to 100%. Nearly all protocols had a low sensitivity, thereby failing to identify severely injured patients. Additionally, the critical appraisal showed poor quality of the majority of included studies. This systematic review shows that nearly all protocols are incapable of identifying severely injured patients. Future studies of high methodological quality should be performed to improve prehospital trauma triage protocols. Systematic review, level III.

Triage Drift:

DEFF Research Database (Denmark)

Bjørn, Pernille; Rødje, Kjetil

2008-01-01

This paper presents a workplace study of triage work practices within an emergency department (ED). We examine the practices, procedures, and organization in which ED staff uses tools and technologies when coordinating the essential activity of assessing and sorting patients arriving at the ED...

Automated Budget System -

Data.gov (United States)

Department of Transportation — The Automated Budget System (ABS) automates management and planning of the Mike Monroney Aeronautical Center (MMAC) budget by providing enhanced capability to plan,...

MANCHESTER TRIAGE SYSTEM IN PRIMARY HEALTH CARE: AMBIGUITIES AND CHALLENGES RELATED TO ACCESS

OpenAIRE

Danielle de Araújo Moreira; Hanna Beatriz Bacelar Tibães; Renata Cristina Rocha Batista; Cecília Maria Lima Cardoso; Maria José Menezes Brito

2017-01-01

Objetivo: comprender ambigüedades y desafíos relacionados con el acceso, después de la implantación del Sistema de Triage de Manchester en la atención primaria en salud. Método: investigación cualitativa, que utilizó la entrevista semiestructurada con enfermeros, médicos y auxiliares de enfermería, totalizando 22 profesionales. Los datos fueron analizados por medio de análisis de contenido temático . Resultados: el Sistema de Triage de Manchester interfirió de forma antagónica en el acce...

Sepsis Alert - a triage model that reduces time to antibiotics and length of hospital stay.

Science.gov (United States)

Rosenqvist, Mari; Fagerstrand, Emma; Lanbeck, Peter; Melander, Olle; Åkesson, Per

2017-07-01

To study if a modified triage system at an Emergency Department (ED) combined with educational efforts resulted in reduced time to antibiotics and decreased length of hospital stay (LOS) for patients with severe infection. A retrospective, observational study comparing patients before and after the start of a new triage model at the ED of a University Hospital. After the implementation of the model, patients with fever and abnormal vital signs were triaged into a designated sepsis line (Sepsis Alert) for rapid evaluation by the attending physician supported by a infectious diseases (IDs) specialist. Also, all ED staff participated in a designated sepsis education before Sepsis Alert was introduced. Medical records were evaluated for patients during a 3-month period after the triage system was started in 2012, and also during the corresponding months in 2010 and 2014. A total of 1837 patients presented with abnormal vital signs. Of these, 221 patients presented with fever and thus at risk of having severe sepsis. Among patients triaged according to the new model, median time to antibiotics was 58.5 at startup and 24.5 minutes at follow-up two years later. This was significantly less than for patients treated before the new model, 190 minutes. Also, median LOS was significantly decreased after introduction of the new triage model, from nine to seven days. A triage model at the ED with special attention to severe sepsis patients, led to sustained improvements of time to antibiotic treatment and LOS.

Do poison center triage guidelines affect healthcare facility referrals?

Science.gov (United States)

Benson, B E; Smith, C A; McKinney, P E; Litovitz, T L; Tandberg, W D

2001-01-01

The purpose of this study was to determine the extent to which poison center triage guidelines influence healthcare facility referral rates for acute, unintentional acetaminophen-only poisoning and acute, unintentional adult formulation iron poisoning. Managers of US poison centers were interviewed by telephone to determine their center's triage threshold value (mg/kg) for acute iron and acute acetaminophen poisoning in 1997. Triage threshold values and healthcare facility referral rates were fit to a univariate logistic regression model for acetaminophen and iron using maximum likelihood estimation. Triage threshold values ranged from 120-201 mg/kg (acetaminophen) and 16-61 mg/kg (iron). Referral rates ranged from 3.1% to 24% (acetaminophen) and 3.7% to 46.7% (iron). There was a statistically significant inverse relationship between the triage value and the referral rate for acetaminophen (p variability in poison center triage values and referral rates for iron and acetaminophen poisoning. Guidelines can account for a meaningful proportion of referral variation. Their influence appears to be substance dependent. These data suggest that efforts to determine and utilize the highest, safe, triage threshold value could substantially decrease healthcare costs for poisonings as long as patient medical outcomes are not compromised.

Predicting blood transfusion using automated analysis of pulse oximetry signals and laboratory values.

Science.gov (United States)

Shackelford, Stacy; Yang, Shiming; Hu, Peter; Miller, Catriona; Anazodo, Amechi; Galvagno, Samuel; Wang, Yulei; Hartsky, Lauren; Fang, Raymond; Mackenzie, Colin

2015-10-01

Identification of hemorrhaging trauma patients and prediction of blood transfusion needs in near real time will expedite care of the critically injured. We hypothesized that automated analysis of pulse oximetry signals in combination with laboratory values and vital signs obtained at the time of triage would predict the need for blood transfusion with accuracy greater than that of triage vital signs or pulse oximetry analysis alone. Continuous pulse oximetry signals were recorded for directly admitted trauma patients with abnormal prehospital shock index (heart rate [HR] / systolic blood pressure) of 0.62 or greater. Predictions of blood transfusion within 24 hours were compared using Delong's method for area under the receiver operating characteristic (AUROC) curves to determine the optimal combination of triage vital signs (prehospital HR + systolic blood pressure), pulse oximetry features (40 waveform features, O2 saturation, HR), and laboratory values (hematocrit, electrolytes, bicarbonate, prothrombin time, international normalization ratio, lactate) in multivariate logistic regression models. We enrolled 1,191 patients; 339 were excluded because of incomplete data; 40 received blood within 3 hours; and 14 received massive transfusion. Triage vital signs predicted need for transfusion within 3 hours (AUROC, 0.59) and massive transfusion (AUROC, 0.70). Pulse oximetry for 15 minutes predicted transfusion more accurately than triage vital signs for both time frames (3-hour AUROC, 0.74; p = 0.004) (massive transfusion AUROC, 0.88; p transfusion prediction (3-hour AUROC, 0.84; p transfusion AUROC, 0.91; p blood transfusion during trauma resuscitation more accurately than triage vital signs or pulse oximetry analysis alone. Results suggest automated calculations from a noninvasive vital sign monitor interfaced with a point-of-care laboratory device may support clinical decisions by recognizing patients with hemorrhage sufficient to need transfusion. Epidemiologic

Implementing RFID technology in a novel triage system during a simulated mass casualty situation.

Science.gov (United States)

Jokela, Jorma; Simons, Tomi; Kuronen, Pentti; Tammela, Juha; Jalasvirta, Pertti; Nurmi, Jouni; Harkke, Ville; Castrén, Maaret

2008-01-01

The purpose of this study is to determine the applicability of Radio Frequency Identification (RFID) technology and commercial cellular networks to provide an online triage system for handling mass casualty situations. This was tested by a using a pilot system for a simulated mass casualty situation during a military field exercise. The system proved to be usable. Compared to the currently used system, it also dramatically improves the general view of mass casualty situations and enhances medical emergency readiness in a military medical setting. The system can also be adapted without any difficulties by the civilian sector for the management of mass casualty disasters.

Automated PCB Inspection System

Directory of Open Access Journals (Sweden)

Syed Usama BUKHARI

2017-05-01

Full Text Available Development of an automated PCB inspection system as per the need of industry is a challenging task. In this paper a case study is presented, to exhibit, a proposed system for an immigration process of a manual PCB inspection system to an automated PCB inspection system, with a minimal intervention on the existing production flow, for a leading automotive manufacturing company. A detailed design of the system, based on computer vision followed by testing and analysis was proposed, in order to aid the manufacturer in the process of automation.

Mass casualty triage after an airplane crash near Amsterdam

NARCIS (Netherlands)

Postma, Ingri L. E.; Weel, Hanneke; Heetveld, Martin J.; van der Zande, Ineke; Bijlsma, Taco S.; Bloemers, Frank W.; Goslings, J. Carel

2013-01-01

Triage is an important aspect of the management of mass casualty incidents. This study describes the triage after the Turkish Airlines Crash near Amsterdam in 2009. The results of the triage and the injuries of P3 casualties were evaluated. In addition, the role of the trauma mechanism and its

Working with Manchester triage -- job satisfaction in nursing.

Science.gov (United States)

Forsgren, Susanne; Forsman, Berit; Carlström, Eric D

2009-10-01

This article covers nurses' job satisfaction during triage at emergency departments in Western Sweden. Data was collected from 74 triage nurses using a questionnaire containing 37 short form open questions. The answers were analyzed descriptively and by measuring the covariance. The open questions were analyzed by content analysis. The results showed a high degree of job satisfaction (88%). Triage as a method, the interesting nature of the work, and a certain freedom in connection with the triage tasks contributed to job satisfaction (R(2) = 0.40). The nurses found their work interesting and stimulating, although some reported job dissatisfaction due to a heavy workload and lack of competence. Most of the nurses thought that Manchester triage (MTS) was a clear and straightforward method but in need of development. The rational modelling structure by which the triage method is constructed is unable to distinguish all the parameters that an experienced nurse takes into account. When the model is allowed to take precedence over experience, it can be of hindrance and contribute to certain estimates not corresponding with the patient's needs. The participants requested regular exercises solving and discussing patient scenarios. They also wanted to participate on a regular basis in the development of the instrument.

[Clinical evaluation of triage as drug-of-abuse test kit].

Science.gov (United States)

Yoshioka, Toshiharu; Kohriyama, Kazuaki; Kondo, Rumiko; Goto, Kyoko; Yashiki, Mikio

2003-01-01

There are about 60,000 chemical substances which may cause poisoning. Identifying the cause substances is, therefore, very important for patient at emergency department. Triage is an immunoassay kit for the qualitative test for the metabolites of 8 major abuse drugs in urine. We assessed the usefullness of Triage on two patient groups. The first Group consists of the patients considered having not taken substances at initial diagnosis; the second Group consists of the patients considered having taken substances. The result are as follows. 1) The rate of Triage positive patients in the first Group were: attempt-suicide 23%, coma 24%, shock 10%, trauma 7%, respectively. Except for the habitually used medicine, narcotic and stimulant drugs were detected. In the first Group, negative result of Triage was effective in diagnosing the patients as not poisoned, excluding the possitivity of 8 major drugs usage. 2) The rate of Triage positive patients in the second Group were very high: attempt-suicide 77%, coma 51%, shock 57%, trauma 30%, respectively, showing mostly any of 8 major drugs were the cause of poisoning. In the second Group, positive result of Triage was effective in diagnosing the patient as poisoning or as coexisting poisoning with other diseases. 3) The specificity of Triage diagnosis in the first Group was 80% (113/142). The specificity and the sensitivity in the second Group were 64% (50/78) and 97% (74/76), respectively. These results means that Triage is very useful for diagnosis on 8 major drugs poisoning. 4) Triage is efficient for identifying the cause substances in drug poisoning and, therefore, can save medical expense. Triage is a very useful test kit at emergency department.

Automated System Marketplace 1994.

Science.gov (United States)

Griffiths, Jose-Marie; Kertis, Kimberly

1994-01-01

Reports results of the 1994 Automated System Marketplace survey based on responses from 60 vendors. Highlights include changes in the library automation marketplace; estimated library systems revenues; minicomputer and microcomputer-based systems; marketplace trends; global markets and mergers; research needs; new purchase processes; and profiles…

The accuracy of nurse performance of the triage process in a tertiary ...

African Journals Online (AJOL)

The South African Triage Scale (SATS) is a hospital-based triage tool that has been adopted by numerous ... used as a nurse-led, in-hospital triage tool. ... management in the ED. ..... Physician-led team triage based on lean principles may be.

Buying Program of the Standard Automated Materiel Management System. Automated Small Purchase System: Defense Supply Center Philadelphia

National Research Council Canada - National Science Library

2001-01-01

The Standard Automated Materiel Management System Automated Small Purchase System is a fully automated micro-purchases system used by the General and Industrial Directorate at the Defense Supply Center Philadelphia...

Automation System Products and Research

OpenAIRE

Rintala, Mikko; Sormunen, Jussi; Kuisma, Petri; Rahkala, Matti

2014-01-01

Automation systems are used in most buildings nowadays. In the past they were mainly used in industry to control and monitor critical systems. During the past few decades the automation systems have become more common and are used today from big industrial solutions to homes of private customers. With the growing need for ecologic and cost-efficient management systems, home and building automation systems are becoming a standard way of controlling lighting, ventilation, heating etc. Auto...

Automation systems for radioimmunoassay

International Nuclear Information System (INIS)

Yamasaki, Paul

1974-01-01

The application of automation systems for radioimmunoassay (RIA) was discussed. Automated systems could be useful in the second step, of the four basic processes in the course of RIA, i.e., preparation of sample for reaction. There were two types of instrumentation, a semi-automatic pipete, and a fully automated pipete station, both providing for fast and accurate dispensing of the reagent or for the diluting of sample with reagent. Illustrations of the instruments were shown. (Mukohata, S.)

Employees' views on home-based, after-hours telephone triage by Dutch GP cooperatives.

Science.gov (United States)

Backhaus, Ramona; van Exel, Job; de Bont, Antoinette

2013-11-04

Dutch out-of-hours (OOH) centers find it difficult to attract sufficient triage staff. They regard home-based triage as an option that might attract employees. Specially trained nurses are supposed to conduct triage by telephone from home for after-hours medical care. The central aim of this research is to investigate the views of employees of OOH centers in The Netherlands on home-based telephone triage in after-hours care. The study is a Q methodology study. Triage nurses, general practitioners (GPs) and managers of OOH centers ranked 36 opinion statements on home-based triage. We interviewed 10 participants to help develop and validate the statements for the Q sort, and 77 participants did the Q sort. We identified four views on home-based telephone triage. Two generally favor home-based triage, one highlights some concerns and conditions, and one opposes it out of concern for quality. The four views perceive different sources of credibility for nurse triagists working from home. Home-based telephone triage is a controversial issue among triage nurses, GPs and managers of OOH centers. By identifying consensus and dissension among GPs, triagists, managers and regulators, this study generates four perspectives on home-based triage. In addition, it reveals the conditions considered important for home-based triage.

[Triage evaluation making in a pediatric emergency department of a tertiary hospital].

Science.gov (United States)

Pascual-Fernández, Ma Cristina; Ignacio-Cerro, Ma Carmen; Jiménez-Carrascosa, Ma Amalia

2014-03-01

Evaluation triage level assignments depending level of the professionals' education and experience in the unit. This was a retrospective and observational study to triages making from January to March 2012 in Pediatric Emergency Department of tertiary hospital in Madrid. The collection data included variables from Pediatric Canadian Triage with five levels, triage tool using in the unit. 6443 triages were evaluated. The most common mistakes was: not to register pain level, 1445 (22.4%); not to register hydration level, 377 (5.9%); principal symptoms inappropriate, 232 (3.6%). Didn't indicate pain level 140 (5.6%) nurses with 12 hour formal training on triage; 492 (14.5%) with training in the unit, and 92 (16.3%) without training in the last year (p hydration level 296 (7.7%). The triage education favors better adaptation in the triage assignment. The most common errors are: not to register level pain and hydration when it's needed for the principal symptoms.

Triage en urgencias y emergencias hospitalarias: revisión de los principales sistemas de triage internacionales.

OpenAIRE

Estebaranz Santamaría, Cristina

2014-01-01

Trabajo fin de grado en Enfermería Introducción. El “triage” es un proceso de valoración que permite priorizar el nivel de urgencia de los pacientes. Para su aplicación, se utilizan los sistemas de triage estructurado, existiendo en la actualidad cinco modelos a nivel internacional. Objetivo. Analizar los sistemas de triage en el servicio de urgencias y emergencias hospitalarias, determinando las diferencias de sus últimas actualizaciones. Material y método. Revisión narrati...

Impact of the ABCDE triage in primary care emergency department on the number of patient visits to different parts of the health care system in Espoo City

Directory of Open Access Journals (Sweden)

Kantonen Jarmo

2012-01-01

Full Text Available Abstract Background Many Finnish emergency departments (ED serve both primary and secondary health care patients and are therefore referred to as combined emergency departments. Primary care doctors are responsible for the initial assessment and treatment. They, thereby, also regulate referral and access to secondary care. Primary health care EDs are easy for the public to access, leading to non-acute patient visits to the emergency department. This has caused increased queues and unnecessary difficulties in providing immediate treatment for urgent patients. The primary aim of this study was to assess whether the flow of patients was changed by implementing the ABCDE-triage system in the EDs of Espoo City, Finland. Methods The numbers of monthly visits to doctors were recorded before and after intervention in Espoo primary care EDs. To study if the implementation of the triage system redirects patients to other health services, the numbers of monthly visits to doctors were also scored in the private health care, the public sector health services of Espoo primary care during office hours and local secondary health care ED (Jorvi hospital. A face-to-face triage system was applied in the primary care EDs as an attempt to provide immediate treatment for the most acute patients. It is based on the letters A (patient sent directly to secondary care, B (to be examined within 10 min, C (to be examined within 1 h, D (to be examined within 2 h and E (no need for immediate treatment for assessing the urgency of patients' treatment needs. The first step was an initial patient assessment by a health care professional (triage nurse. The introduction of this triage system was combined with information to the public on the "correct" use of emergency services. Results After implementation of the ABCDE-triage system the number of patient visits to a primary care doctor decreased by up to 24% (962 visits/month as compared to the three previous years in the EDs

An exploration of clinical decision making in mental health triage.

Science.gov (United States)

Sands, Natisha

2009-08-01

Mental health (MH) triage is a specialist area of clinical nursing practice that involves complex decision making. The discussion in this article draws on the findings of a Ph.D. study that involved a statewide investigation of the scope of MH triage nursing practice in Victoria, Australia. Although the original Ph.D. study investigated a number of core practices in MH triage, the focus of the discussion in this article is specifically on the findings related to clinical decision making in MH triage, which have not previously been published. The study employed an exploratory descriptive research design that used mixed data collection methods including a survey questionnaire (n = 139) and semistructured interviews (n = 21). The study findings related to decision making revealed a lack of empirically tested evidence-based decision-making frameworks currently in use to support MH triage nursing practice. MH triage clinicians in Australia rely heavily on clinical experience to underpin decision making and have little of knowledge of theoretical models for practice, such as methodologies for rating urgency. A key recommendation arising from the study is the need to develop evidence-based decision-making frameworks such as clinical guidelines to inform and support MH triage clinical decision making.

Conservation Triage Falls Short Because Conservation Is Not Like Emergency Medicine

Directory of Open Access Journals (Sweden)

John A. Vucetich

2017-05-01

Full Text Available Conservation triage, as a concept, seems to have been born from analogizing circumstances that characterize conservation with triage, as the concept applies to emergency medicine. Careful consideration—facilitated through the aid of formal argumentation—demonstrates the critical limitations of the analogy. Those limitations reveal how the concept of conservation triage falls short. For example, medical triage presupposes that resources available for an emergency are limited and fixed. By contrast, the resources available for conservation are not fixed. Moreover, the ethics of prioritization in medical triage is characterized by there being universal agreement on the moral value of the patients. However, in conservation there is not universal agreement on the value of various objects of conservation concern. The looming importance of those features of conservation—disputed values and unfixed resources—make conservation triage a largely un-useful concept.

Prehospital Trauma Triage Decision-making: A Model of What Happens between the 9-1-1 Call and the Hospital.

Science.gov (United States)

Jones, Courtney Marie Cora; Cushman, Jeremy T; Lerner, E Brooke; Fisher, Susan G; Seplaki, Christopher L; Veazie, Peter J; Wasserman, Erin B; Dozier, Ann; Shah, Manish N

2016-01-01

We describe the decision-making process used by emergency medical services (EMS) providers in order to understand how 1) injured patients are evaluated in the prehospital setting; 2) field triage criteria are applied in-practice; and 3) selection of a destination hospital is determined. We conducted separate focus groups with advanced and basic life support providers from rural and urban/suburban regions. Four exploratory focus groups were conducted to identify overarching themes and five additional confirmatory focus groups were conducted to verify initial focus group findings and provide additional detail regarding trauma triage decision-making and application of field triage criteria. All focus groups were conducted by a public health researcher with formal training in qualitative research. A standardized question guide was used to facilitate discussion at all focus groups. All focus groups were audio-recorded and transcribed. Responses were coded and categorized into larger domains to describe how EMS providers approach trauma triage and apply the Field Triage Decision Scheme. We conducted 9 focus groups with 50 EMS providers. Participants highlighted that trauma triage is complex and there is often limited time to make destination decisions. Four overarching domains were identified within the context of trauma triage decision-making: 1) initial assessment; 2) importance of speed versus accuracy; 3) usability of current field triage criteria; and 4) consideration of patient and emergency care system-level factors. Field triage is a complex decision-making process which involves consideration of many patient and system-level factors. The decision model presented in this study suggests that EMS providers place significant emphasis on speed of decisions, relying on initial impressions and immediately observable information, rather than precise measurement of vital signs or systematic application of field triage criteria.

Automated Status Notification System

Science.gov (United States)

2005-01-01

NASA Lewis Research Center's Automated Status Notification System (ASNS) was born out of need. To prevent "hacker attacks," Lewis' telephone system needed to monitor communications activities 24 hr a day, 7 days a week. With decreasing staff resources, this continuous monitoring had to be automated. By utilizing existing communications hardware, a UNIX workstation, and NAWK (a pattern scanning and processing language), we implemented a continuous monitoring system.

Programmable automation systems in PSA

International Nuclear Information System (INIS)

Pulkkinen, U.

1997-06-01

The Finnish safety authority (STUK) requires plant specific PSAs, and quantitative safety goals are set on different levels. The reliability analysis is more problematic when critical safety functions are realized by applying programmable automation systems. Conventional modeling techniques do not necessarily apply to the analysis of these systems, and the quantification seems to be impossible. However, it is important to analyze contribution of programmable automation systems to the plant safety and PSA is the only method with system analytical view over the safety. This report discusses the applicability of PSA methodology (fault tree analyses, failure modes and effects analyses) in the analysis of programmable automation systems. The problem of how to decompose programmable automation systems for reliability modeling purposes is discussed. In addition to the qualitative analysis and structural reliability modeling issues, the possibility to evaluate failure probabilities of programmable automation systems is considered. One solution to the quantification issue is the use of expert judgements, and the principles to apply expert judgements is discussed in the paper. A framework to apply expert judgements is outlined. Further, the impacts of subjective estimates on the interpretation of PSA results are discussed. (orig.) (13 refs.)

Wireless Android Based Home Automation System

Directory of Open Access Journals (Sweden)

Muhammad Tanveer Riaz

2017-01-01

Full Text Available This manuscript presents a prototype and design implementation of an advance home automation system that uses Wi-Fi technology as a network infrastructure connecting its parts. The proposed system consists of two main components; the first part is the server, which presents system core that manages and controls user’s home. Users and system administrator can locally (Local Area Network or remotely (internet manage and control the system. Second part is the hardware interface module, which provides appropriate interface to sensors and actuator of home automation system. Unlike most of the available home automation system in the market, the proposed system is scalable that one server can manage many hardware interface modules as long as it exists within network coverage. System supports a wide range of home automation devices like appliances, power management components, and security components. The proposed system is better in terms of the flexibility and scalability than the commercially available home automation systems

Adoption of the 2006 Field Triage Decision Scheme for Injured Patients

Directory of Open Access Journals (Sweden)

Sasser, Scott

2011-07-01

Full Text Available Background: When emergency medical services (EMS providers respond to the scene of an injury, they must decide where to transport the injured patients for further evaluation and treatment. This is done through a process known as “field triage”, whereby a patient’s injuries are matched to the most appropriate hospital. In 2005-2006 the National Expert Panel on Field Triage, convened by the Centers for Disease Control and Prevention and the National Highway Traffic Safety Administration, revised the 1999 American College of Surgeons Committee on Trauma Field Triage Decision Scheme. This revision, the 2006 Field Triage Decision Scheme, was published in 2006.Methods: State Public Health departments’ and EMS’ external websites were evaluated to ascertain the current status of implementation of the 2006 Field Triage Decision Scheme.Results: Information regarding field triage was located for 41 states. In nine states no information regarding field triage was available on their websites. Of the 41 states where information was located, seven were classified as “full adopters” of the 2006 Field Triage Decision Scheme; nine were considered “partial adopters”; 17 states were found to be using a full version or modification of the 1999 Field Triage Decision Scheme; and eight states were considered to be using a different protocol or scheme for field triage.Conclusion: Many states have adopted the 2006 Decision Scheme (full or partial. Further investigation is needed to determine the reasons why some states do not adopt the guidelines. [West J Emerg Med. 2011;12(3:275-283.

Improvements of Paediatric Triage at the Emergency Department

NARCIS (Netherlands)

N. Seiger (Nienke)

2014-01-01

markdownabstract__Abstract__ The practice of triage, originated from the French word “trier” which means to sort, was conceived around 1792 by Baron Dominique-Jean Larrey, Surgeon in Chief to Napoleon’s Imperial Gard. In these days, triage was used to identify soldiers whose injuries were

Validating the implementation of the triage system in an emergency department in a University Hospital

Directory of Open Access Journals (Sweden)

Abdulaziz Bin Saeed

2017-01-01

Conclusion: The nurses' overall results were below expectations. Statistically significant variables affecting correct categorisation included age, experience, education level and nationality of the nurses. Nurses above the age of 45 years with more years of experience, obtained top scores. Nurses with the highest level of education also scored significantly higher. Filipino nurses scored better than nurses of other nationalities. With the widespread utilisation of triage systems in the region, further studies that evaluate their implementation are needed.

Triage: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

Science.gov (United States)

Christian, Michael D; Sprung, Charles L; King, Mary A; Dichter, Jeffrey R; Kissoon, Niranjan; Devereaux, Asha V; Gomersall, Charles D

2014-10-01

Pandemics and disasters can result in large numbers of critically ill or injured patients who may overwhelm available resources despite implementing surge-response strategies. If this occurs, critical care triage, which includes both prioritizing patients for care and rationing scarce resources, will be required. The suggestions in this chapter are important for all who are involved in large-scale pandemics or disasters with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. The Triage topic panel reviewed previous task force suggestions and the literature to identify 17 key questions for which specific literature searches were then conducted to identify studies upon which evidence-based recommendations could be made. No studies of sufficient quality were identified. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. Suggestions from the previous task force that were not being updated were also included for validation by the expert panel. The suggestions from the task force outline the key principles upon which critical care triage should be based as well as a path for the development of the plans, processes, and infrastructure required. This article provides 11 suggestions regarding the principles upon which critical care triage should be based and policies to guide critical care triage. Ethical and efficient critical care triage is a complex process that requires significant planning and preparation. At present, the prognostic tools required to produce an effective decision support system (triage protocol) as well as the infrastructure, processes, legal protections, and training are largely lacking in most jurisdictions. Therefore, critical care triage should be a last resort after mass critical care surge strategies.

Automation of the dicentric chromosome assay and related assays

International Nuclear Information System (INIS)

Balajee, Adayabalam S.; Dainiak, Nicholas

2016-01-01

Dicentric Chromosome Assay (DCA) is considered to be the 'gold standard' for personalized dose assessment in humans after accidental or incidental radiation exposure. Although this technique is superior to other cytogenetic assays in terms of specificity and sensitivity, its potential application to radiation mass casualty scenarios is highly restricted because DCA is time consuming and labor intensive when performed manually. Therefore, it is imperative to develop high throughput automation techniques to make DCA suitable for radiological triage scenarios. At the Cytogenetic Biodosimetry Laboratory in Oak Ridge, efforts are underway to develop high throughput automation of DCA. Current status on development of various automated cytogenetic techniques in meeting the biodosimetry needs of radiological/nuclear incident(s) will be discussed

Under-triage in telephone consultation is related to non-normative symptom description and interpersonal communication

DEFF Research Database (Denmark)

Gamst-Jensen, Hejdi; Lippert, Freddy K; Egerod, Ingrid

2017-01-01

BACKGROUND: Telephone consultation and triage are used to limit the workload on emergency departments. Lack of visual cues and clinical tests put telephone consultations to a disadvantage compared to face-to-face consultations increasing the risk of under-triage. Under-triage occurs in telephone...... triage; however why under-triage happens is not explored yet. The aim of the study was to describe situations of under-triage in context, to assess the quality of under-triaged calls, and to identify communication patterns contributing to under-triage in a regional OOH service in the capital region...... (19%), respiratory (15%) and all others (42%). Thematic analysis of the voice logs suggested that inadequate communication and non-normative symptom description contributed to under-triage. DISCUSSION: The incidence of potentially under-triage is low (0.04%). However, the over...

Implementing telephone triage in general practice: a process evaluation of a cluster randomised controlled trial.

Science.gov (United States)

Murdoch, Jamie; Varley, Anna; Fletcher, Emily; Britten, Nicky; Price, Linnie; Calitri, Raff; Green, Colin; Lattimer, Valerie; Richards, Suzanne H; Richards, David A; Salisbury, Chris; Taylor, Rod S; Campbell, John L

2015-04-10

Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. However, limited evidence exists of the challenges GP practices face in implementing telephone triage. We conducted a qualitative process evaluation alongside a UK-based cluster randomised trial (ESTEEM) which compared the impact of GP-led and nurse-led telephone triage with usual care on primary care workload, cost, patient experience, and safety for patients requesting a same-day GP consultation. The aim of the process study was to provide insights into the observed effects of the ESTEEM trial from the perspectives of staff and patients, and to specify the circumstances under which triage is likely to be successfully implemented. Here we report perspectives of staff. The intervention comprised implementation of either GP-led or nurse-led telephone triage for a period of 2-3 months. A qualitative evaluation was conducted using staff interviews recruited from eight general practices (4 GP triage, 4 Nurse triage) in the UK, implementing triage as part of the ESTEEM trial. Qualitative interviews were undertaken with 44 staff members in GP triage and nurse triage practices (16 GPs, 8 nurses, 7 practice managers, 13 administrative staff). Staff reported diverse experiences and perceptions regarding the implementation of telephone triage, its effects on workload, and on the benefits of triage. Such diversity were explained by the different ways triage was organised, the staffing models used to support triage, how the introduction of triage was communicated across practice staff, and by how staff roles were reconfigured as a result of implementing triage. The findings from the process evaluation offer insight into the range of ways GP practices participating in ESTEEM implemented telephone triage, and the circumstances under which telephone triage can be successfully implemented beyond the context of a clinical trial. Staff experiences and perceptions of telephone

Evaluation of an Automated Keywording System.

Science.gov (United States)

Malone, Linda C.; And Others

1990-01-01

Discussion of automated indexing techniques focuses on ways to statistically document improvements in the development of an automated keywording system over time. The system developed by the Joint Chiefs of Staff to automate the storage, categorization, and retrieval of information from military exercises is explained, and performance measures are…

Momentary fitting in a fluid environment: A grounded theory of triage nurse decision making.

Science.gov (United States)

Reay, Gudrun; Rankin, James A; Then, Karen L

2016-05-01

Triage nurses control access to the Emergency Department (ED) and make decisions about patient acuity, patient priority, and placement of the patient in the ED. Understanding the processes and strategies that triage nurses use to make decisions is therefore vital for patient safety and the operation of the ED. The aim of the current study was to generate a substantive grounded theory (GT) of decision making by emergency triage Registered Nurses (RNs). Data collection consisted of seven observations of the triage environment at three tertiary care hospitals where RNs conducted triage and twelve interviews with triage RNs. The data were analyzed by constant comparison in accordance with the classical GT method. In the resultant theory, Momentary Fitting in a Fluid Environment, triage is conceptualized as a process consisting of four categories, determining acuity, anticipating needs, managing space, and creating space. The findings indicate that triage RNs continually strive to achieve fit, while simultaneously considering the individual patient and the ED as a whole entity. Triage RNs require appropriately designed triage environments and computer technology that enable them to secure real time knowledge of the ED to maintain situation awareness. Copyright © 2015 Elsevier Ltd. All rights reserved.

A DSS with dynamically pluggable rules take emergency triage as example.

Science.gov (United States)

Sheng, Yu-Hsiang; Chang, Polun

2006-01-01

We propose a new method to develop Decision Support System, which has the flexibility to install new rules into the system remotely during run time, and can change system behavior on the fly. Take OSGi as a platform we build an emergency triage system which can apply different decision-making strategy while facing different situation.

Programmable Automated Welding System (PAWS)

Science.gov (United States)

Kline, Martin D.

1994-01-01

An ambitious project to develop an advanced, automated welding system is being funded as part of the Navy Joining Center with Babcock & Wilcox as the prime integrator. This program, the Programmable Automated Welding System (PAWS), involves the integration of both planning and real-time control activities. Planning functions include the development of a graphical decision support system within a standard, portable environment. Real-time control functions include the development of a modular, intelligent, real-time control system and the integration of a number of welding process sensors. This paper presents each of these components of the PAWS and discusses how they can be utilized to automate the welding operation.

Autonomy, Automation, and Systems

Science.gov (United States)

Turner, Philip R.

1987-02-01

Aerospace industry interest in autonomy and automation, given fresh impetus by the national goal of establishing a Space Station, is becoming a major item of research and technology development. The promise of new technology arising from research in Artificial Intelligence (AI) has focused much attention on its potential in autonomy and automation. These technologies can improve performance in autonomous control functions that involve planning, scheduling, and fault diagnosis of complex systems. There are, however, many aspects of system and subsystem design in an autonomous system that impact AI applications, but do not directly involve AI technology. Development of a system control architecture, establishment of an operating system within the design, providing command and sensory data collection features appropriate to automated operation, and the use of design analysis tools to support system engineering are specific examples of major design issues. Aspects such as these must also receive attention and technology development support if we are to implement complex autonomous systems within the realistic limitations of mass, power, cost, and available flight-qualified technology that are all-important to a flight project.

21 CFR 862.2900 - Automated urinalysis system.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated urinalysis system. 862.2900 Section 862....2900 Automated urinalysis system. (a) Identification. An automated urinalysis system is a device... that duplicate manual urinalysis systems. This device is used in conjunction with certain materials to...

Control and automation systems

International Nuclear Information System (INIS)

Schmidt, R.; Zillich, H.

1986-01-01

A survey is given of the development of control and automation systems for energy uses. General remarks about control and automation schemes are followed by a description of modern process control systems along with process control processes as such. After discussing the particular process control requirements of nuclear power plants the paper deals with the reliability and availability of process control systems and refers to computerized simulation processes. The subsequent paragraphs are dedicated to descriptions of the operating floor, ergonomic conditions, existing systems, flue gas desulfurization systems, the electromagnetic influences on digital circuits as well as of light wave uses. (HAG) [de

Machine-Learning-Based Electronic Triage More Accurately Differentiates Patients With Respect to Clinical Outcomes Compared With the Emergency Severity Index.

Science.gov (United States)

Levin, Scott; Toerper, Matthew; Hamrock, Eric; Hinson, Jeremiah S; Barnes, Sean; Gardner, Heather; Dugas, Andrea; Linton, Bob; Kirsch, Tom; Kelen, Gabor

2018-05-01

Standards for emergency department (ED) triage in the United States rely heavily on subjective assessment and are limited in their ability to risk-stratify patients. This study seeks to evaluate an electronic triage system (e-triage) based on machine learning that predicts likelihood of acute outcomes enabling improved patient differentiation. A multisite, retrospective, cross-sectional study of 172,726 ED visits from urban and community EDs was conducted. E-triage is composed of a random forest model applied to triage data (vital signs, chief complaint, and active medical history) that predicts the need for critical care, an emergency procedure, and inpatient hospitalization in parallel and translates risk to triage level designations. Predicted outcomes and secondary outcomes of elevated troponin and lactate levels were evaluated and compared with the Emergency Severity Index (ESI). E-triage predictions had an area under the curve ranging from 0.73 to 0.92 and demonstrated equivalent or improved identification of clinical patient outcomes compared with ESI at both EDs. E-triage provided rationale for risk-based differentiation of the more than 65% of ED visits triaged to ESI level 3. Matching the ESI patient distribution for comparisons, e-triage identified more than 10% (14,326 patients) of ESI level 3 patients requiring up triage who had substantially increased risk of critical care or emergency procedure (1.7% ESI level 3 versus 6.2% up triaged) and hospitalization (18.9% versus 45.4%) across EDs. E-triage more accurately classifies ESI level 3 patients and highlights opportunities to use predictive analytics to support triage decisionmaking. Further prospective validation is needed. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Disassembly automation automated systems with cognitive abilities

CERN Document Server

Vongbunyong, Supachai

2015-01-01

This book presents a number of aspects to be considered in the development of disassembly automation, including the mechanical system, vision system and intelligent planner. The implementation of cognitive robotics increases the flexibility and degree of autonomy of the disassembly system. Disassembly, as a step in the treatment of end-of-life products, can allow the recovery of embodied value left within disposed products, as well as the appropriate separation of potentially-hazardous components. In the end-of-life treatment industry, disassembly has largely been limited to manual labor, which is expensive in developed countries. Automation is one possible solution for economic feasibility. The target audience primarily comprises researchers and experts in the field, but the book may also be beneficial for graduate students.

The effects of technology on triage in A & E.

Science.gov (United States)

Roberts, J

1998-04-01

Within the specialty of Accident and Emergency (A & E) nursing, triage is a term meaning to classify or sort patients according to their need for care (Blythin 1988). Burgess (1992) views this process as a means of prioritizing patients in order, so that the more seriously ill or injured are seen first (Table 1). Triage performance is measured in the author's department by computer. This technological source is used to record the patient's arrival time and the time at which the patient is triaged. Technology is defined by the Oxford Dictionary (1996) as 'the study of mechanical arts and science, their application in industry'. This paper explores the impact of this technology and the related issues on the A & E triage nurse, and will focus on issues related to the Patients' Charter (1991), resource implications, safety and staff training. In conclusion, the quality of a patient's total care, in which the author participated, is discussed with reference to the related issues and implications for future practice.

Therapeutic Assessment in Psychological Triage Using the PAI.

Science.gov (United States)

Brown, Joshua D; Morey, Leslie C

2016-01-01

This case illustrates the utility of incorporating therapeutic assessment in a triage context that typically involves a focus on gathering information. A man referred to our clinic by a local mental health center was seen by our assessment team for a triage that includes the administration of a single psychological test, the Personality Assessment Inventory (PAI). Although this triage must rapidly gather information to determine client suitability and treatment assignment, we still attempt to work with clients to collaboratively develop goals for this assessment that include addressing questions that are central concerns for the clients. In this case, the test results suggested a severe disorder that accounted for many phenomena that he had been experiencing but had apparently been reluctant to share. The information gathered led to a referral to a different treatment program that could provide pharmacological and more intensive forms of treatment. However, the collaborative bond formed between the assessor and the client during this triage was sufficiently strong that it was our assessor to whom the client turned in a subsequent crisis precipitated by a symptomatic exacerbation. This case illustrates complementary information gathering and therapeutic goals of assessment even in the context of a brief assessment.

Robotics/Automated Systems Technicians.

Science.gov (United States)

Doty, Charles R.

Major resources exist that can be used to develop or upgrade programs in community colleges and technical institutes that educate robotics/automated systems technicians. The first category of resources is Economic, Social, and Education Issues. The Office of Technology Assessment (OTA) report, "Automation and the Workplace," presents analyses of…

A system-level approach to automation research

Science.gov (United States)

Harrison, F. W.; Orlando, N. E.

1984-01-01

Automation is the application of self-regulating mechanical and electronic devices to processes that can be accomplished with the human organs of perception, decision, and actuation. The successful application of automation to a system process should reduce man/system interaction and the perceived complexity of the system, or should increase affordability, productivity, quality control, and safety. The expense, time constraints, and risk factors associated with extravehicular activities have led the Automation Technology Branch (ATB), as part of the NASA Automation Research and Technology Program, to investigate the use of robots and teleoperators as automation aids in the context of space operations. The ATB program addresses three major areas: (1) basic research in autonomous operations, (2) human factors research on man-machine interfaces with remote systems, and (3) the integration and analysis of automated systems. This paper reviews the current ATB research in the area of robotics and teleoperators.

The accuracy of nurse performance of the triage process in a tertiary hospital emergency department in Gauteng Province, South Africa

Directory of Open Access Journals (Sweden)

L N Goldstein

2017-03-01

Full Text Available Background. Triage in the emergency department (ED is necessary to prioritise management according to the severity of a patient’s condition.The South African Triage Scale (SATS is a hospital-based triage tool that has been adopted by numerous EDs countrywide.Many factors can influence the outcome of a patient’s triage result, and evaluation of performance is therefore pivotal. Objectives. To determine how often patients were allocated to the correct triage category and the extent to which they were incorrectly promoted or demoted, and to determine the main reasons for errors in a nurse-led triage system. Methods. Triage forms from a tertiary hospital ED in Gauteng Province, South Africa, were collected over a 1-week period and reviewed retrospectively. Results. A total of 1 091 triage forms were reviewed. Triage category allocations were correct 68.3% of the time. Of the incorrect category assignments, 44.4% of patients were promoted and 55.6% demoted. Patients in the green category were most commonly promoted (29.4% and patients who should have been in orange were most commonly demoted (35.0%. Trauma patients were more likely to be incorrectly promoted and non-trauma patients to be incorrectly demoted. Mistakes were mainly due to discriminator errors (57.8%, followed by numerical miscalculations (21.5%. The leading omitted discriminators were ‘abdominal pain’, ‘chest pain’ and ‘shortness of breath’. Conclusions. Mis-triaging using the SATS can be attributed to incorrect or lack of discriminator use, numerical miscalculations and other human errors. Quality control and quality assurance measures must target training in these areas to minimise mis-triage in the ED.

Launch Control System Software Development System Automation Testing

Science.gov (United States)

Hwang, Andrew

2017-01-01

The Spaceport Command and Control System (SCCS) is the National Aeronautics and Space Administration's (NASA) launch control system for the Orion capsule and Space Launch System, the next generation manned rocket currently in development. This system requires high quality testing that will measure and test the capabilities of the system. For the past two years, the Exploration and Operations Division at Kennedy Space Center (KSC) has assigned a group including interns and full-time engineers to develop automated tests to save the project time and money. The team worked on automating the testing process for the SCCS GUI that would use streamed simulated data from the testing servers to produce data, plots, statuses, etc. to the GUI. The software used to develop automated tests included an automated testing framework and an automation library. The automated testing framework has a tabular-style syntax, which means the functionality of a line of code must have the appropriate number of tabs for the line to function as intended. The header section contains either paths to custom resources or the names of libraries being used. The automation library contains functionality to automate anything that appears on a desired screen with the use of image recognition software to detect and control GUI components. The data section contains any data values strictly created for the current testing file. The body section holds the tests that are being run. The function section can include any number of functions that may be used by the current testing file or any other file that resources it. The resources and body section are required for all test files; the data and function sections can be left empty if the data values and functions being used are from a resourced library or another file. To help equip the automation team with better tools, the Project Lead of the Automated Testing Team, Jason Kapusta, assigned the task to install and train an optical character recognition (OCR

War casualties: recent trends in evacuation, triage and the golden hour

International Nuclear Information System (INIS)

Safdar, C. A.

2010-01-01

Prompt medical treatment and early evacuation is the goal of military medicine in the battlefield. 'Triage' is a process of sorting the casualties according to the severity of injury and the prioritization of treatment. In trauma management 'Golden Hour' is the first sixty minutes or so after injury; this emphasizes that the chances of the victim's survival are the greatest if definitive care is given as early as possible. Our evacuation protocols follow the triage but the time to treatment is beyond sixty minutes. Many Armies have developed evacuation systems which allow the casualty to be seen within this specified time. This has been achieved by streamlining the evacuation chain, extensive incorporation of air transport and training of paramedics in advanced life support measures. In line with the modern trends we need to modernize our own system of casualty evacuation and treatment. (author)

Emergency nurses' knowledge and experience with the triage process in Hunan Province, China.

Science.gov (United States)

Hammad, Karen; Peng, Lingli; Anikeeva, Olga; Arbon, Paul; Du, Huiyun; Li, Yinglan

2017-11-01

Triage is implemented to facilitate timely and appropriate treatment of patients, and is typically conducted by senior nurses. Triage accuracy and consistency across emergency departments remain a problem in mainland China. This study aimed to investigate the current status of triage practice and knowledge among emergency nurses in Changsha, Hunan Province, China. A sample of 300 emergency nurses was selected from 13 tertiary hospitals in Changsha and a total of 193 completed surveys were returned (response rate=64.3%). Surveys were circulated to head nurses, who then distributed them to nurses who met the selection criteria. Nurses were asked to complete the surveys and return them via dedicated survey return boxes that were placed in discreet locations to ensure anonymity. Just over half (50.8%) of participants reported receiving dedicated triage training, which was provided by their employer (38.6%), an education organisation (30.7%) or at a conference (26.1%). Approximately half (53.2%) reported using formal triage scales, which were predominantly 4-tier (43%) or 5-tier (34%). The findings highlight variability in triage practices and training of emergency nurses in Changsha. This has implications for the comparability of triage data and transferability of triage skills across hospitals. Copyright © 2017 Elsevier Ltd. All rights reserved.

ED Triage Decision-Making With Mental Health Presentations: A "Think Aloud" Study.

Science.gov (United States)

Clarke, Diana E; Boyce-Gaudreau, Krystal; Sanderson, Ana; Baker, John A

2015-11-01

Triage is the process whereby persons presenting to the emergency department are quickly assessed by a nurse and their need for care and service is prioritized. Research examining the care of persons presenting to emergency departments with psychiatric and mental health problems has shown that triage has often been cited as the most problematic aspect of the encounter. Three questions guided this investigation: Where do the decisions that triage nurses make fall on the intuitive versus analytic dimensions of decision making for mental health presentations in the emergency department, and does this differ according to comfort or familiarity with the type of mental health/illness presentation? How do "decision aids" (i.e., structured triage scales) help in the decision-making process? To what extent do other factors, such as attitudes, influence triage nurses' decision making? Eleven triage nurses participating in this study were asked to talk out loud about the reasoning process they would engage in while triaging patients in 5 scenarios based on mental health presentations to the emergency department. Themes emerging from the data were tweaking the results (including the use of intuition and early judgments) to arrive at the desired triage score; consideration of the current ED environment; managing uncertainty and risk (including the consideration of physical reasons for presentation); and confidence in communicating with patients in distress and managing their own emotive reactions to the scenario. Findings support the preference for using the intuitive mode of decision making with only tacit reliance on the decision aid. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

The Impact of Telemedicine on Pediatric Critical Care Triage.

Science.gov (United States)

Harvey, Jillian B; Yeager, Brooke E; Cramer, Christina; Wheeler, David; McSwain, S David

2017-11-01

To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations. Retrospective evaluation of consultations occurring between April 2012 and March 2016. Pediatric critical care telemedicine and telephone consultations in 52 rural healthcare settings in South Carolina. Pediatric patients receiving critical care telemedicine or telephone consultations. Telemedicine consultations. Data were collected from the consulting provider for 484 total consultations by telephone or telemedicine. We examined the providers' self-reported assessments about the consultation, decision-making, and triage outcomes. We estimate a logit model to predict triage location as a function of telemedicine consult age and sex. For telemedicine patients, the odds of triage to a non-ICU level of care are 2.55 times larger than the odds for patients receiving telephone consultations (p = 0.0005). Providers rated the accuracy of their assessments higher when consultations were provided via telemedicine. When patients were transferred to a non-ICU location following a telemedicine consultation, providers indicated that the use of telemedicine influenced the triage decision in 95.7% of cases (p telemedicine consultation to community hospitals is feasible and results in a reduction in PICU admissions. This study demonstrates an improvement in provider-reported accuracy of patient assessment via telemedicine compared with telephone, which may produce a higher comfort level with transporting patients to a lower level of care. Pediatric critical care telemedicine consultations represent a promising means of improving care and reducing costs for critically ill children in rural areas.

Hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico.

Directory of Open Access Journals (Sweden)

Eduardo Rodriguez-Noriega

2010-05-01

Full Text Available Pandemic influenza A (H1N1 virus emerged during 2009. To help clinicians triage adults with acute respiratory illness, a scoring system for influenza-like illness (ILI was implemented at Hospital Civil de Guadalajara, Mexico.A medical history, laboratory and radiology results were collected on emergency room (ER patients with acute respiratory illness to calculate an ILI-score. Patients were evaluated for admission by their ILI-score and clinicians' assessment of risk for developing complications. Nasal and throat swabs were collected from intermediate and high-risk patients for influenza testing by RT-PCR. The disposition and ILI-score of those oseltamivir-treated versus untreated, clinical characteristics of 2009 pandemic influenza A (H1N1 patients versus test-negative patients were compared by Pearson's Chi(2, Fisher's Exact, and Wilcoxon rank-sum tests.Of 1840 ER patients, 230 were initially hospitalized (mean ILI-score = 15, and the rest were discharged, including 286 ambulatory patients given oseltamivir (median ILI-score = 11, and 1324 untreated (median ILI-score = 5. Fourteen (1% untreated patients returned, and 3 were hospitalized on oseltamivir (median ILI-score = 19. Of 371 patients tested by RT-PCR, 104 (28% had pandemic influenza and 42 (11% had seasonal influenza A detected. Twenty (91% of 22 imaged hospitalized pandemic influenza patients had bilateral infiltrates compared to 23 (38% of 61 imaged hospital test-negative patients (p<0.001. One patient with confirmed pandemic influenza presented 6 days after symptom onset, required mechanical ventilation, and died.The triaging system that used an ILI-score complimented clinicians' judgment of who needed oseltamivir and inpatient care and helped hospital staff manage a surge in demand for services.

Triage medfører hurtigere behandling af de mest syge

DEFF Research Database (Denmark)

Skriver, Claus; Lauritzen, Marlene Mauson Pankoke; Forberg, Jakob Lundager

2011-01-01

Systematic process triage is a relatively unknown concept in Denmark. Currently there are no national recommendations regarding triage models for use in the emergency department (ED). Four medium-sized EDs from different regions across the country cooperated in a joint venture to develop a new...

Computer Forensics Field Triage Process Model

Directory of Open Access Journals (Sweden)

Marcus K. Rogers

2006-06-01

Full Text Available With the proliferation of digital based evidence, the need for the timely identification, analysis and interpretation of digital evidence is becoming more crucial. In many investigations critical information is required while at the scene or within a short period of time - measured in hours as opposed to days. The traditional cyber forensics approach of seizing a system(s/media, transporting it to the lab, making a forensic image(s, and then searching the entire system for potential evidence, is no longer appropriate in some circumstances. In cases such as child abductions, pedophiles, missing or exploited persons, time is of the essence. In these types of cases, investigators dealing with the suspect or crime scene need investigative leads quickly; in some cases it is the difference between life and death for the victim(s. The Cyber Forensic Field Triage Process Model (CFFTPM proposes an onsite or field approach for providing the identification, analysis and interpretation of digital evidence in a short time frame, without the requirement of having to take the system(s/media back to the lab for an in-depth examination or acquiring a complete forensic image(s. The proposed model adheres to commonly held forensic principles, and does not negate the ability that once the initial field triage is concluded, the system(s/storage media be transported back to a lab environment for a more thorough examination and analysis. The CFFTPM has been successfully used in various real world cases, and its investigative importance and pragmatic approach has been amply demonstrated. Furthermore, the derived evidence from these cases has not been challenged in the court proceedings where it has been introduced. The current article describes the CFFTPM in detail, discusses the model’s forensic soundness, investigative support capabilities and practical considerations.

Systems integration (automation system). System integration (automation system)

Energy Technology Data Exchange (ETDEWEB)

Fujii, K; Komori, T; Fukuma, Y; Oikawa, M [Nippon Steal Corp., Tokyo (Japan)

1991-09-26

This paper introduces business activities on an automation systems integration (SI) started by a company in July,1988, and describes the SI concepts. The business activities include, with the CIM (unified production carried out on computers) and AMENITY (living environment) as the mainstays, a single responsibility construction ranging from consultation on structuring optimal systems for processing and assembling industries and intelligent buildings to system design, installation and after-sales services. With an SI standing on users {prime} position taken most importantly, the business starts from a planning and consultation under close coordination. On the conceptual basis of structuring optimal systems using the ompany {prime}s affluent know-hows and tools and adapting and applying with multi-vendors, open networks, centralized and distributed systems, the business is promoted with the accumulated technologies capable of realizing artificial intelligence and neural networks in its background, and supported with highly valuable business results in the past. 10 figs., 1 tab.

Using On-scene EMS Responders' Assessment and Electronic Patient Care Records to Evaluate the Suitability of EMD-triaged, Low-acuity Calls for Secondary Nurse Triage in 911 Centers.

Science.gov (United States)

Scott, Greg; Clawson, Jeff; Fivaz, Mark C; McQueen, Jennie; Gardett, Marie I; Schultz, Bryon; Youngquist, Scott; Olola, Christopher H O

2016-02-01

Using the Medical Priority Dispatch System (MPDS) - a systematic 911 triage process - to identify a large subset of low-acuity patients for secondary nurse triage in the 911 center is a largely unstudied practice in North America. This study examines the ALPHA-level subset of low-acuity patients in the MPDS to determine the suitability of these patients for secondary triage by evaluating vital signs and necessity of lights-and-siren transport, as determined by attending Emergency Medical Services (EMS) ambulance crews. The primary objective of this study was to determine the clinical status of MPDS ALPHA-level (low-acuity) patients, as determined by on-scene EMS crews' patient care records, in two US agencies. A secondary objective was to determine which ALPHA-level codes are suitable candidates for secondary triage by a trained Emergency Communication Nurse (ECN). In this retrospective study, one full year (2013) of both dispatch data and EMS patient records data, associated with all calls coded at the ALPHA-level (low-acuity) in the dispatch protocol, were collected. The primary outcome measure was the number and percentage of ALPHA-level codes categorized as low-acuity, moderate-acuity, high-acuity, and critical using four common vital signs to assign these categories: systolic blood pressure (SBP), pulse rate (PR), oxygen saturation (SpO2), and Glasgow Coma Score (GCS). Vital sign data were obtained from ambulance crew electronic patient care records (ePCRs). The secondary endpoint was the number and percentage of ALPHA-level codes that received a "hot" (lights-and-siren) transport. Out of 19,300 cases, 16,763 (86.9%) were included in the final analysis, after excluding cases from health care providers and those with missing data. Of those, 89% of all cases did not have even one vital sign indicator of unstable patient status (high or critical vital sign). Of all cases, only 1.1% were transported lights-and-siren. With the exception of the low-acuity, ALPHA

New automated pellet/powder assay system

International Nuclear Information System (INIS)

Olsen, R.N.

1975-01-01

This paper discusses an automated, high precision, pellet/ powder assay system. The system is an active assay system using a small isotopic neutron source and a coincidence detection system. The handling of the pellet powder samples has been automated and a programmable calculator has been integrated into the system to provide control and data analysis. The versatile system can assay uranium or plutonium in either active or passive modes

An adapted triage tool (ETAT) at Red Cross War Memorial ...

African Journals Online (AJOL)

Objective. To evaluate the efficacy of an adapted Emergency Triage Assessment and Treatment (ETAT) tool at a children's hospital. Design. A two-armed descriptive study. Setting. Red Cross War Memorial Children's Hospital, Cape Town, South Africa. Methods. Triage data on 1 309 children from October 2007 and July ...

System reliability, performance and trust in adaptable automation.

Science.gov (United States)

Chavaillaz, Alain; Wastell, David; Sauer, Jürgen

2016-01-01

The present study examined the effects of reduced system reliability on operator performance and automation management in an adaptable automation environment. 39 operators were randomly assigned to one of three experimental groups: low (60%), medium (80%), and high (100%) reliability of automation support. The support system provided five incremental levels of automation which operators could freely select according to their needs. After 3 h of training on a simulated process control task (AutoCAMS) in which the automation worked infallibly, operator performance and automation management were measured during a 2.5-h testing session. Trust and workload were also assessed through questionnaires. Results showed that although reduced system reliability resulted in lower levels of trust towards automation, there were no corresponding differences in the operators' reliance on automation. While operators showed overall a noteworthy ability to cope with automation failure, there were, however, decrements in diagnostic speed and prospective memory with lower reliability. Copyright © 2015. Published by Elsevier Ltd.

Point-of-Care Ultrasound for Pulmonary Concerns in Remote Spaceflight Triage Environments.

Science.gov (United States)

Johansen, Benjamin D; Blue, Rebecca S; Castleberry, Tarah L; Antonsen, Erik L; Vanderploeg, James M

2018-02-01

With the development of the commercial space industry, growing numbers of spaceflight participants will engage in activities with a risk for pulmonary injuries, including pneumothorax, ebullism, and decompression sickness, as well as other concomitant trauma. Medical triage capabilities for mishaps involving pulmonary conditions have not been systematically reviewed. Recent studies have advocated the use of point-of-care ultrasound to screen for lung injury or illness. The operational utility of portable ultrasound systems in disaster relief and other austere settings may be relevant to commercial spaceflight. A systematic review of published literature was conducted concerning the use of point-of-care pulmonary ultrasound techniques in austere environments, including suggested examination protocols for triage and diagnosis. Recent studies support the utility of pulmonary ultrasound examinations when performed by skilled operators, and comparability of the results to computed tomography and chest radiography for certain conditions, with important implications for trauma management in austere environments. Pulmonary injury and illness are among the potential health risks facing spaceflight participants. Implementation of point-of-care ultrasound protocols could aid in the rapid diagnosis, triage, and treatment of such conditions. Though operator-dependent, ultrasound, with proper training, experience, and equipment, could be a valuable tool in the hands of a first responder supporting remote spaceflight operations.Johansen BD, Blue RS, Castleberry TL, Antonsen EL, Vanderploeg JM. Point-of-care ultrasound for pulmonary concerns in remote spaceflight triage environments. Aerosp Med Hum Perform. 2018; 89(2):122-129.

Automated packing systems: review of industrial implementations

Science.gov (United States)

Whelan, Paul F.; Batchelor, Bruce G.

1993-08-01

A rich theoretical background to the problems that occur in the automation of material handling can be found in operations research, production engineering, systems engineering and automation, more specifically machine vision, literature. This work has contributed towards the design of intelligent handling systems. This paper will review the application of these automated material handling and packing techniques to industrial problems. The discussion will also highlight the systems integration issues involved in these applications. An outline of one such industrial application, the automated placement of shape templates on to leather hides, is also discussed. The purpose of this system is to arrange shape templates on a leather hide in an efficient manner, so as to minimize the leather waste, before they are automatically cut from the hide. These pieces are used in the furniture and car manufacturing industries for the upholstery of high quality leather chairs and car seats. Currently this type of operation is semi-automated. The paper will outline the problems involved in the full automation of such a procedure.

Automation of analytical systems in power cycles

International Nuclear Information System (INIS)

Staub Lukas

2008-01-01

'Automation' is a widely used term in instrumentation and is often applied to signal exchange, PLC and SCADA systems. Common use, however, does not necessarily described autonomous operation of analytical devices. We define an automated analytical system as a black box with an input (sample) and an output (measured value). In addition we need dedicated status lines for assessing the validities of the input for our black box and the output for subsequent systems. We will discuss input parameters, automated analytical processes and output parameters. Further considerations will be given to signal exchange and integration into the operating routine of a power plant. Local control loops (chemical dosing) and the automation of sampling systems are not discussed here. (author)

Lack of Gender Disparities in Emergency Department Triage of Acute Stroke Patients

Directory of Open Access Journals (Sweden)

Madsen, Tracy E.

2014-12-01

Full Text Available Introduction: Previous literature has shown gender disparities in the care of acute ischemic stroke. Compared to men, women wait longer for brain imaging and are less likely to receive intravenous (IV tissue plasminogen activator (tPA. Emergency department (ED triage is an important step in the rapid assessment of stroke patients and is a possible contributor to disparities. It is unknown whether gender differences exist in ED triage of acute stroke patients. Our primary objective was to determine whether gender disparities exist in the triage of acute stroke patients as defined by Emergency Severity Index (ESI levels and use of ED critical care beds. Methods: This was a retrospective, observational study of both ischemic and hemorrhagic stroke patients age ≥18 years presenting to a large, urban, academic ED within six hours of symptom onset between January 2010, and December 2012. Primary outcomes were triage to a non-critical ED bed and Emergency Severity Index (ESI level. Primary outcome data were extracted from electronic medical records by a blinded data manager; secondary outcome data and covariates were abstracted by trained research assistants. We performed bivariate and multivariate analyses. Logistic regression was performed using age, race, insurance status, mode of and time to arrival, National Institutes of Health Stroke Scale, and presence of atypical symptoms as covariates. Results: There were 537 patients included in this study. Women were older (75.6 vs. 69.5, p<0.001, and more women had a history of atrial fibrillation (39.8% vs. 25.3%, p<0.001. Compared to 9.5% of men, 10.3% of women were triaged to a non-critical care ED bed (p=0.77; 92.1% of women were triaged as ESI 1 or 2 vs. 93.6% of men (p=0.53. After adjustment, gender was not associated with triage location or ESI level, though atypical symptoms were associated with higher odds of being triaged to a non-critical care bed (aOR 1.98, 95%CI [1.03 – 3.81] and 3

Laboratory automation in clinical bacteriology: what system to choose?

Science.gov (United States)

Croxatto, A; Prod'hom, G; Faverjon, F; Rochais, Y; Greub, G

2016-03-01

Automation was introduced many years ago in several diagnostic disciplines such as chemistry, haematology and molecular biology. The first laboratory automation system for clinical bacteriology was released in 2006, and it rapidly proved its value by increasing productivity, allowing a continuous increase in sample volumes despite limited budgets and personnel shortages. Today, two major manufacturers, BD Kiestra and Copan, are commercializing partial or complete laboratory automation systems for bacteriology. The laboratory automation systems are rapidly evolving to provide improved hardware and software solutions to optimize laboratory efficiency. However, the complex parameters of the laboratory and automation systems must be considered to determine the best system for each given laboratory. We address several topics on laboratory automation that may help clinical bacteriologists to understand the particularities and operative modalities of the different systems. We present (a) a comparison of the engineering and technical features of the various elements composing the two different automated systems currently available, (b) the system workflows of partial and complete laboratory automation, which define the basis for laboratory reorganization required to optimize system efficiency, (c) the concept of digital imaging and telebacteriology, (d) the connectivity of laboratory automation to the laboratory information system, (e) the general advantages and disadvantages as well as the expected impacts provided by laboratory automation and (f) the laboratory data required to conduct a workflow assessment to determine the best configuration of an automated system for the laboratory activities and specificities. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Automated Subsystem Control for Life Support System (ASCLSS)

Science.gov (United States)

Block, Roger F.

1987-01-01

The Automated Subsystem Control for Life Support Systems (ASCLSS) program has successfully developed and demonstrated a generic approach to the automation and control of space station subsystems. The automation system features a hierarchical and distributed real-time control architecture which places maximum controls authority at the lowest or process control level which enhances system autonomy. The ASCLSS demonstration system pioneered many automation and control concepts currently being considered in the space station data management system (DMS). Heavy emphasis is placed on controls hardware and software commonality implemented in accepted standards. The approach demonstrates successfully the application of real-time process and accountability with the subsystem or process developer. The ASCLSS system completely automates a space station subsystem (air revitalization group of the ASCLSS) which moves the crew/operator into a role of supervisory control authority. The ASCLSS program developed over 50 lessons learned which will aide future space station developers in the area of automation and controls..

Automated measuring systems. Automatisierte Messsysteme

Energy Technology Data Exchange (ETDEWEB)

1985-01-01

Microprocessors have become a regular component of automated measuring systems. Experts offer their experience and basic information in 24 lectures and 10 poster presentations. The focus is on the following: Automated measuring, computer and microprocessor use, sensor technique, actuator technique, communication, interfaces, man-system interaction, distrubance tolerance and availability as well as uses. A discussion meeting is dedicated to the theme complex sensor digital signal, sensor interface and sensor bus.

Building Automation Systems.

Science.gov (United States)

Honeywell, Inc., Minneapolis, Minn.

A number of different automation systems for use in monitoring and controlling building equipment are described in this brochure. The system functions include--(1) collection of information, (2) processing and display of data at a central panel, and (3) taking corrective action by sounding alarms, making adjustments, or automatically starting and…

Bar-code automated waste tracking system

International Nuclear Information System (INIS)

Hull, T.E.

1994-10-01

The Bar-Code Automated Waste Tracking System was designed to be a site-Specific program with a general purpose application for transportability to other facilities. The system is user-friendly, totally automated, and incorporates the use of a drive-up window that is close to the areas dealing in container preparation, delivery, pickup, and disposal. The system features ''stop-and-go'' operation rather than a long, tedious, error-prone manual entry. The system is designed for automation but allows operators to concentrate on proper handling of waste while maintaining manual entry of data as a backup. A large wall plaque filled with bar-code labels is used to input specific details about any movement of waste

Abnormal vital signs are strong predictors for intensive care unit admission and in-hospital mortality in adults triaged in the emergency department - a prospective cohort study

Directory of Open Access Journals (Sweden)

Barfod Charlotte

2012-04-01

Full Text Available Abstract Background Assessment and treatment of the acutely ill patient have improved by introducing systematic assessment and accelerated protocols for specific patient groups. Triage systems are widely used, but few studies have investigated the ability of the triage systems in predicting outcome in the unselected acute population. The aim of this study was to quantify the association between the main component of the Hillerød Acute Process Triage (HAPT system and the outcome measures; Admission to Intensive Care Unit (ICU and in-hospital mortality, and to identify the vital signs, scored and categorized at admission, that are most strongly associated with the outcome measures. Methods The HAPT system is a minor modification of the Swedish Adaptive Process Triage (ADAPT and ranks patients into five level colour-coded triage categories. Each patient is assigned a triage category for the two main descriptors; vital signs, Tvitals, and presenting complaint, Tcomplaint. The more urgent of the two determines the final triage category, Tfinal. We retrieved 6279 unique adult patients admitted through the Emergency Department (ED from the Acute Admission Database. We performed regression analysis to evaluate the association between the covariates and the outcome measures. Results The covariates, Tvitals, Tcomplaint and Tfinal were all significantly associated with ICU admission and in-hospital mortality, the odds increasing with the urgency of the triage category. The vital signs best predicting in-hospital mortality were saturation of peripheral oxygen (SpO2, respiratory rate (RR, systolic blood pressure (BP and Glasgow Coma Score (GCS. Not only the type, but also the number of abnormal vital signs, were predictive for adverse outcome. The presenting complaints associated with the highest in-hospital mortality were 'dyspnoea' (11.5% and 'altered level of consciousness' (10.6%. More than half of the patients had a Tcomplaint more urgent than Tvitals

A better START for low-acuity victims: data-driven refinement of mass casualty triage.

Science.gov (United States)

Cross, Keith P; Petry, Michael J; Cicero, Mark X

2015-01-01

Methods currently used to triage patients from mass casualty events have a sparse evidence basis. The objective of this project was to assess gaps of the widely used Simple Triage and Rapid Transport (START) algorithm using a large database when it is used to triage low-acuity patients. Subsequently, we developed and tested evidenced-based improvements to START. Using the National Trauma Database (NTDB), a large set of trauma victims were assigned START triage levels, which were then compared to recorded patient mortality outcomes using area under the receiver-operator curve (AUC). Subjects assigned to the "Minor/Green" level who nevertheless died prior to hospital discharge were considered mistriaged. Recursive partitioning identified factors associated with of these mistriaged patients. These factors were then used to develop candidate START models of improved triage, whose overall performance was then re-evaluated using data from the NTDB. This process of evaluating performance, identifying errors, and further adjusting candidate models was repeated iteratively. The study included 322,162 subjects assigned to "Minor/Green" of which 2,046 died before hospital discharge. Age was the primary predictor of under-triage by START. Candidate models which re-assigned patients from the "Minor/Green" triage level to the "Delayed/Yellow" triage level based on age (either for patients >60 or >75), reduced mortality in the "Minor/Green" group from 0.6% to 0.1% and 0.3%, respectively. These candidate START models also showed net improvement in the AUC for predicting mortality overall and in select subgroups. In this research model using trauma registry data, most START under-triage errors occurred in elderly patients. Overall START accuracy was improved by placing elderly but otherwise minimally injured-mass casualty victims into a higher risk triage level. Alternatively, such patients would be candidates for closer monitoring at the scene or expedited transport ahead of other

Automated Information System (AIS) Alarm System

International Nuclear Information System (INIS)

Hunteman, W.

1997-01-01

The Automated Information Alarm System is a joint effort between Los Alamos National Laboratory, Lawrence Livermore National Laboratory, and Sandia National Laboratory to demonstrate and implement, on a small-to-medium sized local area network, an automated system that detects and automatically responds to attacks that use readily available tools and methodologies. The Alarm System will sense or detect, assess, and respond to suspicious activities that may be detrimental to information on the network or to continued operation of the network. The responses will allow stopping, isolating, or ejecting the suspicious activities. The number of sensors, the sensitivity of the sensors, the assessment criteria, and the desired responses may be set by the using organization to meet their local security policies

Automated Information System (AIS) Alarm System

Energy Technology Data Exchange (ETDEWEB)

Hunteman, W.

1997-05-01

The Automated Information Alarm System is a joint effort between Los Alamos National Laboratory, Lawrence Livermore National Laboratory, and Sandia National Laboratory to demonstrate and implement, on a small-to-medium sized local area network, an automated system that detects and automatically responds to attacks that use readily available tools and methodologies. The Alarm System will sense or detect, assess, and respond to suspicious activities that may be detrimental to information on the network or to continued operation of the network. The responses will allow stopping, isolating, or ejecting the suspicious activities. The number of sensors, the sensitivity of the sensors, the assessment criteria, and the desired responses may be set by the using organization to meet their local security policies.

21 CFR 864.9300 - Automated Coombs test systems.

Science.gov (United States)

2010-04-01

... Blood and Blood Products § 864.9300 Automated Coombs test systems. (a) Identification. An automated Coombs test system is a device used to detect and identify antibodies in patient sera or antibodies bound... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated Coombs test systems. 864.9300 Section...

15 CFR 758.2 - Automated Export System (AES).

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Automated Export System (AES). 758.2... CLEARANCE REQUIREMENTS § 758.2 Automated Export System (AES). The Census Bureau's Foreign Trade Statistics...) electronically using the Automated Export System (AES). In order to use AES, you must apply directly to the...

Educational Triage in Open Distance Learning: Walking a Moral Tightrope

Directory of Open Access Journals (Sweden)

Paul Prinsloo

2014-09-01

Full Text Available Higher education, and more specifically, distance education, is in the midst of a rapidly changing environment. Higher education institutions increasingly rely on the harvesting and analyses of student data to inform key strategic decisions across a wide range of issues, including marketing, enrolment, curriculum development, the appointment of staff, and student assessment. In the light of persistent concerns regarding student success and retention in distance education contexts, the harvesting and analysis of student data in particular in the emerging field of learning analytics holds much promise. As such the notion of educational triage needs to be interrogated. Educational triage is defined as balancing between the futility or impact of the intervention juxtaposed with the number of students requiring care, the scope of care required, and the resources available for care/interventions. The central question posed by this article is “how do we make moral decisions when resources are (increasingly limited?” An attempt is made to address this by discussing the use of data to support decisions regarding student support and examining the concept of educational triage. Despite the increase in examples of institutions implementing a triage based approach to student support, there is a serious lack of supporting conceptual and theoretical development, and, more importantly, to consideration of the moral cost of triage in educational settings. This article provides a conceptual framework to realise the potential of educational triage to responsibly and ethically respond to legitimate concerns about the “revolving door” in distance and online learning and the sustainability of higher education, without compromising ‘openness.’ The conceptual framework does not attempt to provide a detailed map, but rather a compass consisting of principles to consider in using learning analytics to classify students according to their perceived risk of

Development of statewide geriatric patients trauma triage criteria.

Science.gov (United States)

Werman, Howard A; Erskine, Timothy; Caterino, Jeffrey; Riebe, Jane F; Valasek, Tricia

2011-06-01

The geriatric population is unique in the type of traumatic injuries sustained, physiological responses to those injuries, and an overall higher mortality when compared to younger adults. No published, evidence-based, geriatric-specific field destination criteria exist as part of a statewide trauma system. The Trauma Committee of the Ohio Emergency Medical Services (EMS) Board sought to develop specific criteria for geriatric trauma victims. A literature search was conducted for all relevant literature to determine potential, geriatric-specific, field-destination criteria. Data from the Ohio Trauma Registry were used to compare elderly patients, defined as age >70 years, to all patients between the ages of 16 to 69 years with regards to mortality risk in the following areas: (1) Glasgow Coma Scale (GCS) score; (2) systolic blood pressure (SBP); (3) falls associated with head, chest, abdominal or spinal injury; (4) mechanism of injury; (5) involvement of more than one body system as defined in the Barell matrix; and (6) co-morbidities and motor vehicle collision with one or more long bone fracture. For GCS score and SBP, those cut-off points with equal or greater risk of mortality as compared to current values were chosen as proposed triage criteria. For other measures, any criterion demonstrating a statistically significant increase in mortality risk was included in the proposed criteria. The following criteria were identified as geriatric-specific criteria: (1) GCS score trauma; (2) SBP trauma. In addition, these data suggested that elderly patients with specific co-morbidities be given strong consideration for evaluation in a trauma center. The state of Ohio is the first state to develop evidence-based geriatric-specific field-destination criteria using data from its state-mandated trauma registry. Further analysis of these criteria will help determine their effects on over-triage and under-triage of geriatric victims of traumatic injuries and the impact on the

Automated drawing generation system

International Nuclear Information System (INIS)

Yoshinaga, Toshiaki; Kawahata, Junichi; Yoshida, Naoto; Ono, Satoru

1991-01-01

Since automated CAD drawing generation systems still require human intervention, improvements were focussed on an interactive processing section (data input and correcting operation) which necessitates a vast amount of work. As a result, human intervention was eliminated, the original objective of a computerized system. This is the first step taken towards complete automation. The effects of development and commercialization of the system are as described below. (1) The interactive processing time required for generating drawings was improved. It was determined that introduction of the CAD system has reduced the time required for generating drawings. (2) The difference in skills between workers preparing drawings has been eliminated and the quality of drawings has been made uniform. (3) The extent of knowledge and experience demanded of workers has been reduced. (author)

Spaceport Command and Control System Automation Testing

Science.gov (United States)

Hwang, Andrew

2017-01-01

The Spaceport Command and Control System (SCCS) is the National Aeronautics and Space Administrations (NASA) launch control system for the Orion capsule and Space Launch System, the next generation manned rocket currently in development. This large system requires high quality testing that will properly measure the capabilities of the system. Automating the test procedures would save the project time and money. Therefore, the Electrical Engineering Division at Kennedy Space Center (KSC) has recruited interns for the past two years to work alongside full-time engineers to develop these automated tests, as well as innovate upon the current automation process.

Spaceport Command and Control System Automated Testing

Science.gov (United States)

Stein, Meriel

2017-01-01

The Spaceport Command and Control System (SCCS) is the National Aeronautics and Space Administrations (NASA) launch control system for the Orion capsule and Space Launch System, the next generation manned rocket currently in development. This large system requires high quality testing that will properly measure the capabilities of the system. Automating the test procedures would save the project time and money. Therefore, the Electrical Engineering Division at Kennedy Space Center (KSC) has recruited interns for the past two years to work alongside full-time engineers to develop these automated tests, as well as innovate upon the current automation process.

In 'big bang' major incidents do triage tools accurately predict clinical priority?: a systematic review of the literature.

Science.gov (United States)

Kilner, T M; Brace, S J; Cooke, M W; Stallard, N; Bleetman, A; Perkins, G D

2011-05-01

The term "big bang" major incidents is used to describe sudden, usually traumatic,catastrophic events, involving relatively large numbers of injured individuals, where demands on clinical services rapidly outstrip the available resources. Triage tools support the pre-hospital provider to prioritise which patients to treat and/or transport first based upon clinical need. The aim of this review is to identify existing triage tools and to determine the extent to which their reliability and validity have been assessed. A systematic review of the literature was conducted to identify and evaluate published data validating the efficacy of the triage tools. Studies using data from trauma patients that report on the derivation, validation and/or reliability of the specific pre-hospital triage tools were eligible for inclusion.Purely descriptive studies, reviews, exercises or reports (without supporting data) were excluded. The search yielded 1982 papers. After initial scrutiny of title and abstract, 181 papers were deemed potentially applicable and from these 11 were identified as relevant to this review (in first figure). There were two level of evidence one studies, three level of evidence two studies and six level of evidence three studies. The two level of evidence one studies were prospective validations of Clinical Decision Rules (CDR's) in children in South Africa, all the other studies were retrospective CDR derivation, validation or cohort studies. The quality of the papers was rated as good (n=3), fair (n=7), poor (n=1). There is limited evidence for the validity of existing triage tools in big bang major incidents.Where evidence does exist it focuses on sensitivity and specificity in relation to prediction of trauma death or severity of injury based on data from single or small number patient incidents. The Sacco system is unique in combining survivability modelling with the degree by which the system is overwhelmed in the triage decision system. The

Use of the Triage Stroke Panel in a neurologic emergency service.

Science.gov (United States)

Sibon, Igor; Rouanet, François; Meissner, Wassilios; Orgogozo, Jean Marc

2009-06-01

Acute stroke is associated with serum elevations of numerous markers. We evaluated the additive accuracy of the Triage Stroke Panel (D-dimer, B-natriuretic peptide, matrix metalloproteinase 9, and S-100beta) to the triaging nurse for acute stroke diagnosis. Consecutive patients with suspected stroke were included in this prospective, controlled, single-center study. A well-trained stroke center triage nurse assigned a probability that the patient had experienced a stroke (certain, very probable, probable, not likely, doubtful, or other); then, the Triage Stroke Panel testing was performed. Patients' diagnosis was based on clinical and imaging data by a neurologist blinded to the test results. Two hundred four patients were evaluated. Confirmed strokes and transient ischemic attacks (TIAs) were observed in 131 patients. When considering an experienced stroke nurse's assessment of "other," "doubtful," or "not likely" to be negative for stroke and categorizing TIA with stroke, the stroke panel's Multimarker Index (MMX) value had identical accuracy (approximately 70%) and equivalent sensitivity (approximately 94%) and specificity (approximately 24%) for stroke diagnosis to that of the nurse. Combining nurse assessment with the MMX result significantly improved the specificity of diagnosing "mimic" vs stroke + TIA from 25.4% (nurse assessment only) to 46.0% (nurse assessment + MMX; P Stroke Panel provides objective information that complements a triage nurse in the assessment of a suspected stroke patient. Its performance compares favorably with that of a well-trained stroke center triage nurse, suggesting potential use in nonexpert centers for improving the accuracy of stroke diagnosis.

Parental satisfaction with paediatric care, triage and waiting times.

Science.gov (United States)

Fitzpatrick, Nicholas; Breen, Daniel T; Taylor, James; Paul, Eldho; Grosvenor, Robert; Heggie, Katrina; Mahar, Patrick D

2014-04-01

The present study aims to determine parental and guardian's perceptions of paediatric emergency care and satisfaction with care, waiting times and triage category in a community ED. A structured questionnaire was provided to parents or guardians of paediatric patients presenting to emergency. The survey evaluated parent perceptions of waiting time, environment/facilities, professionalism and communication skills of staff and overall satisfaction of care. One hundred and thirty-three completed questionnaires were received from parents of paediatric patients. Responses were overall positive with respect to the multiple domains assessed. Parents generally considered waiting times to be appropriate and consistent with triage categories. Overall satisfaction was not significantly different for varying treatment or waiting times. Patients triaged as semi-urgent were of the opinion that waiting times were less appropriate than urgent, less-urgent or non-urgent patients. On the basis of the present study, patient perceptions and overall satisfaction of care does not appear to be primarily influenced by time spent waiting or receiving treatment. Attempts made at the triage process to ensure that semi-urgent patients have reasonable expectations of waiting times might provide an opportunity to improve these patients' expectations and perceptions. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

How to Evaluate Integrated Library Automation Systems.

Science.gov (United States)

Powell, James R.; Slach, June E.

1985-01-01

This paper describes methodology used in compiling a list of candidate integrated library automation systems at a corporate technical library. Priorities for automation, identification of candidate systems, the filtering process, information for suppliers, software and hardware considerations, on-site evaluations, and final system selection are…

Computerized automated remote inspection system

International Nuclear Information System (INIS)

The automated inspection system utilizes a computer to control the location of the ultrasonic transducer, the actual inspection process, the display of the data, and the storage of the data on IBM magnetic tape. This automated inspection equipment provides two major advantages. First, it provides a cost savings, because of the reduced inspection time, made possible by the automation of the data acquisition, processing, and storage equipment. This reduced inspection time is also made possible by a computerized data evaluation aid which speeds data interpretation. In addition, the computer control of the transducer location drive allows the exact duplication of a previously located position or flaw. The second major advantage is that the use of automated inspection equipment also allows a higher-quality inspection, because of the automated data acquisition, processing, and storage. This storage of data, in accurate digital form on IBM magnetic tape, for example, facilitates retrieval for comparison with previous inspection data. The equipment provides a multiplicity of scan data which will provide statistical information on any questionable volume or flaw. An automatic alarm for location of all reportable flaws reduces the probability of operator error. This system has the ability to present data on a cathode ray tube as numerical information, a three-dimensional picture, or ''hard-copy'' sheet. One important advantage of this system is the ability to store large amounts of data in compact magnetic tape reels

Serious gaming technology in major incident triage training: a pragmatic controlled trial.

Science.gov (United States)

Knight, James F; Carley, Simon; Tregunna, Bryan; Jarvis, Steve; Smithies, Richard; de Freitas, Sara; Dunwell, Ian; Mackway-Jones, Kevin

2010-09-01

By exploiting video games technology, serious games strive to deliver affordable, accessible and usable interactive virtual worlds, supporting applications in training, education, marketing and design. The aim of the present study was to evaluate the effectiveness of such a serious game in the teaching of major incident triage by comparing it with traditional training methods. Pragmatic controlled trial. During Major Incident Medical Management and Support Courses, 91 learners were randomly distributed into one of two training groups: 44 participants practiced triage sieve protocol using a card-sort exercise, whilst the remaining 47 participants used a serious game. Following the training sessions, each participant undertook an evaluation exercise, whereby they were required to triage eight casualties in a simulated live exercise. Performance was assessed in terms of tagging accuracy (assigning the correct triage tag to the casualty), step accuracy (following correct procedure) and time taken to triage all casualties. Additionally, the usability of both the card-sort exercise and video game were measured using a questionnaire. Tagging accuracy by participants who underwent the serious game training was significantly higher than those who undertook the card-sort exercise [Chi2=13.126, p=0.02]. Step accuracy was also higher in the serious game group but only for the numbers of participants that followed correct procedure when triaging all eight casualties [Chi2=5.45, p=0.0196]. There was no significant difference in time to triage all casualties (card-sort=435+/-74 s vs video game=456+/-62 s, p=0.155). Serious game technologies offer the potential to enhance learning and improve subsequent performance when compared to traditional educational methods. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Economic analysis of human papillomavirus triage, repeat cytology, and immediate colposcopy in management of women with minor cytological abnormalities in Sweden.

Science.gov (United States)

Ostensson, Ellinor; Fröberg, Maria; Hjerpe, Anders; Zethraeus, Niklas; Andersson, Sonia

2010-10-01

To assess the cost-effectiveness of using human papillomavirus testing (HPV triage) in the management of women with minor cytological abnormalities in Sweden. An economic analysis based on a clinical trial, complemented with data from published meta-analyses on accuracy of HPV triage. The study takes perspective of the Swedish healthcare system. The Swedish population-based cervical cancer screening program. A decision analytic model was constructed to evaluate cost-effectiveness of HPV triage compared to repeat cytology and immediate colposcopy with biopsy, stratifying by index cytology (ASCUS = atypical squamous cells of undetermined significance, and LSIL = low-grade squamous intraepithelial lesion) and age (23-60 years, cytological abnormalities. Today, immediate colposcopy with biopsy is a cost-effective alternative compared to HPV triage and repeat cytology.

Decision analytic model exploring the cost and cost-offset implications of street triage.

Science.gov (United States)

Heslin, Margaret; Callaghan, Lynne; Packwood, Martin; Badu, Vincent; Byford, Sarah

2016-02-11

To determine if street triage is effective at reducing the total number of people with mental health needs detained under section 136, and is associated with cost savings compared to usual police response. Routine data from a 6-month period in the year before and after the implementation of a street triage scheme were used to explore detentions under section 136, and to populate a decision analytic model to explore the impact of street triage on the cost to the NHS and the criminal justice sector of supporting people with a mental health need. A predefined area of Sussex, South East England, UK. All people who were detained under section 136 within the predefined area or had contact with the street triage team. The street triage model used here was based on a psychiatric nurse attending incidents with a police constable. The primary outcome was change in the total number of detentions under section 136 between the before and after periods assessed. Secondary analysis focused on whether the additional costs of street triage were offset by cost savings as a result of changes in detentions under section 136. Detentions under section 136 in the street triage period were significantly lower than in the usual response period (118 vs 194 incidents, respectively; χ(2) (1df) 18.542, p<0.001). Total NHS and criminal justice costs were estimated to be £1043 in the street triage period compared to £1077 in the usual response period. Investment in street triage was offset by savings as a result of reduced detentions under section 136, particularly detentions in custody. Data available did not include assessment of patient outcomes, so a full economic evaluation was not possible. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Smart GSM Based Home Automation System

OpenAIRE

Teymourzadeh, Rozita

2013-01-01

This research work investigates the potential of ‘Full Home Control’, which is the aim of the Home Automation Systems in near future. The analysis and implementation of the home automation technology using Global System for Mobile Communication (GSM) modem to control home appliances such as light, conditional system, and security system via Short Message Service (SMS) text messages is presented in this paper. The proposed research work is focused on the functionality of the GSM protocol, whic...

47 CFR 80.54 - Automated Maritime Telecommunications System (AMTS)-System Licensing.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Automated Maritime Telecommunications System (AMTS)-System Licensing. 80.54 Section 80.54 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... § 80.54 Automated Maritime Telecommunications System (AMTS)—System Licensing. AMTS licensees will be...

Survey and comparison of automated UT systems

International Nuclear Information System (INIS)

Neeley, V.I.; Avioli, M.J.

1988-01-01

In the past decade, the limitations of manual UT inspections have become more severe and adverse. Perhaps the best evidence of this has been the problem of intergranular stress corrosion cracking (IGSCC) in boiling water reactors (BWR). The onset of this problem clearly showed that better and more sophisticated UT inspection methods must be developed to assure the industry that an appropriate level of inspection integrity could be maintained. While automated UT inspection systems have been under development for some time, this event certainly spurred this activity and has resulted in a variety of commercial systems. The intent of this project, sponsored by EPRI, is to develop a utility engineer's 'Buyer guide' to automated UT systems. Comparison of different automated UT systems along with results of questionnaires on manual UT versus automated UT costs and effectiveness are reviewed. (author)

A control system verifier using automated reasoning software

International Nuclear Information System (INIS)

Smith, D.E.; Seeman, S.E.

1985-08-01

An on-line, automated reasoning software system for verifying the actions of other software or human control systems has been developed. It was demonstrated by verifying the actions of an automated procedure generation system. The verifier uses an interactive theorem prover as its inference engine with the rules included as logical axioms. Operation of the verifier is generally transparent except when the verifier disagrees with the actions of the monitored software. Testing with an automated procedure generation system demonstrates the successful application of automated reasoning software for verification of logical actions in a diverse, redundant manner. A higher degree of confidence may be placed in the verified actions of the combined system

A study of automated self-assessment in a primary care student health centre setting.

Science.gov (United States)

Poote, Aimee E; French, David P; Dale, Jeremy; Powell, John

2014-04-01

We evaluated the advice given by a prototype self-assessment triage system in a university student health centre. Students attending the health centre with a new problem used the automated self-assessment system prior to a face-to-face consultation with the general practitioner (GP). The system's rating of urgency was available to the GP, and following the consultation, the GP recorded their own rating of the urgency of the patient's presentation. Full data were available for 154 of the 207 consultations. Perfect agreement, where both the GP and the self-assessment system selected the same category of advice, occurred in 39% of consultations. The association between the GP assessment and the self-assessment rankings of urgency was low but significant (rho = 0.19, P = 0.016). The self-assessment system tended to be risk averse compared to the GP assessments, with advice for more urgent level of care seeking being recommended in 86 consultations (56%) and less urgent advice in only 8 (5%). This difference in assessment of urgency was significant (P self-assessment system was more risk averse than the GPs, which resulted in a high proportion of patients being triaged as needing emergency or immediate care, the self-assessment system successfully identified a proportion of patients who were felt by the GP to have a self-limiting condition that did not need a consultation. In its prototype form, the self-assessment system was not a replacement for clinician assessment and further refinement is necessary.

Reliability of the primary triage process after the volendam fire disaster

NARCIS (Netherlands)

Welling, Lieke; van Harten, Sabine M.; Henny, C. Pieter; Mackie, Dave P.; Ubbink, Dirk T.; Kreis, Robert W.; Trouwborst, Ad

2008-01-01

In a major incident, correct triage is crucial to emergency treatment and transportation priority. The aim of this study was to evaluate the triage process pursued at the site of the fire disaster in Volendam, the Netherlands on January 1, 2001. On-site (OS) and Emergency Department (ED) data

Automated imaging system for single molecules

Science.gov (United States)

Schwartz, David Charles; Runnheim, Rodney; Forrest, Daniel

2012-09-18

There is provided a high throughput automated single molecule image collection and processing system that requires minimal initial user input. The unique features embodied in the present disclosure allow automated collection and initial processing of optical images of single molecules and their assemblies. Correct focus may be automatically maintained while images are collected. Uneven illumination in fluorescence microscopy is accounted for, and an overall robust imaging operation is provided yielding individual images prepared for further processing in external systems. Embodiments described herein are useful in studies of any macromolecules such as DNA, RNA, peptides and proteins. The automated image collection and processing system and method of same may be implemented and deployed over a computer network, and may be ergonomically optimized to facilitate user interaction.

Application of a first impression triage in the Japan railway west disaster.

Science.gov (United States)

Hashimoto, Atsunori; Ueda, Takahiro; Kuboyama, Kazutoshi; Yamada, Taihei; Terashima, Mariko; Miyawaki, Atsushi; Nakao, Atsunori; Kotani, Joji

2013-01-01

On April 25, 2005, a Japanese express train derailed into a building, resulting in 107 deaths and 549 injuries. We used "First Impression Triage (FIT)", our new triage strategy based on general inspection and palpation without counting pulse/respiratory rates, and determined the feasibility of FIT in the chaotic situation of treating a large number of injured people in a brief time period. The subjects included 39 patients who required hospitalization among 113 victims transferred to our hospital. After initial assessment with FIT by an emergency physician, patients were retrospectively reassessed with the preexisting the modified Simple Triage and Rapid Treatment (START) methodology, based on Injury Severity Score, probability of survival, and ICU stay. FIT resulted in shorter waiting time for triage. FIT designations comprised 11 red (immediate), 28 yellow (delayed), while START assigned six to red and 32 to yellow. There were no statistical differences between FIT and START in the accuracy rate calculated by means of probability of survival and ICU stay. Overall validity and reliability of FIT determined by outcome assessment were similar to those of START. FIT would be a simple and accurate technique to quickly triage a large number of patients.

Future of Automated Insulin Delivery Systems.

Science.gov (United States)

Castle, Jessica R; DeVries, J Hans; Kovatchev, Boris

2017-06-01

Advances in continuous glucose monitoring (CGM) have brought on a paradigm shift in the management of type 1 diabetes. These advances have enabled the automation of insulin delivery, where an algorithm determines the insulin delivery rate in response to the CGM values. There are multiple automated insulin delivery (AID) systems in development. A system that automates basal insulin delivery has already received Food and Drug Administration approval, and more systems are likely to follow. As the field of AID matures, future systems may incorporate additional hormones and/or multiple inputs, such as activity level. All AID systems are impacted by CGM accuracy and future CGM devices must be shown to be sufficiently accurate to be safely incorporated into AID. In this article, we summarize recent achievements in AID development, with a special emphasis on CGM sensor performance, and discuss the future of AID systems from the point of view of their input-output characteristics, form factor, and adaptability.

Facilitating Automation Development in Internal Logistics Systems

OpenAIRE

Granlund, Anna

2014-01-01

The internal logistics system includes all activities connected with managing the flow of materials within the physical limits of a facility. This system is an important part of operations in need of increased focus and continuous improvements. Automation is one possible tool with a previously confirmed great potential to improve internal logistics. Despite this great potential and a growing trend of using automation in the area, internal logistics activities are still not automated to the sa...

A sensor-based automation system for handling nuclear materials

International Nuclear Information System (INIS)

Drotning, W.; Kimberly, H.; Wapman, W.; Darras, D.

1997-01-01

An automated system is being developed for handling large payloads of radioactive nuclear materials in an analytical laboratory. The automation system performs unpacking and repacking of payloads from shipping and storage containers, and delivery of the payloads to the stations in the laboratory. The system uses machine vision and force/torque sensing to provide sensor-based control of the automation system in order to enhance system safety, flexibility, and robustness, and achieve easy remote operation. The automation system also controls the operation of the laboratory measurement systems and the coordination of them with the robotic system. Particular attention has been given to system design features and analytical methods that provide an enhanced level of operational safety. Independent mechanical gripper interlock and tool release mechanisms were designed to prevent payload mishandling. An extensive Failure Modes and Effects Analysis of the automation system was developed as a safety design analysis tool

22 CFR 120.30 - The Automated Export System (AES).

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false The Automated Export System (AES). 120.30... DEFINITIONS § 120.30 The Automated Export System (AES). The Automated Export System (AES) is the Department of... system for collection of export data for the Department of State. In accordance with this subchapter U.S...

21 CFR 864.5620 - Automated hemoglobin system.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated hemoglobin system. 864.5620 Section 864.5620 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Automated and Semi-Automated Hematology Devices § 864...

MiRTE: Mixed Reality Triage and Evacuation game for Mass Casualty information systems design, testing and training.

Science.gov (United States)

Yu, Xunyi; Ganz, Aura

2011-01-01

In this paper we introduce a Mixed Reality Triage and Evacuation game, MiRTE, that is used in the development, testing and training of Mass Casualty Incident (MCI) information systems for first responders. Using the Source game engine from Valve software, MiRTE creates immersive virtual environments to simulate various incident scenarios, and enables interactions between multiple players/first responders. What distinguishes it from a pure computer simulation game is that it can interface with external mass casualty incident management systems, such as DIORAMA. The game will enable system developers to specify technical requirements of underlying technology, and test different alternatives of design. After the information system hardware and software are completed, the game can simulate various algorithms such as localization technologies, and interface with an actual user interface on PCs and Smartphones. We implemented and tested the game with the DIORAMA system.

Assessing the reliability and accuracy of nurse triage ratings when using the South African Triage Scale in the Emergency Department of District Headquarter Hospital of Timergara, Pakistan

Directory of Open Access Journals (Sweden)

M. Dalwai*

2013-12-01

Conclusion: The SATS has been shown to be a reliable triage scale for a developing country such as Pakistan. With accuracy being acceptable in the context of Timergara, we would suggest further validation studies looking at simple ways of validating the triage scale bearing in mind the challenges facing a developing country ED.

Implementation of a Prehospital Triage System for Patients With Chest Pain and Logistics for Primary Percutaneous Coronary Intervention in the Region of Amsterdam, The Netherlands

NARCIS (Netherlands)

Adams, Rob; Appelman, Yolande; Bronzwaer, Jean G.; Slagboom, Ton; Amoroso, Giovanni; van Exter, Pieternel; Tijssen, G. P. Jan; de Winter, Robbert J.

2010-01-01

We aimed to describe the logistics of a prehospital triage system for patients with acute chest pain in the region of Amsterdam, The Netherlands. Ambulance electrocardiograms (ECGs) were evaluated immediately in 1 of the percutaneous coronary intervention (PCI)-capable centers. Patients accepted for

[Unmanned aerial vehicles: usefulness for victim searches and triage in disasters].

Science.gov (United States)

Pardo Ríos, Manuel; Pérez Alonso, Nuria; Lasheras Velasco, Joaquín; Juguera Rodríguez, Laura; López Ayuso, Belén; Muñoz Solera, Rubén; Martínez Riquelme, Carolina; Nieto Fernández-Pacheco, Antonio

2016-01-01

To analyze the influence of drones equipped with thermal cameras for finding victims and aiding triage during disasters. We carried out a prospective, cross-sectional analysis and 6 experimental simulations, each with 25 victims to locate and triage. Nurses were randomized to a control group or a drone group. Drone-group nurses were given access to images from the thermal cameras 10 minutes before the exercise started. The mean (SD) distance the nurses searched in the control group (1091.11 [146.41] m) was significantly greater than the distance searched by nurses in the drone group (920 [ 71.93] m (P = .0031). The control group found a mean of 66.7% of the victims, a significantly smaller percentage than the drone group's mean of 92% (P = .0001). Triage quality (undertriage and overtriage) was similar in the 2 groups as shown by maneuvers undertaken to open airways and control bleeding. Drones with thermal cameras were useful in searching for victims of simulated disasters in this study, although they had no impact on the quality of the nurses' triage.

Virtual reality and live simulation: a comparison between two simulation tools for assessing mass casualty triage skills.

Science.gov (United States)

Luigi Ingrassia, Pier; Ragazzoni, Luca; Carenzo, Luca; Colombo, Davide; Ripoll Gallardo, Alba; Della Corte, Francesco

2015-04-01

This study tested the hypothesis that virtual reality simulation is equivalent to live simulation for testing naive medical students' abilities to perform mass casualty triage using the Simple Triage and Rapid Treatment (START) algorithm in a simulated disaster scenario and to detect the improvement in these skills after a teaching session. Fifty-six students in their last year of medical school were randomized into two groups (A and B). The same scenario, a car accident, was developed identically on the two simulation methodologies: virtual reality and live simulation. On day 1, group A was exposed to the live scenario and group B was exposed to the virtual reality scenario, aiming to triage 10 victims. On day 2, all students attended a 2-h lecture on mass casualty triage, specifically the START triage method. On day 3, groups A and B were crossed over. The groups' abilities to perform mass casualty triage in terms of triage accuracy, intervention correctness, and speed in the scenarios were assessed. Triage and lifesaving treatment scores were assessed equally by virtual reality and live simulation on day 1 and on day 3. Both simulation methodologies detected an improvement in triage accuracy and treatment correctness from day 1 to day 3 (PVirtual reality simulation proved to be a valuable tool, equivalent to live simulation, to test medical students' abilities to perform mass casualty triage and to detect improvement in such skills.

Algorithmic Approach With Clinical Pathology Consultation Improves Access to Specialty Care for Patients With Systemic Lupus Erythematosus.

Science.gov (United States)

Chen, Lei; Welsh, Kerry J; Chang, Brian; Kidd, Laura; Kott, Marylee; Zare, Mohammad; Carroll, Kelley; Nguyen, Andy; Wahed, Amer; Tholpady, Ashok; Pung, Norin; McKee, Donna; Risin, Semyon A; Hunter, Robert L

2016-09-01

Harris Health System (HHS) is a safety net system providing health care to the underserved of Harris County, Texas. There was a 6-month waiting period for a rheumatologist consult for patients with suspected systemic lupus erythematosus (SLE). The objective of the intervention was to improve access to specialty care. An algorithmic approach to testing for SLE was implemented initially through the HHS referral center. The algorithm was further offered as a "one-click" order for physicians, with automated reflex testing, interpretation, and case triaging by clinical pathology. Data review revealed that prior to the intervention, 80% of patients did not have complete laboratory workups available at the first rheumatology visit. Implementation of algorithmic testing and triaging of referrals by pathologists resulted in decreasing the waiting time for a rheumatologist by 50%. Clinical pathology intervention and case triaging can improve access to care in a county health care system. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Automated Vehicle Monitoring System

OpenAIRE

Wibowo, Agustinus Deddy Arief; Heriansyah, Rudi

2014-01-01

An automated vehicle monitoring system is proposed in this paper. The surveillance system is based on image processing techniques such as background subtraction, colour balancing, chain code based shape detection, and blob. The proposed system will detect any human's head as appeared at the side mirrors. The detected head will be tracked and recorded for further action.

The Value of Initial Ionized Calcium as a Predictor of Mortality and Triage Tool in Adult Trauma Patients

OpenAIRE

Choi, Young Cheol; Hwang, Seong Youn

2008-01-01

Ionized hypocalcemia is a common finding in critically ill patients, but the relationship between ionized hypocalcemia and mortality risk in trauma patients has not been well established. The aim of this study was to assess the usefulness of initial ionized calcium (iCa) in predicting mortality in the trauma population, and evaluate its superiority over the three other triage tools: base deficit, systemic inflammatory response syndrome (SIRS) score, and triage-revised trauma score (t-RTS). A ...

Test Results for the Automated Rendezvous and Capture System

Science.gov (United States)

Cruzen, Craig; Dabney, Richard; Lomas, James

1999-01-01

The Automated Rendezvous and Capture (AR&C) system was designed and tested at NASA's Marshall Space Flight Center (MSFC) to demonstrate technologies and mission strategies for automated rendezvous and docking of spacecraft in Earth orbit, The system incorporates some of the latest innovations in Global Positioning, System space navigation, laser sensor technologies and automated mission sequencing algorithms. The system's initial design and integration was completed in 1998 and has undergone testing at MSFC. This paper describes the major components of the AR&C system and presents results from the official system tests performed in MSFC's Flight Robotics Laboratory with digital simulations and hardware in the loop tests. The results show that the AR&C system can safely and reliably perform automated rendezvous and docking missions in the absence of system failures with 100 percent success. When system failures are included, the system uses its automated collision avoidance maneuver logic to recover in a safe manner. The primary objective of the AR&C project is to prove that by designing a safe and robust automated system, mission operations cost can be reduced by decreasing the personnel required for mission design, preflight planning and training required for crewed rendezvous and docking missions.

The accuracy and consistency of rural, remote and outpost triage nurse decision making in one Western Australia Country Health Service Region.

Science.gov (United States)

Ekins, Kylie; Morphet, Julia

2015-11-01

The Australasian Triage Scale aims to ensure that the triage category allocated, reflects the urgency with which the patient needs medical assistance. This is dependent on triage nurse accuracy in decision making. The Australasian Triage Scale also aims to facilitate triage decision consistency between individuals and organisations. Various studies have explored the accuracy and consistency of triage decisions throughout Australia, yet no studies have specifically focussed on triage decision making in rural health services. Further, no standard has been identified by which accuracy or consistency should be measured. Australian emergency departments are measured against a set of standard performance indicators, including time from triage to patient review, and patient length of stay. There are currently no performance indicators for triage consistency. An online questionnaire was developed to collect demographic data and measure triage accuracy and consistency. The questionnaire utilised previously validated triage scenarios.(1) Triage decision accuracy was measured, and consistency was compared by health site type using Fleiss' kappa. Forty-six triage nurses participated in this study. The accuracy of participants' triage decision-making decreased with each less urgent triage category. Post-graduate qualifications had no bearing on triage accuracy. There was no significant difference in the consistency of decision-making between paediatric and adult scenarios. Overall inter-rater agreement using Fleiss' kappa coefficient, was 0.4. This represents a fair-to-good level of inter-rater agreement. A standard definition of accuracy and consistency in triage nurse decision making is required. Inaccurate triage decisions can result in increased morbidity and mortality. It is recommended that emergency department performance indicator thresholds be utilised as a benchmark for national triage consistency. Crown Copyright © 2015. Published by Elsevier Ltd. All rights

Status of automated nuclear scanning systems

International Nuclear Information System (INIS)

Gold, R.; Roberts, J.H.; Preston, C.C.; McNeece, J.P.; Ruddy, F.H.

1983-07-01

Present day minicomputers and microprocessors enable a range of automation, from partial to total, of tasks once thought beyond approach. The status of three computer controlled systems for quantitative track measurements is reviewed. Two systems, the Hanford optical track scanner (HOTS) and an automated scanning electron microscope (ASEM) are used for scanning solid state track recorders (SSTR). The third systems, the emulsion scanning processor (ESP), is an interactive system used to measure the length of proton tracks in nuclear research emulsions (NRE). Current limitations of these systems for quantitative track scanning are presented. Experimental uncertainties attained with these computer controlled systems are described using results obtained from reactor neutron dosimetry

The accuracy of nurse performance of the triage process in a tertiary ...

African Journals Online (AJOL)

The accuracy of nurse performance of the triage process in a tertiary hospital emergency department in Gauteng Province, South Africa. ... discriminator use, numerical miscalculations and other human errors. Quality control and quality assurance measures must target training in these areas to minimise mis-triage in the ED.

Personal computer based home automation system

OpenAIRE

Hellmuth, George F.

1993-01-01

The systems engineering process is applied in the development of the preliminary design of a home automation communication protocol. The objective of the communication protocol is to provide a means for a personal computer to communicate with adapted appliances in the home. A needs analysis is used to ascertain that a need exist for a home automation system. Numerous design alternatives are suggested and evaluated to determine the best possible protocol design. Coaxial cable...

Evaluating the construct of triage acuity against a set of reference vignettes developed via modified Delphi method.

Science.gov (United States)

Twomey, Michèle; Wallis, Lee A; Myers, Jonathan E

2014-07-01

To evaluate the construct of triage acuity as measured by the South African Triage Scale (SATS) against a set of reference vignettes. A modified Delphi method was used to develop a set of reference vignettes. Delphi participants completed a 2-round consensus-building process, and independently assigned triage acuity ratings to 100 written vignettes unaware of the ratings given by others. Triage acuity ratings were summarised for all vignettes, and only those that reached 80% consensus during round 2 were included in the reference set. Triage ratings for the reference vignettes given by two independent experts using the SATS were compared with the ratings given by the international Delphi panel. Measures of sensitivity, specificity, associated percentages for over-triage/under-triage were used to evaluate the construct of triage acuity (as measured by the SATS) by examining the association between the ratings by the two experts and the international panel. On completion of the Delphi process, 42 of the 100 vignettes reached 80% consensus on their acuity rating and made up the reference set. On average, over all acuity levels, sensitivity was 74% (CI 64% to 82%), specificity 92% (CI 87% to 94%), under-triage occurred 14% (CI 8% to 23%) and over-triage 12% (CI 8% to 23%) of the time. The results of this study provide an alternative to evaluating triage scales against the construct of acuity as measured with the SATS. This method of using 80% consensus vignettes may, however, systematically bias the validity estimate towards better performance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Hydrometeorological Automated Data System

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Office of Hydrologic Development of the National Weather Service operates HADS, the Hydrometeorological Automated Data System. This data set contains the last 48...

SARP: a value-based approach to hospice admissions triage.

Science.gov (United States)

MacDonald, D

1995-01-01

As hospices become established and case referrals increase, many programs are faced with the necessity of instituting waiting lists. Prioritizing cases for order of admission requires a triage method that is rational, fair, and consistent. This article describes the SARP method of hospice admissions triage, which evaluates prospective cases according to seniority, acuity, risk, and political significance. SARP's essential features, operative assumptions, advantages, and limitations are discussed, as well as the core hospice values which underlie its use. The article concludes with a call for trial and evaluation of SARP in other hospice settings.

A New Triage Support Tool in Case of Explosion.

Science.gov (United States)

Yavari-Sartakhti, Olivier; Briche, Frédérique; Jost, Daniel; Michaud, Nicolas; Bignand, Michel; Tourtier, Jean-Pierre

2018-04-01

Deafness frequently observed in explosion victims, currently following terrorist attack, is a barrier to communication between victims and first responders. This may result in a delay in the initial triage and evacuation. In such situations, Paris Fire Brigade (Paris, France) proposes the use of assistance cards to help conscious, but deafened patients at the site of an attack where there may be numerous victims. Yavari-Sartakhti O , Briche F , Jost D , Michaud N , Bignand M , Tourtier JP . A new triage support tool in case of explosion. Prehosp Disaster Med. 2018;33(2):213-214.

An automated thermoluminescence dosimetry (TLD) system

International Nuclear Information System (INIS)

Kicken, P.J.H.; Huyskens, C.J.

1979-01-01

In the Health Physics Division of the Eindhoven University of Technology work is going on in developing an automated TLD-system. Process automization, statistical computation, dose calculation as well as dose recording are carried out, using a microcomputer and floppy disk unit. The main features of this TLD-system are its low costs, flexibility, easy to operate, and the feasibility for use in routine dosimetry as well as in complex TLD research. Because of its modular set-up several components of the system are multifunctional in other operations. The system seems suited for medium sized Health Physics groups. (Auth.)

Triage of febrile children at a GP cooperative : determinants of a consultation

NARCIS (Netherlands)

Monteny, Miriam; Berger, Marjolein Y.; van der Wouden, Johannes C.; Broekman, Berth J.; Koes, Bart W.

Background Most febrile children contacting a GP cooperative are seen by a GP, although the incidence of serious illness is low. The guidelines for triage might not be suitable in primary care. Aim To investigate the determinants related to the outcome of triage in febrile children. Design of study

Impact of an ABCDE team triage process combined with public guidance on the division of work in an emergency department.

Science.gov (United States)

Kantonen, Jarmo; Lloyd, Robert; Mattila, Juho; Kauppila, Timo; Menezes, Ricardo

2015-06-01

To study the effects of applying an emergency department (ED) triage system, combined with extensive publicity in local media about the "right" use of emergency services, on the division of work between ED nurses and general practitioners (GPs). An observational and quasi-experimental study based on before-after comparisons. Implementation of the ABCDE triage system in a Finnish combined ED where secondary care is adjacent, and in a traditional primary care ED where secondary care is located elsewhere. GPs and nurses from two different primary care EDs. Numbers of monthly visits to different professional groups before and after intervention in the studied primary care EDs and numbers of monthly visits to doctors in the local secondary care ED. The beginning of the triage process increased temporarily the number of independent consultations and patient record entries by ED nurses in both types of studied primary care EDs and reduced the number of patient visits to a doctor compared with previous years but had no effect on doctor visits in the adjacent secondary care ED. No further decrease in the number of nurse or GP visits was observed by inhibiting the entrance of non-urgent patients. The ABCDE triage system combined with public guidance may reduce non-urgent patient visits to doctors in different kinds of primary care EDs without increasing visits in the secondary care ED. However, the additional work to implement the ABCDE system is mainly directed to nurses, which may pose a challenge for staffing.

Using robotic telecommunications to triage pediatric disaster victims.

Science.gov (United States)

Burke, Rita V; Berg, Bridget M; Vee, Paul; Morton, Inge; Nager, Alan; Neches, Robert; Wetzel, Randall; Upperman, Jeffrey S

2012-01-01

During a disaster, hospitals may be overwhelmed and have an insufficient number of pediatric specialists available to care for injured children. The aim of this study was to determine the feasibility of remotely providing pediatric expertise via a robot to treat pediatric victims. In 2008, Los Angeles County held 2 drills involving telemedicine. The first was the Tri-Hospital drill in which 3 Los Angeles County hospitals, one being a pediatric hospital, participated. The disaster scenario involved a Metrolink train crash, resulting in a large surge of traumatic injuries. The second drill involved multiple agencies and was called the Great California Shakeout, a simulated earthquake exercise. The telemedicine equipment installed is an InTouch Health, Inc, Santa Barbara, CA robotic telecommunications system. We used mixed-methods to evaluate the use of telemedicine during these drills. Pediatric specialists successfully provided remote triage and treatment consults of victims via the robot. The robot proved to be a useful means to extend resources and provide expert consult if pediatric specialists were unable to physically be at the site. Telemedicine can be used in the delayed treatment areas as well as for training first receivers to collaborate with specialists in remote locations to triage and treat seriously injured pediatric victims. Copyright © 2012 Elsevier Inc. All rights reserved.

Ambulance Clinical Triage for Acute Stroke Treatment: Paramedic Triage Algorithm for Large Vessel Occlusion.

Science.gov (United States)

Zhao, Henry; Pesavento, Lauren; Coote, Skye; Rodrigues, Edrich; Salvaris, Patrick; Smith, Karen; Bernard, Stephen; Stephenson, Michael; Churilov, Leonid; Yassi, Nawaf; Davis, Stephen M; Campbell, Bruce C V

2018-04-01

Clinical triage scales for prehospital recognition of large vessel occlusion (LVO) are limited by low specificity when applied by paramedics. We created the 3-step ambulance clinical triage for acute stroke treatment (ACT-FAST) as the first algorithmic LVO identification tool, designed to improve specificity by recognizing only severe clinical syndromes and optimizing paramedic usability and reliability. The ACT-FAST algorithm consists of (1) unilateral arm drift to stretcher <10 seconds, (2) severe language deficit (if right arm is weak) or gaze deviation/hemineglect assessed by simple shoulder tap test (if left arm is weak), and (3) eligibility and stroke mimic screen. ACT-FAST examination steps were retrospectively validated, and then prospectively validated by paramedics transporting culturally and linguistically diverse patients with suspected stroke in the emergency department, for the identification of internal carotid or proximal middle cerebral artery occlusion. The diagnostic performance of the full ACT-FAST algorithm was then validated for patients accepted for thrombectomy. In retrospective (n=565) and prospective paramedic (n=104) validation, ACT-FAST displayed higher overall accuracy and specificity, when compared with existing LVO triage scales. Agreement of ACT-FAST between paramedics and doctors was excellent (κ=0.91; 95% confidence interval, 0.79-1.0). The full ACT-FAST algorithm (n=60) assessed by paramedics showed high overall accuracy (91.7%), sensitivity (85.7%), specificity (93.5%), and positive predictive value (80%) for recognition of endovascular-eligible LVO. The 3-step ACT-FAST algorithm shows higher specificity and reliability than existing scales for clinical LVO recognition, despite requiring just 2 examination steps. The inclusion of an eligibility step allowed recognition of endovascular-eligible patients with high accuracy. Using a sequential algorithmic approach eliminates scoring confusion and reduces assessment time. Future

Under-triage in telephone consultation is related to non-normative symptom description and interpersonal communication: a mixed methods study.

Science.gov (United States)

Gamst-Jensen, Hejdi; Lippert, Freddy K; Egerod, Ingrid

2017-05-15

Telephone consultation and triage are used to limit the workload on emergency departments. Lack of visual cues and clinical tests put telephone consultations to a disadvantage compared to face-to-face consultations increasing the risk of under-triage. Under-triage occurs in telephone triage; however why under-triage happens is not explored yet. The aim of the study was to describe situations of under-triage in context, to assess the quality of under-triaged calls, and to identify communication patterns contributing to under-triage in a regional OOH service in the capital region of Denmark. Explanatory simultaneous mixed method with thematic analysis and descriptive statistics was chosen. The study was carried out in an Out-Of-Hours service (OOH) in the Capital Region of Denmark, Copenhagen. Under-triage was defined as Potentially Under-Triaged Calls (PUTC) by specific criteria to an OOH Hotline, and identification by integration of three databases: Medical Hotline database, Emergency number database, including the Ambulance database, and electronic patient records. Distribution of PUTC were carried out using ICD-10 codes to identify diagnosis and main themes identified by qualitative analysis of audio recorded under-triaged calls. Study period was October 15 th to November 30 th 2014. Three hundred twenty seven PUTC were identified, representing 0.04% of all calls (n = 937.056) to the OOH. Distribution of PUTC according to diagnoses was: digestive (24%), circulatory (19%), respiratory (15%) and all others (42%). Thematic analysis of the voice logs suggested that inadequate communication and non-normative symptom description contributed to under-triage. The incidence of potentially under-triage is low (0.04%). However, the over-representation of digestive, circulatory, and respiratory diagnoses might suggest that under-triage is related to inadequate symptom description. We recommend that caller and call-handler collaborate systematically on problem

Systematic Review of Real-time Remote Health Monitoring System in Triage and Priority-Based Sensor Technology: Taxonomy, Open Challenges, Motivation and Recommendations.

Science.gov (United States)

Albahri, O S; Albahri, A S; Mohammed, K I; Zaidan, A A; Zaidan, B B; Hashim, M; Salman, Omar H

2018-03-22

The new and ground-breaking real-time remote monitoring in triage and priority-based sensor technology used in telemedicine have significantly bounded and dispersed communication components. To examine these technologies and provide researchers with a clear vision of this area, we must first be aware of the utilised approaches and existing limitations in this line of research. To this end, an extensive search was conducted to find articles dealing with (a) telemedicine, (b) triage, (c) priority and (d) sensor; (e) comprehensively review related applications and establish the coherent taxonomy of these articles. ScienceDirect, IEEE Xplore and Web of Science databases were checked for articles on triage and priority-based sensor technology in telemedicine. The retrieved articles were filtered according to the type of telemedicine technology explored. A total of 150 articles were selected and classified into two categories. The first category includes reviews and surveys of triage and priority-based sensor technology in telemedicine. The second category includes articles on the three-tiered architecture of telemedicine. Tier 1 represents the users. Sensors acquire the vital signs of the users and send them to Tier 2, which is the personal gateway that uses local area network protocols or wireless body area network. Medical data are sent from Tier 2 to Tier 3, which is the healthcare provider in medical institutes. Then, the motivation for using triage and priority-based sensor technology in telemedicine, the issues related to the obstruction of its application and the development and utilisation of telemedicine are examined on the basis of the findings presented in the literature.

An evaluation of the use of the South African Triage Scale in an ...

African Journals Online (AJOL)

S Soogun

Conclusion: Nurse-led triage has been successfully implemented at the emergency centre of this hospital using SATS ... points for hospital care for patients referred by local clinics, ..... made decisions on the final triage score in 7.5% of cases.

Home Automation System Using Capacitive Touchscreen

OpenAIRE

Yash Inaniya; Naresh Kumari

2014-01-01

Technology has been constantly evolving and with the advent of touchscreen in human life , devices are much easier and simple to operate. This work is mainly focused on building home automation system which is more user friendly and thus can be operated by anyone. Earlier home automation systems were completely mechanically operated and thus required a lot of maintenance and were costly also. Now that human and computer interaction has been developed into a more wide and sophi...

Application of automated reasoning software: procedure generation system verifier

International Nuclear Information System (INIS)

Smith, D.E.; Seeman, S.E.

1984-09-01

An on-line, automated reasoning software system for verifying the actions of other software or human control systems has been developed. It was demonstrated by verifying the actions of an automated procedure generation system. The verifier uses an interactive theorem prover as its inference engine with the rules included as logic axioms. Operation of the verifier is generally transparent except when the verifier disagrees with the actions of the monitored software. Testing with an automated procedure generation system demonstrates the successful application of automated reasoning software for verification of logical actions in a diverse, redundant manner. A higher degree of confidence may be placed in the verified actions gathered by the combined system

Wireless Home Automation System using IoT

Directory of Open Access Journals (Sweden)

Alexandra MIHALACHE

2017-01-01

Full Text Available Nowadays, the chance of having an automated home is no longer a fancy luxury, but a reality accessible to a wide range of consumers, because smart home systems have replaced those that only automated the home in the past. More and more solutions based on IoT are being devel-oped to transform homes into smart ones, but the problem is that the benefits of home automa-tion are still not clear to everyone as they are not promoted enough, so we cannot talk about a broad mass of consumers already using integrated or DIY solutions to improve their lives. In this paper, I will present a home automation system using Arduino Uno integrated with rele-vant modules which are used to allow remote control of lights or fans, changes being made on the basis of different sensors data. The system is designed to be low cost and expandable, bring-ing accessibility, convenience and energy efficiency.

Paediatric triage in South Africa

African Journals Online (AJOL)

2013-05-07

May 7, 2013 ... There has been a lot of interest and work in the field of triage of sick children in South Africa over the past few years. Despite this ... So opens the World Health Organization (WHO)'s Countdown to 2015, the .... walk as normal. 27 or more. 160 or more. Unrespon- sive. Reacts to. Pain ... Each time the IMCI or.

Use of biomarkers in triage of patients with suspected stroke.

Science.gov (United States)

Vanni, Simone; Polidori, Gianluca; Pepe, Giuseppe; Chiarlone, Melisenda; Albani, Alberto; Pagnanelli, Adolfo; Grifoni, Stefano

2011-05-01

The absence of a rapidly available and sensitive diagnostic test represents an important limitation in the triage of patients with suspected stroke. The aim of the present study was to investigate the triage accuracy of a novel test that measures blood-borne biomarkers (triage stroke panel, TSP) and to compare its accuracy with that of the Cincinnati Prehospital Stroke Scale (CPSS). Consecutive patients with suspected stroke presenting to the Emergency Departments of three Italian hospitals underwent triage by a trained nurse according to the CPSS and had blood drawn for TSP testing. The TSP simultaneously measures four markers (B-type natriuretic peptide, D-dimer, matrix metalloproteinase-9, and S100β) presenting a single composite result, the Multimarker Index (MMX). Stroke diagnosis was established by an expert committee blinded to MMX and CPSS results. There were 155 patients enrolled, 87 (56%) of whom had a final diagnosis of stroke. The area under the receiver operating characteristic (ROC) curve for CPSS was 0.77 (95% confidence interval [CI] 0.70-0.84) and that of MMX was 0.74 (95% CI 0.66-0.82) (p = 0.285). Thus, both tests, when used alone, failed to recognize approximately 25% of strokes. The area under the ROC curve of the combination of the two tests (0.86, 95% CI 0.79-0.91) was significantly greater than that of either single test (p = 0.01 vs. CPSS and p vs. TSP). In an emergency care setting, a panel test using multiple biochemical markers showed triage accuracy similar to that of CPSS. Further studies are needed before biomarkers can be introduced in the clinical work-up of patients with suspected stroke. Copyright © 2011 Elsevier Inc. All rights reserved.

Automated 741 document preparation: Oak Ridge National Laboratory's Automated Safeguards Information System (OASIS)

International Nuclear Information System (INIS)

Austin, H.C.; Gray, L.M.

1982-01-01

OASIS has been providing for Oak Ridge National Laboratory's total safeguards needs since being place on line in April 1980. The system supports near real-time nuclear materials safeguards and accountability control. The original design of OASIS called for an automated facsimile of a 741 document to be prepared as a functional by-product of updating the inventory. An attempt was made to utilize, intact, DOE-Albuquerque's automated 741 system to generate the facsimile; however, the five page document produced proved too cumbersome. Albuquerque's programs were modified to print an original 741 document utilizing standard DOE/NRC 741 forms. It is felt that the best features of both the automated and manually generated 741 documents have been incorporated. Automation of the source data for 741 shipping documents produces greater efficiency while reducing possible errors. Through utilization of the standard DOE/NRC form, continuity within the NMMSS system is maintained, thus minimizing the confusion and redundancy associated with facsimiles. OASIS now fulfills the original concept of near real-time accountability by furnishing a viable 741 document as a function of updating the inventory

Automated activation-analysis system

International Nuclear Information System (INIS)

Minor, M.M.; Hensley, W.K.; Denton, M.M.; Garcia, S.R.

1981-01-01

An automated delayed neutron counting and instrumental neutron activation analysis system has been developed at Los Alamos National Laboratory's Omega West Reactor (OWR) to analyze samples for uranium and 31 additional elements with a maximum throughput of 400 samples per day. The system and its mode of operation for a large reconnaissance survey are described

Development of design principles for automated systems in transport control.

Science.gov (United States)

Balfe, Nora; Wilson, John R; Sharples, Sarah; Clarke, Theresa

2012-01-01

This article reports the results of a qualitative study investigating attitudes towards and opinions of an advanced automation system currently used in UK rail signalling. In-depth interviews were held with 10 users, key issues associated with automation were identified and the automation's impact on the signalling task investigated. The interview data highlighted the importance of the signallers' understanding of the automation and their (in)ability to predict its outputs. The interviews also covered the methods used by signallers to interact with and control the automation, and the perceived effects on their workload. The results indicate that despite a generally low level of understanding and ability to predict the actions of the automation system, signallers have developed largely successful coping mechanisms that enable them to use the technology effectively. These findings, along with parallel work identifying desirable attributes of automation from the literature in the area, were used to develop 12 principles of automation which can be used to help design new systems which better facilitate cooperative working. The work reported in this article was completed with the active involvement of operational rail staff who regularly use automated systems in rail signalling. The outcomes are currently being used to inform decisions on the extent and type of automation and user interfaces in future generations of rail control systems.

Automated clearing system and the banking sector performance: the ...

African Journals Online (AJOL)

Automated clearing system and the banking sector performance: the Nigerian experience. ... Abstract. This study investigated the impact of automated clearing system on the Nigerian banking system. ... AJOL African Journals Online. HOW TO ...

Triage Simulation in a Virtual Environment

NARCIS (Netherlands)

Dumay, A.C.M.

1995-01-01

Triage is the assessment of physical conditions of casualties with limited support of staff and equipment. The critical factor in handling a mass casualty situation is time. The focus is on the quick and accurate assessment of the physical conditions of casualties and the application of life-saving

Cost analysis and provider satisfaction with pediatrician in triage.

Science.gov (United States)

Kezirian, Janice; Muhammad, Warees T; Wan, Jim Y; Godambe, Sandip A; Pershad, Jay

2012-10-01

The goals of this study were to (1) conduct a cost-benefit analysis, from a hospital's perspective, of using a pediatrician in triage (PIT) in the emergency department (ED) and (2) assess the impact of a physician in triage on provider satisfaction. This was a prospective, controlled trial of PIT (intervention) versus conventional registered nurse-driven triage (control), at an urban, academic, tertiary level pediatric ED, which led to a cost-benefit analysis by looking at the effect that PIT has on length of stay (LOS) and thus on ED revenue. Provider satisfaction was assessed through surveys. During the 8-week study period, a total of 6579 patients were triaged: 3242 in the PIT group and 3337 in the control group. The 2 groups were similar in age, sex, admission rate, left-without-being-seen rate, and level of acuity. The mean LOS in the PIT group was 24.3 minutes shorter than in the control group. The costs of PIT seem to be increased and are not offset by savings; the net margin (total revenue minus costs) was $42,883 per year lower in the PIT than in the control group. Sensitivity analysis showed that if the LOS were reduced by more than 98.4 minutes, the cost savings would favor PIT. Most of the physicians and nurses (67%) reported that PIT facilitated their job. Placement of a PIT during periods of peak census resulted in shorter stay and notable provider satisfaction but at an incremental cost of $42,883 per year.

Adoption of automated livestock production systems in Northern Europe

DEFF Research Database (Denmark)

Pedersen, Søren Marcus; Lind, Kim Martin Hjorth

2014-01-01

In the last decades the development of automated systems in livestock production has gained increasing interest among farmers. A combined use of computers and sensor systems has lead the development into new research areas with automated milking systems, grain drying systems and automated feeding...... on the relationship and adoption patterns among these countries. The paper presents the results of the surveyed population, demography, farm structure with livestock production characteristics and farmers use of selected automated systems in livestock production....... systems. The aim of this paper is to present the results of a farm survey and cluster analysis that have been made among 4 countries in Europe. This study is based on replies from 413 respondents in Germany (eastern part), Greece, Finland and Denmark, respectively, and the study comments...

Triage Decision Trees and Triage Protocols: Changing Strategies for Medical Rescue in Civilian Mass Casualty Situations.

Science.gov (United States)

1984-02-06

capacity loads. o Passenger instruction in the use of and the design of escape and floatation gear are grossly inadequate. o Hazards change with weather...triage, Canad Anesth Soc J., 27(3) May 80, p. 201 * 52. Cope 0. and Moore F.D., The redistribution of body water in the fluid therapy of the burned

IDAPS (Image Data Automated Processing System) System Description

Science.gov (United States)

1988-06-24

This document describes the physical configuration and components used in the image processing system referred to as IDAPS (Image Data Automated ... Processing System). This system was developed by the Environmental Research Institute of Michigan (ERIM) for Eglin Air Force Base. The system is designed

21 CFR 864.5700 - Automated platelet aggregation system.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated platelet aggregation system. 864.5700 Section 864.5700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Automated and Semi-Automated Hematology Devices...

Automated Classification of Consumer Health Information Needs in Patient Portal Messages.

Science.gov (United States)

Cronin, Robert M; Fabbri, Daniel; Denny, Joshua C; Jackson, Gretchen Purcell

2015-01-01

Patients have diverse health information needs, and secure messaging through patient portals is an emerging means by which such needs are expressed and met. As patient portal adoption increases, growing volumes of secure messages may burden healthcare providers. Automated classification could expedite portal message triage and answering. We created four automated classifiers based on word content and natural language processing techniques to identify health information needs in 1000 patient-generated portal messages. Logistic regression and random forest classifiers detected single information needs well, with area under the curves of 0.804-0.914. A logistic regression classifier accurately found the set of needs within a message, with a Jaccard index of 0.859 (95% Confidence Interval: (0.847, 0.871)). Automated classification of consumer health information needs expressed in patient portal messages is feasible and may allow direct linking to relevant resources or creation of institutional resources for commonly expressed needs.

Implementation and evaluation of an automated dispensing system.

Science.gov (United States)

Schwarz, H O; Brodowy, B A

1995-04-15

An institution's experience in replacing a traditional unit dose cassette-exchange system with an automated dispensing system is described. A 24-hour unit dose cassette-exchange system was replaced with an automated dispensing system (Pyxis's Medstation Rx) on a 36-bed cardiovascular surgery unit and an 8-bed cardiovascular intensive care unit. Significantly fewer missing doses were reported after Medstation Rx was implemented. No conclusions could be made about the impact of the system on the reporting of medication errors. The time savings for pharmacy associated with the filling, checking, and delivery of new medication orders equated to about 0.5 full-time equivalent (FTE). Medstation Rx also saved substantial nursing time for acquisition of controlled substances and for controlled-substance inventory taking at shift changes. A financial analysis showed that Medstation Rx could save the institution about $1 million over five years if all personnel time savings could be translated into FTE reductions. The automated system was given high marks by the nurses in a survey; 80% wanted to keep the system on their unit. Pilot implementation of an automated dispensing system improved the efficiency of drug distribution over that of the traditional unit dose cassette-exchange system.

Development and implementation of a custom integrated database with dashboards to assist with hematopathology specimen triage and traffic

Directory of Open Access Journals (Sweden)

Elizabeth M Azzato

2014-01-01

Full Text Available Background: At some institutions, including ours, bone marrow aspirate specimen triage is complex, with hematopathology triage decisions that need to be communicated to downstream ancillary testing laboratories and many specimen aliquot transfers that are handled outside of the laboratory information system (LIS. We developed a custom integrated database with dashboards to facilitate and streamline this workflow. Methods: We developed user-specific dashboards that allow entry of specimen information by technologists in the hematology laboratory, have custom scripting to present relevant information for the hematopathology service and ancillary laboratories and allow communication of triage decisions from the hematopathology service to other laboratories. These dashboards are web-accessible on the local intranet and accessible from behind the hospital firewall on a computer or tablet. Secure user access and group rights ensure that relevant users can edit or access appropriate records. Results: After database and dashboard design, two-stage beta-testing and user education was performed, with the first focusing on technologist specimen entry and the second on downstream users. Commonly encountered issues and user functionality requests were resolved with database and dashboard redesign. Final implementation occurred within 6 months of initial design; users report improved triage efficiency and reduced need for interlaboratory communications. Conclusions: We successfully developed and implemented a custom database with dashboards that facilitates and streamlines our hematopathology bone marrow aspirate triage. This provides an example of a possible solution to specimen communications and traffic that are outside the purview of a standard LIS.

Automated activation-analysis system

International Nuclear Information System (INIS)

Minor, M.M.; Garcia, S.R.; Denton, M.M.

1982-01-01

An automated delayed neutron counting and instrumental neutron activation analysis system has been developed at Los Alamos National Laboratory's Omega West Reactor (OWR) to analyze samples for uranium and 31 additional elements with a maximum throughput of 400 samples per day

An automated digital imaging system for environmental monitoring applications

Science.gov (United States)

Bogle, Rian; Velasco, Miguel; Vogel, John

2013-01-01

Recent improvements in the affordability and availability of high-resolution digital cameras, data loggers, embedded computers, and radio/cellular modems have advanced the development of sophisticated automated systems for remote imaging. Researchers have successfully placed and operated automated digital cameras in remote locations and in extremes of temperature and humidity, ranging from the islands of the South Pacific to the Mojave Desert and the Grand Canyon. With the integration of environmental sensors, these automated systems are able to respond to local conditions and modify their imaging regimes as needed. In this report we describe in detail the design of one type of automated imaging system developed by our group. It is easily replicated, low-cost, highly robust, and is a stand-alone automated camera designed to be placed in remote locations, without wireless connectivity.

AUTOMATION DESIGN FOR MONORAIL - BASED SYSTEM PROCESSES

Directory of Open Access Journals (Sweden)

Bunda BESA

2016-12-01

Full Text Available Currently, conventional methods of decline development put enormous cost pressure on the profitability of mining operations. This is the case with narrow vein ore bodies where current methods and mine design of decline development may be too expensive to support economic extraction of the ore. According to studies, the time it takes to drill, clean and blast an end in conventional decline development can be up to 224 minutes. This is because once an end is blasted, cleaning should first be completed before drilling can commence, resulting in low advance rates per shift. Improvements in advance rates during decline development can be achieved by application of the Electric Monorail Transport System (EMTS based drilling system. The system consists of the drilling and loading components that use monorail technology to drill and clean the face during decline development. The two systems work simultaneously at the face in such a way that as the top part of the face is being drilled the pneumatic loading system cleans the face. However, to improve the efficiency of the two systems, critical processes performed by the two systems during mining operations must be automated. Automation increases safety and productivity, reduces operator fatigue and also reduces the labour costs of the system. The aim of this paper is, therefore, to describe automation designs of the two processes performed by the monorail drilling and loading systems during operations. During automation design, critical processes performed by the two systems and control requirements necessary to allow the two systems execute such processes automatically have also been identified.

Home Automation and Security System

OpenAIRE

Surinder Kaur,; Rashmi Singh; Neha Khairwal; Pratyk Jain

2016-01-01

Easy Home or Home automation plays a very important role in modern era because of its flexibility in using it at different places with high precision which will save money and time by decreasing human hard work. Prime focus of this technology is to control the household equipment’s like light, fan, door, AC etc. automatically. This research paper has detailed information on Home Automation and Security System using Arduino, GSM and how we can control home appliances using Android application....

DEVELOPMENT OF AUTOMATED SYSTEM OF CLIMATE CONDITIONS MANAGEMENT

Directory of Open Access Journals (Sweden)

Novikova L.V.

2017-12-01

Full Text Available The scientific work is devoted to the analysis and development of the automated control system of the climatic conditions of the minites. The analysis of existing automated control systems is carried out, in particular attention is paid to the systems of climate control of greenhouses. The technical means of the control system are determined. As a platform, Arduino®Uno is selected.

Automated Cryocooler Monitor and Control System Software

Science.gov (United States)

Britchcliffe, Michael J.; Conroy, Bruce L.; Anderson, Paul E.; Wilson, Ahmad

2011-01-01

This software is used in an automated cryogenic control system developed to monitor and control the operation of small-scale cryocoolers. The system was designed to automate the cryogenically cooled low-noise amplifier system described in "Automated Cryocooler Monitor and Control System" (NPO-47246), NASA Tech Briefs, Vol. 35, No. 5 (May 2011), page 7a. The software contains algorithms necessary to convert non-linear output voltages from the cryogenic diode-type thermometers and vacuum pressure and helium pressure sensors, to temperature and pressure units. The control function algorithms use the monitor data to control the cooler power, vacuum solenoid, vacuum pump, and electrical warm-up heaters. The control algorithms are based on a rule-based system that activates the required device based on the operating mode. The external interface is Web-based. It acts as a Web server, providing pages for monitor, control, and configuration. No client software from the external user is required.

Partial Automated Alignment and Integration System

Science.gov (United States)

Kelley, Gary Wayne (Inventor)

2014-01-01

The present invention is a Partial Automated Alignment and Integration System (PAAIS) used to automate the alignment and integration of space vehicle components. A PAAIS includes ground support apparatuses, a track assembly with a plurality of energy-emitting components and an energy-receiving component containing a plurality of energy-receiving surfaces. Communication components and processors allow communication and feedback through PAAIS.

Driver support and automated driving systems : Acceptance and effects on behavior

NARCIS (Netherlands)

De Waard, D.; Brookhuis, K.A.; Scerbo, MW; Mouloua, M

1999-01-01

Automation in driving ranges from simple in-vehicle information systems to completely automated driving in the Automated Highway System (AHS). An increased level of automation and increased restriction in behavioural freedom, as well as decreased control over tasks, have serious consequences for

Recent advances in automated system model extraction (SME)

International Nuclear Information System (INIS)

Narayanan, Nithin; Bloomsburgh, John; He Yie; Mao Jianhua; Patil, Mahesh B; Akkaraju, Sandeep

2006-01-01

In this paper we present two different techniques for automated extraction of system models from FEA models. We discuss two different algorithms: for (i) automated N-DOF SME for electrostatically actuated MEMS and (ii) automated N-DOF SME for MEMS inertial sensors. We will present case studies for the two different algorithms presented

Automated metabolic gas analysis systems: a review.

Science.gov (United States)

Macfarlane, D J

2001-01-01

The use of automated metabolic gas analysis systems or metabolic measurement carts (MMC) in exercise studies is common throughout the industrialised world. They have become essential tools for diagnosing many hospital patients, especially those with cardiorespiratory disease. Moreover, the measurement of maximal oxygen uptake (VO2max) is routine for many athletes in fitness laboratories and has become a defacto standard in spite of its limitations. The development of metabolic carts has also facilitated the noninvasive determination of the lactate threshold and cardiac output, respiratory gas exchange kinetics, as well as studies of outdoor activities via small portable systems that often use telemetry. Although the fundamental principles behind the measurement of oxygen uptake (VO2) and carbon dioxide production (VCO2) have not changed, the techniques used have, and indeed, some have almost turned through a full circle. Early scientists often employed a manual Douglas bag method together with separate chemical analyses, but the need for faster and more efficient techniques fuelled the development of semi- and full-automated systems by private and commercial institutions. Yet, recently some scientists are returning back to the traditional Douglas bag or Tissot-spirometer methods, or are using less complex automated systems to not only save capital costs, but also to have greater control over the measurement process. Over the last 40 years, a considerable number of automated systems have been developed, with over a dozen commercial manufacturers producing in excess of 20 different automated systems. The validity and reliability of all these different systems is not well known, with relatively few independent studies having been published in this area. For comparative studies to be possible and to facilitate greater consistency of measurements in test-retest or longitudinal studies of individuals, further knowledge about the performance characteristics of these

Telephone triage by GPs in out-of-hours primary care in Denmark: a prospective observational study of efficiency and relevance

NARCIS (Netherlands)

Huibers, L.; Moth, G.; Carlsen, A.H.; Christensen, M.B.; Vedsted, P.

2016-01-01

BACKGROUND: In the UK, telephone triage in out-of-hours primary care is mostly managed by nurses, whereas GPs perform triage in Denmark. AIM: To describe telephone contacts triaged to face-to-face contacts, GP-assessed relevance, and factors associated with triage to face-to-face contact. DESIGN AND

Investigating the validity and usability of an interactive computer programme for assessing competence in telephone-based mental health triage.

Science.gov (United States)

Sands, Natisha; Elsom, Stephen; Keppich-Arnold, Sandra; Henderson, Kathryn; King, Peter; Bourke-Finn, Karen; Brunning, Debra

2016-02-01

Telephone-based mental health triage services are frontline health-care providers that operate 24/7 to facilitate access to psychiatric assessment and intervention for people requiring assistance with a mental health problem. The mental health triage clinical role is complex, and the populations triage serves are typically high risk; yet to date, no evidence-based methods have been available to assess clinician competence to practice telephone-based mental health triage. The present study reports the findings of a study that investigated the validity and usability of the Mental Health Triage Competency Assessment Tool, an evidence-based, interactive computer programme designed to assist clinicians in developing and assessing competence to practice telephone-based mental health triage. © 2015 Australian College of Mental Health Nurses Inc.

Saturn facility oil transfer automation system

Energy Technology Data Exchange (ETDEWEB)

Joseph, Nathan R.; Thomas, Rayburn Dean; Lewis, Barbara Ann; Malagon, Hector Ricardo.

2014-02-01

The Saturn accelerator, owned by Sandia National Laboratories, has been in operation since the early 1980s and still has many of the original systems. A critical legacy system is the oil transfer system which transfers 250,000 gallons of transformer oil from outside storage tanks to the Saturn facility. The oil transfer system was iden- ti ed for upgrade to current technology standards. Using the existing valves, pumps, and relay controls, the system was automated using the National Instruments cRIO FGPA platform. Engineered safety practices, including a failure mode e ects analysis, were used to develop error handling requirements. The uniqueness of the Saturn Oil Automated Transfer System (SOATS) is in the graphical user interface. The SOATS uses an HTML interface to communicate to the cRIO, creating a platform independent control system. The SOATS was commissioned in April 2013.

Diagnostic triage for low back pain: a practical approach for primary care.

Science.gov (United States)

Bardin, Lynn D; King, Peter; Maher, Chris G

2017-04-03

Diagnostic triage is an essential guideline recommendation for low back pain (LBP), which is the most frequent musculoskeletal condition that general practitioners encounter in Australia. Clinical diagnosis of LBP - informed by a focused history and clinical examination - is the key initial step for GPs, and determines subsequent diagnostic workup and allied health and medical specialist referral. The goal of diagnostic triage of LBP is to exclude non-spinal causes and to allocate patients to one of three broad categories: specific spinal pathology (pain, radiculopathy and spinal stenosis. Differential diagnosis of back-related leg pain is complex and clinical manifestations are highly variable. However, distinctive clusters of characteristic history cues and positive clinical examination signs, particularly from neurological examination, guide differential diagnosis within this triage category. A diagnosis of NSLBP presumes exclusion of specific pathologies and nerve root involvement. A biopsychosocial model of care underpins NSLBP; this includes managing pain intensity and considering risk for disability, which directs matched pathways of care. Back pain is a symptom and not a diagnosis. Careful diagnostic differentiation is required and, in primary care, diagnostic triage of LBP is the anchor for a diagnosis.

DESIGN OF SMALL AUTOMATION WORK CELL SYSTEM DEMONSTRATIONS

International Nuclear Information System (INIS)

TURNER, C.; PEHL, J.

2000-01-01

The introduction of automation systems into many of the facilities dealing with the production, use and disposition of nuclear materials has been an ongoing objective. Many previous attempts have been made, using a variety of monolithic and, in some cases, modular technologies. Many of these attempts were less than successful, owing to the difficulty of the problem, the lack of maturity of the technology, and over optimism about the capabilities of a particular system. Consequently, it is not surprising that suggestions that automation can reduce worker Occupational Radiation Exposure (ORE) levels are often met with skepticism and caution. The development of effective demonstrations of these technologies is of vital importance if automation is to become an acceptable option for nuclear material processing environments. The University of Texas Robotics Research Group (UTRRG) has been pursuing the development of technologies to support modular small automation systems (each of less than 5 degrees-of-freedom) and the design of those systems for more than two decades. Properly designed and implemented, these technologies have a potential to reduce the worker ORE associated with work in nuclear materials processing facilities. Successful development of systems for these applications requires the development of technologies that meet the requirements of the applications. These application requirements form a general set of rules that applicable technologies and approaches need to adhere to, but in and of themselves are generally insufficient for the design of a specific automation system. For the design of an appropriate system, the associated task specifications and relationships need to be defined. These task specifications also provide a means by which appropriate technology demonstrations can be defined. Based on the requirements and specifications of the operations of the Advanced Recovery and Integrated Extraction System (ARIES) pilot line at Los Alamos National

Automated system for crack detection using infrared thermograph

International Nuclear Information System (INIS)

Starman, Stanislav

2009-01-01

The objective of this study was the development of the automated system for crack detection on square steel bars used in the automotive industry for axle and shaft construction. The automated system for thermographic crack detection uses brief pulsed eddy currents to heat steel components under inspection. Cracks, if present, will disturb the current flow and so generate changes in the temperature profile in the crack area. These changes of temperature are visualized using an infrared camera. The image acquired by the infrared camera is evaluated through an image processing system. The advantages afforded by the system are its inspection time, its excellent flaw detection sensitivity and its ability to detect hidden, subsurface cracks. The automated system consists of four IR cameras (each side of steel bar is evaluated at a time), coil, high frequency generator and control place with computers. The system is a part of the inspection line where the subsurface and surface cracks are searched. If the crack is present, the cracked place is automatically marked. The components without cracks are then deposited apart from defective blocks. The system is fully automated and its ability is to evaluate four meter blocks within 20 seconds. This is the real reason for using this system in real industrial applications. (author)

Patient Ethnicity Affects Triage Assessments and Patient Prioritization in U.S. Department of Veterans Affairs Emergency Departments

Science.gov (United States)

Vigil, Jacob M.; Coulombe, Patrick; Alcock, Joe; Kruger, Eric; Stith, Sarah S.; Strenth, Chance; Parshall, Mark; Cichowski, Sara B.

2016-01-01

Abstract Ethnic minority patients receive lower priority triage assignments in Veteran's Affairs (VA) emergency departments (EDs) compared to White patients, but it is currently unknown whether this disparity arises from generalized biases across the triage assessment process or from differences in how objective and/or subjective institution-level or person-level information is incorporated into the triage assessment process, thus contributing to disparate treatment. The VA database of electronic medical records of patients who presented to the VA ED from 2008 to 2012 was used to measure patient ethnicity, self-reported pain intensity (PI) levels, heart rate (HR), respiratory rate (RR), and nurse-provided triage assignment, the Emergency Severity Index (ESI) score. Multilevel, random effects linear modeling was used to control for demographic and clinical characteristics of patients as well as age, gender, and experience of triage nurses. A total of 359,642 patient/provider encounters between 129,991 VA patients and 774 nurses were included in the study. Patients were 61% non-Hispanic White [NHW], 28% African-American, 7% Hispanic, 2% Asian-American, ESI ratings with lower PI when compared against African-American patients. NHW patients with low to moderate HRs also received higher priority ESI scoring than African-American, Hispanic, Asian-American, and Mixed-ethnicity patients; however, when HR was high NHWs received lower priority ESI ratings than each of the minority groups (except for African-Americans). This study provides evidence for systemic differences in how patients’ vital signs are applied for determining ESI scores for different ethnic groups. Additional prospective research will be needed to determine how this specific person-level mechanism affects healthcare quality and outcomes. PMID:27057847

Automated transmission system operation and management : meeting stakeholder information needs

Energy Technology Data Exchange (ETDEWEB)

Peelo, D.F.; Toom, P.O. [British Columbia Hydro, Vancouver, BC (Canada)

1998-12-01

Information monitoring is considered to be the fundamental basis for moving beyond substation automation and into automated transmission system operation and management. Information monitoring was defined as the acquisition of data and processing the data into decision making. Advances in digital technology and cheaper, more powerful computing capability has made it possible to capture all transmission stakeholder needs in a shared and automated operation and management system. Recognizing that the key to success in the development of transmission systems is automation, BC Hydro has initiated a long-term research and development project to develop the structure and detail of transmission system automation. The involvement of partners, be they utility or equipment suppliers, is essential in order to deal with protocol and similar issues. 3 refs., 1 tab., 3 figs.

Automated Car Park Management System

Science.gov (United States)

Fabros, J. P.; Tabañag, D.; Espra, A.; Gerasta, O. J.

2015-06-01

This study aims to develop a prototype for an Automated Car Park Management System that will increase the quality of service of parking lots through the integration of a smart system that assists motorist in finding vacant parking lot. The research was based on implementing an operating system and a monitoring system for parking system without the use of manpower. This will include Parking Guidance and Information System concept which will efficiently assist motorists and ensures the safety of the vehicles and the valuables inside the vehicle. For monitoring, Optical Character Recognition was employed to monitor and put into list all the cars entering the parking area. All parking events in this system are visible via MATLAB GUI which contain time-in, time-out, time consumed information and also the lot number where the car parks. To put into reality, this system has a payment method, and it comes via a coin slot operation to control the exit gate. The Automated Car Park Management System was successfully built by utilizing microcontrollers specifically one PIC18f4550 and two PIC16F84s and one PIC16F628A.

Home Automation and Security System Using Android ADK

OpenAIRE

Deepali Javale; Mohd. Mohsin; Shreerang Nandanwar; Mayur Shingate

2013-01-01

Today we are living in 21st century where automation is playing important role in human life. Home automation allows us to control household appliances like light, door, fan, AC etc. It also provides home security and emergency system to be activated. Home automation not only refers to reduce human efforts but also energy efficiency and time saving. The main objective of home automation and security is to help handicapped and old aged people which will enable them to control home appliances a...

DOMOTICS Aplicability and home automation systems

Directory of Open Access Journals (Sweden)

César Luiz de Azevedo Dias

2010-05-01

Full Text Available This article discusses the benefits and applicability of domestic automation, also known as Domotics. According to Domotics Integration Project (DIP, Domotics or smart house technology is the integration of services and technologies applied to homes, flats, apartments, houses and small buildings with the purpose of automating them and obtaining and increasing safety and security, comfort, communication and technical management. This papper also presents a summary of the elements which may be part of a “smart home”, the advantages given by its integration and, illustrations of various systems and technologies applied to domestic automation that have achieved both national and international commercial relevance.

Automated Classification of Consumer Health Information Needs in Patient Portal Messages

Science.gov (United States)

Cronin, Robert M.; Fabbri, Daniel; Denny, Joshua C.; Jackson, Gretchen Purcell

2015-01-01

Patients have diverse health information needs, and secure messaging through patient portals is an emerging means by which such needs are expressed and met. As patient portal adoption increases, growing volumes of secure messages may burden healthcare providers. Automated classification could expedite portal message triage and answering. We created four automated classifiers based on word content and natural language processing techniques to identify health information needs in 1000 patient-generated portal messages. Logistic regression and random forest classifiers detected single information needs well, with area under the curves of 0.804–0.914. A logistic regression classifier accurately found the set of needs within a message, with a Jaccard index of 0.859 (95% Confidence Interval: (0.847, 0.871)). Automated classification of consumer health information needs expressed in patient portal messages is feasible and may allow direct linking to relevant resources or creation of institutional resources for commonly expressed needs. PMID:26958285

Emergency Severity Index version 4: a valid and reliable tool in pediatric emergency department triage.

Science.gov (United States)

Green, Nicole A; Durani, Yamini; Brecher, Deena; DePiero, Andrew; Loiselle, John; Attia, Magdy

2012-08-01

The Emergency Severity Index version 4 (ESI v.4) is the most recently implemented 5-level triage system. The validity and reliability of this triage tool in the pediatric population have not been extensively established. The goals of this study were to assess the validity of ESI v.4 in predicting hospital admission, emergency department (ED) length of stay (LOS), and number of resources utilized, as well as its reliability in a prospective cohort of pediatric patients. The first arm of the study was a retrospective chart review of 780 pediatric patients presenting to a pediatric ED to determine the validity of ESI v.4. Abstracted data included acuity level assigned by the triage nurse using ESI v.4 algorithm, disposition (admission vs discharge), LOS, and number of resources utilized in the ED. To analyze the validity of ESI v.4, patients were divided into 2 groups for comparison: higher-acuity patients (ESI levels 1, 2, and 3) and lower-acuity patients (ESI levels 4 and 5). Pearson χ analysis was performed for categorical variables. For continuous variables, we conducted a comparison of means based on parametric distribution of variables. The second arm was a prospective cohort study to determine the interrater reliability of ESI v.4 among and between pediatric triage (PT) nurses and pediatric emergency medicine (PEM) physicians. Three raters (2 PT nurses and 1 PEM physician) independently assigned triage scores to 100 patients; k and interclass correlation coefficient were calculated among PT nurses and between the primary PT nurses and physicians. In the validity arm, the distribution of ESI score levels among the 780 cases are as follows: ESI 1: 2 (0.25%); ESI 2: 73 (9.4%); ESI 3: 289 (37%); ESI 4: 251 (32%); and ESI 5: 165 (21%). Hospital admission rates by ESI level were 1: 100%, 2: 42%, 3: 14.9%, 4: 1.2%, and 5: 0.6%. The admission rate of the higher-acuity group (76/364, 21%) was significantly greater than the lower-acuity group (4/415, 0.96%), P group was

Secure Automated Microgrid Energy System

Science.gov (United States)

2016-12-01

O&M Operations and Maintenance PSO Power System Optimization PV Photovoltaic RAID Redundant Array of Independent Disks RBAC Role...elements of the initial study and operational power system model (feeder size , protective devices, generation sources, controllable loads, transformers...EW-201340) Secure Automated Microgrid Energy System December 2016 This document has been cleared for public release; Distribution Statement A

Automated systems to identify relevant documents in product risk management

Science.gov (United States)

2012-01-01

Background Product risk management involves critical assessment of the risks and benefits of health products circulating in the market. One of the important sources of safety information is the primary literature, especially for newer products which regulatory authorities have relatively little experience with. Although the primary literature provides vast and diverse information, only a small proportion of which is useful for product risk assessment work. Hence, the aim of this study is to explore the possibility of using text mining to automate the identification of useful articles, which will reduce the time taken for literature search and hence improving work efficiency. In this study, term-frequency inverse document-frequency values were computed for predictors extracted from the titles and abstracts of articles related to three tumour necrosis factors-alpha blockers. A general automated system was developed using only general predictors and was tested for its generalizability using articles related to four other drug classes. Several specific automated systems were developed using both general and specific predictors and training sets of different sizes in order to determine the minimum number of articles required for developing such systems. Results The general automated system had an area under the curve value of 0.731 and was able to rank 34.6% and 46.2% of the total number of 'useful' articles among the first 10% and 20% of the articles presented to the evaluators when tested on the generalizability set. However, its use may be limited by the subjective definition of useful articles. For the specific automated system, it was found that only 20 articles were required to develop a specific automated system with a prediction performance (AUC 0.748) that was better than that of general automated system. Conclusions Specific automated systems can be developed rapidly and avoid problems caused by subjective definition of useful articles. Thus the efficiency of

A review of factors affecting patient satisfaction with nurse led triage in emergency departments.

Science.gov (United States)

Rehman, Salma Abdul; Ali, Parveen Azam

2016-11-01

To determine the factors that affect patient satisfaction with nurse-led-triage in EDs using a systematic review. Nurses' involvement in the triage services provided in the Emergency Department has been an integral part of practice for several decades in some countries. Although studies exploring patient satisfaction with nurse-led ED triage exist, no systematic review of this evidence is available. MEDLINE, CINAHL, PsycInfo, EMBASE, the Cochrane Library, Joanna Briggs Library and Google Scholar were searched (January 1980-June 2013). Eighteen studies that met the inclusion criteria were reviewed. Factors that affect patient satisfaction with nurse-led-triage include nurses' abilities to provide patient centred care, communication skills, nurses' caring abilities, concern for the patient and competence in diagnosing and treating the health problem. Other factors include availability and visibility of nurses, provision of appropriate health related information in a jargon-free language, nurses' ability to answer questions, and an ability to provide patients with an opportunity to ask questions. There is continued scope for nurse-led-triage services in the ED. Patients are generally satisfied with the service provided by nurses in EDs and report a willingness to see the same professional again in the future if needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Biomek Cell Workstation: A Variable System for Automated Cell Cultivation.

Science.gov (United States)

Lehmann, R; Severitt, J C; Roddelkopf, T; Junginger, S; Thurow, K

2016-06-01

Automated cell cultivation is an important tool for simplifying routine laboratory work. Automated methods are independent of skill levels and daily constitution of laboratory staff in combination with a constant quality and performance of the methods. The Biomek Cell Workstation was configured as a flexible and compatible system. The modified Biomek Cell Workstation enables the cultivation of adherent and suspension cells. Until now, no commercially available systems enabled the automated handling of both types of cells in one system. In particular, the automated cultivation of suspension cells in this form has not been published. The cell counts and viabilities were nonsignificantly decreased for cells cultivated in AutoFlasks in automated handling. The proliferation of manual and automated bioscreening by the WST-1 assay showed a nonsignificant lower proliferation of automatically disseminated cells associated with a mostly lower standard error. The disseminated suspension cell lines showed different pronounced proliferations in descending order, starting with Jurkat cells followed by SEM, Molt4, and RS4 cells having the lowest proliferation. In this respect, we successfully disseminated and screened suspension cells in an automated way. The automated cultivation and dissemination of a variety of suspension cells can replace the manual method. © 2015 Society for Laboratory Automation and Screening.

An Online Tool for Nurse Triage to Evaluate Risk for Acute Coronary Syndrome at Emergency Department

Directory of Open Access Journals (Sweden)

Yuwares Sittichanbuncha

2015-01-01

Full Text Available Background. To differentiate acute coronary syndrome (ACS from other causes in patients presenting with chest pain at the emergency department (ED is crucial and can be performed by the nurse triage. We evaluated the effectiveness of the ED nurse triage for ACS of the tertiary care hospital. Methods. We retrospectively enrolled consecutive patients who were identified as ACS at risk patients by the ED nurse triage. Patients were categorized as ACS and non-ACS group by the final diagnosis. Multivariate logistic analysis was used to predict factors associated with ACS. An online model predictive of ACS for the ED nurse triage was constructed. Results. There were 175 patients who met the study criteria. Of those, 28 patients (16.0% were diagnosed with ACS. Patients with diabetes, patients with previous history of CAD, and those who had at least one character of ACS chest pain were independently associated with having ACS by multivariate logistic regression. The adjusted odds ratios (95% confidence interval were 4.220 (1.445, 12.327, 3.333 (1.040, 10.684, and 12.539 (3.876, 40.567, respectively. Conclusions. The effectiveness of the ED nurse triage for ACS was 16%. The online tool is available for the ED triage nurse to evaluate risk of ACS in individuals.

Automating large-scale reactor systems

International Nuclear Information System (INIS)

Kisner, R.A.

1985-01-01

This paper conveys a philosophy for developing automated large-scale control systems that behave in an integrated, intelligent, flexible manner. Methods for operating large-scale systems under varying degrees of equipment degradation are discussed, and a design approach that separates the effort into phases is suggested. 5 refs., 1 fig

Towards a characterization of information automation systems on the flight deck

Science.gov (United States)

Dudley, Rachel Feddersen

This thesis summarizes research to investigate the characteristics that define information automation systems used on aircraft flight decks and the significant impacts that these characteristics have on pilot performance. Major accomplishments of the work include the development of a set of characteristics that describe information automation systems on the flight deck and an experiment designed to study a subset of these characteristics. Information automation systems on the flight deck are responsible for the collection, processing, analysis, and presentation of data to the flightcrew. These systems pose human factors issues and challenges that must be considered by designers of these systems. Based on a previously developed formal definition of information automation for aircraft flight deck systems, an analysis process was developed and conducted to reach a refined set of information automation characteristics. In this work, characteristics are defined as a set of properties or attributes that describe an information automation system's operation or behavior, which can be used to identify and assess potential human factors issues. Hypotheses were formed for a subset of the characteristics: Automation Visibility, Information Quality, and Display Complexity. An experimental investigation was developed to measure performance impacts related to these characteristics, which showed mixed results of expected and surprising findings, with many interactions. A set of recommendations were then developed based on the experimental observations. Ensuring that the right information is presented to pilots at the right time and in the appropriate manner is the job of flight deck system designers. This work provides a foundation for developing recommendations and guidelines specific to information automation on the flight deck with the goal of improving the design and evaluation of information automation systems before they are implemented.

ED Triage Process Improvement: Timely Vital Signs for Less Acute Patients.

Science.gov (United States)

Falconer, Stella S; Karuppan, Corinne M; Kiehne, Emily; Rama, Shravan

2018-06-13

Vital signs can result in an upgrade of patients' Emergency Severity Index (ESI) levels. It is therefore preferable to obtain vital signs early in the triage process, particularly for ESI level 3 patients. Emergency departments have an opportunity to redesign triage processes to meet required protocols while enhancing the quality and experience of care. We performed process analyses to redesign the door-to-vital signs process. We also developed spaghetti diagrams to reconfigure the patient arrival area. The door-to-vital signs time was reduced from 43.1 minutes to 6.44 minutes. Both patients and triage staff seemed more satisfied with the new process. The patient arrival area was less congested and more welcoming. Performing activities in parallel reduces flow time with no additional resources. Staff involvement in process planning, redesign, and control ensures engagement and early buy-in. One should anticipate how changes to one process might affect other processes. Copyright © 2018. Published by Elsevier Inc.

Automated discovery systems and the inductivist controversy

Science.gov (United States)

Giza, Piotr

2017-09-01

The paper explores possible influences that some developments in the field of branches of AI, called automated discovery and machine learning systems, might have upon some aspects of the old debate between Francis Bacon's inductivism and Karl Popper's falsificationism. Donald Gillies facetiously calls this controversy 'the duel of two English knights', and claims, after some analysis of historical cases of discovery, that Baconian induction had been used in science very rarely, or not at all, although he argues that the situation has changed with the advent of machine learning systems. (Some clarification of terms machine learning and automated discovery is required here. The key idea of machine learning is that, given data with associated outcomes, software can be trained to make those associations in future cases which typically amounts to inducing some rules from individual cases classified by the experts. Automated discovery (also called machine discovery) deals with uncovering new knowledge that is valuable for human beings, and its key idea is that discovery is like other intellectual tasks and that the general idea of heuristic search in problem spaces applies also to discovery tasks. However, since machine learning systems discover (very low-level) regularities in data, throughout this paper I use the generic term automated discovery for both kinds of systems. I will elaborate on this later on). Gillies's line of argument can be generalised: thanks to automated discovery systems, philosophers of science have at their disposal a new tool for empirically testing their philosophical hypotheses. Accordingly, in the paper, I will address the question, which of the two philosophical conceptions of scientific method is better vindicated in view of the successes and failures of systems developed within three major research programmes in the field: machine learning systems in the Turing tradition, normative theory of scientific discovery formulated by Herbert Simon

El triage en enfermería

OpenAIRE

Macías de Plasencia, Guillermo

2013-01-01

El objetivo del trabajo es dar a conocer y desarrollar todo lo relacionado con el triage, técnica que se pone en práctica en los servicios de emergencias médicas con la finalidad de mejorar la atención de los pacientes reducir la espera a los más graves y mandarles al especialista adecuado

Are triage questions sufficient to assign fall risk precautions in the ED?

Science.gov (United States)

Southerland, Lauren T; Slattery, Lauren; Rosenthal, Joseph A; Kegelmeyer, Deborah; Kloos, Anne

2017-02-01

The American College of Emergency Physicians Geriatric Emergency Department (ED) Guidelines and the Center for Disease Control recommend that older adults be assessed for risk of falls. The standard ED assessment is a verbal query of fall risk factors, which may be inadequate. We hypothesized that the addition of a functional balance test endorsed by the Center for Disease Control Stop Elderly Accidents, Deaths, and Injuries Falls Prevention Guidelines, the 4-Stage Balance Test (4SBT), would improve the detection of patients at risk for falls. Prospective pilot study of a convenience sample of ambulatory adults 65 years and older in the ED. All participants received the standard nursing triage fall risk assessment. After patients were stabilized in their ED room, the 4SBT was administered. The 58 participants had an average age of 74.1 years (range, 65-94), 40.0% were women, and 98% were community dwelling. Five (8.6%) presented to the ED for a fall-related chief complaint. The nursing triage screen identified 39.7% (n=23) as at risk for falls, whereas the 4SBT identified 43% (n=25). Combining triage questions with the 4SBT identified 60.3% (n=35) as at high risk for falls, as compared with 39.7% (n=23) with triage questions alone (Ppatients at high risk by 4SBT and missed by triage questions were inpatients unaware that they were at risk for falls (new diagnoses). Incorporating a quick functional test of balance into the ED assessment for fall risk is feasible and significantly increases the detection of older adults at risk for falls. Copyright © 2016 Elsevier Inc. All rights reserved.

Delivery room triage of large for gestational age infants of diabetic mothers.

Science.gov (United States)

Cordero, Leandro; Rath, Krista; Zheng, Katherine; Landon, Mark B; Nankervis, Craig A

2014-01-01

To review our 4-year experience (2008-2011) with delivery room triage of large for gestational age infants of diabetic mothers. Retrospective cohort investigation of 311 large for gestational age infants of diabetic mothers (White's Class A1 (77), A2 (87), B (77), and C-R (70)). Of 311 women, 31% delivered at 34-36 weeks gestational age and 69% at term. While 70% were delivered by cesarean, 30% were vaginal deliveries. A total of 160 asymptomatic infants were triaged from the delivery room to the well baby nursery. Of these, 55 (34%) developed hypoglycemia. In 43 cases, the hypoglycemia was corrected by early feedings; in the remaining 12, intravenous dextrose treatment was required. A total of 151 infants were triaged from the delivery room to the neonatal intensive care unit. Admission diagnoses included respiratory distress (51%), prevention of hypoglycemia (27%), prematurity (21%), and asphyxia (1%). Hypoglycemia affected 66 (44%) of all neonatal intensive care unit infants. Safe triage of asymptomatic large for gestational age infants of diabetic mothers from the delivery room to well baby nursery can be accomplished in the majority of cases. Those infants in need of specialized care can be accurately identified and effectively treated in the neonatal intensive care unit setting.

Overweight and Body Image Perception in Adolescents with Triage of Eating Disorders

Directory of Open Access Journals (Sweden)

Roberta Stofeles Cecon

2017-01-01

Full Text Available Purpose. To verify the influence of overweight and alteration in the perception of the corporal image during the triage of eating disorders. Method. A food disorder triage was performed in adolescents with 10 to 19 years of age using the Eating Attitudes Test (EAT-26, Children’s Eating Attitudes Test (ChEAT, and Bulimic Investigatory Test Edinburgh (BITE, as well as a nutritional status evaluation. The perception of body image was evaluated in a subsample of adolescents with 10 to 14 years of age, using the Brazilian Silhouette Scale. The project was approved by the Human Research Ethics Committee of the Federal University of Viçosa, Minas Gerais, Brazil. Results. The prevalence of eating disorder triage was 11.4% (n=242 for the 2,123 adolescents evaluated. Overweight was present in 21.1% (n=447 of the students, being more prevalent in the early adolescence phase, which presented levels of distortion of 56.9% (n=740 and dissatisfaction of 79.3% (n=1031. Body dissatisfaction was considered as a risk factor, increasing by more than 13 times the chance of TA screening. Conclusion. Overweight was correlated with the ED triage and body dissatisfaction was considered as a risk factor, increasing the chances of these disorders by more than 13 times.

Computer automation of a dilution cryogenic system

International Nuclear Information System (INIS)

Nogues, C.

1992-09-01

This study has been realized in the framework of studies on developing new technic for low temperature detectors for neutrinos and dark matter. The principles of low temperature physics and helium 4 and dilution cryostats, are first reviewed. The cryogenic system used and the technic for low temperature thermometry and regulation systems are then described. The computer automation of the dilution cryogenic system involves: numerical measurement of the parameter set (pressure, temperature, flow rate); computer assisted operating of the cryostat and the pump bench; numerical regulation of pressure and temperature; operation sequence full automation allowing the system to evolve from a state to another (temperature descent for example)

A machine learning approach to triaging patients with chronic obstructive pulmonary disease

Science.gov (United States)

Qirko, Klajdi; Smith, Ted; Corcoran, Ethan; Wysham, Nicholas G.; Bazaz, Gaurav; Kappel, George; Gerber, Anthony N.

2017-01-01

COPD patients are burdened with a daily risk of acute exacerbation and loss of control, which could be mitigated by effective, on-demand decision support tools. In this study, we present a machine learning-based strategy for early detection of exacerbations and subsequent triage. Our application uses physician opinion in a statistically and clinically comprehensive set of patient cases to train a supervised prediction algorithm. The accuracy of the model is assessed against a panel of physicians each triaging identical cases in a representative patient validation set. Our results show that algorithm accuracy and safety indicators surpass all individual pulmonologists in both identifying exacerbations and predicting the consensus triage in a 101 case validation set. The algorithm is also the top performer in sensitivity, specificity, and ppv when predicting a patient’s need for emergency care. PMID:29166411

A machine learning approach to triaging patients with chronic obstructive pulmonary disease.

Directory of Open Access Journals (Sweden)

Sumanth Swaminathan

Full Text Available COPD patients are burdened with a daily risk of acute exacerbation and loss of control, which could be mitigated by effective, on-demand decision support tools. In this study, we present a machine learning-based strategy for early detection of exacerbations and subsequent triage. Our application uses physician opinion in a statistically and clinically comprehensive set of patient cases to train a supervised prediction algorithm. The accuracy of the model is assessed against a panel of physicians each triaging identical cases in a representative patient validation set. Our results show that algorithm accuracy and safety indicators surpass all individual pulmonologists in both identifying exacerbations and predicting the consensus triage in a 101 case validation set. The algorithm is also the top performer in sensitivity, specificity, and ppv when predicting a patient's need for emergency care.

Automated Podcasting System for Universities

Directory of Open Access Journals (Sweden)

Ypatios Grigoriadis

2013-03-01

Full Text Available This paper presents the results achieved at Graz University of Technology (TU Graz in the field of automating the process of recording and publishing university lectures in a very new way. It outlines cornerstones of the development and integration of an automated recording system such as the lecture hall setup, the recording hardware and software architecture as well as the development of a text-based search for the final product by method of indexing video podcasts. Furthermore, the paper takes a look at didactical aspects, evaluations done in this context and future outlook.

Machine Learning or Information Retrieval Techniques for Bug Triaging: Which is better?

Directory of Open Access Journals (Sweden)

Anjali Goyal

2017-07-01

Full Text Available Bugs are the inevitable part of a software system. Nowadays, large software development projects even release beta versions of their products to gather bug reports from users. The collected bug reports are then worked upon by various developers in order to resolve the defects and make the final software product more reliable. The high frequency of incoming bugs makes the bug handling a difficult and time consuming task. Bug assignment is an integral part of bug triaging that aims at the process of assigning a suitable developer for the reported bug who corrects the source code in order to resolve the bug. There are various semi and fully automated techniques to ease the task of bug assignment. This paper presents the current state of the art of various techniques used for bug report assignment. Through exhaustive research, the authors have observed that machine learning and information retrieval based bug assignment approaches are most popular in literature. A deeper investigation has shown that the trend of techniques is taking a shift from machine learning based approaches towards information retrieval based approaches. Therefore, the focus of this work is to find the reason behind the observed drift and thus a comparative analysis is conducted on the bug reports of the Mozilla, Eclipse, Gnome and Open Office projects in the Bugzilla repository. The results of the study show that the information retrieval based technique yields better efficiency in recommending the developers for bug reports.

Using an original triage and on call management tool aids identification and assessment of the acutely unwell surgical patient.

Science.gov (United States)

Hodge, Stacie; Helliar, Sebastian; Macdonald, Hamish Ian; Mackey, Paul

2018-01-01

Until now, there have been no published surgical triage tools. We have developed the first such tool with a tiered escalation policy, aiming to improve identification and management of critically unwell patients. The existing sheet which is used to track new referrals and admissions to the surgical assessment unit was reviewed. The sheet was updated and a traffic light triage tool generated using National Early Warning Scores (NEWS), sepsis criteria and user discretion. A tiered escalation policy to guide urgency of assessment was introduced and education sessions for all staff undertaken, to ensure understanding and compliance. Through multiple 'plan-do-study-act' cycles, the new system and its efficiency have been analysed. Prior to intervention, documentation of NEWS did not occur and only 13% of admission observations were communicated to the surgical team. Following multiple cycles and interventions, 93% of patients were fully triaged, and 80% of 'red' and 'amber' patients' observations were communicated to the surgical team. The average time for a registrar to review a 'red' patient was 37 min and 79% of 'green' patients were reviewed within an hour of their presentation. Rapid identification of the unwell patient is crucial. Here we publish the first triage tool that enables early assessment of septic and otherwise potentially unwell surgical patients.

Software complex AS (automation of spectrometry). User interface of experiment automation system implementation

International Nuclear Information System (INIS)

Astakhova, N.V.; Beskrovnyj, A.I.; Bogdzel', A.A.; Butorin, P.E.; Vasilovskij, S.G.; Gundorin, N.A.; Zlokazov, V.B.; Kutuzov, S.A.; Salamatin, I.M.; Shvetsov, V.N.

2003-01-01

An instrumental software complex for automation of spectrometry (AS) that enables prompt realization of experiment automation systems for spectrometers, which use data buferisation, has been developed. In the development new methods of programming and building of automation systems together with novel net technologies were employed. It is suggested that programs to schedule and conduct experiments should be based on the parametric model of the spectrometer, the approach that will make it possible to write programs suitable for any FLNP (Frank Laboratory of Neutron Physics) spectrometer and experimental technique applied and use different hardware interfaces for introducing the spectrometric data into the data acquisition system. The article describes the possibilities provided to the user in the field of scheduling and control of the experiment, data viewing, and control of the spectrometer parameters. The possibility of presenting the current spectrometer state, programs and the experimental data in the Internet in the form of dynamically formed protocols and graphs, as well as of the experiment control via the Internet is realized. To use the means of the Internet on the side of the client, applied programs are not needed. It suffices to know how to use the two programs to carry out experiments in the automated mode. The package is designed for experiments in condensed matter and nuclear physics and is ready for using. (author)

Computer-Assisted Automated Scoring of Polysomnograms Using the Somnolyzer System.

Science.gov (United States)

Punjabi, Naresh M; Shifa, Naima; Dorffner, Georg; Patil, Susheel; Pien, Grace; Aurora, Rashmi N

2015-10-01

Manual scoring of polysomnograms is a time-consuming and tedious process. To expedite the scoring of polysomnograms, several computerized algorithms for automated scoring have been developed. The overarching goal of this study was to determine the validity of the Somnolyzer system, an automated system for scoring polysomnograms. The analysis sample comprised of 97 sleep studies. Each polysomnogram was manually scored by certified technologists from four sleep laboratories and concurrently subjected to automated scoring by the Somnolyzer system. Agreement between manual and automated scoring was examined. Sleep staging and scoring of disordered breathing events was conducted using the 2007 American Academy of Sleep Medicine criteria. Clinical sleep laboratories. A high degree of agreement was noted between manual and automated scoring of the apnea-hypopnea index (AHI). The average correlation between the manually scored AHI across the four clinical sites was 0.92 (95% confidence interval: 0.90-0.93). Similarly, the average correlation between the manual and Somnolyzer-scored AHI values was 0.93 (95% confidence interval: 0.91-0.96). Thus, interscorer correlation between the manually scored results was no different than that derived from manual and automated scoring. Substantial concordance in the arousal index, total sleep time, and sleep efficiency between manual and automated scoring was also observed. In contrast, differences were noted between manually and automated scored percentages of sleep stages N1, N2, and N3. Automated analysis of polysomnograms using the Somnolyzer system provides results that are comparable to manual scoring for commonly used metrics in sleep medicine. Although differences exist between manual versus automated scoring for specific sleep stages, the level of agreement between manual and automated scoring is not significantly different than that between any two human scorers. In light of the burden associated with manual scoring, automated

Pediatric Early Warning Systems aid in triage to intermediate versus intensive care for pediatric oncology patients in resource-limited hospitals.

Science.gov (United States)

Agulnik, Asya; Nadkarni, Anisha; Mora Robles, Lupe Nataly; Soberanis Vasquez, Dora Judith; Mack, Ricardo; Antillon-Klussmann, Federico; Rodriguez-Galindo, Carlos

2018-04-10

Pediatric oncology patients hospitalized in resource-limited settings are at high risk for clinical deterioration resulting in mortality. Intermediate care units (IMCUs) provide a cost-effective alternative to pediatric intensive care units (PICUs). Inappropriate IMCU triage, however, can lead to poor outcomes and suboptimal resource utilization. In this study, we sought to characterize patients with clinical deterioration requiring unplanned transfer to the IMCU in a resource-limited pediatric oncology hospital. Patients requiring subsequent early PICU transfer had longer PICU length of stay. PEWS results prior to IMCU transfer were higher in patients requiring early PICU transfer, suggesting PEWS can aid in triage between IMCU and PICU care. © 2018 Wiley Periodicals, Inc.

Development of automated analytical systems for large throughput

International Nuclear Information System (INIS)

Ernst, P.C.; Hoffman, E.L.

1982-01-01

The need to be able to handle a large throughput of samples for neutron activation analysis has led to the development of automated counting and sample handling systems. These are coupled with available computer-assisted INAA techniques to perform a wide range of analytical services on a commercial basis. A fully automated delayed neutron counting system and a computer controlled pneumatic transfer for INAA use are described, as is a multi-detector gamma-spectroscopy system. (author)

Automated road marking recognition system

Science.gov (United States)

Ziyatdinov, R. R.; Shigabiev, R. R.; Talipov, D. N.

2017-09-01

Development of the automated road marking recognition systems in existing and future vehicles control systems is an urgent task. One way to implement such systems is the use of neural networks. To test the possibility of using neural network software has been developed with the use of a single-layer perceptron. The resulting system based on neural network has successfully coped with the task both when driving in the daytime and at night.

Using Publish-Subscribe Messaging for System Status and Automation

Science.gov (United States)

Smith, Danford S.

2015-01-01

The NASA Goddard Mission Services Evolution Center (GMSEC) system is a message-based plug-and-play open system architecture used in many of NASA mission operations centers. This presentation will focus on the use of GMSEC standard messages to report and analyze the status of a system and enable the automation of the system's components. In GMSEC systems, each component reports its status using a keep-alive message and also publishes status and activities as log messages. In addition, the components can accept functional directive messages from the GMSEC message bus. Over the past several years, development teams have found ways to utilize these messages to create innovative display pages and increasingly sophisticated approaches to automation. This presentation will show the flexibility and value of the message-based approach to system awareness and automation.

Preventive child health care at elementary school age: The costs of routine assessments with a triage approach.

Directory of Open Access Journals (Sweden)

Janine Bezem

Full Text Available Triage in Preventive Child Health Care (PCH assessments could further the efficient use of human resources and budgets and therefore make extra care possible for children with specific needs. We assessed the costs of routine PCH assessments with and without triage for children aged 5/6 years and 10/11 years. In a triage approach, PCH assistants conduct pre-assessments to identify children requiring follow-up assessments by a physician or nurse. In the usual approach, all children are assessed by a physician and an assistant (children aged 5/6 years or a nurse (children aged 10/11 years.All the direct costs of conducting routine PCH assessments with the triage and usual approach were assessed using a bottom-up micro-costing approach. In four PCH services in the Netherlands, two using triage and two the usual approach, professionals completed questionnaires about time spent on assessments, including time related to non-attendance at assessments, the referral of children and administration.The projected costs for PCH professionals working on PCH assessments amounted to €5.2 million per cohort of 100,000 children aged 5/6 years in the triage approach, and €7.6 million in the usual approach. The projected costs in both approaches for children aged 10/11 years were about €4 million per 100,000 children.The triage approach to PCH resulted in a projected cost reduction of about one-third, compared with usual practice, for routine assessments by physicians of children aged 5/6 years. There are minimal cost savings in the group of children aged 10/11 years when nurses are involved and so other considerations such as workforce shortages would be required to justify a change to a triage approach. Further research is needed to investigate the differences in costs of care after the completion of the routine assessments.

WIDAFELS flexible automation systems

International Nuclear Information System (INIS)

Shende, P.S.; Chander, K.P.; Ramadas, P.

1990-01-01

After discussing the various aspects of automation, some typical examples of various levels of automation are given. One of the examples is of automated production line for ceramic fuel pellets. (M.G.B.)

Delay Tolerant Networking with Data Triage Method based on Emergent User Policies for Disaster Information Network System

Directory of Open Access Journals (Sweden)

Noriki Uchida

2014-01-01

Full Text Available When Disaster Information Network System is considered in local areas that were heavy damaged by the East Japan Great Earthquake in 2011, the resiliency of the network system is one of significant subjects for the restoration of the areas. DTN (Delay Tolerant Network has been focused for the effective methods for such inoperable network circumstances. However, when DTN is applied for the local areas, there are some problems such as message delivery rate and latency because there are fewer roads, cars, and pedestrians than in urban areas. In this paper, we propose the Enhanced Media Coordinate System for its architecture, and Data Triage method by emergent user policies is introduced to improve the QoS in Disaster Information Network System in local areas. In the proposed method, every message is tagged with the priority levels by data types with considering emergent user policies, and the high priority messages are firstly duplicated to transmittable nodes. Then, the experimental results by the GIS map of a Japanese coastal town and the future studies are discussed.

An ultraviolet-visible spectrophotometer automation system. Part 3: Program documentation

Science.gov (United States)

Roth, G. S.; Teuschler, J. M.; Budde, W. L.

1982-07-01

The Ultraviolet-Visible Spectrophotometer (UVVIS) automation system accomplishes 'on-line' spectrophotometric quality assurance determinations, report generations, plot generations and data reduction for chlorophyll or color analysis. This system also has the capability to process manually entered data for the analysis of chlorophyll or color. For each program of the UVVIS system, this document contains a program description, flowchart, variable dictionary, code listing, and symbol cross-reference table. Also included are descriptions of file structures and of routines common to all automated analyses. The programs are written in Data General extended BASIC, Revision 4.3, under the RDOS operating systems, Revision 6.2. The BASIC code has been enhanced for real-time data acquisition, which is accomplished by CALLS to assembly language subroutines. Two other related publications are 'An Ultraviolet-Visible Spectrophotometer Automation System - Part I Functional Specifications,' and 'An Ultraviolet-Visible Spectrophotometer Automation System - Part II User's Guide.'

Automated reasoning in man-machine control systems

International Nuclear Information System (INIS)

Stratton, R.C.; Lusk, E.L.

1983-01-01

This paper describes a project being undertaken at Argonne National Laboratory to demonstrate the usefulness of automated reasoning techniques in the implementation of a man-machine control system being designed at the EBR-II nuclear power plant. It is shown how automated reasoning influences the choice of optimal roles for both man and machine in the system control process, both for normal and off-normal operation. In addition, the requirements imposed by such a system for a rigorously formal specification of operating states, subsystem states, and transition procedures have a useful impact on the analysis phase. The definitions and rules are discussed for a prototype system which is physically simple yet illustrates some of the complexities inherent in real systems

[DNA Extraction from Old Bones by AutoMate Express™ System].

Science.gov (United States)

Li, B; Lü, Z

2017-08-01

To establish a method for extracting DNA from old bones by AutoMate Express™ system. Bones were grinded into powder by freeze-mill. After extraction by AutoMate Express™, DNA were amplified and genotyped by Identifiler®Plus and MinFiler™ kits. DNA were extracted from 10 old bone samples, which kept in different environments with the postmortem interval from 10 to 20 years, in 3 hours by AutoMate Express™ system. Complete STR typing results were obtained from 8 samples. AutoMate Express™ system can quickly and efficiently extract DNA from old bones, which can be applied in forensic practice. Copyright© by the Editorial Department of Journal of Forensic Medicine

48 CFR 2452.239-70 - Background investigations for sensitive automated systems/applications.

Science.gov (United States)

2010-10-01

... for sensitive automated systems/applications. 2452.239-70 Section 2452.239-70 Federal Acquisition... automated systems/applications. As prescribed in 2439.107(a), insert the following clause: Background Investigations for Sensitive Automated Systems/Applications (OCT 1999) (a) General. This contract involves work...

Servir: an automated document delivery system

International Nuclear Information System (INIS)

Lima, E.C.; Azevedo Coutinho, O.C. de

1986-01-01

SERVIR, an automated document delivery system developed by CIN/CNEN, is described. Parametric procedures for reading bibliographic data bases and requesting documents from libraries through computer are specified. Statistical procedures, accounting system and the on-line fulfillment of requests are presented. (Author) [pt

Self-rated worry in acute care telephone triage

DEFF Research Database (Denmark)

Gamst-Jensen, Hejdi; Huibers, Linda; Pedersen, Kristoffer

2018-01-01

the caller's ability to quantify their degree of worry, the association between degree of worry and variables related to the caller, the effect of degree of worry on triage outcome, and the thematic content of the caller's worry. DESIGN AND SETTING: A mixed-methods study with simultaneous convergent design...... combining descriptive statistics and thematic analysis of 180 calls to a Danish out-of-hours service. METHOD: The following quantitative data were measured: age of caller, sex, reason for encounter, symptom duration, triage outcome, and degree of worry (rated from 1 = minimally worried to 5 = extremely...... worried). Qualitative data consisted of audio-recorded telephone calls. RESULTS: Most callers (170 out of 180) were able to scale their worry when contacting the out-of-hours service (median = 3, interquartile range = 2-4, mean = 2.76). Degree of worry was associated with female sex (odds ratio [OR] 1...

Energy Production System Management - Renewable energy power supply integration with Building Automation System

International Nuclear Information System (INIS)

Figueiredo, Joao; Martins, Joao

2010-01-01

Intelligent buildings, historically and technologically, refers to the integration of four distinctive systems: Building Automation Systems (BAS), Telecommunication Systems, Office Automation Systems and Computer Building Management Systems. The increasing sophisticated BAS has become the 'heart and soul' of modern intelligent buildings. Integrating energy supply and demand elements - often known as Demand-Side Management (DSM) - has became an important energy efficiency policy concept. Nowadays, European countries have diversified their power supplies, reducing the dependence on OPEC, and developing a broader mix of energy sources maximizing the use of renewable energy domestic sources. In this way it makes sense to include a fifth system into the intelligent building group: Energy Production System Management (EPSM). This paper presents a Building Automation System where the Demand-Side Management is fully integrated with the building's Energy Production System, which incorporates a complete set of renewable energy production and storage systems.

Automated validation of a computer operating system

Science.gov (United States)

Dervage, M. M.; Milberg, B. A.

1970-01-01

Programs apply selected input/output loads to complex computer operating system and measure performance of that system under such loads. Technique lends itself to checkout of computer software designed to monitor automated complex industrial systems.

Advanced paratransit system : an application of digital map, automated vehicle scheduling and vehicle location systems

Science.gov (United States)

1997-05-01

This report documents and evaluates an advanced Paratransit system demonstration project. The Santa Clara Valley Transportation Agency (SCVTA), via OUTREACH, implemented such a system, comprised of an automated trip scheduling system (ATSS) and autom...

Automated Assume-Guarantee Reasoning for Omega-Regular Systems and Specifications

Science.gov (United States)

Chaki, Sagar; Gurfinkel, Arie

2010-01-01

We develop a learning-based automated Assume-Guarantee (AG) reasoning framework for verifying omega-regular properties of concurrent systems. We study the applicability of non-circular (AGNC) and circular (AG-C) AG proof rules in the context of systems with infinite behaviors. In particular, we show that AG-NC is incomplete when assumptions are restricted to strictly infinite behaviors, while AG-C remains complete. We present a general formalization, called LAG, of the learning based automated AG paradigm. We show how existing approaches for automated AG reasoning are special instances of LAG.We develop two learning algorithms for a class of systems, called infinite regular systems, that combine finite and infinite behaviors. We show that for infinity-regular systems, both AG-NC and AG-C are sound and complete. Finally, we show how to instantiate LAG to do automated AG reasoning for infinite regular, and omega-regular, systems using both AG-NC and AG-C as proof rules

Testing a videogame intervention to recalibrate physician heuristics in trauma triage: study protocol for a randomized controlled trial.

Science.gov (United States)

Mohan, Deepika; Rosengart, Matthew R; Fischhoff, Baruch; Angus, Derek C; Farris, Coreen; Yealy, Donald M; Wallace, David J; Barnato, Amber E

2016-11-11

Between 30 and 40 % of patients with severe injuries receive treatment at non-trauma centers (under-triage), largely because of physician decision making. Existing interventions to improve triage by physicians ignore the role that intuition (heuristics) plays in these decisions. One such heuristic is to form an initial impression based on representativeness (how typical does a patient appear of one with severe injuries). We created a video game (Night Shift) to recalibrate physician's representativeness heuristic in trauma triage. We developed Night Shift in collaboration with emergency medicine physicians, trauma surgeons, behavioral scientists, and game designers. Players take on the persona of Andy Jordan, an emergency medicine physician, who accepts a new job in a small town. Through a series of cases that go awry, they gain experience with the contextual cues that distinguish patients with minor and severe injuries (based on the theory of analogical encoding) and receive emotionally-laden feedback on their performance (based on the theory of narrative engagement). The planned study will compare the effect of Night Shift with that of an educational program on physician triage decisions and on physician heuristics. Psychological theory predicts that cognitive load increases reliance on heuristics, thereby increasing the under-triage rate when heuristics are poorly calibrated. We will randomize physicians (n = 366) either to play the game or to review an educational program, and will assess performance using a validated virtual simulation. The validated simulation includes both control and cognitive load conditions. We will compare rates of under-triage after exposure to the two interventions (primary outcome) and will compare the effect of cognitive load on physicians' under-triage rates (secondary outcome). We hypothesize that: a) physicians exposed to Night Shift will have lower rates of under-triage compared to those exposed to the educational program

Distribution system analysis and automation

CERN Document Server

Gers, Juan

2013-01-01

A comprehensive guide to techniques that allow engineers to simulate, analyse and optimise power distribution systems which combined with automation, underpin the emerging concept of the "smart grid". This book is supported by theoretical concepts with real-world applications and MATLAB exercises.

Automated Operations Development for Advanced Exploration Systems

Science.gov (United States)

Haddock, Angie T.; Stetson, Howard

2012-01-01

Automated space operations command and control software development and its implementation must be an integral part of the vehicle design effort. The software design must encompass autonomous fault detection, isolation, recovery capabilities and also provide "single button" intelligent functions for the crew. Development, operations and safety approval experience with the Timeliner system onboard the International Space Station (ISS), which provided autonomous monitoring with response and single command functionality of payload systems, can be built upon for future automated operations as the ISS Payload effort was the first and only autonomous command and control system to be in continuous execution (6 years), 24 hours a day, 7 days a week within a crewed spacecraft environment. Utilizing proven capabilities from the ISS Higher Active Logic (HAL) System, along with the execution component design from within the HAL 9000 Space Operating System, this design paper will detail the initial HAL System software architecture and interfaces as applied to NASA's Habitat Demonstration Unit (HDU) in support of the Advanced Exploration Systems, Autonomous Mission Operations project. The development and implementation of integrated simulators within this development effort will also be detailed and is the first step in verifying the HAL 9000 Integrated Test-Bed Component [2] designs effectiveness. This design paper will conclude with a summary of the current development status and future development goals as it pertains to automated command and control for the HDU.

Orthopaedic podiatry triage: process outcomes of a skill mix initiative.

Science.gov (United States)

Homeming, Lyndon J; Kuipers, Pim; Nihal, Aneel

2012-11-01

The Orthopaedic Podiatry Triage Clinic (OPodTC) is a 'skill mix' model of care developed in Queensland Health to address the problem of lengthy waiting times for orthopaedic surgery on foot and ankle pathologies. It is based on the recognition that many orthopaedic surgery referrals can be identified early and treated conservatively with podiatry, averting the need for more costly and invasive surgical interventions. The model is collaborative and relies on screening and triage by the podiatrist, rather than delegation by the orthopaedic surgeon. Screening and triage through OPodTC was trialled at three Queensland Health hospital facilities during 2009 and 2010 to improve service timeliness. Patients identified by the OPodTC podiatrist as suitable for conservative management were provided with non-surgical podiatry interventions and discharged if appropriate. Those identified as still requiring surgical intervention after the benefit of interim conservative treatment provided by the podiatrist (or who chose to remain on the list) were returned to their previous place on the orthopaedic waiting list. This paper presents a summary and description of waiting list changes in association with this trial. The OPodTC intervention resulted in a reduction in the non-urgent category of the waiting list across the three hospitals of between 23.3% and 49.7%. Indications from wait-list service data demonstrated increased timeliness and improved patient flow, which are core goals of these skill mix initiatives. This study highlights the potential of screening and triage functions in the skill mix debate. In this example, conservative treatment options were considered first, suitable patients did not have to wait long periods to receive timely and appropriate interventions, and those for whom surgery was indicated, were provided with a more targeted service.

Using a forehead reflectance pulse oximeter to detect changes in sympathetic tone.

Science.gov (United States)

Wendelken, Suzanne M; McGrath, Susan P; Akay, Metin; Blike, George T

2004-01-01

The extreme conditions of combat and multi-casualty rescue often make field triage difficult and put the medic or first responder at risk. In an effort to improve field triage, we have developed an automated remote triage system called ARTEMIS (automated remote triage and emergency management information system) for use in the battlefield or disaster zone. Common to field injuries is a sudden change in arterial pressure resulting from massive blood loss or shock. In effort to stabilize the arterial pressure, the sympathetic system is strongly activated and sympathetic tone is increased. This preliminary research seeks to empirically demonstrate that a forehead reflectance pulse oximeter is a viable sensor for detecting sudden changes in sympathetic tone. We performed the classic supine-standing experiment and collected the raw waveform, the photoplethysmogram (PPG), continuously using a forehead reflectance pulse oximeter. The resulting waveform was processed in Matlab using various spectral analysis techniques (FFT and AR). Our preliminary results show that a relative ratio analysis (low frequency power/high frequency power) for both the raw PPG signal and its derived pulse statistics (height, beat-to-beat interval) is a useful technique for detecting change in sympathetic tone resulting from positional change.

Automated Transportation Management System (ATMS) user's manual. Revision 1

International Nuclear Information System (INIS)

Smith, P.D.

1994-01-01

The Automated Transportation Management System (ATMS) Software User Guide (SUG) constitutes the user procedures for the ATMS System. Information in this document will be used by the user to operate the automated system. It is intended to be used as a reference manual to guide and direct the user(s) through the ATMS software product and its environment. The objectives of ATMS are as follows: to better support the Procurement function with freight rate information; to free Transportation Logistics personnel from routine activities such as the auditing and input of freight billing information; to comply with Headquarters Department of Energy-Inspector General (DOE-IG) audit findings to automate transportation management functions; to reduce the keying of data into the Shipment Mobility Accountability Collection (SMAC) database; and to provide automation for the preparing of Bill of Lading, Declaration of Dangerous Goods, Emergency Response Guide and shipping Labels using HM181 Retrieval of hazardous material table text information

Booster: Development of a Toolbox for Triage of a Large Group of Individuals Exposed to Radioactive Material

International Nuclear Information System (INIS)

Schoepff, V.; Carrel, F.; Gmar, M.; Lemaire, H.; Carvajal, F.; Perez-Llopis, I.; Gaboriau, D.-C.; Morrison, C.-G.; Almasi, I.; Szabo, S.; Kovacs, A; Szeles, E.; Amgarou, K.; Menaa, N.; Morat, L.; Testard, I.; Ugolin, N.; Viau, M.; Becker, F.; Raskob, W.; Trybushnyi, D.; Vincze, A.

2013-06-01

The effective management of an event involving the exposure of a large number of people to radioactive material requires a mechanism for fast triage of exposed people. BOOSTER is a project founded by the European Union under the Seventh Framework Programme, addressing this requirement. It is a capability project designed to provide an integrated system which could easily be deployed and used. For this purpose, the BOOSTER consortium, relying on the expertise of seven members, researches and develops new approaches to allow an effective and fast management of most kind of nuclear threats. BOOSTER System was designed to help first responders mitigating the crisis by providing the necessary information to quickly assess the radiological situation, to support triage staff in performing an efficient and fast categorization of the potentially affected victims, and to give medical staff crucial information for further treatment at medium or long term post-accident. (authors)

The efficacy of an automated feedback system for general practitioners

NARCIS (Netherlands)

Bindels, Rianne; Hasman, Arie; Kester, Arnold D.; Talmon, Jan L.; de Clercq, Paul A.; Winkens, Ron A. G.

2003-01-01

OBJECTIVE: An automated feedback system that produces comments about the non-adherence of general practitioners (GPs) to accepted practice guidelines for ordering diagnostic tests was developed. Before implementing the automated feedback system in daily practice, we assessed the potential effect of

An Automated System for Incubation of Pelagic Fish Eggs

Directory of Open Access Journals (Sweden)

Leif Jørgensen

1987-01-01

Full Text Available An automated system for incubation of pelagic fish eggs is described. The system has an internal air driven water circulation which separates healthy and dead or strongly infected eggs. A processor controlled, pulsed water exchange provides a strongly reduced water requirement. The equipment has also an automated temperature and salinity control and adjustment.

Wireless energizing system for an automated implantable sensor

Energy Technology Data Exchange (ETDEWEB)

Swain, Biswaranjan; Nayak, Praveen P.; Kar, Durga P.; Bhuyan, Satyanarayan; Mishra, Laxmi P. [Department of Electronics and Instrumentation Engineering, Siksha ‘O’ Anusandhan University, Bhubaneswar 751030 (India)

2016-07-15

The wireless drive of an automated implantable electronic sensor has been explored for health monitoring applications. The proposed system comprises of an automated biomedical sensing system which is energized through resonant inductive coupling. The implantable sensor unit is able to monitor the body temperature parameter and sends back the corresponding telemetry data wirelessly to the data recoding unit. It has been observed that the wireless power delivery system is capable of energizing the automated biomedical implantable electronic sensor placed over a distance of 3 cm from the power transmitter with an energy transfer efficiency of 26% at the operating resonant frequency of 562 kHz. This proposed method ensures real-time monitoring of different human body temperatures around the clock. The monitored temperature data have been compared with a calibrated temperature measurement system to ascertain the accuracy of the proposed system. The investigated technique can also be useful for monitoring other body parameters such as blood pressure, bladder pressure, and physiological signals of the patient in vivo using various implantable sensors.

Wireless energizing system for an automated implantable sensor

International Nuclear Information System (INIS)

Swain, Biswaranjan; Nayak, Praveen P.; Kar, Durga P.; Bhuyan, Satyanarayan; Mishra, Laxmi P.

2016-01-01

The wireless drive of an automated implantable electronic sensor has been explored for health monitoring applications. The proposed system comprises of an automated biomedical sensing system which is energized through resonant inductive coupling. The implantable sensor unit is able to monitor the body temperature parameter and sends back the corresponding telemetry data wirelessly to the data recoding unit. It has been observed that the wireless power delivery system is capable of energizing the automated biomedical implantable electronic sensor placed over a distance of 3 cm from the power transmitter with an energy transfer efficiency of 26% at the operating resonant frequency of 562 kHz. This proposed method ensures real-time monitoring of different human body temperatures around the clock. The monitored temperature data have been compared with a calibrated temperature measurement system to ascertain the accuracy of the proposed system. The investigated technique can also be useful for monitoring other body parameters such as blood pressure, bladder pressure, and physiological signals of the patient in vivo using various implantable sensors.

Wireless energizing system for an automated implantable sensor.

Science.gov (United States)

Swain, Biswaranjan; Nayak, Praveen P; Kar, Durga P; Bhuyan, Satyanarayan; Mishra, Laxmi P

2016-07-01

The wireless drive of an automated implantable electronic sensor has been explored for health monitoring applications. The proposed system comprises of an automated biomedical sensing system which is energized through resonant inductive coupling. The implantable sensor unit is able to monitor the body temperature parameter and sends back the corresponding telemetry data wirelessly to the data recoding unit. It has been observed that the wireless power delivery system is capable of energizing the automated biomedical implantable electronic sensor placed over a distance of 3 cm from the power transmitter with an energy transfer efficiency of 26% at the operating resonant frequency of 562 kHz. This proposed method ensures real-time monitoring of different human body temperatures around the clock. The monitored temperature data have been compared with a calibrated temperature measurement system to ascertain the accuracy of the proposed system. The investigated technique can also be useful for monitoring other body parameters such as blood pressure, bladder pressure, and physiological signals of the patient in vivo using various implantable sensors.

Physiotherapy in Primary Care Triage - the effects on utilization of medical services at primary health care clinics by patients and sub-groups of patients with musculoskeletal disorders: a case-control study.

Science.gov (United States)

Bornhöft, Lena; Larsson, Maria E H; Thorn, Jörgen

2015-01-01

Primary Care Triage is a patient sorting system used in some primary health care clinics (PHCCs) in Sweden where patients with musculoskeletal disorders (MSD) are triaged directly to physiotherapists. The purpose of this study was to investigate whether sorting/triaging patients seeking a PHCC for MSD directly to physiotherapists affects their utilization of medical services at the clinic for the MSD and to determine whether the effects of the triaging system vary for different sub-groups of patients. A retrospective case-control study design was used at two PHCCs. At the intervention clinic, 656 patients with MSD were initially triaged to physiotherapists. At the control clinic, 1673 patients were initially assessed by general practitioners (GPs). The main outcome measures were the number of patients continuing to visit GPs after the initial assessment, the number of patients receiving referrals to specialists/external examinations, doctors' notes for sick-leave or prescriptions for analgesics during one year, all for the original MSD. Significantly fewer patients triaged to physiotherapists required multiple GP visits for the MSD or received MSD-related referrals to specialists/external examinations, sick-leave recommendations or prescriptions during the following year compared to the GP-assessed group. This applies to all sub-groups except for the group with lower extremity disorders, which did not reach significance for either multiple GP visits or sick-leave recommendations. The reduced utilization of medical services by patients with MSD who were triaged to physiotherapists at a PHCC is likely due to altered management of MSD with initial assessment by physiotherapists.

Helicopter emergency medical services (HEMS) over-triage and the financial implications for major trauma centres in NSW, Australia.

Science.gov (United States)

Taylor, Colman B; Curtis, Kate; Jan, Stephen; Newcombe, Mark

2013-07-01

In NSW Australia, a formal trauma system including the use of helicopter emergency medical services (HEMS) has existed for over 20 years. Despite providing many advantages in NSW, HEMS patients are frequently over-triaged; leading to financial implications for major trauma centres that receive HEMS patients. The aim of this study was to investigate the financial implications of HEMS over-triage from the perspective of major trauma centres in NSW. The study sample included all trauma patients transported via HEMS to 12 major trauma centres in NSW during the period: 1 July 2008 to 30 June 2009. Clinical data were gathered from individual hospital trauma registries and merged with financial information obtained from casemix units at respective hospitals. HEMS over-triage was estimated based on the local definition of minor to moderate trauma (ISS≤12) and hospital length of stay of less than 24 hrs. The actual treatment costs were determined and compared to state-wide peer group averages to obtain estimates of potential funding discrepancies. A total of 707 patients transported by HEMS were identified, including 72% pre-hospital (PH; n=507) and 28% inter-hospital (IH; n=200) transports. Over-triage was estimated at 51% for PH patients and 29% for IH patients. Compared to PH patients, IH patients were more costly to treat on average (IH: $42,604; PH: $25,162), however PH patients were more costly overall ($12,329,618 [PH]; $8,265,152 [IH]). When comparing actual treatment costs to peer group averages we found potential funding discrepancies ranging between 4% and 32% across patient groups. Using a sensitivity analysis, the potential funding discrepancy increased with increasing levels of over-triage. HEMS patients are frequently over-triaged in NSW, leading to funding implications for major trauma centres. In general, HEMS patient treatment costs are higher than the peer group average and the potential funding discrepancy varies by injury severity and the type of

A pivot nurse at triage.

Science.gov (United States)

Martin, Marie

2012-01-01

According to Drs Thom Mayer and Kirk Jensen, widely recognized experts in leadership, management, and customer service, "Improving patient flow essentially means patients spend exactly the right amount of time at every juncture in their journey through an organization, when you improve flow, you can serve more patients, with less effort and you can serve them better." 2 Recognizing that backups in the emergency department are a result of broken processes throughout the hospital is the first step in solving these problems. The most significant challenges are the prevailing attitudes that team triage and immediate bedding could not be done. Another challenge is the broad reaching nature of the issue. ED throughput is truly a system problem. As ED crowding worsens, it is important for departments to improve operations to promote patient throughput. No doubt, operational bottlenecks at the back end of the emergency department will ultimately lead to front-end delays. However, proficient patient processing at the ED front end can minimize the time to physician evaluation, increase patient satisfaction, and decrease totalED length of stay.

Optimizing human-system interface automation design based on a skill-rule-knowledge framework

International Nuclear Information System (INIS)

Lin, Chiuhsiang Joe; Yenn, T.-C.; Yang, C.-W.

2010-01-01

This study considers the technological change that has occurred in complex systems within the past 30 years. The role of human operators in controlling and interacting with complex systems following the technological change was also investigated. Modernization of instrumentation and control systems and components leads to a new issue of human-automation interaction, in which human operational performance must be considered in automated systems. The human-automation interaction can differ in its types and levels. A system design issue is usually realized: given these technical capabilities, which system functions should be automated and to what extent? A good automation design can be achieved by making an appropriate human-automation function allocation. To our knowledge, only a few studies have been published on how to achieve appropriate automation design with a systematic procedure. Further, there is a surprising lack of information on examining and validating the influences of levels of automation (LOAs) on instrumentation and control systems in the advanced control room (ACR). The study we present in this paper proposed a systematic framework to help in making an appropriate decision towards types of automation (TOA) and LOAs based on a 'Skill-Rule-Knowledge' (SRK) model. From the evaluating results, it was shown that the use of either automatic mode or semiautomatic mode is insufficient to prevent human errors. For preventing the occurrences of human errors and ensuring the safety in ACR, the proposed framework can be valuable for making decisions in human-automation allocation.

NASA Systems Autonomy Demonstration Project - Development of Space Station automation technology

Science.gov (United States)

Bull, John S.; Brown, Richard; Friedland, Peter; Wong, Carla M.; Bates, William

1987-01-01

A 1984 Congressional expansion of the 1958 National Aeronautics and Space Act mandated that NASA conduct programs, as part of the Space Station program, which will yield the U.S. material benefits, particularly in the areas of advanced automation and robotics systems. Demonstration programs are scheduled for automated systems such as the thermal control, expert system coordination of Station subsystems, and automation of multiple subsystems. The programs focus the R&D efforts and provide a gateway for transfer of technology to industry. The NASA Office of Aeronautics and Space Technology is responsible for directing, funding and evaluating the Systems Autonomy Demonstration Project, which will include simulated interactions between novice personnel and astronauts and several automated, expert subsystems to explore the effectiveness of the man-machine interface being developed. Features and progress on the TEXSYS prototype thermal control system expert system are outlined.

The Effect of Start Triage Education on Knowledge and Practice of Emergency Medical Technicians in Disasters

Directory of Open Access Journals (Sweden)

Mahboub Pouraghaei

2017-06-01

Full Text Available Introduction: Pre-hospital triage is one of the most fundamental concepts in emergency management. Limited human resource changes triage to an inevitable solution in the management of disasters. The aim of this study was to evaluate the role of education of simple triage and rapid treatment (START in the knowledge and practice of Emergency Medical Service (EMS employees of Eastern Azerbaijan. Methods: This is a pre-and post-intervention study conducted on two hundred and five (205 of employees of EMS sector, in the disaster and emergency management center of Eastern Azerbaijan Province, 2015. The utilized tool is a questionnaire of the knowledge and practice of individuals regarding START triage. The questionnaire was filled by the participants pre- and post-education; thereafter the data were analyzed using SPSS 13 software. Results: The total score of the participants increased from 22.02 (4.49 to 28.54 (3.47. Moreover, the score of sections related to knowledge of the triage was a necessity and the mean score of the section related to the practice increased from 11.47 (2.15 to 13.63 (1.38, and 10.73 (3.57 to 14.93 (2.78, respectively, which were statistically significant. Conclusion: In this study, it was found that holding the educational classes of pre-hospital triage before the disasters is effective in improving the knowledge and practice of employees such as EMS technicians and this resulted to decreased error in performing this process as well as reduced overload in hospitals.

The Effect of Start Triage Education on Knowledge and Practice of Emergency Medical Technicians in Disasters.

Science.gov (United States)

Pouraghaei, Mahboub; Sadegh Tabrizi, Jaafar; Moharamzadeh, Payman; Rajaei Ghafori, Rozbeh; Rahmani, Farzad; Najafi Mirfakhraei, Baharak

2017-06-01

Introduction: Pre-hospital triage is one of the most fundamental concepts in emergency management. Limited human resource changes triage to an inevitable solution in the management of disasters. The aim of this study was to evaluate the role of education of simple triage and rapid treatment (START) in the knowledge and practice of Emergency Medical Service (EMS) employees of Eastern Azerbaijan. Methods: This is a pre-and post-intervention study conducted on two hundred and five (205) of employees of EMS sector, in the disaster and emergency management center of Eastern Azerbaijan Province, 2015. The utilized tool is a questionnaire of the knowledge and practice of individuals regarding START triage. The questionnaire was filled by the participants pre- and post-education; thereafter the data were analyzed using SPSS 13 software. Results: The total score of the participants increased from 22.02 (4.49) to 28.54 (3.47). Moreover, the score of sections related to knowledge of the triage was a necessity and the mean score of the section related to the practice increased from 11.47 (2.15) to 13.63 (1.38), and 10.73 (3.57) to 14.93 (2.78), respectively, which were statistically significant. Conclusion: In this study, it was found that holding the educational classes of pre-hospital triage before the disasters is effective in improving the knowledge and practice of employees such as EMS technicians and this resulted to decreased error in performing this process as well as reduced overload in hospitals.

Electronic sorting of radioactive ores; Triage electronique des minerais radioactifs

Energy Technology Data Exchange (ETDEWEB)

Sandier, J.

1958-01-15

Electronic sorting of radioactive ores consists in passing the rock lumps, after sieving, one by one in front of radioactivity detectors; these detectors command electromechanical systems which class the ores according to their radioactivity level. This note sets on the state of progress of the work going on at the D.R.E.M.: use of scintillometers for γ-ray detection, with circuits carrying magnetic memories to improve their operation; results of laboratory and semi-industrial tests on several deposits; description of the material, data on the first factory project; notes on the financial returns of the process. A description is also given of the electronic sorting material used skip by skip for a first rough classification of the ores according to their content, as they leave the shaft. (author) [French] Le triage electronique des minerais radioactifs consiste a faire passer, apres criblage, les cailloux un par un devant des detecteurs de radioactivite; ces detecteurs commandent des systemes electromecaniques qui classent les minerais selon leur niveau de radioactivite. La note expose l'etat d'avancement des travaux en cours a la D.R.E.M: utilisation des scintillometres pour la detection des rayonnements γ, de circuits comportant des memoires magnetiques pour ameliorer le fonctionnement; resultats d'essais de laboratoire et semi-industriels sur plusieurs gisements; description du materiel, donnees sur le premier projet d'usine; notes sur la rentabilite du procede. Est egalement decrit le materiel de triage electronique skip par skip utilise pour une premiere classification grossiere des minerais selon leurs teneurs, des la sortie des puits. (auteur)

Outcomes of nighttime refusal of admission to the intensive care unit: The role of the intensivist in triage.

Science.gov (United States)

Hinds, Nicholas; Borah, Amit; Yoo, Erika J

2017-06-01

To compare outcomes of patients refused medical intensive care unit (MICU) admission overnight to those refused during the day and to examine the impact of the intensivist in triage. Retrospective, observational study of patients refused MICU admission at an urban university hospital. Of 294 patients, 186 (63.3%) were refused admission overnight compared to 108 (36.7%) refused during the day. Severity-of-illness by the Mortality Probability Model was similar between the two groups (P=.20). Daytime triage refusals were more likely to be staffed by an intensivist (P=.01). After risk-adjustment, daytime refusals had a lower odds of subsequent ICU admission (OR 0.46, 95% CI 0.22-0.95, P=.04) than patients triaged at night. There was no evidence for interaction between time of triage and intensivist staffing of the patient (P=.99). Patients refused MICU admission overnight are more likely to be later admitted to an ICU than patients refused during the day. However, the mechanism for this observation does not appear to depend on the intensivist's direct evaluation of the patient. Further investigation into the clinician-specific effects of ICU triage and identification of potentially modifiable hospital triage practices will help to improve both ICU utilization and patient safety. Copyright © 2017 Elsevier Inc. All rights reserved.

Automation and robotics technology for intelligent mining systems

Science.gov (United States)

Welsh, Jeffrey H.

1989-01-01

The U.S. Bureau of Mines is approaching the problems of accidents and efficiency in the mining industry through the application of automation and robotics to mining systems. This technology can increase safety by removing workers from hazardous areas of the mines or from performing hazardous tasks. The short-term goal of the Automation and Robotics program is to develop technology that can be implemented in the form of an autonomous mining machine using current continuous mining machine equipment. In the longer term, the goal is to conduct research that will lead to new intelligent mining systems that capitalize on the capabilities of robotics. The Bureau of Mines Automation and Robotics program has been structured to produce the technology required for the short- and long-term goals. The short-term goal of application of automation and robotics to an existing mining machine, resulting in autonomous operation, is expected to be accomplished within five years. Key technology elements required for an autonomous continuous mining machine are well underway and include machine navigation systems, coal-rock interface detectors, machine condition monitoring, and intelligent computer systems. The Bureau of Mines program is described, including status of key technology elements for an autonomous continuous mining machine, the program schedule, and future work. Although the program is directed toward underground mining, much of the technology being developed may have applications for space systems or mining on the Moon or other planets.

Awareness and usage of automated library systems by patrons in ...

African Journals Online (AJOL)

The emergence of automated information systems in libraries has changed the landscape of library environment. This paper assessed awareness and usage of automated information systems in two academic libraries in Nigeria; University of Lagos Main Library and Keneth Dike Library, University of Ibadan. Survey ...

Audit of the Reporting Requirements for Major Automated Information System Programs

National Research Council Canada - National Science Library

2000-01-01

.... There are 71 Major Automated Information System programs with total program costs of $26 billion. To qualify as a Major Automated Information System, the program must meet the following critena...

Safeguards and security considerations for automated and robotic systems

Energy Technology Data Exchange (ETDEWEB)

Jordan, S.E.; Jaeger, C.D.

1994-09-01

Within the reconfigured Nuclear Weapons Complex there will be a large number of automated and robotic (A&R) systems because of the many benefits derived from their use. To meet the overall security requirements of a facility, consideration must be given to those systems that handle and process nuclear material. Since automation and robotics is a relatively new technology, not widely applied to the Nuclear Weapons Complex, safeguards and security (S&S) issues related to these systems have not been extensively explored, and no guidance presently exists. The goal of this effort is to help integrate S&S into the design of future A&R systems. Towards this, the authors first examined existing A and R systems from a security perspective to identify areas of concern and possible solutions of these problems. They then were able to develop generalized S&S guidance and design considerations for automation and robotics.

Comparison of the 1999 and 2006 Trauma Triage Guidelines: Where do Patients Go?

Science.gov (United States)

Lerner, E. Brooke; Shah, Manish N.; Swor, Robert; Cushman, Jeremy T.; Guse, Clare E.; Brasel, Karen; Blatt, Alan; Jurkovich, Gregory J.

2010-01-01

In 2006, the CDC released a revised Field Triage Decision Scheme. It is unknown how this modified scheme will affect the number of patients identified by EMS for transport to a trauma center. Objective To determine the change in the number of patients transported by EMS who meet the 2006 scheme, compared to the 1999 scheme, and to determine how the scheme change would affect under- and over-triage rates. Methods EMS providers in charge of care for injured adult patients transported to a regional trauma center in three mid-sized cities were interviewed immediately after completing transport. All injured patients were included, regardless of severity. The interview included patient demographics, vital signs, apparent anatomic injury, and the mechanism of injury. Included patients were then followed through hospital discharge. The 1999 and 2006 scheme criteria were each retrospectively applied to the collected data. The number of patients identified by the two schemes was determined. Patients were considered to have needed a trauma center if they had non-orthopedic surgery within 24 hours, ICU admission, or died. Data were analyzed using descriptive statistics including 95% confidence intervals. Results EMS interviews were conducted for 11,892 patients and outcome data was unavailable for one patient. Average patient age was 48 years; 51% were men. Providers reported bringing 54% of the enrolled patients to the trauma center based on their local trauma protocol. 12% of enrolled patients were identified as needing a trauma center based on medical record review. Use of the 2006 scheme would have resulted in 1,423 fewer patients (12%; 95% CI:11-13%) being identified as needing a trauma center by EMS providers (40%; 95%CI:39-41% versus 28%; 95%CI:27-29%). 1,344 of those patients did not actually need the resources of a trauma center (94%). 78 (6%) of those patients actually needed the resources of a trauma center and would have been under-triaged. Conclusion Use of the

The reliability of the Manchester Triage System (MTS): a meta-analysis.

Science.gov (United States)

Mirhaghi, Amir; Mazlom, Reza; Heydari, Abbas; Ebrahimi, Mohsen

2017-05-01

Although the Manchester Triage System (MTS) was first developed two decades ago, the reliability of the MTS has not been questioned through comparison with a moderating variable; therefore, the aim of this study is to determine the extent of the reliability of MTS using a meta-analytic review. Electronic databases were searched up to 1 March 2014. Studies were only included if they had reported sample sizes, reliability coefficients, and adequate description of the reliability assessment. The Guidelines for Reporting Reliability and Agreement Studies was used. Two reviewers independently examined abstracts and extracted data. The effect size was obtained by the z-transformation of reliability coefficients. Data were pooled with random-effects models, and meta-regression was performed based on the method-of-moments estimator. Seven studies were included. The pooled coefficient for the MTS was substantial at 0.751 (CI 95%: 0.677 to 0.810); the incidence of mistriage is greater than 50%. Agreement is higher for the latest version of MTS (for adults) among nurse-experts and in countries in closer proximity to the country of MTS origin (the UK, in Manchester) than for the oldest (pediatric) version, nurse-nurse raters, and countries at a greater distance from the UK. The MTS showed an acceptable level of overall reliability in the emergency department, but more development is required to attain almost perfect agreement. © 2016 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

Perceptions and Challenges of Using Emergency Triage Assessment Treatment Guideline in Emergency Department at Muhimbili National Hospital, Tanzania

OpenAIRE

Safari, Sixtus Ruyumbu

2012-01-01

Triage is the process of determining the priority of patients' treatments based on the severity of their conditions. This helps treating patients efficiently when resources are insufficient for all to be treated immediately. Health care providers use ETAT guideline during triaging patients to improve quality of care and reduce morbidity and mortality rates. But the adherence to the guidelines protocol has been a challenge in triage rooms. This paper assessed perspective of HCWs and challenges...

Development of an automation system for a tablet coater

DEFF Research Database (Denmark)

Ruotsalainen, Mirja; Heinämäki, Jyrki; Rantanen, Jukka

2002-01-01

An instrumentation and automation system for a side-vented pan coater with a novel air-flow rate measurement system for monitoring the film-coating process of tablets was designed and tested. The instrumented coating system was tested and validated by film-coating over 20 pilot-scale batches...... and automated pan-coating system described, including historical data storage capability and a novel air-flow measurement system, is a useful tool for controlling and characterizing the tablet film-coating process. Monitoring of critical process parameters increases the overall coating process efficiency...

System of automated map design

International Nuclear Information System (INIS)

Ponomarjov, S.Yu.; Rybalko, S.I.; Proskura, N.I.

1992-01-01

Preprint 'System of automated map design' contains information about the program shell for construction of territory map, performing level line drawing of arbitrary two-dimension field (in particular, the radionuclide concentration field). The work schedule and data structures are supplied, as well as data on system performance. The preprint can become useful for experts in radioecology and for all persons involved in territory pollution mapping or multi-purpose geochemical mapping. (author)

THE QUESTION OF DEVELOPMENT OF AUTOMATED SYSTEMS FOR TRAFFIC MANAGEMENT

Directory of Open Access Journals (Sweden)

V. Shirin

2015-12-01

Full Text Available The current systems and methods for automated traffic management in cities are analyzed. The management in cities is analyzed. The management levels are specified. There were fermulated the general requirements, objectives and funnctions of the automated sistems for traffic management with regard to the modern transport problems as well as proposed their aditional managemrnt and infor-maton functions. A phased approach to the implementation of projects on creation of automated sys-tems of traffic management is offered.

Can interprofessional teamwork reduce patient throughput times? A longitudinal single-centre study of three different triage processes at a Swedish emergency department.

Science.gov (United States)

Liu, Jenny; Masiello, Italo; Ponzer, Sari; Farrokhnia, Nasim

2018-04-19

To determine the impact on emergency department (ED) throughput times and proportion of patients who leave without being seen by a physician (LWBS) of two triage interventions, where comprehensive nurse-led triage was first replaced by senior physician-led triage and then by interprofessional teamwork. Single-centre before-and-after study. Adult ED of a Swedish urban hospital. Patients arriving on weekdays 08:00 to 21:00 during three 1-year periods in the interval May 2012 to November 2015. A total of 185 806 arrivals were included. Senior physicians replaced triage nurses May 2013 to May 2014. Interprofessional teamwork replaced the triage process on weekdays 08:00 to 21:00 November 2014 to November 2015. Primary outcomes were the median time to physician (TTP) and the median length of stay (LOS). Secondary outcome was the LWBS rate. The crude median LOS was shortest for teamwork, 228 min (95% CI 226.4 to 230.5) compared with 232 min (95% CI 230.8 to 233.9) for nurse-led and 250 min (95% CI 248.5 to 252.6) for physician-led triage. The adjusted LOS for the teamwork period was 16 min shorter than for nurse-led triage and 23 min shorter than for physician-led triage. The median TTP was shortest for physician-led triage, 56 min (95% CI 54.5 to 56.6) compared with 116 min (95% CI 114.4 to 117.5) for nurse-led triage and 74 min (95% CI 72.7 to 74.8) for teamwork. The LWBS rate was 1.9% for nurse-led triage, 1.2% for physician-led triage and 3.2% for teamwork. All outcome measure differences had two-tailed p valuesteamwork had the shortest length of stay, a shorter time to physician than nurse-led triage, but a higher LWBS rate. Interprofessional teamwork may be a useful approach to reducing ED throughput times. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Automated Systems for Road Safety control in a Developing World ...

African Journals Online (AJOL)

An Automated system was finally designed and developed for road safety control. This Automated system is believed to have the capacity to minimize or eliminate the problems identified in this study on traffic control in a developing world. Key words: drivers, traffic situation information, accident causation, FRSC ...

Meta-domains for Automated System Identification

National Research Council Canada - National Science Library

Easley, Matthew; Bradley, Elizabeth

2000-01-01

.... In particular we introduce a new structure for automated model building known as a meta-domain which, when instantiated with domain-specific components tailors the space of candidate models to the system at hand...

CERES AuTomAted job Loading SYSTem (CATALYST): An automated workflow manager for satellite data production

Science.gov (United States)

Gleason, J. L.; Hillyer, T. N.; Wilkins, J.

2012-12-01

The CERES Science Team integrates data from 5 CERES instruments onboard the Terra, Aqua and NPP missions. The processing chain fuses CERES observations with data from 19 other unique sources. The addition of CERES Flight Model 5 (FM5) onboard NPP, coupled with ground processing system upgrades further emphasizes the need for an automated job-submission utility to manage multiple processing streams concurrently. The operator-driven, legacy-processing approach relied on manually staging data from magnetic tape to limited spinning disk attached to a shared memory architecture system. The migration of CERES production code to a distributed, cluster computing environment with approximately one petabyte of spinning disk containing all precursor input data products facilitates the development of a CERES-specific, automated workflow manager. In the cluster environment, I/O is the primary system resource in contention across jobs. Therefore, system load can be maximized with a throttling workload manager. This poster discusses a Java and Perl implementation of an automated job management tool tailored for CERES processing.

Home Automation System Based on Intelligent Transducer Enablers

Science.gov (United States)

Suárez-Albela, Manuel; Fraga-Lamas, Paula; Fernández-Caramés, Tiago M.; Dapena, Adriana; González-López, Miguel

2016-01-01

This paper presents a novel home automation system named HASITE (Home Automation System based on Intelligent Transducer Enablers), which has been specifically designed to identify and configure transducers easily and quickly. These features are especially useful in situations where many transducers are deployed, since their setup becomes a cumbersome task that consumes a significant amount of time and human resources. HASITE simplifies the deployment of a home automation system by using wireless networks and both self-configuration and self-registration protocols. Thanks to the application of these three elements, HASITE is able to add new transducers by just powering them up. According to the tests performed in different realistic scenarios, a transducer is ready to be used in less than 13 s. Moreover, all HASITE functionalities can be accessed through an API, which also allows for the integration of third-party systems. As an example, an Android application based on the API is presented. Remote users can use it to interact with transducers by just using a regular smartphone or a tablet. PMID:27690031

Home Automation System Based on Intelligent Transducer Enablers.

Science.gov (United States)

Suárez-Albela, Manuel; Fraga-Lamas, Paula; Fernández-Caramés, Tiago M; Dapena, Adriana; González-López, Miguel

2016-09-28

This paper presents a novel home automation system named HASITE (Home Automation System based on Intelligent Transducer Enablers), which has been specifically designed to identify and configure transducers easily and quickly. These features are especially useful in situations where many transducers are deployed, since their setup becomes a cumbersome task that consumes a significant amount of time and human resources. HASITE simplifies the deployment of a home automation system by using wireless networks and both self-configuration and self-registration protocols. Thanks to the application of these three elements, HASITE is able to add new transducers by just powering them up. According to the tests performed in different realistic scenarios, a transducer is ready to be used in less than 13 s. Moreover, all HASITE functionalities can be accessed through an API, which also allows for the integration of third-party systems. As an example, an Android application based on the API is presented. Remote users can use it to interact with transducers by just using a regular smartphone or a tablet.

Home Automation System Based on Intelligent Transducer Enablers

Directory of Open Access Journals (Sweden)

Manuel Suárez-Albela

2016-09-01

Full Text Available This paper presents a novel home automation system named HASITE (Home Automation System based on Intelligent Transducer Enablers, which has been specifically designed to identify and configure transducers easily and quickly. These features are especially useful in situations where many transducers are deployed, since their setup becomes a cumbersome task that consumes a significant amount of time and human resources. HASITE simplifies the deployment of a home automation system by using wireless networks and both self-configuration and self-registration protocols. Thanks to the application of these three elements, HASITE is able to add new transducers by just powering them up. According to the tests performed in different realistic scenarios, a transducer is ready to be used in less than 13 s. Moreover, all HASITE functionalities can be accessed through an API, which also allows for the integration of third-party systems. As an example, an Android application based on the API is presented. Remote users can use it to interact with transducers by just using a regular smartphone or a tablet.

Multibiodose radiation emergency triage categorization software.

Science.gov (United States)

Ainsbury, Elizabeth A; Barnard, Stephen; Barrios, Lleonard; Fattibene, Paola; de Gelder, Virginie; Gregoire, Eric; Lindholm, Carita; Lloyd, David; Nergaard, Inger; Rothkamm, Kai; Romm, Horst; Scherthan, Harry; Thierens, Hubert; Vandevoorde, Charlot; Woda, Clemens; Wojcik, Andrzej

2014-07-01

In this note, the authors describe the MULTIBIODOSE software, which has been created as part of the MULTIBIODOSE project. The software enables doses estimated by networks of laboratories, using up to five retrospective (biological and physical) assays, to be combined to give a single estimate of triage category for each individual potentially exposed to ionizing radiation in a large scale radiation accident or incident. The MULTIBIODOSE software has been created in Java. The usage of the software is based on the MULTIBIODOSE Guidance: the program creates a link to a single SQLite database for each incident, and the database is administered by the lead laboratory. The software has been tested with Java runtime environment 6 and 7 on a number of different Windows, Mac, and Linux systems, using data from a recent intercomparison exercise. The Java program MULTIBIODOSE_1.0.jar is freely available to download from http://www.multibiodose.eu/software or by contacting the software administrator: MULTIBIODOSE-software@gmx.com.

Automated control system for the Temelin nuclear power plant

International Nuclear Information System (INIS)

Labik, V.

1990-01-01

Instrumentation of the automated control system of the Temelin nuclear power plant in the section of the main production unit and of the major auxiliary equipment is described, the results of testing are reported, and the present status of design activities is assessed. The suitability of application of Czechoslovak automation facilities to the instrumentation of the automated control system of the power plant was confirmed by the Soviet designer and supplier based on favorable results of polygonal testing. Capacity problems in the development of the designs and user software are alleviated by extensive cooperation. It is envisaged that all tasks will be fulfilled as planned. (P.A.). 1 fig., 5 refs

Remote systems and automation in radioactive waste package handling

International Nuclear Information System (INIS)

Gneiting, B.C.; Hayward, M.L.

1987-01-01

A proof-of-principle test was conducted at the Hanford Engineering Development Laboratory (HEDL) to demonstrate the feasibility of performing cask receiving and unloading operations in a remote and partially automated manner. This development testing showed feasibility of performing critical cask receipt, preparation, and unloading operations from a single control station using remote controls and indirect viewing. Using robotics and remote automation in a cask handling system can result in lower personnel exposure levels and cask turnaround times while maintaining operational flexibility. An automated cask handling system presents a flexible state-of-the-art, cost effective alternative solution to hands-on methods that have been used in the past

Vibration-based Energy Harvesting Systems Characterization Using Automated Electronic Equipment

Directory of Open Access Journals (Sweden)

Ioannis KOSMADAKIS

2015-04-01

Full Text Available A measurement bench has been developed to fully automate the procedure for the characterization of a vibration-based energy scavenging system. The measurement system is capable of monitoring all important characteristics of a vibration harvesting system (input and output voltage, current, and other parameters, frequency and acceleration values, etc.. It is composed of a PC, typical digital measuring instruments (oscilloscope, waveform generator, etc., certain sensors and actuators, along with a microcontroller based automation module. The automation of the procedure and the manipulation of the acquired data are performed by LabVIEW software. Typical measurements of a system consisting of a vibrating source, a vibration transducer and an active rectifier are presented.

Status on the Finnish activities regarding qualification of programmable automation systems

International Nuclear Information System (INIS)

Juslin, K.

1995-01-01

The research work on qualification of programmable automation system is described which describe the development of methods, tools and practices for the evaluation and licensing of safety critical programmable automation systems. 26 refs

Robotic and nuclear safety for an automated/teleoperated glove box system

International Nuclear Information System (INIS)

Domning, E.E.; McMahon, T.T.; Sievers, R.H.

1991-09-01

Lawrence Livermore National Laboratory (LLNL) is developing a fully automated system to handle the processing of special nuclear materials (SNM). This work is performed in response to the new goals at the Department of Energy (DOE) for hazardous waste minimization and radiation dose reduction. This fully automated system, called the automated test bed (ATB), consists of an IBM gantry robot and automated processing equipment sealed within a glove box. While the ATB is a cold system, we are designing it as a prototype of the future hot system. We recognized that identification and application of safety requirements early in the design phase will lead to timely installation and approval of the hot system. This paper identifies these safety issues as well as the general safety requirements necessary for the safe operation of the ATB. 4 refs., 2 figs

High-content phenotypic screening and triaging strategy to identify small molecules driving oligodendrocyte progenitor cell differentiation.

Science.gov (United States)

Peppard, Jane V; Rugg, Catherine A; Smicker, Matthew A; Powers, Elaine; Harnish, Erica; Prisco, Joy; Cirovic, Dragan; Wright, Paul S; August, Paul R; Chandross, Karen J

2015-03-01

Multiple Sclerosis is a demyelinating disease of the CNS and the primary cause of neurological disability in young adults. Loss of myelinating oligodendrocytes leads to neuronal dysfunction and death and is an important contributing factor to this disease. Endogenous oligodendrocyte precursor cells (OPCs), which on differentiation are responsible for replacing myelin, are present in the adult CNS. As such, therapeutic agents that can stimulate OPCs to differentiate and remyelinate demyelinated axons under pathologic conditions may improve neuronal function and clinical outcome. We describe the details of an automated, cell-based, morphometric-based, high-content screen that is used to identify small molecules eliciting the differentiation of OPCs after 3 days. Primary screening was performed using rat CG-4 cells maintained in culture conditions that normally support a progenitor cell-like state. From a library of 73,000 diverse small molecules within the Sanofi collection, 342 compounds were identified that increased OPC morphological complexity as an indicator of oligodendrocyte maturation. Subsequent to the primary high-content screen, a suite of cellular assays was established that identified 22 nontoxic compounds that selectively stimulated primary rat OPCs but not C2C12 muscle cell differentiation. This rigorous triaging yielded several chemical series for further expansion and bio- or cheminformatics studies, and their compelling biological activity merits further investigation. © 2014 Society for Laboratory Automation and Screening.

An Evaluation of the Automated Cost Estimating Integrated Tools (ACEIT) System

Science.gov (United States)

1989-09-01

C~4p DTIC S ELECTE fl JAN12 19 .1R ~OF S%. B -U AN EVALUATION OF THE AUTOMATED COST ESTIMATING INTEGRATED TOOLS ( ACEIT ) SYSTEM THESIS Caroline L...Ohio go 91 022 AFIT/GCA/LSQ/89S-5 AN EVALUATION OF THE AUTOMATED COST ESTIMATING INTEGRATED TOOLS ( ACEIT ) SYSTEM THESIS Caroline L. Hanson Major, USAF...Department of Defense. AFIT/GCA/LSQ/89S-5 AN EVALUATION OF THE AUTOMATED COST ESTIMATING INTEGRATED TOOLS ( ACEIT ) SYSTEM THESIS Presented to the

"MedTRIS" (Medical Triage and Registration Informatics System): A Web-based Client Server System for the Registration of Patients Being Treated in First Aid Posts at Public Events and Mass Gatherings.

Science.gov (United States)

Gogaert, Stefan; Vande Veegaete, Axel; Scholliers, Annelies; Vandekerckhove, Philippe

2016-10-01

First aid (FA) services are provisioned on-site as a preventive measure at most public events. In Flanders, Belgium, the Belgian Red Cross-Flanders (BRCF) is the major provider of these FA services with volunteers being deployed at approximately 10,000 public events annually. The BRCF has systematically registered information on the patients being treated in FA posts at major events and mass gatherings during the last 10 years. This information has been collected in a web-based client server system called "MedTRIS" (Medical Triage and Registration Informatics System). MedTRIS contains data on more than 200,000 patients at 335 mass events. This report describes the MedTRIS architecture, the data collected, and how the system operates in the field. This database consolidates different types of information with regards to FA interventions in a standardized way for a variety of public events. MedTRIS allows close monitoring in "real time" of the situation at mass gatherings and immediate intervention, when necessary; allows more accurate prediction of resources needed; allows to validate conceptual and predictive models for medical resources at (mass) public events; and can contribute to the definition of a standardized minimum data set (MDS) for mass-gathering health research and evaluation. Gogaert S , Vande veegaete A , Scholliers A , Vandekerckhove P . "MedTRIS" (Medical Triage and Registration Informatics System): a web-based client server system for the registration of patients being treated in first aid posts at public events and mass gatherings. Prehosp Disaster Med. 2016;31(5):557-562.

Honeywell modular automation system computer software documentation

International Nuclear Information System (INIS)

Cunningham, L.T.

1997-01-01

This document provides a Computer Software Documentation for a new Honeywell Modular Automation System (MAS) being installed in the Plutonium Finishing Plant (PFP). This system will be used to control new thermal stabilization furnaces in HA-21I

Safeguards and security considerations for automated and robotic systems

International Nuclear Information System (INIS)

Jordan, S.E.; Jaeger, C.D.

1994-01-01

Within the reconfigured Nuclear Weapons Complex there will be a large number of automated and robotic (A ampersand R) systems because of the many benefits derived from their use. To meet the overall security requirements of a facility, consideration must be given to those systems that handle and process nuclear material. Since automation and robotics is a relatively new technology, not widely applied to the Nuclear Weapons Complex, safeguards and security (S ampersand S) issues related to these systems have not been extensively explored, and no guidance presently exists. The goal of this effort is to help integrate S ampersand S into the design of future A ampersand R systems. Towards this, the authors first examined existing A and R systems from a security perspective to identify areas of concern and possible solutions of these problems. They then were able to develop generalized S ampersand S guidance and design considerations for automation and robotics

Safeguards and security considerations for automated and robotic systems

International Nuclear Information System (INIS)

Jordan, S.E.; Jaeger, C.D.

1994-01-01

Within the reconfigured Nuclear Weapons Complex there will be a large number of automated and robotic (A ampersand R) systems because of the many benefits derived from their use. To meet the overall security requirements of a facility, consideration must be given to those systems that handle and process nuclear material. Since automation and robotics is a relatively new technology, not widely applied to the Nuclear Weapons Complex, safeguards and security (S ampersand S) issues related to these systems have not been extensively explored, and no guidance presently exists. The goal of this effort is to help integrate S ampersand S into the design of future A ampersand R systems. Towards this, we first examined existing A ampersand R systems from a security perspective to identify areas of concern and possible solutions to these problems. We then were able to develop generalized S ampersand S guidance and design considerations for automation and robotics

Remotely Piloted Aircraft Systems Panel (RPASP) Working Paper: Autonomy and Automation

Science.gov (United States)

Shively, Jay

2017-01-01

A significant level of debate and confusion has surrounded the meaning of the terms "autonomy" and "automation". Automation is a multi-dimensional concept, and we propose that RPAS automation should be described with reference to the specific system and task that has been automated, the context in which the automation functions, and other relevant dimensions. In this paper, we present a definition of "automation". We recommend that autonomy and autonomous operations are out of the scope of the RPAS panel. WG7 proposes to develop, in consultation with other workgroups, a taxonomy of "Levels of Automation" for RPAS.

Automation: the competitive edge for HMOs and other alternative delivery systems.

Science.gov (United States)

Prussin, J A

1987-12-01

Until recently, many, if not most, Health Maintenance Organizations (HMO) were not automated. Moreover, HMOs that were automated tended to be automated only on a limited basis. Recently, however, the highly competitive marketplace within which HMOs and other Alternative Delivery Systems (ADS) exist has required that they operate at a maximum effectiveness and efficiency. Given the complex nature of ADSs, the volume of transactions in ADSs, the large number of members served by ADSs, and the numerous providers who are paid at different rates and on different bases by ADSs, it is impossible for an ADS to operate effectively or efficiently, let alone show optimal performance, without a sophisticated, comprehensive automated system. Reliable automated systems designed specifically to address ADS functions such as enrollment and premium billing, finance and accounting, medical information and patient management, and marketing have recently become available at a reasonable cost.

10 CFR 1017.28 - Processing on Automated Information Systems (AIS).

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Processing on Automated Information Systems (AIS). 1017.28... UNCLASSIFIED CONTROLLED NUCLEAR INFORMATION Physical Protection Requirements § 1017.28 Processing on Automated Information Systems (AIS). UCNI may be processed or produced on any AIS that complies with the guidance in OMB...

Driver-centred vehicle automation: using network analysis for agent-based modelling of the driver in highly automated driving systems.

Science.gov (United States)

Banks, Victoria A; Stanton, Neville A

2016-11-01

To the average driver, the concept of automation in driving infers that they can become completely 'hands and feet free'. This is a common misconception, however, one that has been shown through the application of Network Analysis to new Cruise Assist technologies that may feature on our roads by 2020. Through the adoption of a Systems Theoretic approach, this paper introduces the concept of driver-initiated automation which reflects the role of the driver in highly automated driving systems. Using a combination of traditional task analysis and the application of quantitative network metrics, this agent-based modelling paper shows how the role of the driver remains an integral part of the driving system implicating the need for designers to ensure they are provided with the tools necessary to remain actively in-the-loop despite giving increasing opportunities to delegate their control to the automated subsystems. Practitioner Summary: This paper describes and analyses a driver-initiated command and control system of automation using representations afforded by task and social networks to understand how drivers remain actively involved in the task. A network analysis of different driver commands suggests that such a strategy does maintain the driver in the control loop.

Achieving Lights-Out Operation of SMAP Using Ground Data System Automation

Science.gov (United States)

Sanders, Antonio

2013-01-01

The approach used in the SMAP ground data system to provide reliable, automated capabilities to conduct unattended operations has been presented. The impacts of automation on the ground data system architecture were discussed, including the three major automation patterns identified for SMAP and how these patterns address the operations use cases. The architecture and approaches used by SMAP will set the baseline for future JPL Earth Science missions.

Developments towards a fully automated AMS system

International Nuclear Information System (INIS)

Steier, P.; Puchegger, S.; Golser, R.; Kutschera, W.; Priller, A.; Rom, W.; Wallner, A.; Wild, E.

2000-01-01

The possibilities of computer-assisted and automated accelerator mass spectrometry (AMS) measurements were explored. The goal of these efforts is to develop fully automated procedures for 'routine' measurements at the Vienna Environmental Research Accelerator (VERA), a dedicated 3-MV Pelletron tandem AMS facility. As a new tool for automatic tuning of the ion optics we developed a multi-dimensional optimization algorithm robust to noise, which was applied for 14 C and 10 Be. The actual isotope ratio measurements are performed in a fully automated fashion and do not require the presence of an operator. Incoming data are evaluated online and the results can be accessed via Internet. The system was used for 14 C, 10 Be, 26 Al and 129 I measurements

When the news crew descends: a media triage plan.

Science.gov (United States)

Larson, Laurie

2002-01-01

Two high-profile media cases near Akron, Ohio, showed local hospital public relations staff that when dealing with a crisis, help from their colleagues could be a life saver. The result: a "media triage" plan steered by the Akron Regional Hospital Association.

Bell automation system on STM32F4 Discovery board

OpenAIRE

Božović, Denis

2017-01-01

A bell automation system is a device, the aim of which is to maximize the automation of bell ringing and thus release from duty the person in charge of it. The modern way of life and forms of employment generally make it difficult for human bell-ringers to carry out the task as they did for centuries. In this thesis it is explained what can be expected of the bell automation system in the regions of Slovenia, and why it is desirable that it supports certain functionalities. Using as an exampl...

The effect of system aesthetics on trust, cooperation, satisfaction and annoyance in an imperfect automated system.

Science.gov (United States)

Weinstock, Alona; Oron-Gilad, Tal; Parmet, Yisrael

2012-01-01

Lack of system reliability has been repeatedly identified as a factor that decreases trust. However, aesthetics has an important role in the development of trust. Most of the research concerning the connection between aesthetics and trust focused on mobile commerce and websites while very little has been done in examining aesthetics in automated systems. This study integrated aesthetics manipulations into an imperfect in-vehicle automation system and focused on the power of aesthetics to decrease the negative effects of errors on trust, satisfaction, annoyance, and human-automation cooperation perceptions. Participants used the navigation system in either 100% or 85% accuracy levels with an aesthetic or non aesthetic system (4 conditions). In both aesthetic and non aesthetic systems, perceptions of trust, satisfaction and human automation cooperation were decreased in the imperfect system compared to the perfect one. However, in the annoyance rating, this trend was found only in the aesthetic system while in the non-aesthetic system no difference was found between the two levels of accuracy. This single effect may indicate upon the possibility that in automated systems aesthetics affects trust and satisfaction more moderately compared to mobile commerce applications and websites. However, more research is needed to assess this assumption.

Control and automation of the Pegasus multi-point Thomson scattering system

Energy Technology Data Exchange (ETDEWEB)

Bodner, G. M., E-mail: gbodner@wisc.edu; Bongard, M. W.; Fonck, R. J.; Reusch, J. A.; Rodriguez Sanchez, C.; Schlossberg, D. J. [Department of Engineering Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706 (United States)

2016-11-15

A new control system for the Pegasus Thomson scattering diagnostic has recently been deployed to automate the laser operation, data collection process, and interface with the system-wide Pegasus control code. Automation has been extended to areas outside of data collection, such as manipulation of beamline cameras and remotely controlled turning mirror actuators to enable intra-shot beam alignment. Additionally, the system has been upgraded with a set of fast (∼1 ms) mechanical shutters to mitigate contamination from background light. Modification and automation of the Thomson system have improved both data quality and diagnostic reliability.

Wireless Android Based Home Automation System

OpenAIRE

Muhammad Tanveer Riaz; Eman Manzoor Ahmed; Fariha Durrani; Muhammad Asim Mond

2017-01-01

This manuscript presents a prototype and design implementation of an advance home automation system that uses Wi-Fi technology as a network infrastructure connecting its parts. The proposed system consists of two main components; the first part is the server, which presents system core that manages and controls user’s home. Users and system administrator can locally (Local Area Network) or remotely (internet) manage and control the system. Second part is the hardware interface module, which p...

Aviation Safety: Modeling and Analyzing Complex Interactions between Humans and Automated Systems

Science.gov (United States)

Rungta, Neha; Brat, Guillaume; Clancey, William J.; Linde, Charlotte; Raimondi, Franco; Seah, Chin; Shafto, Michael

2013-01-01

The on-going transformation from the current US Air Traffic System (ATS) to the Next Generation Air Traffic System (NextGen) will force the introduction of new automated systems and most likely will cause automation to migrate from ground to air. This will yield new function allocations between humans and automation and therefore change the roles and responsibilities in the ATS. Yet, safety in NextGen is required to be at least as good as in the current system. We therefore need techniques to evaluate the safety of the interactions between humans and automation. We think that current human factor studies and simulation-based techniques will fall short in front of the ATS complexity, and that we need to add more automated techniques to simulations, such as model checking, which offers exhaustive coverage of the non-deterministic behaviors in nominal and off-nominal scenarios. In this work, we present a verification approach based both on simulations and on model checking for evaluating the roles and responsibilities of humans and automation. Models are created using Brahms (a multi-agent framework) and we show that the traditional Brahms simulations can be integrated with automated exploration techniques based on model checking, thus offering a complete exploration of the behavioral space of the scenario. Our formal analysis supports the notion of beliefs and probabilities to reason about human behavior. We demonstrate the technique with the Ueberligen accident since it exemplifies authority problems when receiving conflicting advices from human and automated systems.

Impact of a Two-step Emergency Department Triage Model with START, then CTAS, on Patient Flow During a Simulated Mass-casualty Incident.

Science.gov (United States)

Lee, James S; Franc, Jeffrey M

2015-08-01

A high influx of patients during a mass-casualty incident (MCI) may disrupt patient flow in an already overcrowded emergency department (ED) that is functioning beyond its operating capacity. This pilot study examined the impact of a two-step ED triage model using Simple Triage and Rapid Treatment (START) for pre-triage, followed by triage with the Canadian Triage and Acuity Scale (CTAS), on patient flow during a MCI simulation exercise. Hypothesis/Problem It was hypothesized that there would be no difference in time intervals nor patient volumes at each patient-flow milestone. Physicians and nurses participated in a computer-based tabletop disaster simulation exercise. Physicians were randomized into the intervention group using START, then CTAS, or the control group using START alone. Patient-flow milestones including time intervals and patient volumes from ED arrival to triage, ED arrival to bed assignment, ED arrival to physician assessment, and ED arrival to disposition decision were compared. Triage accuracy was compared for secondary purposes. There were no significant differences in the time interval from ED arrival to triage (mean difference 108 seconds; 95% CI, -353 to 596 seconds; P=1.0), ED arrival to bed assignment (mean difference 362 seconds; 95% CI, -1,269 to 545 seconds; P=1.0), ED arrival to physician assessment (mean difference 31 seconds; 95% CI, -1,104 to 348 seconds; P=0.92), and ED arrival to disposition decision (mean difference 175 seconds; 95% CI, -1,650 to 1,300 seconds; P=1.0) between the two groups. There were no significant differences in the volume of patients to be triaged (32% vs 34%; 95% CI for the difference -16% to 21%; P=1.0), assigned a bed (16% vs 21%; 95% CI for the difference -11% to 20%; P=1.0), assessed by a physician (20% vs 22%; 95% CI for the difference -14% to 19%; P=1.0), and with a disposition decision (20% vs 9%; 95% CI for the difference -25% to 4%; P=.34) between the two groups. The accuracy of triage was similar

Office of Coast Survey's Automated Wreck and Obstruction Information System

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Automated Wreck and Obstruction Information System (AWOIS) is an automated file that contains information on wrecks and obstructions, and other significant...

Remote systems and automation in radioactive waste package handling

International Nuclear Information System (INIS)

Gneiting, B.C.; Hayward, M.L.

1987-01-01

A proof-of-principle test was conducted at the Hanford Engineering Development Laboratory (HEDL) to demonstrate the feasibility of performing cask receiving and unloading operations in a remote and partially automated manner. This development testing showed feasibility of performing critical cask receipt, preparation, and unloading operations from a single control station using remote controls and indirect viewing. Using robotics and remote automation in a cask handling system can result in lower personnel exposure levels and cask turnaround times while maintaining operational flexibility. An automated cask handling system presents a flexible state-of-the-art, cost effective alternative solution to hands-on methods that have been used in the past. 7 refs., 13 figs

A robotic system for automation of logistics functions on the Space Station

Science.gov (United States)

Martin, J. C.; Purves, R. B.; Hosier, R. N.; Krein, B. A.

1988-01-01

Spacecraft inventory management is currently performed by the crew and as systems become more complex, increased crew time will be required to perform routine logistics activities. If future spacecraft are to function effectively as research labs and production facilities, the efficient use of crew time as a limited resource for performing mission functions must be employed. The use of automation and robotics technology, such as automated warehouse and materials handling functions, can free the crew from many logistics tasks and provide more efficient use of crew time. Design criteria for a Space Station Automated Logistics Inventory Management System is focused on through the design and demonstration of a mobile two armed terrestrial robot. The system functionally represents a 0 gravity automated inventory management system and the problems associated with operating in such an environment. Features of the system include automated storage and retrieval, item recognition, two armed robotic manipulation, and software control of all inventory item transitions and queries.

Accounting for vulnerability to illness and social disadvantage in pandemic critical care triage.

Science.gov (United States)

Kaposy, Chris

2010-01-01

In a pandemic situation, resources in intensive care units may be stretched to the breaking point, and critical care triage may become necessary. In such a situation, I argue that a patient's combined vulnerability to illness and social disadvantage should be a justification for giving that patient some priority for critical care. In this article I present an example of a critical care triage protocol that recognizes the moral relevance of vulnerability to illness and social disadvantage, from the Canadian province of Newfoundland and Labrador.

3S-R10 automated RBS system

International Nuclear Information System (INIS)

Norton, G.A.; Schroeder, J.B.; Klody, G.M.; Strathman, M.D.

1989-01-01

The NEC 3S-R10 automated RBS spectrometer system includes the features required for routine application of Rutherford backscattering (RBS) and related techniques for materials analysis in both research and industrial settings. The NEC Model 3SDH Pelletron accelerator system provides stable, monoenergetic beams of helium ions up to 3.3 MeV and protons to 2.2 MeV and has heavy ion capability. The analytical end station is the fully computerized Charles Evans and Associates Model RBS-400. Automated features include sample positioning (precision 4-axis goniometer), channeling alignment, polar plot generation, and data acquisition and reduction. Computer automation of accelerator and chamber functions includes storage and recall of operating parameters. Unattended data acquisition, e.g., overnight or over a weekend, is possible for up to 100 samples per batch for random orientation, rotating random or channeling analyses at any sample location. Single samples may be up to 50 cm in diameter. A laser for sample alignment and a TV for video monitoring are included. Simultaneous detection (up to 4 detectors) at normal and grazing angles, external control of grazing angle detector position, and transmission scattering capabiltiy enhance system flexibility. The system is also compatible with PIXE, NRA, and hydrogen forward-backscattering analyses. Data reduction is part of the computer system, which features displays (several formats) and manipulation of up to five spectra at one time using constant multipliers or point by point operations between spectra. (orig.)

Programmable, automated transistor test system

Science.gov (United States)

Truong, L. V.; Sundburg, G. R.

1986-01-01

A programmable, automated transistor test system was built to supply experimental data on new and advanced power semiconductors. The data will be used for analytical models and by engineers in designing space and aircraft electric power systems. A pulsed power technique was used at low duty cycles in a nondestructive test to examine the dynamic switching characteristic curves of power transistors in the 500 to 1000 V, 10 to 100 A range. Data collection, manipulation, storage, and output are operator interactive but are guided and controlled by the system software.

22 CFR 308.10 - Security of records systems-manual and automated.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Security of records systems-manual and automated... Security of records systems—manual and automated. The head of the agency has the responsibility of... destruction of manual and automatic record systems. These security safeguards shall apply to all systems in...

Monitoring system for automation of experimental researches in cutting

International Nuclear Information System (INIS)

Kuzinovski, Mikolaj; Trajchevski, Neven; Filipovski, Velimir; Tomov, Mite; Cichosz, Piotr

2009-01-01

This study presents procedures being performed when projecting and realizing experimental scientific researches by application of the automated measurement system with a computer support in all experiment stages. A special accent is placed on the measurement system integration and mathematical processing of data from experiments. Automation processes are described through the realized own automated monitoring system for research of physical phenomena in the cutting process with computer-aided data acquisition. The monitoring system is intended for determining the tangential, axial and radial component of the cutting force, as well as average temperature in the cutting process. The hardware acquisition art consists of amplifiers and A/D converters, while as for analysis and visualization software for P C is developed by using M S Visual C++. For mathematical description researched physical phenomena CADEX software is made, which in connection with MATLAB is intended for projecting processing and analysis of experimental scientific researches against the theory for planning multi-factorial experiments. The design and construction of the interface and the computerized measurement system were done by the Faculty of Mechanical Engineering in Skopje in collaboration with the Faculty of Electrical Engineering and Information Technologies in Skopje and the Institute of Production Engineering and Automation, Wroclaw University of Technology, Poland. Gaining own scientific research measurement system with free access to hardware and software parts provides conditions for a complete control of the research process and reduction of interval of the measuring uncertainty of gained results from performed researches.

Automated remedial assessment methodology software system

International Nuclear Information System (INIS)

Whiting, M.; Wilkins, M.; Stiles, D.

1994-11-01

The Automated Remedial Analysis Methodology (ARAM) software system has been developed by the Pacific Northwest Laboratory to assist the U.S. Department of Energy (DOE) in evaluating cleanup options for over 10,000 contaminated sites across the DOE complex. The automated methodology comprises modules for decision logic diagrams, technology applicability and effectiveness rules, mass balance equations, cost and labor estimating factors and equations, and contaminant stream routing. ARAM is used to select technologies for meeting cleanup targets; determine the effectiveness of the technologies in destroying, removing, or immobilizing contaminants; decide the nature and amount of secondary waste requiring further treatment; and estimate the cost and labor involved when applying technologies

Using novel biomarkers to triage young adult women with minor cervical lesions: a cost-effectiveness analysis.

Science.gov (United States)

Pedersen, K; Sørbye, S W; Kristiansen, I S; Burger, E A

2017-02-01

To evaluate the short-term consequences and cost-effectiveness associated with the use of novel biomarkers to triage young adult women with minor cervical cytological lesions. Model-based economic evaluation using primary epidemiological data from Norway, supplemented with data from European and American clinical trials. Organised cervical cancer screening in Norway. Women aged 25-33 years with minor cervical cytological lesions detected at their primary screening test. We expanded an existing simulation model to compare 12 triage strategies involving alternative biomarkers (i.e. reflex human papillomavirus (HPV) DNA/mRNA testing, genotyping, and dual staining) with the current Norwegian triage guidelines. The number of high-grade precancers detected and resource use (e.g. monetary costs and colposcopy referrals) for a single screening round (3 years) for each triage strategy. Cost-efficiency, defined as the additional cost per additional precancer detected of each strategy compared with the next most costly strategy. Five strategies were identified as cost-efficient, and are projected to increase the precancer detection rate between 18 and 57%, compared with current guidelines; however, the strategies did not uniformly require additional resources. Strategies involving HPV mRNA testing required fewer resources, whereas HPV DNA-based strategies detected >50% more precancers, but were more costly and required twice as many colposcopy referrals compared with the current guidelines. Strategies involving biomarkers to triage younger women with minor cervical cytological lesions have the potential to detect additional precancers, yet the optimal strategy depends on the resources available as well as decision-makers' and women's acceptance of additional screening procedures. Women with minor cervical lesions may be triaged more accurately and effectively using novel biomarkers. © 2016 Royal College of Obstetricians and Gynaecologists.

Assessing drivers' response during automated driver support system failures with non-driving tasks.

Science.gov (United States)

Shen, Sijun; Neyens, David M

2017-06-01

With the increase in automated driver support systems, drivers are shifting from operating their vehicles to supervising their automation. As a result, it is important to understand how drivers interact with these automated systems and evaluate their effect on driver responses to safety critical events. This study aimed to identify how drivers responded when experiencing a safety critical event in automated vehicles while also engaged in non-driving tasks. In total 48 participants were included in this driving simulator study with two levels of automated driving: (a) driving with no automation and (b) driving with adaptive cruise control (ACC) and lane keeping (LK) systems engaged; and also two levels of a non-driving task (a) watching a movie or (b) no non-driving task. In addition to driving performance measures, non-driving task performance and the mean glance duration for the non-driving task were compared between the two levels of automated driving. Drivers using the automated systems responded worse than those manually driving in terms of reaction time, lane departure duration, and maximum steering wheel angle to an induced lane departure event. These results also found that non-driving tasks further impaired driver responses to a safety critical event in the automated system condition. In the automated driving condition, driver responses to the safety critical events were slower, especially when engaged in a non-driving task. Traditional driver performance variables may not necessarily effectively and accurately evaluate driver responses to events when supervising autonomous vehicle systems. Thus, it is important to develop and use appropriate variables to quantify drivers' performance under these conditions. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.

A fully automated fast analysis system for capillary gas chromatography. Part 1. Automation of system control

NARCIS (Netherlands)

Snijders, H.M.J.; Rijks, J.P.E.M.; Bombeeck, A.J.; Rijks, J.A.; Sandra, P.; Lee, M.L.

1992-01-01

This paper is dealing with the design, the automation and evaluation of a high speed capillary gas chromatographic system. A combination of software and hardware was developed for a new cold trap/reinjection device that allows selective solvent eliminating and on column sample enrichment and an

The Automated Aircraft Rework System (AARS): A system integration approach

Science.gov (United States)

Benoit, Michael J.

1994-01-01

The Mercer Engineering Research Center (MERC), under contract to the United States Air Force (USAF) since 1989, has been actively involved in providing the Warner Robins Air Logistics Center (WR-ALC) with a robotic workcell designed to perform rework automated defastening and hole location/transfer operations on F-15 wings. This paper describes the activities required to develop and implement this workcell, known as the Automated Aircraft Rework System (AARS). AARS is scheduled to be completely installed and in operation at WR-ALC by September 1994.

About development of automation control systems

Science.gov (United States)

Myshlyaev, L. P.; Wenger, K. G.; Ivushkin, K. A.; Makarov, V. N.

2018-05-01

The shortcomings of approaches to the development of modern control automation systems and ways of their improvement are given: the correct formation of objects for study and optimization; a joint synthesis of control objects and control systems, an increase in the structural diversity of the elements of control systems. Diagrams of control systems with purposefully variable structure of their elements are presented. Structures of control algorithms for an object with a purposefully variable structure are given.

The Prototype Automated Research Management System (ARMS)

National Research Council Canada - National Science Library

Prekop, Paul

2004-01-01

Automated Research Management System (ARMS) is a knowledge management application designed to address many of the knowledge management problems identified by SmartWays and FASSP's Knowledge Management Review...

Rapid Automated Mission Planning System, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — The proposed innovation is an automated UAS mission planning system that will rapidly identify emergency (contingency) landing sites, manage contingency routing, and...

Preventive child health care at elementary school age: The costs of routine assessments with a triage approach

NARCIS (Netherlands)

Bezem, J.; Ploeg, C. van der; Numans, M.; Buitendijk, S.; Kocken, P.; Akker, E. van der

2017-01-01

Background. Triage in Preventive Child Health Care (PCH) assessments could further the efficient use of human resources and budgets and therefore make extra care possible for children with specific needs. We assessed the costs of routine PCH assessments with and without triage for children aged 5/6

Automation and Robotics for Space-Based Systems, 1991

Science.gov (United States)

Williams, Robert L., II (Editor)

1992-01-01

The purpose of this in-house workshop was to assess the state-of-the-art of automation and robotics for space operations from an LaRC perspective and to identify areas of opportunity for future research. Over half of the presentations came from the Automation Technology Branch, covering telerobotic control, extravehicular activity (EVA) and intra-vehicular activity (IVA) robotics, hand controllers for teleoperation, sensors, neural networks, and automated structural assembly, all applied to space missions. Other talks covered the Remote Manipulator System (RMS) active damping augmentation, space crane work, modeling, simulation, and control of large, flexible space manipulators, and virtual passive controller designs for space robots.

Assessment of hospital-based adult triage at emergency receiving ...

African Journals Online (AJOL)

The study was conducted in 6 of the 7 hospitals in the region. ... gency department, the rest receive emergency patients/perform triage from .... gional Referral Hospital (government facility) with emer- ... sionals who were involved in daily initial management of ..... for receiving emergency cases can be complex especially.

Computer-automated neutron activation analysis system

International Nuclear Information System (INIS)

Minor, M.M.; Garcia, S.R.

1983-01-01

An automated delayed neutron counting and instrumental neutron activation analysis system has been developed at Los Alamos National Laboratory's Omega West Reactor (OWR) to analyze samples for uranium and 31 additional elements with a maximum throughput of 400 samples per day. 5 references

Operator adaptation to changes in system reliability under adaptable automation.

Science.gov (United States)

Chavaillaz, Alain; Sauer, Juergen

2017-09-01

This experiment examined how operators coped with a change in system reliability between training and testing. Forty participants were trained for 3 h on a complex process control simulation modelling six levels of automation (LOA). In training, participants either experienced a high- (100%) or low-reliability system (50%). The impact of training experience on operator behaviour was examined during a 2.5 h testing session, in which participants either experienced a high- (100%) or low-reliability system (60%). The results showed that most operators did not often switch between LOA. Most chose an LOA that relieved them of most tasks but maintained their decision authority. Training experience did not have a strong impact on the outcome measures (e.g. performance, complacency). Low system reliability led to decreased performance and self-confidence. Furthermore, complacency was observed under high system reliability. Overall, the findings suggest benefits of adaptable automation because it accommodates different operator preferences for LOA. Practitioner Summary: The present research shows that operators can adapt to changes in system reliability between training and testing sessions. Furthermore, it provides evidence that each operator has his/her preferred automation level. Since this preference varies strongly between operators, adaptable automation seems to be suitable to accommodate these large differences.

Improving the driver-automation interaction: an approach using automation uncertainty.

Science.gov (United States)

Beller, Johannes; Heesen, Matthias; Vollrath, Mark

2013-12-01

The aim of this study was to evaluate whether communicating automation uncertainty improves the driver-automation interaction. A false system understanding of infallibility may provoke automation misuse and can lead to severe consequences in case of automation failure. The presentation of automation uncertainty may prevent this false system understanding and, as was shown by previous studies, may have numerous benefits. Few studies, however, have clearly shown the potential of communicating uncertainty information in driving. The current study fills this gap. We conducted a driving simulator experiment, varying the presented uncertainty information between participants (no uncertainty information vs. uncertainty information) and the automation reliability (high vs.low) within participants. Participants interacted with a highly automated driving system while engaging in secondary tasks and were required to cooperate with the automation to drive safely. Quantile regressions and multilevel modeling showed that the presentation of uncertainty information increases the time to collision in the case of automation failure. Furthermore, the data indicated improved situation awareness and better knowledge of fallibility for the experimental group. Consequently, the automation with the uncertainty symbol received higher trust ratings and increased acceptance. The presentation of automation uncertaintythrough a symbol improves overall driver-automation cooperation. Most automated systems in driving could benefit from displaying reliability information. This display might improve the acceptance of fallible systems and further enhances driver-automation cooperation.

AN AUTOMATED RAILWAY STATION TRAFFIC CONTROL SYSTEM

African Journals Online (AJOL)

AN AUTOMATED RAILWAY STATION TRAFFIC CONTROL SYSTEM. ... involve collision with automobiles or other vehicles and collision with other trains. ... the processed signals to control electromagnetic devices through motor drivers.

Sport Tournament Automated Scheduling System

OpenAIRE

Raof R. A. A; Sudin S.; Mahrom N.; Rosli A. N. C

2018-01-01

The organizer of sport events often facing problems such as wrong calculations of marks and scores, as well as difficult to create a good and reliable schedule. Most of the time, the issues about the level of integrity of committee members and also issues about errors made by human came into the picture. Therefore, the development of sport tournament automated scheduling system is proposed. The system will be able to automatically generate the tournament schedule as well as automatically calc...

System approach to automation and robotization of drivage

Science.gov (United States)

Zinov’ev, VV; Mayorov, AE; Starodubov, AN; Nikolaev, PI

2018-03-01

The authors consider the system approach to finding ways of no-man drilling and blasting in the face area by means of automation and robotization of operations with a view to reducing injuries in mines. The analysis is carried out in terms of the drilling and blasting technology applied in Makarevskoe Coal Field, Kuznetsk Coal Basin. Within the system-functional approach and using INDEFO procedure, the processes of drilling and blasthole charging are decomposed into related elementary operations. The automation and robotization methods to avoid the presence of miners in the face are found for each operation.

Honeywell Modular Automation System Computer Software Documentation

International Nuclear Information System (INIS)

CUNNINGHAM, L.T.

1999-01-01

This document provides a Computer Software Documentation for a new Honeywell Modular Automation System (MAS) being installed in the Plutonium Finishing Plant (PFP). This system will be used to control new thermal stabilization furnaces in HA-211 and vertical denitration calciner in HC-230C-2

A Systems Approach to Information Technology (IT) Infrastructure Design for Utility Management Automation Systems

OpenAIRE

A. Fereidunian; H. Lesani; C. Lucas; M. Lehtonen; M. M. Nordman

2006-01-01

Almost all of electric utility companies are planning to improve their management automation system, in order to meet the changing requirements of new liberalized energy market and to benefit from the innovations in information and communication technology (ICT or IT). Architectural design of the utility management automation (UMA) systems for their IT-enabling requires proper selection of IT choices for UMA system, which leads to multi-criteria decision-makings (MCDM). In resp...

Wireless ZigBee home automation system

Science.gov (United States)

Craciunescu, Razvan; Halunga, Simona; Fratu, Octavian

2015-02-01

The home automation system concept existed for many years but in the last decade, due to the rapid development of sensors and wireless technologies, a large number of various such "intelligent homes" have been developed. The purpose of the present paper is to demonstrate the flexibility, reliability and affordability of home automation projects, based on a simple and affordable implementation. A wireless sensing and control system have been developed and tested, having a number of basic functionalities such as switching on/off the light according to ambient lighting and turning on/off the central heating. The system has been built around low power microcontrollers and ZigBee modems for wireless communication, using a set of Vishay 640 thermistor sensors for temperature measurements and Vishay LDR07 photo-resistor for humidity measurements. A trigger is activated when the temperature or light measurements are above/below a given threshold and a command is transmitted to the central unit through the ZigBee radio module. All the data processing is performed by a low power microcontroller both at the sensing device and at the control unit.

Automated attendance management and alert system | Rahim ...

African Journals Online (AJOL)

Automated attendance management and alert system. ... Journal of Fundamental and Applied Sciences ... AAMAS provides various functions, from managing and recording students' attendance record, to sending automatic alerts to students ...

The effectiveness of the South African Triage Toll use in Mahalapye District Hospital – Emergency Department, Botswana

Directory of Open Access Journals (Sweden)

Stephane T. Tshitenge

2016-07-01

Full Text Available Background: The study aimed to determine the proportion of each priority level of patients, time of performance in each priority level, and the reliability of the South African Triage Scale (SATS tool at the Mahalapye District Hospital - Emergency Department (MDH-ED, a setting where the majority of the nurses were not formally trained on the use of the SATS. Methods: This was a cross-sectional study using case records in MDH-ED from 1 January 2014 to 31 December 2014. A panel of experts from the Mahalapye site of the Family Medicine Department, University of Botswana, reviewed and scored each selected case record that was compared with the scores previously attributed to the nurse triage. Results: From the 315 case records, both the nurse triage and the panel of expert triage assigned the majority of cases in the routine category (green, 146 (46% and 125 (40%, respectively, or in the urgent category (yellow, they assigned 140 (44% and 111 (35% cases, respectively.Overall, there was an adequate agreement between the nurse triage and the panel of expert triage (k = 0.4, 95% confidence interval: 0.3–0.5, although the level of agreement was satisfactory. Conclusion: Findings of the study reported that the profile of the priority-level categories in MDH-ED was made in the majority of routine and urgent patients, only the routine and the emergency patients were seen within the targeted time and they had a satisfactory level of reliability (between 0.4 and 0.6.

MDSplus automated build and distribution system

Energy Technology Data Exchange (ETDEWEB)

Fredian, T., E-mail: twf@psfc.mit.edu [Massachusetts Institute of Technology, 175 Albany Street, Cambridge, MA 02139 (United States); Stillerman, J. [Massachusetts Institute of Technology, 175 Albany Street, Cambridge, MA 02139 (United States); Manduchi, G. [Consorzio RFX, Euratom-ENEA Association, Corso Stati Uniti 4, Padova 35127 (Italy)

2014-05-15

Support of the MDSplus data handling system has been enhanced by the addition of an automated build system which does nightly builds of MDSplus for many computer platforms producing software packages which can now be downloaded using a web browser or via package repositories suitable for automatic updating. The build system was implemented using an extensible continuous integration server product called Hudson which schedules software builds on a collection of VMware based virtual machines. New releases are created based on updates via the MDSplus cvs code repository and versioning are managed using cvs tags and branches. Currently stable, beta and alpha releases of MDSplus are maintained for eleven different platforms including Windows, MacOSX, RedHat Enterprise Linux, Fedora, Ubuntu and Solaris. For some of these platforms, MDSplus packaging has been broken into functional modules so users can pick and choose which MDSplus features they want to install. An added feature to the latest Linux based platforms is the use of package dependencies. When installing MDSplus from the package repositories, any additional required packages used by MDSplus will be installed automatically greatly simplifying the installation of MDSplus. This paper will describe the MDSplus package automated build and distribution system.

MDSplus automated build and distribution system

International Nuclear Information System (INIS)

Fredian, T.; Stillerman, J.; Manduchi, G.

2014-01-01

Support of the MDSplus data handling system has been enhanced by the addition of an automated build system which does nightly builds of MDSplus for many computer platforms producing software packages which can now be downloaded using a web browser or via package repositories suitable for automatic updating. The build system was implemented using an extensible continuous integration server product called Hudson which schedules software builds on a collection of VMware based virtual machines. New releases are created based on updates via the MDSplus cvs code repository and versioning are managed using cvs tags and branches. Currently stable, beta and alpha releases of MDSplus are maintained for eleven different platforms including Windows, MacOSX, RedHat Enterprise Linux, Fedora, Ubuntu and Solaris. For some of these platforms, MDSplus packaging has been broken into functional modules so users can pick and choose which MDSplus features they want to install. An added feature to the latest Linux based platforms is the use of package dependencies. When installing MDSplus from the package repositories, any additional required packages used by MDSplus will be installed automatically greatly simplifying the installation of MDSplus. This paper will describe the MDSplus package automated build and distribution system

Designing an automated blood fractionation system.

Science.gov (United States)

McQuillan, Adrian C; Sales, Sean D

2008-04-01

UK Biobank will be collecting blood samples from a cohort of 500 000 volunteers and it is expected that the rate of collection will peak at approximately 3000 blood collection tubes per day. These samples need to be prepared for long-term storage. It is not considered practical to manually process this quantity of samples so an automated blood fractionation system is required. Principles of industrial automation were applied to the blood fractionation process leading to the requirement of developing a vision system to identify the blood fractions within the blood collection tube so that the fractions can be accurately aspirated and dispensed into micro-tubes. A prototype was manufactured and tested on a range of human blood samples collected in different tube types. A specially designed vision system was capable of accurately measuring the position of the plasma meniscus, plasma/buffy coat interface and the red cells/buffy coat interface within a vacutainer. A rack of 24 vacutainers could be processed in blood fractionation system offers a solution to the problem of processing human blood samples collected in vacutainers in a consistent manner and provides a means of ensuring data and sample integrity.

Operational Testing of a Combined Hardware-Software Strategy for Triage of Radiologically-Contaminated Persons.

Science.gov (United States)

Waller, Edward J

2015-08-01

After a radiological dispersal device (RDD) event, it is possible for radionuclides to enter the human body through inhalation, ingestion, and skin and wound absorption. The dominant pathway will be through inhalation. From a health physics perspective, it is important to know the magnitude of the intake to perform dosimetric assessments. From a medical perspective, removal of radionuclides leading to dose (hence risk) aversion is of high importance. The efficacy of medical decorporation strategies is extremely dependent upon the time of treatment delivery after intake. The "golden hour," or more realistically 3-4 h, is imperative when attempting to increase removal of radionuclides from extracellular fluids prior to cellular incorporation. To assist medical first response personnel in making timely decisions regarding appropriate treatment delivery modes, a software tool has been developed which compiles existing radionuclide decorporation therapy data and allows a user to perform simple triage leading to potential appropriate decorporation treatment strategies. Three triage algorithms were included: (1) multi-parameter model (MPM), (2) clinical decision guidance (CDG) model, and (3) annual limit on intake (ALI) model. A radiation triage mask (RTM) has simultaneously been developed to provide a simple and rapid hardware solution for first responders to triage internally exposed personnel in the field. The hardware/software strategy was field tested with a military medical unit and was found by end-users to be relatively simple to learn and use.

Automated Records Management Systems in the ESARBICA Region

African Journals Online (AJOL)

Automated Records Management Systems in the ESARBICA Region. ... to organizations as human and financial resources and that their management is important. ... Latter day archivists work with other professionals such as auditors, systems ...

Potential of Laboratory Execution Systems (LESs) to Simplify the Application of Business Process Management Systems (BPMSs) in Laboratory Automation.

Science.gov (United States)

Neubert, Sebastian; Göde, Bernd; Gu, Xiangyu; Stoll, Norbert; Thurow, Kerstin

2017-04-01

Modern business process management (BPM) is increasingly interesting for laboratory automation. End-to-end workflow automation and improved top-level systems integration for information technology (IT) and automation systems are especially prominent objectives. With the ISO Standard Business Process Model and Notation (BPMN) 2.X, a system-independent and interdisciplinary accepted graphical process control notation is provided, allowing process analysis, while also being executable. The transfer of BPM solutions to structured laboratory automation places novel demands, for example, concerning the real-time-critical process and systems integration. The article discusses the potential of laboratory execution systems (LESs) for an easier implementation of the business process management system (BPMS) in hierarchical laboratory automation. In particular, complex application scenarios, including long process chains based on, for example, several distributed automation islands and mobile laboratory robots for a material transport, are difficult to handle in BPMSs. The presented approach deals with the displacement of workflow control tasks into life science specialized LESs, the reduction of numerous different interfaces between BPMSs and subsystems, and the simplification of complex process modelings. Thus, the integration effort for complex laboratory workflows can be significantly reduced for strictly structured automation solutions. An example application, consisting of a mixture of manual and automated subprocesses, is demonstrated by the presented BPMS-LES approach.

47 CFR 80.475 - Scope of service of the Automated Maritime Telecommunications System (AMTS).

Science.gov (United States)

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Scope of service of the Automated Maritime Telecommunications System (AMTS). 80.475 Section 80.475 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... Automated Systems § 80.475 Scope of service of the Automated Maritime Telecommunications System (AMTS). (a...

An Automated Motion Detection and Reward System for Animal Training.

Science.gov (United States)

Miller, Brad; Lim, Audrey N; Heidbreder, Arnold F; Black, Kevin J

2015-12-04

A variety of approaches has been used to minimize head movement during functional brain imaging studies in awake laboratory animals. Many laboratories expend substantial effort and time training animals to remain essentially motionless during such studies. We could not locate an "off-the-shelf" automated training system that suited our needs.  We developed a time- and labor-saving automated system to train animals to hold still for extended periods of time. The system uses a personal computer and modest external hardware to provide stimulus cues, monitor movement using commercial video surveillance components, and dispense rewards. A custom computer program automatically increases the motionless duration required for rewards based on performance during the training session but allows changes during sessions. This system was used to train cynomolgus monkeys (Macaca fascicularis) for awake neuroimaging studies using positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). The automated system saved the trainer substantial time, presented stimuli and rewards in a highly consistent manner, and automatically documented training sessions. We have limited data to prove the training system's success, drawn from the automated records during training sessions, but we believe others may find it useful. The system can be adapted to a range of behavioral training/recording activities for research or commercial applications, and the software is freely available for non-commercial use.

Maximizing Your Investment in Building Automation System Technology.

Science.gov (United States)

Darnell, Charles

2001-01-01

Discusses how organizational issues and system standardization can be important factors that determine an institution's ability to fully exploit contemporary building automation systems (BAS). Further presented is management strategy for maximizing BAS investments. (GR)

Advancements, prospects, and impacts of automated driving systems

Directory of Open Access Journals (Sweden)

Ching-Yao Chan

2017-09-01

Full Text Available Over the last decade, significant progress has been made in automated driving systems (ADS. Given the current momentum and progress, ADS can be expected to continue to advance and a variety of ADS products will become commercially available within a decade. It is envisioned that automated driving technology will lead to a paradigm shift in transportation systems in terms of user experience, mode choices, and business models. In this paper, we start with a review of the state-of-the-art in the field of ADS and their deployment paths. It is followed by a discussion of the future prospects of ADS and their effects on various aspects of the transportation field. We then identify two specific use cases of ADS where the impacts can be significant – personal mobility services and vehicle automation for aging society. A survey of impact assessment studies and the associated methodologies for evaluating ADS is given, which is followed by concluding remarks at the end of the paper.

Planning and Resource Management in an Intelligent Automated Power Management System

Science.gov (United States)

Morris, Robert A.

1991-01-01

Power system management is a process of guiding a power system towards the objective of continuous supply of electrical power to a set of loads. Spacecraft power system management requires planning and scheduling, since electrical power is a scarce resource in space. The automation of power system management for future spacecraft has been recognized as an important R&D goal. Several automation technologies have emerged including the use of expert systems for automating human problem solving capabilities such as rule based expert system for fault diagnosis and load scheduling. It is questionable whether current generation expert system technology is applicable for power system management in space. The objective of the ADEPTS (ADvanced Electrical Power management Techniques for Space systems) is to study new techniques for power management automation. These techniques involve integrating current expert system technology with that of parallel and distributed computing, as well as a distributed, object-oriented approach to software design. The focus of the current study is the integration of new procedures for automatically planning and scheduling loads with procedures for performing fault diagnosis and control. The objective is the concurrent execution of both sets of tasks on separate transputer processors, thus adding parallelism to the overall management process.

Problems in modernization of automation systems at coal preparation plants

Science.gov (United States)

Myshlyaev, L. P.; Lyakhovets, M. V.; Venger, K. G.; Leontiev, I. A.; Makarov, G. V.; Salamatin, A. S.

2018-05-01

The factors influencing the process of modernization (reconstruction) of the automation systems at coal preparation plants are described. Problems such as heterogeneity of existing and developed systems, planning of reconstruction of a technological complex without taking into account modernization of automated systems, commissioning without stopping the existing technological complex, as well as problems of conducting procurement procedures are discussed. The option of stage-by-stage start-up and adjustment works in the conditions of modernization of systems without long stops of the process equipment is offered.

ABOUT THE BUILDING SYSTEMS OF PLANT AUTOMATION WITH ADVANCED SECURITY

OpenAIRE

Yu. I. Khmarskyi

2008-01-01

A structure and principle of construction of microprocessor circuit of local railway automation is examined on relay-and-contact principle, which realize the three-level filtration of errors providing the highest protection of the systems of station automation from errors.

The impact of using computer decision-support software in primary care nurse-led telephone triage: interactional dilemmas and conversational consequences.

Science.gov (United States)

Murdoch, Jamie; Barnes, Rebecca; Pooler, Jillian; Lattimer, Valerie; Fletcher, Emily; Campbell, John L

2015-02-01

Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. Although computer decision-support software (CDSS) is increasingly used by nurses to triage patients, little is understood about how interaction is organized in this setting. Specifically any interactional dilemmas this computer-mediated setting invokes; and how these may be consequential for communication with patients. Using conversation analytic methods we undertook a multi-modal analysis of 22 audio-recorded telephone triage nurse-caller interactions from one GP practice in England, including 10 video-recordings of nurses' use of CDSS during triage. We draw on Goffman's theoretical notion of participation frameworks to make sense of these interactions, presenting 'telling cases' of interactional dilemmas nurses faced in meeting patient's needs and accurately documenting the patient's condition within the CDSS. Our findings highlight troubles in the 'interactional workability' of telephone triage exposing difficulties faced in aligning the proximal and wider distal context that structures CDSS-mediated interactions. Patients present with diverse symptoms, understanding of triage consultations, and communication skills which nurses need to negotiate turn-by-turn with CDSS requirements. Nurses therefore need to have sophisticated communication, technological and clinical skills to ensure patients' presenting problems are accurately captured within the CDSS to determine safe triage outcomes. Dilemmas around how nurses manage and record information, and the issues of professional accountability that may ensue, raise questions about the impact of CDSS and its use in supporting nurses to deliver safe and effective patient care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Intelligent Automated Nuclear Fuel Pellet Inspection System

International Nuclear Information System (INIS)

Keyvan, S.

1999-01-01

At the present time, nuclear pellet inspection is performed manually using naked eyes for judgment and decisionmaking on accepting or rejecting pellets. This current practice of pellet inspection is tedious and subject to inconsistencies and error. Furthermore, unnecessary re-fabrication of pellets is costly and the presence of low quality pellets in a fuel assembly is unacceptable. To improve the quality control in nuclear fuel fabrication plants, an automated pellet inspection system based on advanced techniques is needed. Such a system addresses the following concerns of the current manual inspection method: (1) the reliability of inspection due to typical human errors, (2) radiation exposure to the workers, and (3) speed of inspection and its economical impact. The goal of this research is to develop an automated nuclear fuel pellet inspection system which is based on pellet video (photographic) images and uses artificial intelligence techniques

Medical ADP Systems: Automated Medical Records Hold Promise to Improve Patient Care

Science.gov (United States)

1991-01-01

automated medical records. The report discusses the potential benefits that automation could make to the quality of patient care and the factors that impede...information systems, but no organization has fully automated one of the most critical types of information, patient medical records. The patient medical record...its review of automated medical records. GAO’s objectives in this study were to identify the (1) benefits of automating patient records and (2) factors

Development of nuclear power plant automated remote patrol system

International Nuclear Information System (INIS)

Nakayama, R.; Kubo, K.; Sato, K.; Taguchi, J.

1984-01-01

An Automated Remote Patrol System was developed for a remote inspection, observation and monitoring of nuclear power plant's components. This automated remote patrol system consists of; a vehicle moving along a monorail; three rails mounted in a monorail for data transmission and for power supply; an image fiber connected to a TV camera; an arm type mechanism (manipulator) for moving image fiber; a computer for control and data processing and operator's console. Special features of this Automated Remote Patrol System are as follows: The inspection vehicle runs along horizontal and vertical (up/down) monorails. The arm type mechanism (manipulator) on the vehicle is used to move image fiber. Slide type electric collectors are used for data transmission and power supply. Time-division multiplexing is adapted for data transmission. Voice communication is used for controlling mechanisms. Pattern recognition is used for data processing. The experience that has been obtained from a series of various tests is summarized. (author)

Automated TLD systems: what can we expect from the market today?

International Nuclear Information System (INIS)

Duftschmid, K.E.; Strachotinsky, Ch.

1990-01-01

The personnel monitoring service at the Austrian Research Centre Seibersdorf, which presently handles some 16,000 dosemeters per month, has been operating for more than ten years with three automated TLD systems, Harshaw model 2271. In order to renew the instrumentation an extensive evaluation and comparison of four commercially available automated systems designed to the present state-of-the-art has been carried out. The test procedures included dosimetric performance, reliability, handling speed and throughput, and additional information such as glow curve evaluation etc. The results should provide useful advice to monitoring services interested in the application of modern automated TLD systems currently on the market. (author)

Development of automated blender and dispensing system

International Nuclear Information System (INIS)

Kulkarni, Anupama; Aherwal, P.; Patil, C.B.

2014-01-01

This paper describes automated blender and dispensing system designed and developed in Nuclear Recycle Board for its reprocessing plant. Obtaining sinterable grade oxide powder from the product solution received in the heavy metal product line involves skilled manpower and time consuming, laborious manual operations. Entire treatment is carried out in a train of closed containments called as glove boxes. In view of this Automated blender and dispensing system has been developed to reduce tedious manual operations. System consists of PLC based control system to drive motorised charging mechanism, a conical ribbon blender which homogenises the product and load cell triggered, indexing dispensing mechanism. Schematic design of the system has been done in-house, while fabrication was outsourced. System has been built, tested and installed at component test facility (CTF) at Tarapur. Actual blending tests were carried out by using dummy material like calcium carbonate and barium carbonate powder, with different sets of parameter. Blended product was chemically analysed for its homogeneity. System has now been put to trial runs by operating staff. This development has circumvented tedious operations of Scooping and increased the throughput. This paper describes challenges in undertaking this developmental work. (author)

Designing of smart home automation system based on Raspberry Pi

Science.gov (United States)

Saini, Ravi Prakash; Singh, Bhanu Pratap; Sharma, Mahesh Kumar; Wattanawisuth, Nattapol; Leeprechanon, Nopbhorn

2016-03-01

Locally networked or remotely controlled home automation system becomes a popular paradigm because of the numerous advantages and is suitable for academic research. This paper proposes a method for an implementation of Raspberry Pi based home automation system presented with an android phone access interface. The power consumption profile across the connected load is measured accurately through programming. Users can access the graph of total power consumption with respect to time worldwide using their Dropbox account. An android application has been developed to channelize the monitoring and controlling operation of home appliances remotely. This application facilitates controlling of operating pins of Raspberry Pi by pressing the corresponding key for turning "on" and "off" of any desired appliance. Systems can range from the simple room lighting control to smart microcontroller based hybrid systems incorporating several other additional features. Smart home automation systems are being adopted to achieve flexibility, scalability, security in the sense of data protection through the cloud-based data storage protocol, reliability, energy efficiency, etc.

21 CFR 864.9175 - Automated blood grouping and antibody test system.

Science.gov (United States)

2010-04-01

...) Identification. An automated blood grouping and antibody test system is a device used to group erythrocytes (red blood cells) and to detect antibodies to blood group antigens. (b) Classification. Class II (performance... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated blood grouping and antibody test system...

Establishment of automated culture system for murine induced pluripotent stem cells

Directory of Open Access Journals (Sweden)

Koike Hiroyuki

2012-11-01

Full Text Available Abstract Background Induced pluripotent stem (iPS cells can differentiate into any cell type, which makes them an attractive resource in fields such as regenerative medicine, drug screening, or in vitro toxicology. The most important prerequisite for these industrial applications is stable supply and uniform quality of iPS cells. Variation in quality largely results from differences in handling skills between operators in laboratories. To minimize these differences, establishment of an automated iPS cell culture system is necessary. Results We developed a standardized mouse iPS cell maintenance culture, using an automated cell culture system housed in a CO2 incubator commonly used in many laboratories. The iPS cells propagated in a chamber uniquely designed for automated culture and showed specific colony morphology, as for manual culture. A cell detachment device in the system passaged iPS cells automatically by dispersing colonies to single cells. In addition, iPS cells were passaged without any change in colony morphology or expression of undifferentiated stem cell markers during the 4 weeks of automated culture. Conclusions Our results show that use of this compact, automated cell culture system facilitates stable iPS cell culture without obvious effects on iPS cell pluripotency or colony-forming ability. The feasibility of iPS cell culture automation may greatly facilitate the use of this versatile cell source for a variety of biomedical applications.

ABOUT THE BUILDING SYSTEMS OF PLANT AUTOMATION WITH ADVANCED SECURITY

Directory of Open Access Journals (Sweden)

Yu. I. Khmarskyi

2008-03-01

Full Text Available A structure and principle of construction of microprocessor circuit of local railway automation is examined on relay-and-contact principle, which realize the three-level filtration of errors providing the highest protection of the systems of station automation from errors.

Mockup of an automated material transport system for remote handling

International Nuclear Information System (INIS)

Porter, M.L.

1992-01-01

An Automated Material Transport System (AMTS) was identified for transport of samples within a Material and Process Control Laboratory (MPCL). The MPCL was designed with a dry sample handling laboratory and a wet chemistry analysis laboratory. Each laboratory contained several processing gloveboxes. The function of the AMTS was to automate the handling of materials, multiple process samples, and bulky items between process stations with a minimum of operator intervention and with minimum o[ waiting periods and nonproductive activities. This paper discusses the system design features, capabilities and results of initial testing. The overall performance of the AMTS is very good. No major problems or concerns were identified. System commands are simple and logical making the system user friendly. Operating principle and design of individual components is simple. With the addition of various track modules, the system can be configured in most any configuration. The AMTS lends itself very well for integration with other automated systems or products. The AMTS is suited for applications involving light payloads which require multiple sample and material handling, lot tracking, and system integration with other products

Operations management system advanced automation: Fault detection isolation and recovery prototyping

Science.gov (United States)

Hanson, Matt

1990-01-01

The purpose of this project is to address the global fault detection, isolation and recovery (FDIR) requirements for Operation's Management System (OMS) automation within the Space Station Freedom program. This shall be accomplished by developing a selected FDIR prototype for the Space Station Freedom distributed processing systems. The prototype shall be based on advanced automation methodologies in addition to traditional software methods to meet the requirements for automation. A secondary objective is to expand the scope of the prototyping to encompass multiple aspects of station-wide fault management (SWFM) as discussed in OMS requirements documentation.

Creation and Delphi-method refinement of pediatric disaster triage simulations.

Science.gov (United States)

Cicero, Mark X; Brown, Linda; Overly, Frank; Yarzebski, Jorge; Meckler, Garth; Fuchs, Susan; Tomassoni, Anthony; Aghababian, Richard; Chung, Sarita; Garrett, Andrew; Fagbuyi, Daniel; Adelgais, Kathleen; Goldman, Ran; Parker, James; Auerbach, Marc; Riera, Antonio; Cone, David; Baum, Carl R

2014-01-01

There is a need for rigorously designed pediatric disaster triage (PDT) training simulations for paramedics. First, we sought to design three multiple patient incidents for EMS provider training simulations. Our second objective was to determine the appropriate interventions and triage level for each victim in each of the simulations and develop evaluation instruments for each simulation. The final objective was to ensure that each simulation and evaluation tool was free of bias toward any specific PDT strategy. We created mixed-methods disaster simulation scenarios with pediatric victims: a school shooting, a school bus crash, and a multiple-victim house fire. Standardized patients, high-fidelity manikins, and low-fidelity manikins were used to portray the victims. Each simulation had similar acuity of injuries and 10 victims. Examples include children with special health-care needs, gunshot wounds, and smoke inhalation. Checklist-based evaluation tools and behaviorally anchored global assessments of function were created for each simulation. Eight physicians and paramedics from areas with differing PDT strategies were recruited as Subject Matter Experts (SMEs) for a modified Delphi iterative critique of the simulations and evaluation tools. The modified Delphi was managed with an online survey tool. The SMEs provided an expected triage category for each patient. The target for modified Delphi consensus was ≥85%. Using Likert scales and free text, the SMEs assessed the validity of the simulations, including instances of bias toward a specific PDT strategy, clarity of learning objectives, and the correlation of the evaluation tools to the learning objectives and scenarios. After two rounds of the modified Delphi, consensus for expected triage level was >85% for 28 of 30 victims, with the remaining two achieving >85% consensus after three Delphi iterations. To achieve consensus, we amended 11 instances of bias toward a specific PDT strategy and corrected 10

History of a Building Automation System.

Science.gov (United States)

Martin, Anthony A.

1984-01-01

Having successfully used computer control in the solar-heated and cooled Terraset School, the Fairfax County, VA, Public Schools are now computerizing all their facilities. This article discusses the configuration and use of a countywide control system, reasons for the project's success, and problems of facility automation. (MCG)

The Automated Conflict Resolution System (ACRS)

Science.gov (United States)

Kaplan, Ted; Musliner, Andrew; Wampler, David

1993-01-01

The Automated Conflict Resolution System (ACRS) is a mission-current scheduling aid that predicts periods of mutual interference when two or more orbiting spacecraft are scheduled to communicate with the same Tracking and Data Relay Satellite (TDRS) at the same time. The mutual interference predicted has the potential to degrade or prevent communications. Thus the ACRS system is a useful tool for aiding in the scheduling of Space Network (SN) communications.

Reliability and accuracy of the South African Triage Scale when ...

African Journals Online (AJOL)

Reliability and accuracy of the South African Triage Scale when used by nurses in the emergency department of Timergara Hospital, Pakistan. MK Dalwai, M Twomey, J Maikere, M Wakeel, J-P Jemmy, P Valles, K Tayler-Smith, L Wallis, R Zachariah ...

Design and control of automated guided vehicle systems: A case study

NARCIS (Netherlands)

Li, Q.; Adriaansen, A.C.; Udding, J.T.; Pogromski, A.Y.

2011-01-01

In this paper, we study the design and control of automated guided vehicle (AGV) systems, with the focus on the quayside container transport in an automated container terminal. We first set up an event-driven model for an AGV system in the zone control framework. Then a number of layouts of the road

Benchmarking Glucose Results through Automation: The 2009 Remote Automated Laboratory System Report

Science.gov (United States)

Anderson, Marcy; Zito, Denise; Kongable, Gail

2010-01-01

Background Hyperglycemia in the adult inpatient population remains a topic of intense study in U.S. hospitals. Most hospitals have established glycemic control programs but are unable to determine their impact. The 2009 Remote Automated Laboratory System (RALS) Report provides trends in glycemic control over 4 years to 576 U.S. hospitals to support their effort to manage inpatient hyperglycemia. Methods A proprietary software application feeds de-identified patient point-of-care blood glucose (POC-BG) data from the Medical Automation Systems RALS-Plus data management system to a central server. Analyses include the number of tests and the mean and median BG results for intensive care unit (ICU), non-ICU, and each hospital compared to the aggregate of the other hospitals. Results More than 175 million BG results were extracted from 2006–2009; 25% were from the ICU. Mean range of BG results for all inpatients in 2006, 2007, 2008, and 2009 was 142.2–201.9, 145.6–201.2, 140.6–205.7, and 140.7–202.4 mg/dl, respectively. The range for ICU patients was 128–226.5, 119.5–219.8, 121.6–226.0, and 121.1–217 mg/dl, respectively. The range for non-ICU patients was 143.4–195.5, 148.6–199.8, 145.2–201.9, and 140.7–203.6 mg/dl, respectively. Hyperglycemia rates of >180 mg/dl in 2008 and 2009 were examined, and hypoglycemia rates of Automated POC-BG data management software can assist in this effort. PMID:21129348

Automated information retrieval system for radioactivation analysis

International Nuclear Information System (INIS)

Lambrev, V.G.; Bochkov, P.E.; Gorokhov, S.A.; Nekrasov, V.V.; Tolstikova, L.I.

1981-01-01

An automated information retrieval system for radioactivation analysis has been developed. An ES-1022 computer and a problem-oriented software ''The description information search system'' were used for the purpose. Main aspects and sources of forming the system information fund, characteristics of the information retrieval language of the system are reported and examples of question-answer dialogue are given. Two modes can be used: selective information distribution and retrospective search [ru

Model-Based approaches to Human-Automation Systems Design

DEFF Research Database (Denmark)

Jamieson, Greg A.; Andersson, Jonas; Bisantz, Ann

2012-01-01

Human-automation interaction in complex systems is common, yet design for this interaction is often conducted without explicit consideration of the role of the human operator. Fortunately, there are a number of modeling frameworks proposed for supporting this design activity. However...... (and reportedly one or two critics) can engage one another on several agreed questions about such frameworks. The goal is to aid non-aligned practitioners in choosing between alternative frameworks for their human-automation interaction design challenges....

A rule-based smart automated fertilization and irrigation systems

Science.gov (United States)

Yousif, Musab El-Rashid; Ghafar, Khairuddin; Zahari, Rahimi; Lim, Tiong Hoo

2018-04-01

Smart automation in industries has become very important as it can improve the reliability and efficiency of the systems. The use of smart technologies in agriculture have increased over the year to ensure and control the production of crop and address food security. However, it is important to use proper irrigation systems avoid water wastage and overfeeding of the plant. In this paper, a Smart Rule-based Automated Fertilization and Irrigation System is proposed and evaluated. We propose a rule based decision making algorithm to monitor and control the food supply to the plant and the soil quality. A build-in alert system is also used to update the farmer using a text message. The system is developed and evaluated using a real hardware.

An integrated system for buildings’ energy-efficient automation: Application in the tertiary sector

International Nuclear Information System (INIS)

Marinakis, Vangelis; Doukas, Haris; Karakosta, Charikleia; Psarras, John

2013-01-01

Highlights: ► We developed an interactive software for building automation systems. ► Monitoring of energy consumption in real time. ► Optimization of energy consumption implementing appropriate control scenarios. ► Pilot appraisal on remote control of active systems in the tertiary sector building. ► Significant decrease in energy and operating cost of A/C system. -- Abstract: Although integrated building automation systems have become increasingly popular, an integrated system which includes remote control technology to enable real-time monitoring of the energy consumption by energy end-users, as well as optimization functions is required. To respond to this common interest, the main aim of the paper is to present an integrated system for buildings’ energy-efficient automation. The proposed system is based on a prototype software tool for the simulation and optimization of energy consumption in the building sector, enhancing the interactivity of building automation systems. The system can incorporate energy-efficient automation functions for heating, cooling and/or lighting based on recent guidance and decisions of the National Law, energy efficiency requirements of EN 15232 and ISO 50001 Energy Management Standard among others. The presented system was applied to a supermarket building in Greece and focused on the remote control of active systems.

ASUPT Automated Objective Performance Measurement System.

Science.gov (United States)

Waag, Wayne L.; And Others

To realize its full research potential, a need exists for the development of an automated objective pilot performance evaluation system for use in the Advanced Simulation in Undergraduate Pilot Training (ASUPT) facility. The present report documents the approach taken for the development of performance measures and also presents data collected…

Automated plant, production management system

Science.gov (United States)

Aksenova, V. I.; Belov, V. I.

1984-12-01

The development of a complex of tasks for the operational management of production (OUP) within the framework of an automated system for production management (ASUP) shows that it is impossible to have effective computations without reliable initial information. The influence of many factors involving the production and economic activity of the entire enterprise upon the plan and course of production are considered. It is suggested that an adequate model should be available which covers all levels of the hierarchical system: workplace, section (bridgade), shop, enterprise, and the model should be incorporated into the technological sequence of performance and there should be provisions for an adequate man machine system.

Routine blood tests are associated with short term mortality and can improve emergency department triage

DEFF Research Database (Denmark)

Kristensen, Michael; Iversen, Anne Kristine Servais; Gerds, Thomas Alexander

2017-01-01

BACKGROUND: Prioritization of acutely ill patients in the Emergency Department remains a challenge. We aimed to evaluate whether routine blood tests can predict mortality in unselected patients in an emergency department and to compare risk prediction with a formalized triage algorithm. METHODS...... registration. Multiple logistic regressions were used to predict 30-day mortality. Validation was performed by applying the regression models on the 2013 validation cohort. RESULTS: Thirty-day mortality was 5.3%. The routine blood tests had a significantly stronger discriminative value on 30-day mortality...... compared to the formalized triage (AUC 88.1 [85.7;90.5] vs. 63.4 [59.1;67.5], p blood tests was able to identify a larger number of low risk patients (n = 2100, 30-day mortality 0.1% [95% CI 0.0;0.3%]) compared to formalized triage (n = 1591, 2.8% [95% CI 2...

Systems automated reporting of patient dose in digital radiology

International Nuclear Information System (INIS)

Collado Chamorro, P.; Sanz Freire, C. J.; Martinez Mirallas, O.; Tejada San Juan, S.; Lopez de Gammarra, M. S.

2013-01-01

It has developed a procedure automated reporting of doses to patients in Radiology. This procedure allows to save the time required of the data used to calculate the dose to patients by yields. Also saves the time spent in the transcription of these data for the realization of the necessary calculations. This system has been developed using open source software. The characteristics of the systems of digital radiography for the automation of procedures, in particular the registration of dose should benefit from patient. This procedure is validated and currently in use at our institution. (Author)

The Sydney Triage to Admission Risk Tool (START): A prospective validation study.

Science.gov (United States)

Ebker-White, Anja A; Bein, Kendall J; Dinh, Michael M

2018-02-08

The present study aims to prospectively validate the Sydney Triage to Admission Risk Tool (START) to predict ED disposition. This was a prospective validation study at two metropolitan EDs in Sydney, Australia. Consecutive triage encounters were observed by a trained researcher and START scores calculated. The primary outcome was patient disposition (discharge or inpatient admission) from the ED. Multivariable logistic regression was used to estimate area under curve of receiver operator characteristic (AUC ROC) for START scores as well as START score in combination with other variables such as frailty, general practitioner referral, overcrowding and major medical comorbidities. There were 894 patients analysed during the study period. The START score when applied to the data had AUC ROC of 0.80 (95% CI 0.77-0.83). The inclusion of other clinical variables identified at triage did not improve the overall performance of the model with an AUC ROC of 0.81 (95% CI 0.78-0.84) in the present study. The overall performance of the START tool with respect to model discrimination and accuracy has been prospectively validated. Further clinical trials are required to test the clinical effectiveness of the tool in improving patient flow and overall ED performance. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Towards automated construction of dependable software/hardware systems

Energy Technology Data Exchange (ETDEWEB)

Yakhnis, A.; Yakhnis, V. [Pioneer Technologies & Rockwell Science Center, Albuquerque, NM (United States)

1997-11-01

This report contains viewgraphs on the automated construction of dependable computer architecture systems. The outline of this report is: examples of software/hardware systems; dependable systems; partial delivery of dependability; proposed approach; removing obstacles; advantages of the approach; criteria for success; current progress of the approach; and references.

Automated integration of continuous glucose monitor data in the electronic health record using consumer technology.

Science.gov (United States)

Kumar, Rajiv B; Goren, Nira D; Stark, David E; Wall, Dennis P; Longhurst, Christopher A

2016-05-01

The diabetes healthcare provider plays a key role in interpreting blood glucose trends, but few institutions have successfully integrated patient home glucose data in the electronic health record (EHR). Published implementations to date have required custom interfaces, which limit wide-scale replication. We piloted automated integration of continuous glucose monitor data in the EHR using widely available consumer technology for 10 pediatric patients with insulin-dependent diabetes. Establishment of a passive data communication bridge via a patient's/parent's smartphone enabled automated integration and analytics of patient device data within the EHR between scheduled clinic visits. It is feasible to utilize available consumer technology to assess and triage home diabetes device data within the EHR, and to engage patients/parents and improve healthcare provider workflow. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Automated system for calibration and control of the CHSPP-800 multichannel γ detector parameters

International Nuclear Information System (INIS)

Avvakumov, N.A.; Belikov, N.I.; Goncharenko, Yu.M.

1987-01-01

An automated system for adjustment, calibration and control of total absorption Cherenkov spectrometer is described. The system comprises a mechanical platform, capable of moving in two mutually perpendicular directions; movement detectors and limit switches; power unit, automation unit with remote control board. The automated system can operate both in manual control regime with coordinate control by a digital indicator, and in operation regime with computer according to special programs. The platform mounting accuracy is ± 0.1 mm. Application of the automated system has increased the rate of the course of the counter adjustment works 3-5 times

A survey on automated wheeze detection systems for asthmatic patients

Directory of Open Access Journals (Sweden)

Syamimi Mardiah Shaharum

2012-11-01

Full Text Available The purpose of this paper is to present an evidence of automated wheeze detection system by a survey that can be very beneficial for asthmatic patients. Generally, for detecting asthma in a patient, stethoscope is used for ascertaining wheezes present. This causes a major problem nowadays because a number of patients tend to delay the interpretation time, which can lead to misinterpretations and in some worst cases to death. Therefore, the development of automated system would ease the burden of medical personnel. A further discussion on automated wheezes detection system will be presented later in the paper. As for the methodology, a systematic search of articles published as early as 1985 to 2012 was conducted. Important details including the hardware used, placement of hardware, and signal processing methods have been presented clearly thus hope to help and encourage future researchers to develop commercial system that will improve the diagnosing and monitoring of asthmatic patients.

Towards an Automated Acoustic Detection System for Free Ranging Elephants.

Science.gov (United States)

Zeppelzauer, Matthias; Hensman, Sean; Stoeger, Angela S

The human-elephant conflict is one of the most serious conservation problems in Asia and Africa today. The involuntary confrontation of humans and elephants claims the lives of many animals and humans every year. A promising approach to alleviate this conflict is the development of an acoustic early warning system. Such a system requires the robust automated detection of elephant vocalizations under unconstrained field conditions. Today, no system exists that fulfills these requirements. In this paper, we present a method for the automated detection of elephant vocalizations that is robust to the diverse noise sources present in the field. We evaluate the method on a dataset recorded under natural field conditions to simulate a real-world scenario. The proposed method outperformed existing approaches and robustly and accurately detected elephants. It thus can form the basis for a future automated early warning system for elephants. Furthermore, the method may be a useful tool for scientists in bioacoustics for the study of wildlife recordings.

Selecting and Planning for an Automated Library System: Guidelines for Libraries.

Science.gov (United States)

Piccininni, James

Guidelines are given for automating a library. Issues arising in automation are illustrated through the experience of the Doherty Library of the University of St. Thomas, Houston (Texas). The first step is to decide what type of system is right for the needs of the library and its patrons. In considering vendors of systems, it is important to…

[Automated anesthesia record systems].

Science.gov (United States)

Heinrichs, W; Mönk, S; Eberle, B

1997-07-01

The introduction of electronic anaesthesia documentation systems was attempted as early as in 1979, although their efficient application has become reality only in the past few years. The advantages of the electronic protocol are apparent: Continuous high quality documentation, comparability of data due to the availability of a data bank, reduction in the workload of the anaesthetist and availability of additional data. Disadvantages of the electronic protocol have also been discussed in the literature. By going through the process of entering data on the course of the anaesthetic procedure on the protocol sheet, the information is mentally absorbed and evaluated by the anaesthetist. This information may, however, be lost when the data are recorded fully automatically-without active involvement on the part of the anaesthetist. Recent publications state that by using intelligent alarms and/or integrated displays manual record keeping is no longer necessary for anaesthesia vigilance. The technical design of automated anaesthesia records depends on an integration of network technology into the hospital. It will be appropriate to connect the systems to the internet, but safety requirements have to be followed strictly. Concerning the database, client server architecture as well as language standards like SQL should be used. Object oriented databases will be available in the near future. Another future goal of automated anaesthesia record systems will be using knowledge based technologies within these systems. Drug interactions, disease related anaesthetic techniques and other information sources can be integrated. At this time, almost none of the commercially available systems has matured to a point where their purchase can be recommended without reservation. There is still a lack of standards for the subsequent exchange of data and a solution to a number of ergonomic problems still remains to be found. Nevertheless, electronic anaesthesia protocols will be required in

The Automation Control System Design of Walking Beam Heating Furnace

OpenAIRE

Hong-Yu LIU; Jun-Qing LIU; Jun-Jie XI

2014-01-01

Combining the transformation project of certain strip steel rolling production line, the techniques process of walking beam heating furnace was elaborated in this paper. The practical application of LOS-T18-2ZC1 laser detector was elaborated. The network communication model of walking beam heating furnace control system was designed. The realization method of production process automation control was elaborated. The entire automation control system allocation picture and PLC power distributio...

Energy conservation and management system using efficient building automation

Science.gov (United States)

Ahmed, S. Faiz; Hazry, D.; Tanveer, M. Hassan; Joyo, M. Kamran; Warsi, Faizan A.; Kamarudin, H.; Wan, Khairunizam; Razlan, Zuradzman M.; Shahriman A., B.; Hussain, A. T.

2015-05-01

In countries where the demand and supply gap of electricity is huge and the people are forced to endure increasing hours of load shedding, unnecessary consumption of electricity makes matters even worse. So the importance and need for electricity conservation increases exponentially. This paper outlines a step towards the conservation of energy in general and electricity in particular by employing efficient Building Automation technique. It should be noted that by careful designing and implementation of the Building Automation System, up to 30% to 40% of energy consumption can be reduced, which makes a huge difference for energy saving. In this study above mentioned concept is verified by performing experiment on a prototype experimental room and by implementing efficient building automation technique. For the sake of this efficient automation, Programmable Logic Controller (PLC) is employed as a main controller, monitoring various system parameters and controlling appliances as per required. The hardware test run and experimental findings further clarifies and proved the concept. The added advantage of this project is that it can be implemented to both small and medium level domestic homes thus greatly reducing the overall unnecessary load on the Utility provider.

ROBOCAL: An automated NDA [nondestructive analysis] calorimetry and gamma isotopic system

International Nuclear Information System (INIS)

Hurd, J.R.; Powell, W.D.; Ostenak, C.A.

1989-01-01

ROBOCAL, which is presently being developed and tested at Los Alamos National Laboratory, is a full-scale, prototype robotic system for remote calorimetric and gamma-ray analysis of special nuclear materials. It integrates a fully automated, multidrawer, vertical stacker-retriever system for staging unmeasured nuclear materials, and a fully automated gantry robot for computer-based selection and transfer of nuclear materials to calorimetric and gamma-ray measurement stations. Since ROBOCAL is designed for minimal operator intervention, a completely programmed user interface is provided to interact with the automated mechanical and assay systems. The assay system is designed to completely integrate calorimetric and gamma-ray data acquisition and to perform state-of-the-art analyses on both homogeneous and heterogeneous distributions of nuclear materials in a wide variety of matrices

Automated phased array ultrasonic inspection system for rail wheel sets

International Nuclear Information System (INIS)

Grosser, Paul; Weiland, M.G.

2013-01-01

This paper covers the design, system automation, calibration and validation of an automated ultrasonic system for the inspection of new and in service wheel set assemblies from diesel-electric locomotives and gondola cars. This system uses Phased Array (PA) transducers for flaw detection and Electro-Magnetic Acoustic Transducers (EMAT) for the measurement of residual stress. The system collects, analyses, evaluates and categorizes the wheel sets automatically. This data is archived for future comparison and trending. It is also available for export to a portal lathe for increased efficiency and accuracy of machining, therefore allowing prolonged wheel life.

Scope of practice review: providers for triage and assessment of spine-related disorders

Directory of Open Access Journals (Sweden)

Boakye O

2016-05-01

Full Text Available Omenaa Boakye,1 Arden Birney,1 Esther Suter,1 Leah Adeline Phillips,2 Victoria YM Suen3 1Workforce Research and Evaluation, Alberta Health Services, Calgary, 2College of Licensed Practical Nurses of Alberta, Edmonton, 3Addiction and Mental Health SCN, Alberta Health Services, Edmonton, AB, Canada Purpose: This study explored which health care providers could be involved in centralized intake for patients with nonspecific low back pain to enhance access, continuity, and appropriateness of care. Methods: We reviewed the scope of practice regulations for a range of health care providers. We also conducted telephone interviews with 17 individuals representing ten provincial colleges and regulatory bodies to further understand providers' legislated scopes of practice. Activities relevant to triaging and assessing patients with low back pain were mapped against professionals' scope of practice. Results: Family physicians and nurse practitioners have the most comprehensive scopes and can complete all restricted activities for spine assessment and triage, while the scope of registered nurses and licensed practical nurses are progressively narrower. Chiropractors, occupational therapists, physiotherapists, and athletic therapists are considered experts in musculoskeletal assessments and appear best suited for musculoskeletal specific assessment and triage. Other providers may play a complementary role depending on the individual patient needs. Conclusion: These findings indicate that an interprofessional assessment and triage team that includes allied health professionals would be a feasible option to create a centralized intake model. Implementation of such teams would require removing barriers that currently prevent providers from delivering on their full scope of practice. Keywords: scope of practice review, low back pain, integrated service model, centralized intake, interprofessional team

The developing technique for automated UT system

International Nuclear Information System (INIS)

Kim, Y. S.; Baek, C. H.

1994-01-01

This paper presents an experiential summary of the developing technique for automated ultrasonic testing system that consists of an ultrasonic tester, mechanical moving and fixing parts, controller and testing software. The application knowledges and limitations on these items are helpful to prevent the misoperation, the unadequate test result analysis and to build up the own test system.

Automating occupational protection records systems

International Nuclear Information System (INIS)

Lyon, M.; Martin, J.B.

1991-10-01

Occupational protection records have traditionally been generated by field and laboratory personnel, assembled into files in the safety office, and eventually stored in a warehouse or other facility. Until recently, these records have been primarily paper copies, often handwritten. Sometimes, the paper is microfilmed for storage. However, electronic records are beginning to replace these traditional methods. The purpose of this paper is to provide guidance for making the transition to automated record keeping and retrieval using modern computer equipment. This paper describes the types of records most readily converted to electronic record keeping and a methodology for implementing an automated record system. The process of conversion is based on a requirements analysis to assess program needs and a high level of user involvement during the development. The importance of indexing the hard copy records for easy retrieval is also discussed. The concept of linkage between related records and its importance relative to reporting, research, and litigation will be addressed. 2 figs

Building automation: Photovoltaic assisted thermal comfort management system for energy saving

International Nuclear Information System (INIS)

Khan, M Reyasudin Basir; Jidin, Razali; Shaaya, Sharifah Azwa; Pasupuleti, Jagadeesh