WorldWideScience

Sample records for safe clinical development

  1. Clinical, information and business process modeling to promote development of safe and flexible software.

    Science.gov (United States)

    Liaw, Siaw-Teng; Deveny, Elizabeth; Morrison, Iain; Lewis, Bryn

    2006-09-01

    Using a factorial vignette survey and modeling methodology, we developed clinical and information models - incorporating evidence base, key concepts, relevant terms, decision-making and workflow needed to practice safely and effectively - to guide the development of an integrated rule-based knowledge module to support prescribing decisions in asthma. We identified workflows, decision-making factors, factor use, and clinician information requirements. The Unified Modeling Language (UML) and public domain software and knowledge engineering tools (e.g. Protégé) were used, with the Australian GP Data Model as the starting point for expressing information needs. A Web Services service-oriented architecture approach was adopted within which to express functional needs, and clinical processes and workflows were expressed in the Business Process Execution Language (BPEL). This formal analysis and modeling methodology to define and capture the process and logic of prescribing best practice in a reference implementation is fundamental to tackling deficiencies in prescribing decision support software.

  2. The BMC ACCESS project: the development of a medically enhanced safe haven shelter.

    Science.gov (United States)

    Lincoln, Alisa; Johnson, Peggy; Espejo, Dennis; Plachta-Elliott, Sara; Lester, Peggy; Shanahan, Christopher; Abbott, Susan; Cabral, Howard; Jamanka, Amber; Delman, Jonathan; Kenny, Patty

    2009-10-01

    This paper describes the development and implementation of the Boston Medical Center (BMC) Advanced Clinical Capacity for Engagement, Safety, and Services Project. In October 2002, the BMC Division of Psychiatry became the first such entity to open a Safe Haven shelter for people who are chronically homeless, struggling with severe mental illness, and actively substance abusing. The low-demand Safe Haven model targets the most difficult to reach population and serves as a "portal of entry" to the mental health and addiction service systems. In this paper, the process by which this blended funded, multi-level collaboration, consisting of a medical center, state, city, local, and community-based consumer organizations, was created and is maintained, as well as the clinical model of care is described. Lessons learned from creating the Safe Haven Shelter and the development and implementation of the consumer-informed evaluation are discussed as well as implications for future work with this population.

  3. Nurses' clinical reasoning practices that support safe medication administration: An integrative review of the literature.

    Science.gov (United States)

    Rohde, Emily; Domm, Elizabeth

    2018-02-01

    To review the current literature about nurses' clinical reasoning practices that support safe medication administration. The literature about medication administration frequently focuses on avoiding medication errors. Nurses' clinical reasoning used during medication administration to maintain medication safety receives less attention in the literature. As healthcare professionals, nurses work closely with patients, assessing and intervening to promote mediation safety prior to, during and after medication administration. They also provide discharge teaching about using medication safely. Nurses' clinical reasoning and practices that support medication safety are often invisible when the focus is medication errors avoidance. An integrative literature review was guided by Whittemore and Knafl's (Journal of Advanced Nursing, 5, 2005 and 546) five-stage review of the 11 articles that met review criteria. This review is modelled after Gaffney et al.'s (Journal of Clinical Nursing, 25, 2016 and 906) integrative review on medical error recovery. Health databases were accessed and systematically searched for research reporting nurses' clinical reasoning practices that supported safe medication administration. The level and quality of evidence of the included research articles were assessed using The Johns Hopkins Nursing Evidence-Based Practice Rating Scale©. Nurses have a central role in safe medication administration, including but not limited to risk awareness about the potential for medication errors. Nurses assess patients and their medication and use knowledge and clinical reasoning to administer medication safely. Results indicated nurses' use of clinical reasoning to maintain safe medication administration was inadequately articulated in 10 of 11 studies reviewed. Nurses are primarily responsible for safe medication administration. Nurses draw from their foundational knowledge of patient conditions and organisational processes and use clinical reasoning that

  4. The SafeBoosC phase II clinical trial

    DEFF Research Database (Denmark)

    Riera, Joan; Hyttel-Sorensen, Simon; Bravo, María Carmen

    2016-01-01

    BACKGROUND: The SafeBoosC phase II randomised clinical trial recently demonstrated the benefits of a combination of cerebral regional tissue oxygen saturation (rStO2) by near-infrared spectroscopy (NIRS) and a treatment guideline to reduce the oxygen imbalance in extremely preterm infants. AIMS: ...

  5. Development of Safe and Effective Botanical Dietary Supplements.

    Science.gov (United States)

    van Breemen, Richard B

    2015-11-12

    Regulated differently than drugs or foods, the market for botanical dietary supplements continues to grow worldwide. The recently implemented U.S. FDA regulation that all botanical dietary supplements must be produced using good manufacturing practice is an important step toward enhancing the safety of these products, but additional safeguards could be implemented, and unlike drugs, there are currently no efficacy requirements. To ensure a safe and effective product, botanical dietary supplements should be developed in a manner analogous to pharmaceuticals that involves identification of mechanisms of action and active constituents, chemical standardization based on the active compounds, biological standardization based on pharmacological activity, preclinical evaluation of toxicity and potential for drug-botanical interactions, metabolism of active compounds, and finally, clinical studies of safety and efficacy. Completing these steps will enable the translation of botanicals from the field to safe human use as dietary supplements.

  6. Development of Safe and Effective Botanical Dietary Supplements

    Science.gov (United States)

    2015-01-01

    Regulated differently than drugs or foods, the market for botanical dietary supplements continues to grow worldwide. The recently implemented U.S. FDA regulation that all botanical dietary supplements must be produced using good manufacturing practice is an important step toward enhancing the safety of these products, but additional safeguards could be implemented, and unlike drugs, there are currently no efficacy requirements. To ensure a safe and effective product, botanical dietary supplements should be developed in a manner analogous to pharmaceuticals that involves identification of mechanisms of action and active constituents, chemical standardization based on the active compounds, biological standardization based on pharmacological activity, preclinical evaluation of toxicity and potential for drug–botanical interactions, metabolism of active compounds, and finally, clinical studies of safety and efficacy. Completing these steps will enable the translation of botanicals from the field to safe human use as dietary supplements. PMID:26125082

  7. Safe clinical practice for patients hospitalised in a suicidal crisis: a study protocol for a qualitative case study.

    Science.gov (United States)

    Berg, Siv Hilde; Rørtveit, Kristine; Walby, Fredrik A; Aase, Karina

    2017-01-27

    Suicide prevention in psychiatric care is arguably complex and incompletely understood as a patient safety issue. A resilient healthcare approach provides perspectives through which to understand this complexity by understanding everyday clinical practice. By including suicidal patients and healthcare professionals as sources of knowledge, a deeper understanding of what constitutes safe clinical practice can be achieved. This planned study aims to adopt the perspective of resilient healthcare to provide a deeper understanding of safe clinical practice for suicidal patients in psychiatric inpatient care. It will describe the experienced components and conditions of safe clinical practice and the experienced practice of patient safety. The study will apply a descriptive case study approach consisting of qualitative semistructured interviews and focus groups. The data sources are hospitalised patients in a suicidal crisis and healthcare professionals in clinical practice. This study was approved by the Regional Ethics Committee (2016/34). The results will be disseminated through scientific articles, a PhD dissertation, and national and international conferences. These findings can generate knowledge to be integrated into the practice of safety for suicidal inpatients in Norway and to improve the feasibility of patient safety measures. Theoretical generalisations can be drawn regarding safe clinical practice by taking into account the experiences of patients and healthcare professionals. Thus, this study can inform the conceptual development of safe clinical practice for suicidal patients. 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/.

  8. The SafeBoosC Phase II Randomised Clinical Trial

    DEFF Research Database (Denmark)

    Pellicer, Adelina; Greisen, Gorm; Benders, Manon

    2013-01-01

    Near-infrared spectroscopy-derived regional tissue oxygen saturation of haemoglobin (rStO2) reflects venous oxygen saturation. If cerebral metabolism is stable, rStO2 can be used as an estimate of cerebral oxygen delivery. The SafeBoosC phase II randomised clinical trial hypothesises that the bur...

  9. Prelicensure Baccalaureate Nursing Students' Perceptions of Their Development of Clinical Reasoning.

    Science.gov (United States)

    Herron, Elizabeth K; Sudia, Tanya; Kimble, Laura P; Davis, Alison H

    2016-06-01

    Establishing a strong foundation for the development of clinical reasoning in nursing students is essential to ensure safe and effective patient care. This study explored prelicensure baccalaureate nursing students' perceptions of their development of clinical reasoning, as well as their perceptions of how it is taught. In this phenomenological study, individual semistructured interviews were conducted to gather data related to participants' perceptions of their development of clinical reasoning. Data were analyzed using procedural steps delineated by Giorgi. Data analysis revealed three main themes: Instructor Characteristics, Importance of Clinical Reasoning, and Best Place to Learn Clinical Reasoning. Students recognized how clinical reasoning enhances safe and effective clinical practice and indicated the clinical arena was the most beneficial environment in which to learn clinical reasoning. Understanding students' perceptions of learning benefits nurse educators in planning nursing program curricula to enhance and facilitate the development of clinical reasoning. [J Nurs Educ. 2016;55(6):329-335.]. Copyright 2016, SLACK Incorporated.

  10. Strategies and challenges for safe injection practice in developing countries.

    Science.gov (United States)

    Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, Kc Vikash

    2013-01-01

    Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of "Safe Injection Global Network (SIGN)" was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice.

  11. Supporting safe driving with arthritis: developing a driving toolkit for clinical practice and consumer use.

    Science.gov (United States)

    Vrkljan, Brenda H; Cranney, Ann; Worswick, Julia; O'Donnell, Siobhan; Li, Linda C; Gélinas, Isabelle; Byszewski, Anna; Man-Son-Hing, Malcolm; Marshall, Shawn

    2010-01-01

    We conducted a series of focus groups to explore the information needs of clinicians and consumers related to arthritis and driving. An open coding analysis identified common themes across both consumer and clinician-based focus groups that underscored the importance of addressing driving-related concerns and the challenges associated with assessing safety. The results revealed that although driving is critical for maintaining independence and community mobility, drivers with arthritis experience several problems that can affect safe operation of a motor vehicle. Findings from this study are part of a broader research initiative that will inform the development of the Arthritis and Driving toolkit. This toolkit outlines strategies to support safe mobility for people with arthritis and will be an important resource in the coming years given the aging population.

  12. Clarification of Safe Delivery by Iranian Experts Based on Clinical Governance: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Forozun Olfati

    2015-10-01

    Full Text Available Objective:To clarify the principles of a safe delivery based on Clinical Governance Criteria, as recommended by the pertinent experts.Materials and methods:The current study was part of a qualitative research conducted by content analysis method in 2013 and purposive sampling, performing 24 in-depth interviews based on semi-structured questions and analyzed using thematic content analysis. The participants in this research included midwives, obstetricians, managers, and hospital doctors. The data were under continuous consideration and comparative analysis in order to achieve data saturation.Results:The main concepts derived from interpretations of the pertinent experts include: Patient & Public involvement; Risk Management; Education; Clinical efficiency; Clinical audit; Personnel & Management.Conclusion:In a safe delivery, there is a vicious cycle of causes the elimination of which is only possible through benchmarking patterns that attend to most aspects of a safe delivery.Changes to services require utilization of appropriate change management strategies.

  13. Development of a protocol that allows safe consumption of the hypoallergenic apple cultivar Santana

    OpenAIRE

    Maas, van der, M.P.; Schenk, M.F.

    2009-01-01

    The apple (Malus ×domestica) cultivar Santana was shown to have a low allergenicity in a previously reported clinical trial. A protocol was developed to validate these results outside a clinical setting and to market the Santana as a hypoallergenic apple for large-scale consumption. This protocol was designed to ensure safe consumption of the Santana by consumers suffering from apple allergy. We tested the protocol in a pilot in 100 supermarket stores and evaluated in an internet-based survey...

  14. Development of Safe Food Handling Guidelines for Korean Consumers.

    Science.gov (United States)

    Kang, Hee-Jin; Lee, Min-Woo; Hwang, In-Kyeong; Kim, Jeong-Weon

    2015-08-01

    The purpose of this study was to develop guidelines for Korean consumers with regard to safe food handling practices at home by identifying current food handling issues. Korean consumers' behaviors regarding their safe food handling were identified via survey questionnaires that included items on individual hygiene practices, prepreparation steps when cooking, the cooking process, and the storage of leftover foods. The subjects were 417 Korean parents with elementary school children living in Seoul and Gyeonggi Province in the central area of Korea. The survey results revealed gaps between the knowledge or practices of Korean consumers and scientific evidence pertaining to safe food handling practices. Based on these findings, a leaflet on safe food handling guidelines was developed in accordance with Korean food culture. These guidelines suggest personal hygiene practices as well as fundamental principles and procedures for safe food handling from the stage of food purchase to that of keeping leftover dishes. A pilot application study with 50 consumers revealed that the guidelines effectively improved Korean consumers' safe food handling practices, suggesting that they can serve as practical educational material suitable for Korean consumers.

  15. Update on the Clinical Development of Candidate Malaria Vaccines

    National Research Council Canada - National Science Library

    Ballou, W. R; Arevalo-Herrera, Myriam; Carucci, Daniel; Richie, Thomas L; Corradin, Giampietro; Diggs, Carter; Druilhe, Pierre; Giersing, Birgitte K; Saul, Allan; Heppner, D. G

    2004-01-01

    ... powerful driver for stimulating clinical development of candidate vaccines for malaria. This new way forward promises to greatly increase the likelihood of bringing a safe and effective vaccine to licensure...

  16. Implementation of Safe-by-Design for Nanomaterial Development and Safe Innovation: Why We Need a Comprehensive Approach.

    Science.gov (United States)

    Kraegeloh, Annette; Suarez-Merino, Blanca; Sluijters, Teun; Micheletti, Christian

    2018-04-14

    Manufactured nanomaterials (MNMs) are regarded as key components of innovations in various fields with high potential impact (e.g., energy generation and storage, electronics, photonics, diagnostics, theranostics, or drug delivery agents). Widespread use of MNMs raises concerns about their safety for humans and the environment, possibly limiting the impact of the nanotechnology-based innovation. The development of safe MNMs and nanoproducts has to result in a safe as well as functional material or product. Its safe use, and disposal at the end of its life cycle must be taken into account too. However, not all MNMs are similarly useful for all applications, some might bear a higher hazard potential than others, and use scenarios could lead to different exposure probabilities. To improve both safety and efficacy of nanotechnology, we think that a new proactive approach is necessary, based on pre-regulatory safety assessment and dialogue between stakeholders. On the basis of the work carried out in different European Union (EU) initiatives, developing and integrating MNMs Safe-by-Design and Trusted Environments (NANoREG, ProSafe, and NanoReg2), we present our point of view here. This concept, when fully developed, will allow for cost effective industrial innovation, and an exchange of key information between regulators and innovators. Regulators are thus informed about incoming innovations in good time, supporting a proactive regulatory action. The final goal is to contribute to the nanotechnology governance, having faster, cheaper, effective, and safer nano-products on the market.

  17. Clinical Practice Guideline: Safe Medication Use in the ICU.

    Science.gov (United States)

    Kane-Gill, Sandra L; Dasta, Joseph F; Buckley, Mitchell S; Devabhakthuni, Sandeep; Liu, Michael; Cohen, Henry; George, Elisabeth L; Pohlman, Anne S; Agarwal, Swati; Henneman, Elizabeth A; Bejian, Sharon M; Berenholtz, Sean M; Pepin, Jodie L; Scanlon, Mathew C; Smith, Brian S

    2017-09-01

    To provide ICU clinicians with evidence-based guidance on safe medication use practices for the critically ill. PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and ISI Web of Science for relevant material to December 2015. Based on three key components: 1) environment and patients, 2) the medication use process, and 3) the patient safety surveillance system. The committee collectively developed Population, Intervention, Comparator, Outcome questions and quality of evidence statements pertaining to medication errors and adverse drug events addressing the key components. A total of 34 Population, Intervention, Comparator, Outcome questions, five quality of evidence statements, and one commentary on disclosure was developed. Subcommittee members were assigned selected Population, Intervention, Comparator, Outcome questions or quality of evidence statements. Subcommittee members completed their Grading of Recommendations Assessment, Development, and Evaluation of the question with his/her quality of evidence assessment and proposed strength of recommendation, then the draft was reviewed by the relevant subcommittee. The subcommittee collectively reviewed the evidence profiles for each question they developed. After the draft was discussed and approved by the entire committee, then the document was circulated among all members for voting on the quality of evidence and strength of recommendation. The committee followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation system to determine quality of evidence and strength of recommendations. This guideline evaluates the ICU environment as a risk for medication-related events and the environmental changes that are possible to improve safe medication use. Prevention strategies for medication-related events are reviewed by medication use process node (prescribing, distribution, administration, monitoring). Detailed

  18. Strategies and challenges for safe injection practice in developing countries

    OpenAIRE

    Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, KC Vikash

    2013-01-01

    Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the earl...

  19. Workshop on Developing Safe Software

    International Nuclear Information System (INIS)

    Lawrence, J.D.

    1994-11-01

    The Workshop on Developing Safe Software was held July 22--23, 1992, at the Hotel del Coronado, San Diego, California. The purpose of the workshop was to have four world experts discuss among themselves software safety issues which are of interest to the US Nuclear Regulatory Commission. These issues concern the development of software systems for use in nuclear power plant protection systems. The workshop comprised four sessions. Wednesday morning, July 22, consisted of presentations from each of the four panel members. On Wednesday afternoon, the panel members went through a list of possible software development techniques and commented on them. The Thursday morning, July 23, session consisted of an extended discussion among the panel members and the observers from the NRC. A final session on Thursday afternoon consisted of a discussion among the NRC observers as to what was learned from the workshop

  20. Workshop on developing safe software

    International Nuclear Information System (INIS)

    Lawrence, J.D.

    1992-01-01

    The Workshop on Developing Safe Software was held July 22--23 at the Hotel del Coronado, San Diego, California. The purpose of the workshop was to have four world experts discuss among themselves software safety issues which are of interest to the U. S. Nuclear Regulatory Commission (NRC). These issues concern the development of software systems for use in nuclear power plant protection systems. The workshop comprised four sessions. Wednesday morning, July 22, consisted of presentations from each of the four panel members. On Wednesday afternoon, the panel members went through a list of possible software development techniques and commented on them. The Thursday morning, July 23, session consisted of an extended discussion among the panel members and the observers from the NRC. A final session on Thursday afternoon consisted of a discussion among the NRC observers as to what was teamed from the workshop

  1. Recent progress on developments of tritium safe handling techniques in Japan

    International Nuclear Information System (INIS)

    Watanabe, Kuniaki; Matsuyama, Masao

    1993-01-01

    Vast amounts of tritium will be used for thermonuclear fusion reactors. Without establishing safe handling techniques for large amounts of tritium, undoubtedly the fusion reactors will not be accepted. Japanese activity on tritium related research has considerably developed in the last 10 years. This review paper gives a brief summary of safe handling techniques developed by Japanese research groups. (author)

  2. Efficient Development and Verification of Safe Railway Control Software

    DEFF Research Database (Denmark)

    Haxthausen, Anne Elisabeth; Peleska, Jan

    2013-01-01

    the monitoring process; hydraulic absorbers as dampers to dissipate the energy of oscillations in railway electric equipment; development of train fare calculation and adjustment systems using VDM++; efficient development and verification of safe railway control software; and evolution of the connectivity...

  3. Do clinical examination gloves provide adequate electrical insulation for safe hands-on defibrillation? I: Resistive properties of nitrile gloves.

    Science.gov (United States)

    Deakin, Charles D; Lee-Shrewsbury, Victoria; Hogg, Kitwani; Petley, Graham W

    2013-07-01

    Uninterrupted chest compressions are a key factor in determining resuscitation success. Interruptions to chest compression are often associated with defibrillation, particularly the need to stand clear from the patient during defibrillation. It has been suggested that clinical examination gloves may provide adequate electrical resistance to enable safe hands-on defibrillation in order to minimise interruptions. We therefore examined whether commonly used nitrile clinical examination gloves provide adequate resistance to current flow to enable safe hands-on defibrillation. Clinical examination gloves (Kimberly Clark KC300 Sterling nitrile) worn by members of hospital cardiac arrest teams were collected immediately following termination of resuscitation. To determine the level of protection afforded by visually intact gloves, electrical resistance across the glove was measured by applying a DC voltage across the glove and measuring subsequent resistance. Forty new unused gloves (control) were compared with 28 clinical (non-CPR) gloves and 128 clinical (CPR) gloves. One glove in each group had a visible tear and was excluded from analysis. Control gloves had a minimum resistance of 120 kΩ (median 190 kΩ) compared with 60 kΩ in clinical gloves (both CPR (median 140 kΩ) and non-CPR groups (median 160 kΩ)). Nitrile clinical examination gloves do not provide adequate electrical insulation for the rescuer to safely undertake 'hands-on' defibrillation and when exposed to the physical forces of external chest compression, even greater resistive degradation occurs. Further work is required to identify gloves suitable for safe use for 'hands-on' defibrillation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. An Exploration of the Needling Depth in Acupuncture: The Safe Needling Depth and the Needling Depth of Clinical Efficacy

    Directory of Open Access Journals (Sweden)

    Jaung-Geng Lin

    2013-01-01

    Full Text Available Objective. To explore the existing scientific information regarding safe needling depth of acupuncture points and the needling depth of clinical efficacy. Methods. We searched the PubMed, EMBASE, Cochrane, Allied and Complementary Medicine (AMED, The National Center for Complementary and Alternative Medicine (NCCAM, and China National Knowledge Infrastructure (CNKI databases to identify relevant monographs and related references from 1991 to 2013. Chinese journals and theses/dissertations were hand searched. Results. 47 studies were recruited and divided into 6 groups by measuring tools, that is, MRI, in vivo evaluation, CT, ultrasound, dissected specimen of cadavers, and another group with clinical efficacy. Each research was analyzed for study design, definition of safe depth, and factors that would affect the measured depths. Depths of clinical efficacy were discussed from the perspective of de-qi and other clinical observations. Conclusions. Great inconsistency in depth of each point measured from different subject groups and tools exists. The definition of safe depth should be established through standardization. There is also lack of researches to compare the clinical efficacy. A well-designed clinical trial selecting proper measuring tools to decide the actual and advisable needling depth for each point, to avoid adverse effects or complications and promote optimal clinical efficacy, is a top priority.

  5. Residential tornado safe room from commodity wood products – design and development

    Science.gov (United States)

    Robert H. Falk; James J. Bridwell

    2018-01-01

    In the United States, tornadoes cause significant damage and result in many injuries and deaths. Although the development and use of tornado safe rooms have helped decrease the human toll associated with these events, the cost of these structures is often too high for many that could benefit from their use. The development of a nonproprietary residential tornado safe...

  6. Developing Safe Schools Partnerships with Law Enforcement

    Science.gov (United States)

    Rosiak, John

    2009-01-01

    Safe schools are the concern of communities throughout the world. If a school is safe, and if children feel safe, students "are better able to learn. But what are the steps to make" this happen? First, it is important to understand the problem: What are the threats to school safety? These include crime-related behaviors that find their way to…

  7. Safe pediatric surgery: development and validation of preoperative interventions checklist

    Directory of Open Access Journals (Sweden)

    Maria Paula de Oliveira Pires

    2013-09-01

    Full Text Available OBJECTIVES: this study was aimed at developing and validating a checklist of preoperative pediatric interventions related to the safety of surgical patients. METHOD: methodological study concerning the construction and validation of an instrument with safe preoperative care indicators. The checklist was subject to validation through the Delphi technique, establishing a consensus level of 80%. RESULTS: five professional specialists in the area conducted the validation and a consensus on the content and the construct was reached after two applications of the Delphi technique. CONCLUSION: the "Safe Pediatric Surgery Checklist", simulating the preoperative trajectory of children, is an instrument capable of contributing to the preparation and promotion of safe surgery, as it identifies the presence or absence of measures required to promote patient safety.

  8. Current nonclinical testing paradigm enables safe entry to First-In-Human clinical trials: The IQ consortium nonclinical to clinical translational database.

    Science.gov (United States)

    Monticello, Thomas M; Jones, Thomas W; Dambach, Donna M; Potter, David M; Bolt, Michael W; Liu, Maggie; Keller, Douglas A; Hart, Timothy K; Kadambi, Vivek J

    2017-11-01

    The contribution of animal testing in drug development has been widely debated and challenged. An industry-wide nonclinical to clinical translational database was created to determine how safety assessments in animal models translate to First-In-Human clinical risk. The blinded database was composed of 182 molecules and contained animal toxicology data coupled with clinical observations from phase I human studies. Animal and clinical data were categorized by organ system and correlations determined. The 2×2 contingency table (true positive, false positive, true negative, false negative) was used for statistical analysis. Sensitivity was 48% with a 43% positive predictive value (PPV). The nonhuman primate had the strongest performance in predicting adverse effects, especially for gastrointestinal and nervous system categories. When the same target organ was identified in both the rodent and nonrodent, the PPV increased. Specificity was 84% with an 86% negative predictive value (NPV). The beagle dog had the strongest performance in predicting an absence of clinical adverse effects. If no target organ toxicity was observed in either test species, the NPV increased. While nonclinical studies can demonstrate great value in the PPV for certain species and organ categories, the NPV was the stronger predictive performance measure across test species and target organs indicating that an absence of toxicity in animal studies strongly predicts a similar outcome in the clinic. These results support the current regulatory paradigm of animal testing in supporting safe entry to clinical trials and provide context for emerging alternate models. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Residential Tornado Safe Rooms from Commodity Wood Products: Wall Development and Impact Testing

    Science.gov (United States)

    Robert H. Falk; James J. Bridwell; John C. Hermanson

    2015-01-01

    In the United States, tornadoes cause significant damage and result in many injuries and deaths. Although the development and use of tornado safe rooms and shelters have helped reduce the human toll associated with these events, the cost of these structures is often too high for many that could benefit from their use. The development of a residential tornado safe room...

  10. Development of safe routes for children in urban environment

    Science.gov (United States)

    Koryagin, M. E.; Medvedev, V. I.; Strykov, P. G.

    2018-01-01

    The matter of development of safe travel routes for children between school and home is analyzed. The availability of various applications and devices to identify the location of the child and his/her travel routes is noted. The main factors to be taken into account when planning children travel routes are described. The most popular Russian services for route planning, Google, Yandex, and 2GIS, are discussed. These services are shown to have a number of shortcomings which does not allow them to choose really safe routes. A decision on making the route selection by two criteria (the travel time and the probability of an accident) is obtained. As a numerical example, the Pareto area for possible routes is constructed.

  11. Safe Patient Handling and Mobility: Development and Implementation of a Large-Scale Education Program.

    Science.gov (United States)

    Lee, Corinne; Knight, Suzanne W; Smith, Sharon L; Nagle, Dorothy J; DeVries, Lori

    This article addresses the development, implementation, and evaluation of an education program for safe patient handling and mobility at a large academic medical center. The ultimate goal of the program was to increase safety during patient mobility/transfer and reduce nursing staff injury from lifting/pulling. This comprehensive program was designed on the basis of the principles of prework, application, and support at the point of care. A combination of online learning, demonstration, skill evaluation, and coaching at the point of care was used to achieve the goal. Specific roles and responsibilities were developed to facilitate implementation. It took 17 master trainers, 88 certified trainers, 176 unit-based trainers, and 98 coaches to put 3706 nurses and nursing assistants through the program. Evaluations indicated both an increase in knowledge about safe patient handling and an increased ability to safely mobilize patients. The challenge now is sustainability of safe patient-handling practices and the growth and development of trainers and coaches.

  12. Technical and safe development features of modern research reactor

    International Nuclear Information System (INIS)

    Wang Jiaying; Dong Duo

    1998-01-01

    The development trend of research reactor in the world, and development situation in China are introduced. Up to now, some research reactors have serviced for long time and equipment have aged, not to be satisfied for requirement of science and technology development. New research reactors must been developed. The technical features and safe features of new type research reactor in China, for example: multi-pile utilization, compact core of high flux, high automation level of control, reactor two independent shutdown systems, great coefficient of negative temperature, passive safety systems, reliable residual heat removal system are studied

  13. Making and Executing Decisions for Safe and Independent Living (MED-SAIL): development and validation of a brief screening tool.

    Science.gov (United States)

    Mills, Whitney L; Regev, Tziona; Kunik, Mark E; Wilson, Nancy L; Moye, Jennifer; McCullough, Laurence B; Naik, Aanand D

    2014-03-01

    Older adults prefer to remain in their own homes for as long as possible. The purpose of this article is to describe the development and preliminary validation of Making and Executing Decisions for Safe and Independent Living (MED-SAIL), a brief screening tool for capacity to live safely and independently in the community. Prospective preliminary validation study. Outpatient geriatrics clinic located in a community-based hospital. Forty-nine community-dwelling older adults referred to the clinic for a comprehensive capacity assessment. We examined internal consistency, criterion-based validity, concurrent validity, and accuracy of classification for MED-SAIL. The items included in MED-SAIL demonstrated internal consistency (5 items; α = 0.85). MED-SAIL was significantly correlated with the Independent Living Scales (r = 0.573, p ≤0.001) and instrumental activities of daily living (r = 0.440, p ≤0.01). The Mann-Whitney U test revealed significant differences between the no capacity and partial/full capacity classifications on MED-SAIL (U(48) = 60.5, Z = -0.38, p SAIL as a brief screening tool to identify older adults with impaired capacity for remaining safe and independent in their current living environment. MED-SAIL is useful tool for health and social service providers in the community for the purpose of referral for definitive capacity evaluation. Published by Elsevier Inc.

  14. Consensus together to jointly promote the safe and efficient development of China's Nuclear industry

    International Nuclear Information System (INIS)

    Lei Zengguang

    2012-01-01

    After the development of China's nuclear industry 56 years, and a certain ability to form a strategic advantage for sustainable development, laying a solid foundation for the development of the national nuclear energy. 2011 Japan's Fukushima Daiichi nuclear accident occurred seven. 2011 of the 'Economic and Social Development Twelfth Five Five Year plan' clearly stated: 'on the basis of ensuring efficient and safe development of nuclear power', the development of China's nuclear industry is facing unprecedented opportunities and challenges, requiring the nuclear industry and nuclear academia work together to jointly promote China's nuclear industry safe and efficient, development

  15. Non-clinical studies in the process of new drug development - Part II: Good laboratory practice, metabolism, pharmacokinetics, safety and dose translation to clinical studies.

    Science.gov (United States)

    Andrade, E L; Bento, A F; Cavalli, J; Oliveira, S K; Schwanke, R C; Siqueira, J M; Freitas, C S; Marcon, R; Calixto, J B

    2016-12-12

    The process of drug development involves non-clinical and clinical studies. Non-clinical studies are conducted using different protocols including animal studies, which mostly follow the Good Laboratory Practice (GLP) regulations. During the early pre-clinical development process, also known as Go/No-Go decision, a drug candidate needs to pass through several steps, such as determination of drug availability (studies on pharmacokinetics), absorption, distribution, metabolism and elimination (ADME) and preliminary studies that aim to investigate the candidate safety including genotoxicity, mutagenicity, safety pharmacology and general toxicology. These preliminary studies generally do not need to comply with GLP regulations. These studies aim at investigating the drug safety to obtain the first information about its tolerability in different systems that are relevant for further decisions. There are, however, other studies that should be performed according to GLP standards and are mandatory for the safe exposure to humans, such as repeated dose toxicity, genotoxicity and safety pharmacology. These studies must be conducted before the Investigational New Drug (IND) application. The package of non-clinical studies should cover all information needed for the safe transposition of drugs from animals to humans, generally based on the non-observed adverse effect level (NOAEL) obtained from general toxicity studies. After IND approval, other GLP experiments for the evaluation of chronic toxicity, reproductive and developmental toxicity, carcinogenicity and genotoxicity, are carried out during the clinical phase of development. However, the necessity of performing such studies depends on the new drug clinical application purpose.

  16. Steering teens safe: a randomized trial of a parent-based intervention to improve safe teen driving.

    Science.gov (United States)

    Peek-Asa, Corinne; Cavanaugh, Joseph E; Yang, Jingzhen; Chande, Vidya; Young, Tracy; Ramirez, Marizen

    2014-07-31

    Crashes are the leading cause of death for teens, and parent-based interventions are a promising approach. We assess the effectiveness of Steering Teens Safe, a parent-focused program to increase safe teen driving. Steering Teens Safe aimed to improve parental communication with teens about safe driving using motivational interviewing techniques in conjunction with 19 safe driving lessons. A randomized controlled trial involved 145 parent-teen dyads (70 intervention and 75 control). Intervention parents received a 45-minute session to learn the program with four follow-up phone sessions, a DVD, and a workbook. Control parents received a standard brochure about safe driving. Scores were developed to measure teen-reported quantity and quality of parental communication about safe driving. The main outcome measure was a previously validated Risky Driving Score reported by teens. Because the Score was highly skewed, a generalized linear model based on a gamma distribution was used for analysis. Intervention teens ranked their parent's success in talking about driving safety higher than control teens (p = 0.035) and reported that their parents talked about more topics (non-significant difference). The Risky Driving Score was 21% lower in intervention compared to control teens (85% CI = 0.60, 1.00). Interaction between communication quantity and the intervention was examined. Intervention teens who reported more successful communication had a 42% lower Risky Driving Score (95% CI = 0.37, 0.94) than control parents with less successful communication. This program had a positive although not strong effect, and it may hold the most promise in partnership with other programs, such as Driver's Education or Graduated Driver's License policies. ClinicalTrials.gov NCT01014923. Registered Nov. 16, 2009.

  17. Development status of PIUS/ISER - a inherently safe reactor for the international use

    International Nuclear Information System (INIS)

    Wakabayashi, Hiroaki

    1987-01-01

    It is just in early 1980s that LWR-based nuclear power has become a substantial power source. Though the safety level of nuclear power is always claimed to be sufficiently high by the industry, it rests on the idea of defense in depth, the calculation by probabilistic risk assessment (PRA) or probabilistic safety assessment (PSA). The TMI-2 and Chernobyl-4 accidents occurred in the industrially most advanced countries. In this paper, an alternative way to safe nuclear power is sought in so-called inherently safe reactors (ISR) including the LWR type PIUS/ISER. With proper consideration into the design of nuclear reactor plants, those can be made basically safe through the use of passive safe mechanism for their design. In short, an ISR is a nuclear power reactor which has passive and intrinsic core cooling capability and automatic shutdown capability. As the nuclear power reactors which are currently claimed to be inherently safe, there are the process inherent and ultimately safe reactor (PIUS) of ASEA-ATOM Sweden and the inherently safe and economical reactor (ISER) of the University of Tokyo, Japan, of LWR type. The current status of the development, the reliability, and some technical problems of ISER/PIUS and the attitude of various countries toward ISER/PIUS are described. (Kako, I.)

  18. The SafeCOP ECSEL Project: Safe Cooperating Cyber-Physical Systems Using Wireless Communication

    DEFF Research Database (Denmark)

    Pop, Paul; Scholle, Detlef; Hansson, Hans

    2016-01-01

    This paper presents an overview of the ECSEL project entitled "Safe Cooperating Cyber-Physical Systems using Wireless Communication" (SafeCOP), which runs during the period 2016 -- 2019. SafeCOP targets safety-related Cooperating Cyber-Physical Systems (CO-CPS) characterised by use of wireless...... detection of abnormal behaviour, triggering if needed a safe degraded mode. SafeCOP will also develop methods and tools, which will be used to produce safety assurance evidence needed to certify cooperative functions. SafeCOP will extend current wireless technologies to ensure safe and secure cooperation...

  19. Vulnerabilities Classification for Safe Development on Android

    Directory of Open Access Journals (Sweden)

    Ricardo Luis D. M. Ferreira

    2016-06-01

    Full Text Available The global sales market is currently led by devices with the Android operating system. In 2015, more than 1 billion smartphones were sold, of which 81.5% were operated by the Android platform. In 2017, it is estimated that 267.78 billion applications will be downloaded from Google Play. According to Qian, 90% of applications are vulnerable, despite the recommendations of rules and standards for the safe software development. This study presents a classification of vulnerabilities, indicating the vulnerability, the safety aspect defined by the Brazilian Association of Technical Standards (Associação Brasileira de Normas Técnicas - ABNT norm NBR ISO/IEC 27002 which will be violated, which lines of code generate the vulnerability and what should be done to avoid it, and the threat agent used by each of them. This classification allows the identification of possible points of vulnerability, allowing the developer to correct the identified gaps.

  20. The Resident-Run Minor Surgery Clinic: A Pilot Study to Safely Increase Operative Autonomy.

    Science.gov (United States)

    Wojcik, Brandon M; Fong, Zhi Ven; Patel, Madhukar S; Chang, David C; Petrusa, Emil; Mullen, John T; Phitayakorn, Roy

    General surgery training has evolved to align with changes in work hour restrictions, supervision regulations, and reimbursement practices. This has culminated in a lack of operative autonomy, leaving residents feeling inadequately prepared to perform surgery independently when beginning fellowship or practice. A resident-run minor surgery clinic increases junior resident autonomy, but its effects on patient outcomes have not been formally established. This pilot study evaluated the safety of implementing a resident-run minor surgery clinic within a university-based general surgery training program. Single institution case-control pilot study of a resident-run minor surgery clinic from 9/2014 to 6/2015. Rotating third-year residents staffed the clinic once weekly. Residents performed operations independently in their own procedure room. A supervising attending surgeon staffed each case prior to residents performing the procedure and viewed the surgical site before wound closure. Postprocedure patient complications and admissions to the hospital because of a complication were analyzed and compared with an attending control cohort. Massachusetts General Hospital General in Boston, MA; an academic tertiary care general surgery residency program. Ten third-year general surgery residents. Overall, 341 patients underwent a total of 399 procedures (110 in the resident clinic vs. 289 in the attending clinic). Minor surgeries included soft tissue mass excision (n = 275), abscess incision and drainage (n = 66), skin lesion excision (n = 37), skin tag removal (n = 15), and lymph node excision (n = 6). There was no significant difference in the overall rate of patients developing a postprocedure complication within 30 days (3.6% resident vs. 2.8% attending; p = 0.65); which persisted on multivariate analysis. Similar findings were observed for the rate of hospital admission resulting from a complication. Resident evaluations overwhelmingly supported the rotation, citing

  1. Development and clinical application of In Vivo dosimetry for radiotherapy

    International Nuclear Information System (INIS)

    Honda, Hirofumi; Oita, Masataka; Tominaga, Masahide; Oto, Yoshihiro

    2016-01-01

    In practical radiotherapy, it is important to deliver radiation to the target correctly and safely according to the treatment planning. The control of radiation dose delivered to each patient in radiotherapy mainly relies on the prediction based on the result of pre-treatment verification and irradiation accuracy of treatment machines. In Vivo dosimetry in radiotherapy is the procedure of quality assurance by the way of direct measurement for the patient whether the calculated prescribed dose in the treatment planning is delivered precisely. The history of In Vivo dosimetry is relatively long, and the TLD dosimetry for clinical radiotherapy started in early 1970's. After 1980's, owing to the development of semiconductor devices such as diode detectors, semiconductor arrays, the clinical applications for the dosimetry and diagnostic radiation imaging devices which contributed to the development of electric portal imaging devices and 2D semiconductor detectors were introduced. In recent years, these radiation measurement devices and non-invasive methods have been developed, they are becoming widespread as clinical practice. In this paper, we reviewed the In Vivo dosimetry devices and their characteristics, and technical application for radiotherapy. (author)

  2. Generic Safety Requirements for Developing Safe Insulin Pump Software

    Science.gov (United States)

    Zhang, Yi; Jetley, Raoul; Jones, Paul L; Ray, Arnab

    2011-01-01

    Background The authors previously introduced a highly abstract generic insulin infusion pump (GIIP) model that identified common features and hazards shared by most insulin pumps on the market. The aim of this article is to extend our previous work on the GIIP model by articulating safety requirements that address the identified GIIP hazards. These safety requirements can be validated by manufacturers, and may ultimately serve as a safety reference for insulin pump software. Together, these two publications can serve as a basis for discussing insulin pump safety in the diabetes community. Methods In our previous work, we established a generic insulin pump architecture that abstracts functions common to many insulin pumps currently on the market and near-future pump designs. We then carried out a preliminary hazard analysis based on this architecture that included consultations with many domain experts. Further consultation with domain experts resulted in the safety requirements used in the modeling work presented in this article. Results Generic safety requirements for the GIIP model are presented, as appropriate, in parameterized format to accommodate clinical practices or specific insulin pump criteria important to safe device performance. Conclusions We believe that there is considerable value in having the diabetes, academic, and manufacturing communities consider and discuss these generic safety requirements. We hope that the communities will extend and revise them, make them more representative and comprehensive, experiment with them, and use them as a means for assessing the safety of insulin pump software designs. One potential use of these requirements is to integrate them into model-based engineering (MBE) software development methods. We believe, based on our experiences, that implementing safety requirements using MBE methods holds promise in reducing design/implementation flaws in insulin pump development and evolutionary processes, therefore improving

  3. SafeNet: a methodology for integrating general-purpose unsafe devices in safe-robot rehabilitation systems.

    Science.gov (United States)

    Vicentini, Federico; Pedrocchi, Nicola; Malosio, Matteo; Molinari Tosatti, Lorenzo

    2014-09-01

    Robot-assisted neurorehabilitation often involves networked systems of sensors ("sensory rooms") and powerful devices in physical interaction with weak users. Safety is unquestionably a primary concern. Some lightweight robot platforms and devices designed on purpose include safety properties using redundant sensors or intrinsic safety design (e.g. compliance and backdrivability, limited exchange of energy). Nonetheless, the entire "sensory room" shall be required to be fail-safe and safely monitored as a system at large. Yet, sensor capabilities and control algorithms used in functional therapies require, in general, frequent updates or re-configurations, making a safety-grade release of such devices hardly sustainable in cost-effectiveness and development time. As such, promising integrated platforms for human-in-the-loop therapies could not find clinical application and manufacturing support because of lacking in the maintenance of global fail-safe properties. Under the general context of cross-machinery safety standards, the paper presents a methodology called SafeNet for helping in extending the safety rate of Human Robot Interaction (HRI) systems using unsafe components, including sensors and controllers. SafeNet considers, in fact, the robotic system as a device at large and applies the principles of functional safety (as in ISO 13489-1) through a set of architectural procedures and implementation rules. The enabled capability of monitoring a network of unsafe devices through redundant computational nodes, allows the usage of any custom sensors and algorithms, usually planned and assembled at therapy planning-time rather than at platform design-time. A case study is presented with an actual implementation of the proposed methodology. A specific architectural solution is applied to an example of robot-assisted upper-limb rehabilitation with online motion tracking. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Clinical evaluation of semiautonomous smart wheelchair architecture (Drive-Safe System) with visually impaired individuals.

    Science.gov (United States)

    Sharma, Vinod; Simpson, Richard C; LoPresti, Edmund F; Schmeler, Mark

    2012-01-01

    Nonambulatory, visually impaired individuals mostly rely on caregivers for their day-to-day mobility needs. The Drive-Safe System (DSS) is a modular, semiautonomous smart wheelchair system aimed at providing independent mobility to people with visual and mobility impairments. In this project, clinical evaluation of the DSS was performed in a controlled laboratory setting with individuals who have visual impairment but no mobility impairment. Their performance using DSS was compared with their performance using a standard cane for navigation assistance. Participants rated their subjective appraisal of the DSS by using the National Aeronautics and Space Administration-Task Load Index inventory. DSS significantly reduced the number and severity of collisions compared with using a cane alone and without increasing the time required to complete the task. Users rated DSS favorably; they experienced less physical demand when using the DSS, but did not feel any difference in perceived effort, mental demand, and level of frustration when using the DSS alone or along with a cane in comparison with using a cane alone. These findings suggest that the DSS can be a safe, reliable, and easy-to-learn and operate independent mobility solution for visually impaired wheelchair users.

  5. Is phototherapy safe for HIV-infected individuals?

    Energy Technology Data Exchange (ETDEWEB)

    Adams, M.L.; Houpt, K.R.; Cruz, P.D. Jr. [Texas Univ., Dallas, TX (United States). Southwestern Medical Center

    1996-08-01

    Patients infected with human immunodeficiency virus (HIV) have a high prevalence of UV radiation-responsive skin diseases including psoriasis, pruitus, eosinophillic folliculitis and eczemas. On the other hand, UV has been shown to suppress T cell-mediated immune responses and to induce activation and replication of HIV. These developments have prompted clinicians and investigators to question whether phototherapy is safe for HIV-infected individuals. We have reviewed these issues and hereby provide a summary and critique of relevant laboratory and clinical evidence. (Author).

  6. Development of a tornado safe room door from wood Products: door design and impact testing

    Science.gov (United States)

    Robert H. Falk; James J. Bridwell

    2016-01-01

    In this study, a tornado safe room door built from wood products and steel sheeting was developed and impact-tested according to tornado safe room standards. Results indicate that an door constructed from as few as two sheets of 23/32-in. (18.26-mm) construction-grade plywood and overlaid with 18-gauge (0.05-in.- (1.27- mm-) thick) steel can pass the required impact...

  7. Safe corridors for K-wiring in phalangeal fractures

    Directory of Open Access Journals (Sweden)

    C Rex

    2015-01-01

    Conclusion: K-wiring through the safe corridor has proved to yield the best clinical results because of least tethering of soft tissues as evidenced by performing "on-table active finger movement test" at the time of surgery. We strongly recommend K-wiring through safe portals in all phalangeal fractures.

  8. Clinical reasoning of nursing students on clinical placement: Clinical educators' perceptions.

    Science.gov (United States)

    Hunter, Sharyn; Arthur, Carol

    2016-05-01

    Graduate nurses may have knowledge and adequate clinical psychomotor skills however they have been identified as lacking the clinical reasoning skills to deliver safe, effective care suggesting contemporary educational approaches do not always facilitate the development of nursing students' clinical reasoning. While nursing literature explicates the concept of clinical reasoning and develops models that demonstrate clinical reasoning, there is very little published about nursing students and clinical reasoning during clinical placements. Semi-structured interviews were conducted with ten clinical educators to gain an understanding of how they recognised, developed and appraised nursing students' clinical reasoning while on clinical placement. This study found variability in the clinical educators' conceptualisation, recognition, and facilitation of students' clinical reasoning. Although most of the clinical educators conceptualised clinical reasoning as a process those who did not demonstrated the greatest variability in the recognition and facilitation of students' clinical reasoning. The clinical educators in this study also described being unable to adequately appraise a student's clinical reasoning during clinical placement with the use of the current performance assessment tool. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Novel Sample Preparation Method for Safe and Rapid Detection of Bacillus anthracis Spores in Environmental Powders and Nasal Swabs

    OpenAIRE

    Luna, Vicki A.; King, Debra; Davis, Carisa; Rycerz, Tony; Ewert, Matthew; Cannons, Andrew; Amuso, Philip; Cattani, Jacqueline

    2003-01-01

    Bacillus anthracis spores have been used as a biological weapon in the United States. We wanted to develop a safe, rapid method of sample preparation that provided safe DNA for the detection of spores in environmental and clinical specimens. Our method reproducibly detects B. anthracis in samples containing

  10. Further developments in generating type-safe messaging

    Energy Technology Data Exchange (ETDEWEB)

    Neswold, R.; King, C.; /Fermilab

    2011-11-01

    At ICALEPCS 09, we introduced a source code generator that allows processes to communicate safely using data types native to each host language. In this paper, we discuss further development that has occurred since the conference in Kobe, Japan, including the addition of three more client languages, an optimization in network packet size and the addition of a new protocol data type. The protocol compiler is continuing to prove itself as an easy and robust way to get applications written in different languages hosted on different computer architectures to communicate. We have two active Erlang projects that are using the protocol compiler to access ACNET data at high data rates. We also used the protocol compiler output to deliver ACNET data to an iPhone/iPad application. Since it takes an average of two weeks to support a new language, we're willing to expand the protocol compiler to support new languages that our community uses.

  11. Derivation and validation of a novel risk score for safe discharge after acute lower gastrointestinal bleeding: a modelling study.

    Science.gov (United States)

    Oakland, Kathryn; Jairath, Vipul; Uberoi, Raman; Guy, Richard; Ayaru, Lakshmana; Mortensen, Neil; Murphy, Mike F; Collins, Gary S

    2017-09-01

    Acute lower gastrointestinal bleeding is a common reason for emergency hospital admission, and identification of patients at low risk of harm, who are therefore suitable for outpatient investigation, is a clinical and research priority. We aimed to develop and externally validate a simple risk score to identify patients with lower gastrointestinal bleeding who could safely avoid hospital admission. We undertook model development with data from the National Comparative Audit of Lower Gastrointestinal Bleeding from 143 hospitals in the UK in 2015. Multivariable logistic regression modelling was used to identify predictors of safe discharge, defined as the absence of rebleeding, blood transfusion, therapeutic intervention, 28 day readmission, or death. The model was converted into a simplified risk scoring system and was externally validated in 288 patients admitted with lower gastrointestinal bleeding (184 safely discharged) from two UK hospitals (Charing Cross Hospital, London, and Hammersmith Hospital, London) that had not contributed data to the development cohort. We calculated C statistics for the new model and did a comparative assessment with six previously developed risk scores. Of 2336 prospectively identified admissions in the development cohort, 1599 (68%) were safely discharged. Age, sex, previous admission for lower gastrointestinal bleeding, rectal examination findings, heart rate, systolic blood pressure, and haemoglobin concentration strongly discriminated safe discharge in the development cohort (C statistic 0·84, 95% CI 0·82-0·86) and in the validation cohort (0·79, 0·73-0·84). Calibration plots showed the new risk score to have good calibration in the validation cohort. The score was better than the Rockall, Blatchford, Strate, BLEED, AIMS65, and NOBLADS scores in predicting safe discharge. A score of 8 or less predicts a 95% probability of safe discharge. We developed and validated a novel clinical prediction model with good discriminative

  12. "From safe source to safe sink" development of colorimetric assay for gabapentin in bulk drug and capsules using naturally derived genipin.

    Science.gov (United States)

    Winotapun, Weerapath; Kongpakwattana, Khachen; Dejpittayanunt, Sirirat; Pathomcharoensukchai, Suwaparp; Suksaran, Udomluck; Nuntharatanapong, Nopparat; Rojanarata, Theerasak

    2012-09-15

    A novel colorimetric assay for gabapentin in bulk drug and capsules has been developed via a safety-and-sustainability concerning concept. The method relied on the reaction of primary amino group of drug with non-toxic and eco-friendly genipin in totally aqueous medium to form the blue product which was subsequently measured by visible spectrophotometry at 590 nm. Under the optimized conditions, Beer's law was obeyed in the concentration range of 0.15-0.50 mM (r(2)=0.9998). It was accurate, precise and insensitive to the interferences from all related compounds specified in the United States Pharmacopeia as well as commonly used excipients. Furthermore, it gave the assay results in agreement with the pharmacopeial chromatographic method. Owing to the environmental concern and responsibility, a fast and facile method was also proposed for the treatment of waste generated from the assay based on the decoloration by using gypsum as a cheap and commonly available adsorbent. After the treatment, more than 95% of the initial blue product was removed from the waste solution and the treated waste was proven to be safe for aquatic organisms, as studied in brine shrimp and guppy fishes. Therefore, this work not only reports for the first time the application of naturally derived genipin to drug analysis, but also presents a new and contemporary paradigm that illustrates the fully benign-by-design development of the analytical methodologies in the era of Green Chemistry, starting from the safe source of reagents toward the safe sink when waste is released into the environment. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Novel and viable acetylcholinesterase target site for developing effective and environmentally safe insecticides.

    Science.gov (United States)

    Pang, Yuan-Ping; Brimijoin, Stephen; Ragsdale, David W; Zhu, Kun Yan; Suranyi, Robert

    2012-04-01

    Insect pests are responsible for human suffering and financial losses worldwide. New and environmentally safe insecticides are urgently needed to cope with these serious problems. Resistance to current insecticides has resulted in a resurgence of insect pests, and growing concerns about insecticide toxicity to humans discourage the use of insecticides for pest control. The small market for insecticides has hampered insecticide development; however, advances in genomics and structural genomics offer new opportunities to develop insecticides that are less dependent on the insecticide market. This review summarizes the literature data that support the hypothesis that an insect-specific cysteine residue located at the opening of the acetylcholinesterase active site is a promising target site for developing new insecticides with reduced off-target toxicity and low propensity for insect resistance. These data are used to discuss the differences between targeting the insect-specific cysteine residue and targeting the ubiquitous catalytic serine residue of acetylcholinesterase from the perspective of reducing off-target toxicity and insect resistance. Also discussed is the prospect of developing cysteine-targeting anticholinesterases as effective and environmentally safe insecticides for control of disease vectors, crop damage, and residential insect pests within the financial confines of the present insecticide market.

  14. Clinical software development for the Web: lessons learned from the BOADICEA project.

    Science.gov (United States)

    Cunningham, Alex P; Antoniou, Antonis C; Easton, Douglas F

    2012-04-10

    In the past 20 years, society has witnessed the following landmark scientific advances: (i) the sequencing of the human genome, (ii) the distribution of software by the open source movement, and (iii) the invention of the World Wide Web. Together, these advances have provided a new impetus for clinical software development: developers now translate the products of human genomic research into clinical software tools; they use open-source programs to build them; and they use the Web to deliver them. Whilst this open-source component-based approach has undoubtedly made clinical software development easier, clinical software projects are still hampered by problems that traditionally accompany the software process. This study describes the development of the BOADICEA Web Application, a computer program used by clinical geneticists to assess risks to patients with a family history of breast and ovarian cancer. The key challenge of the BOADICEA Web Application project was to deliver a program that was safe, secure and easy for healthcare professionals to use. We focus on the software process, problems faced, and lessons learned. Our key objectives are: (i) to highlight key clinical software development issues; (ii) to demonstrate how software engineering tools and techniques can facilitate clinical software development for the benefit of individuals who lack software engineering expertise; and (iii) to provide a clinical software development case report that can be used as a basis for discussion at the start of future projects. We developed the BOADICEA Web Application using an evolutionary software process. Our approach to Web implementation was conservative and we used conventional software engineering tools and techniques. The principal software development activities were: requirements, design, implementation, testing, documentation and maintenance. The BOADICEA Web Application has now been widely adopted by clinical geneticists and researchers. BOADICEA Web

  15. Safe sex

    Science.gov (United States)

    ... sex; Sexually transmitted - safe sex; GC - safe sex; Gonorrhea - safe sex; Herpes - safe sex; HIV - safe sex; ... contact. STIs include: Chlamydia Genital herpes Genital warts Gonorrhea Hepatitis HIV HPV Syphilis STIs are also called ...

  16. Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial.

    Science.gov (United States)

    Şener, Hülya Özlem; Malkoç, Mehtap; Ergin, Gülbin; Karadibak, Didem; Yavuzşen, Tuğba

    2017-01-01

    The aim of the present study was to compare the effects of clinical Pilates exercises with those of the standard lymphedema exercises on lymphedema developing after breast cancer treatment. The study comprised 60 female patients with a mean age of 53.2±7.7 years who developed lymphedema after having breast cancer treatment. The patients were randomized into two groups: the clinical Pilates exercise group (n=30), and the control group (n=30). Before, and at the 8th week of treatment, the following parameters were measured: the severity of lymphedema, limb circumferences, body image using the Social Appearance Anxiety Scale, quality of life with the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-BR23), and upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Both groups performed one-hour exercises three days a week for 8 weeks. After treatment, the symptoms recovered significantly in both groups. Reductions in the severity of lymphedema, improvements in the social appearance anxiety scale scores, quality of life scores, and upper extremity functions scores in the clinical Pilates exercise group were greater than those in the control group. Clinical Pilates exercises were determined to be more effective on the symptoms of patients with lymphedema than were standard lymphedema exercises. Clinical Pilates exercises could be considered a safe model and would contribute to treatment programs.

  17. Safe Grid

    Science.gov (United States)

    Chow, Edward T.; Stewart, Helen; Korsmeyer, David (Technical Monitor)

    2003-01-01

    The biggest users of GRID technologies came from the science and technology communities. These consist of government, industry and academia (national and international). The NASA GRID is moving into a higher technology readiness level (TRL) today; and as a joint effort among these leaders within government, academia, and industry, the NASA GRID plans to extend availability to enable scientists and engineers across these geographical boundaries collaborate to solve important problems facing the world in the 21 st century. In order to enable NASA programs and missions to use IPG resources for program and mission design, the IPG capabilities needs to be accessible from inside the NASA center networks. However, because different NASA centers maintain different security domains, the GRID penetration across different firewalls is a concern for center security people. This is the reason why some IPG resources are been separated from the NASA center network. Also, because of the center network security and ITAR concerns, the NASA IPG resource owner may not have full control over who can access remotely from outside the NASA center. In order to obtain organizational approval for secured remote access, the IPG infrastructure needs to be adapted to work with the NASA business process. Improvements need to be made before the IPG can be used for NASA program and mission development. The Secured Advanced Federated Environment (SAFE) technology is designed to provide federated security across NASA center and NASA partner's security domains. Instead of one giant center firewall which can be difficult to modify for different GRID applications, the SAFE "micro security domain" provide large number of professionally managed "micro firewalls" that can allow NASA centers to accept remote IPG access without the worry of damaging other center resources. The SAFE policy-driven capability-based federated security mechanism can enable joint organizational and resource owner approved remote

  18. Health and safety in clinical laboratories in developing countries: safety considerations.

    Science.gov (United States)

    Ejilemele, A A; Ojule, A C

    2004-01-01

    Clinical laboratories are potentially hazardous work areas. Health and safety in clinical laboratories is becoming an increasingly important subject as a result of the emergence of highly infectious diseases such as hepatitis and HIV. This is even more so in developing countries where health and safety have traditionally been regarded as low priority issues, considering the more important health problems confronting the health authorities in these countries. We conducted a literature search using the medical subheadings titles on the INTERNET over a period of twenty years and summarized our findings. This article identifies hazards in the laboratories and highlights measures to make the laboratory a safer work place. It also emphasizes the mandatory obligations of employers and employees towards the attainment of acceptable safety standards in clinical laboratories in Third World countries in the face of the current HIV/AIDS epidemic in many of these developing countries especially in the sub-Saharan Africa while accommodating the increasing work load in these laboratories. Both the employer and the employee have major roles to play in the maintenance of a safe working environment. This can be achieved if measures discussed are incorporated into everyday laboratory practice.

  19. Safely diagnosing clinically significant penicillin allergy using only penicilloyl-poly-lysine, penicillin, and oral amoxicillin.

    Science.gov (United States)

    Macy, Eric; Ngor, Eunis W

    2013-01-01

    Penicillin skin testing is rarely used to undiagnose penicillin "allergy" in the United States, partially because of concern that commercially available materials are inadequate. We determined whether skin testing with only commercially available penicilloyl-poly-lysine and penicillin followed by an oral amoxicillin challenge, if skin test-negative, can safely identify clinically significant penicillin allergy. Five hundred sequential persons with positive history of penicillin "allergy" were evaluated by skin testing with penicilloyl-poly-lysine and penicillin between June 8, 2010, and March 29, 2012. All persons with negative skin tests were given an oral amoxicillin challenge and observed for 1 hour. Persons undergoing penicillin allergy testing were representative of all health plan members with penicillin allergy. Only 4 persons (0.8%; 95% CI, 0.32%-2.03%) had a positive skin test result. Only 4 persons (0.8%; 95% CI, 0.32%-2.03%) had an acute objective oral amoxicillin challenge reaction. Fifteen persons (3.0%; 95% CI, 1.83%-4.98%) had subjective oral challenge reactions, either acute transient itching or dizziness. All were women and 11 (73.3%) had multiple drug intolerance syndrome. None had severe reactions or objective signs. These were not considered to be positive challenge reactions. Sixty-eight subjects (13.6%) who were negative on testing were exposed to 88 courses of penicillins during 90 days of follow-up. New reactions were reported after 4 courses (4.5%), 3 (75%) occurring in subjects with multiple drug intolerance syndrome. Penicillin skin testing, using only penicilloyl-poly-lysine and penicillin, followed by oral amoxicillin challenge, if negative, can safely identify clinically significant IgE-mediated penicillin allergy in patients who use health care in the United States at this time. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  20. CREST-SAFE: Snow LST validation, wetness profiler creation, and depth/SWE product development

    Science.gov (United States)

    Perez Diaz, C. L.; Lakhankar, T.; Romanov, P.; Khanbilvardi, R.; Munoz Barreto, J.; Yu, Y.

    2017-12-01

    CREST-SAFE: Snow LST validation, wetness profiler creation, and depth/SWE product development The Field Snow Research Station (also referred to as Snow Analysis and Field Experiment, SAFE) is operated by the NOAA Center for Earth System Sciences and Remote Sensing Technologies (CREST) in the City University of New York (CUNY). The field station is located within the premises of the Caribou Municipal Airport (46°52'59'' N, 68°01'07'' W) and in close proximity to the National Weather Service (NWS) Regional Forecast Office. The station was established in 2010 to support studies in snow physics and snow remote sensing. The Visible Infrared Imager Radiometer Suite (VIIRS) Land Surface Temperature (LST) Environmental Data Record (EDR) and Moderate Resolution Imaging Spectroradiometer (MODIS) LST product (provided by the Terra and Aqua Earth Observing System satellites) were validated using in situ LST (T-skin) and near-surface air temperature (T-air) observations recorded at CREST-SAFE for the winters of 2013 and 2014. Results indicate that T-air correlates better than T-skin with VIIRS LST data and that the accuracy of nighttime LST retrievals is considerably better than that of daytime. Several trends in the MODIS LST data were observed, including the underestimation of daytime values and night-time values. Results indicate that, although all the data sets showed high correlation with ground measurements, day values yielded slightly higher accuracy ( 1°C). Additionally, we created a liquid water content (LWC)-profiling instrument using time-domain reflectometry (TDR) at CREST-SAFE and tested it during the snow melt period (February-April) immediately after installation in 2014. Results displayed high agreement when compared to LWC estimates obtained using empirical formulas developed in previous studies, and minor improvement over wet snow LWC estimates. Lastly, to improve on global snow cover mapping, a snow product capable of estimating snow depth and snow water

  1. Infectious Mononucleosis: Ensuring a Safe Return to Sport.

    Science.gov (United States)

    MacKnight, John M.

    2002-01-01

    Clinical properties of infectious mononucleosis include prolonged fatigue, spleen enlargement and fragility, and risk for spleen rupture. Sports medicine practitioners must recognize and manage these clinical features and promote safe, timely return of athletes to sports. Safeguarding against splenic injury and minimizing the duration of…

  2. Hepatic veno-occlusive disease during chemotherapy for nephroblastoma: successful and safe treatment with defibrotide. Report of a clinical case.

    Science.gov (United States)

    Cecinati, Valerio; Giordano, Paola; De Leonardis, Francesco; Grassi, Massimo; Arcamone, Giampaolo; De Mattia, Domenico; Santoro, Nicola

    2009-01-01

    Here we report a case of administration of defibrotide in an 11 months old infant with hepatic veno-occlusive disease during chemotherapy for nephroblastoma. He presented with abdominal distension, a weight gain of 15%, ascites, hepatomegaly with right upper quadrant pain, thrombocytopenia and hypertransaminasemia. Despite therapy, his clinical conditions aggravated, and, therefore intravenous administration of defibrotide on a compassionate-use basis was started. The dosage was 15 mg/kg/day in 4 divided doses, which was increased gradually (in 3 days) to 40 mg/kg/day in 4 divided doses. Defibrotide proved safe and effective in resolving clinical symptoms and normalizing serological findings in the syndrome.

  3. Development and design of an integrated information management system for safe management of radioactive waste

    Energy Technology Data Exchange (ETDEWEB)

    Son, Dong Chan; Hong, Suk Young; An, Kyoung Il [Daesang Information Technology Co., Ltd., Seoul (Korea, Republic of)

    2004-05-15

    An integrated data management system for the safe management of radioactive waste and spent fuel in Korea is developed to collect basic information, provide the framework for national regulation, and improve national competition and efficiency in the management of radioactive waste and spent fuel. This system can also provide public access to information such as a statistical graphs and integrated data from various waste generators to meet increased public needs and interests. Objectives can be summarized as; the five principles (independence, openness, clearance, efficiency and reliance) of safety regulation can be realized. Public understanding and reliance on the safety of spent fuel and radioactive waste management can be promoted by providing reliable information. Ensure an openness within the international nuclear community and efficiently support international agreements among contracting parties by operating safe and efficient management of spent fuel and radioactive waste (IAEA joint convention on the safety of spent fuel management and on the safety of radioactive waste management). The system can compensate for the imperfections In safe regulation of radioactive waste and spent fuel management related to waste generation, storage and disposal, and make it possible to holistic control. Re-organize the basic framework of KINS's intermediate and long term research organization and trends, regarding waste management policy is to integrate safe management and unit safe disposal.

  4. Development and design of an integrated information management system for safe management of radioactive waste

    International Nuclear Information System (INIS)

    Son, Dong Chan; Hong, Suk Young; An, Kyoung Il

    2004-05-01

    An integrated data management system for the safe management of radioactive waste and spent fuel in Korea is developed to collect basic information, provide the framework for national regulation, and improve national competition and efficiency in the management of radioactive waste and spent fuel. This system can also provide public access to information such as a statistical graphs and integrated data from various waste generators to meet increased public needs and interests. Objectives can be summarized as; the five principles (independence, openness, clearance, efficiency and reliance) of safety regulation can be realized. Public understanding and reliance on the safety of spent fuel and radioactive waste management can be promoted by providing reliable information. Ensure an openness within the international nuclear community and efficiently support international agreements among contracting parties by operating safe and efficient management of spent fuel and radioactive waste (IAEA joint convention on the safety of spent fuel management and on the safety of radioactive waste management). The system can compensate for the imperfections In safe regulation of radioactive waste and spent fuel management related to waste generation, storage and disposal, and make it possible to holistic control. Re-organize the basic framework of KINS's intermediate and long term research organization and trends, regarding waste management policy is to integrate safe management and unit safe disposal

  5. Vitamin D status, bone mineral density and mental health in young Australian women: the Safe-D study

    Directory of Open Access Journals (Sweden)

    Emma T. Callegari

    2015-11-01

    Full Text Available Background. Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study. Design and methods. Part A of the Safe-D study is a cross-sectional study aiming to recruit 468 young females aged 16-25 years living in Victoria, Australia, through Facebook advertising. Participants are required to complete an extensive, online questionnaire, wear an ultra-violet dosimeter for 14 consecutive days and attend a study site visit. Outcome measures include areal bone mineral measures at the lumbar spine, total hip and whole body, as well as soft tissue composition using dual energy x-ray absorptiometry. Trabecular and cortical volumetric bone density at the tibia is measured using peripheral quantitative computed tomography. Other tests include serum 25-hydroxyvitamin D, serum biochemistry and a range of health markers. Details of mood disorder/s and depressive and anxiety symptoms are obtained by self-report. Cutaneous melanin density is measured by spectrophotometry. Expected impact. The findings of this cross-sectional study will have implications for health promotion in young women and for clinical care of those with vitamin D deficiency and/or mental ill-health. Optimising both vitamin D status and mental health may protect against poor bone health and fractures in later life.

  6. InaSAFE applications in disaster preparedness

    Science.gov (United States)

    Pranantyo, Ignatius Ryan; Fadmastuti, Mahardika; Chandra, Fredy

    2015-04-01

    Disaster preparedness activities aim to reduce the impact of disasters by being better prepared to respond when a disaster occurs. In order to better anticipate requirements during a disaster, contingency planning activities can be undertaken prior to a disaster based on a realistic disaster scenario. InaSAFE is a tool that can inform this process. InaSAFE is a free and open source software that estimates the impact to people and infrastructure from potential hazard scenarios. By using InaSAFE, disaster managers can develop scenarios of disaster impacts (people and infrastructures affected) to inform their contingency plan and emergency response operation plan. While InaSAFE provides the software framework exposure data and hazard data are needed as inputs to run this software. Then InaSAFE can be used to forecast the impact of the hazard scenario to the exposure data. InaSAFE outputs include estimates of the number of people, buildings and roads are affected, list of minimum needs (rice and clean water), and response checklist. InaSAFE is developed by Indonesia's National Disaster Management Agency (BNPB) and the Australian Government, through the Australia-Indonesia Facility for Disaster Reduction (AIFDR), in partnership with the World Bank - Global Facility for Disaster Reduction and Recovery (GFDRR). This software has been used in many parts of Indonesia, including Padang, Maumere, Jakarta, and Slamet Mountain for emergency response and contingency planning.

  7. Manpower development for safe operation of nuclear power plant. China. Simulator software development. UNDP-Activity: 2.1.8-IAEA-Task-01. Technical report

    International Nuclear Information System (INIS)

    Feng, C.P.

    1994-01-01

    In the frameworks of the project ''manpower development for safe operation of nuclear power plant'' the development of reactor simulator software is described. Qinshan nuclear power plant was chosen as a reference one

  8. Safe Cooperating Cyber-Physical Systems using Wireless Communication

    DEFF Research Database (Denmark)

    Pop, Paul; Scholle, Detlef; Sljivo, Irfan

    2017-01-01

    This paper presents an overview of the ECSEL project entitled ―Safe Cooperating Cyber-Physical Systems using Wireless Communication‖ (SafeCOP), which runs during the period 2016–2019. SafeCOP targets safety-related Cooperating Cyber-Physical Systems (CO-CPS) characterised by use of wireless...... detection of abnormal behaviour, triggering if needed a safe degraded mode. SafeCOP will also develop methods and tools, which will be used to produce safety assurance evidence needed to certify cooperative functions. SafeCOP will extend current wireless technologies to ensure safe and secure cooperation...

  9. Clinical Trials

    Medline Plus

    Full Text Available ... medical strategy, treatment, or device is safe and effective for humans. What Are Clinical Trials? Clinical trials ... medical strategy, treatment, or device is safe and effective for humans. These studies also may show which ...

  10. Safeness of radiological machinery

    International Nuclear Information System (INIS)

    Yokoyama, Shun

    1979-01-01

    The human factors affecting the safeness of radiological machinery, which are often very big and complicated machines, are described from the stand point of handling. 20 to 50% of the troubles on equipments seem to be caused by men. This percentage will become even higher in highly developed equipments. Human factors have a great influence on the safeness of radiological equipments. As the human factors, there are sensory factors and knowledge factors as well as psychological factors, and the combination of these factors causes mishandling and danger. Medical services at present are divided in various areas, and consist of the teamwork of the people in various professions. Good human relationship, education and control are highly required to secure the safeness. (Kobatake, H.)

  11. Development of a national injury prevention/safe community programme in Vietnam.

    Science.gov (United States)

    Luau, H C; Svanström, L; Ekman, R; Duong, H L; Nguyen, O C; Dahlgren, G; Hoang, P

    2001-03-01

    The aim of this study is to describe the initiation of a national programme on injury prevention/safe community (IP/SC). Market economy, Doi Moi, was introduced in Vietnam in 1986, and since then the injury pattern has been reported to have changed. The number of traffic injury deaths has increased three-fold from 1980 to 1996 and traffic injuries more than four-fold. Injuries are now the leading cause of mortality in hospitals. There are difficulties in obtaining a comprehensive picture of the injury pattern from official statistics and, in conjunction with the work initiated by the Ministry of Health, a number of local reporting systems have already been developed. Remarkable results have been achieved within the IP/SC in a very short time, based on 20 years of experience. An organizational construction system has been built from province to local community areas. Management is based on administrative and legislative documents. IP/SC implementation is considered the duty of the whole community, local authorities and people committees, and should be incorporated into local action plans. The programme is a significant contribution towards creating a safe environment in which everybody may live and work, allowing the stability for society to develop. Implementation of the programme in schools is a special characteristic. The programme will be developed in 800 schools with a large number of pupils (25% of the population). This model for safer schools is considerably concerned and is a good experience to disseminate. The recommendations are that more pilot models of IP/SC should be conducted in other localities and that the programme should be expanded to a national scale. Furthermore, co-operation between sectors and mass organizations should be encouraged and professional skills of key SC members at all levels should be raised.

  12. FAST: towards safe and effective subcutaneous immunotherapy of persistent life-threatening food allergies

    Directory of Open Access Journals (Sweden)

    Zuidmeer-Jongejan Laurian

    2012-03-01

    Full Text Available Abstract The FAST project (Food Allergy Specific Immunotherapy aims at the development of safe and effective treatment of food allergies, targeting prevalent, persistent and severe allergy to fish and peach. Classical allergen-specific immunotherapy (SIT, using subcutaneous injections with aqueous food extracts may be effective but has proven to be accompanied by too many anaphylactic side-effects. FAST aims to develop a safe alternative by replacing food extracts with hypoallergenic recombinant major allergens as the active ingredients of SIT. Both severe fish and peach allergy are caused by a single major allergen, parvalbumin (Cyp c 1 and lipid transfer protein (Pru p 3, respectively. Two approaches are being evaluated for achieving hypoallergenicity, i.e. site-directed mutagenesis and chemical modification. The most promising hypoallergens will be produced under GMP conditions. After pre-clinical testing (toxicology testing and efficacy in mouse models, SCIT with alum-absorbed hypoallergens will be evaluated in phase I/IIa and IIb randomized double-blind placebo-controlled (DBPC clinical trials, with the DBPC food challenge as primary read-out. To understand the underlying immune mechanisms in depth serological and cellular immune analyses will be performed, allowing identification of novel biomarkers for monitoring treatment efficacy. FAST aims at improving the quality of life of food allergic patients by providing a safe and effective treatment that will significantly lower their threshold for fish or peach intake, thereby decreasing their anxiety and dependence on rescue medication.

  13. FAST: towards safe and effective subcutaneous immunotherapy of persistent life-threatening food allergies

    Science.gov (United States)

    2012-01-01

    The FAST project (Food Allergy Specific Immunotherapy) aims at the development of safe and effective treatment of food allergies, targeting prevalent, persistent and severe allergy to fish and peach. Classical allergen-specific immunotherapy (SIT), using subcutaneous injections with aqueous food extracts may be effective but has proven to be accompanied by too many anaphylactic side-effects. FAST aims to develop a safe alternative by replacing food extracts with hypoallergenic recombinant major allergens as the active ingredients of SIT. Both severe fish and peach allergy are caused by a single major allergen, parvalbumin (Cyp c 1) and lipid transfer protein (Pru p 3), respectively. Two approaches are being evaluated for achieving hypoallergenicity, i.e. site-directed mutagenesis and chemical modification. The most promising hypoallergens will be produced under GMP conditions. After pre-clinical testing (toxicology testing and efficacy in mouse models), SCIT with alum-absorbed hypoallergens will be evaluated in phase I/IIa and IIb randomized double-blind placebo-controlled (DBPC) clinical trials, with the DBPC food challenge as primary read-out. To understand the underlying immune mechanisms in depth serological and cellular immune analyses will be performed, allowing identification of novel biomarkers for monitoring treatment efficacy. FAST aims at improving the quality of life of food allergic patients by providing a safe and effective treatment that will significantly lower their threshold for fish or peach intake, thereby decreasing their anxiety and dependence on rescue medication. PMID:22409908

  14. The SafeBoosC II randomized trial

    DEFF Research Database (Denmark)

    Plomgaard, Anne M; van Oeveren, Wim; Petersen, Tue Hvass

    2016-01-01

    BACKGROUND: The SafeBoosC phase II multicentre randomized clinical trial investigated the benefits and harms of monitoring cerebral oxygenation by near-infrared spectroscopy (NIRS) combined with an evidence-based treatment guideline vs. no NIRS data and treatment as usual in the control group...

  15. Effective and Safe Ships

    DEFF Research Database (Denmark)

    Pedersen, Preben Terndrup; Amdahl, Jørgen; Rutgersson, Olle

    1996-01-01

    A Joint Nordic Research project "Effecive and Safe Ships" is presented. The project is aiming to develop methods and tools for quantitative evaluation fo ship safety. This report is the report of the preliminary phase where the plan for the main project is developed. The objectives of the project...

  16. 76 FR 12719 - Safe Schools/Healthy Students Program; Office of Safe and Drug-Free Schools; Safe Schools/Healthy...

    Science.gov (United States)

    2011-03-08

    ... DEPARTMENT OF EDUCATION Safe Schools/Healthy Students Program; Office of Safe and Drug- Free Schools; Safe Schools/Healthy Students Program; Catalog of Federal Domestic Assistance (CFDA) Numbers: 84... priorities, requirements, and definitions under the Safe Schools/Healthy Students (SS/HS) program. Since...

  17. An Automated Safe-to-Mate (ASTM) Tester

    Science.gov (United States)

    Nguyen, Phuc; Scott, Michelle; Leung, Alan; Lin, Michael; Johnson, Thomas

    2013-01-01

    Safe-to-mate testing is a common hardware safety practice where impedance measurements are made on unpowered hardware to verify isolation, continuity, or impedance between pins of an interface connector. A computer-based instrumentation solution has been developed to resolve issues. The ASTM is connected to the circuit under test, and can then quickly, safely, and reliably safe-to-mate the entire connector, or even multiple connectors, at the same time.

  18. MRI-guided stereotactic neurosurgical procedures in a diagnostic MRI suite: Background and safe practice recommendations.

    Science.gov (United States)

    Larson, Paul S; Willie, Jon T; Vadivelu, Sudhakar; Azmi-Ghadimi, Hooman; Nichols, Amy; Fauerbach, Loretta Litz; Johnson, Helen Boehm; Graham, Denise

    2017-07-01

    The development of navigation technology facilitating MRI-guided stereotactic neurosurgery has enabled neurosurgeons to perform a variety of procedures ranging from deep brain stimulation to laser ablation entirely within an intraoperative or diagnostic MRI suite while having real-time visualization of brain anatomy. Prior to this technology, some of these procedures required multisite workflow patterns that presented significant risk to the patient during transport. For those facilities with access to this technology, safe practice guidelines exist only for procedures performed within an intraoperative MRI. There are currently no safe practice guidelines or parameters available for facilities looking to integrate this technology into practice in conventional MRI suites. Performing neurosurgical procedures in a diagnostic MRI suite does require precautionary measures. The relative novelty of technology and workflows for direct MRI-guided procedures requires consideration of safe practice recommendations, including those pertaining to infection control and magnet safety issues. This article proposes a framework of safe practice recommendations designed for assessing readiness and optimization of MRI-guided neurosurgical interventions in the diagnostic MRI suite in an effort to mitigate patient risk. The framework is based on existing clinical evidence, recommendations, and guidelines related to infection control and prevention, health care-associated infections, and magnet safety, as well as the clinical and practical experience of neurosurgeons utilizing this technology. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

  19. Practical considerations in clinical strategy to support the development of injectable drug-device combination products for biologics.

    Science.gov (United States)

    Li, Zhaoyang; Easton, Rachael

    2018-01-01

    The development of an injectable drug-device combination (DDC) product for biologics is an intricate and evolving process that requires substantial investments of time and money. Consequently, the commercial dosage form(s) or presentation(s) are often not ready when pivotal trials commence, and it is common to have drug product changes (manufacturing process or presentation) during clinical development. A scientifically sound and robust bridging strategy is required in order to introduce these changes into the clinic safely. There is currently no single developmental paradigm, but a risk-based hierarchical approach has been well accepted. The rigor required of a bridging package depends on the level of risk associated with the changes. Clinical pharmacokinetic/pharmacodynamic comparability or outcome studies are only required when important changes occur at a late stage. Moreover, an injectable DDC needs to be user-centric, and usability assessment in real-world clinical settings may be required to support the approval of a DDC. In this review, we discuss the common issues during the manufacturing process and presentation development of an injectable DDC and practical considerations in establishing a clinical strategy to address these issues, including key elements of clinical studies. We also analyze the current practice in the industry and review relevant and status of regulatory guidance in the DDC field.

  20. [Development and clinical evaluation of an anesthesia information management system].

    Science.gov (United States)

    Feng, Jing-yi; Chen, Hua; Zhu, Sheng-mei

    2010-09-21

    To study the design, implementation and clinical evaluation of an anesthesia information management system. To record, process and store peri-operative patient data automatically, all kinds of bedside monitoring equipments are connected into the system based on information integrating technology; after a statistical analysis of those patient data by data mining technology, patient status can be evaluated automatically based on risk prediction standard and decision support system, and then anesthetist could perform reasonable and safe clinical processes; with clinical processes electronically recorded, standard record tables could be generated, and clinical workflow is optimized, as well. With the system, kinds of patient data could be collected, stored, analyzed and archived, kinds of anesthesia documents could be generated, and patient status could be evaluated to support clinic decision. The anesthesia information management system is useful for improving anesthesia quality, decreasing risk of patient and clinician, and aiding to provide clinical proof.

  1. Developing Clinical Competence

    NARCIS (Netherlands)

    P.F. Wimmers (Paul)

    2006-01-01

    textabstractThe development of clinical competence is the main purpose of medical education. The long road to become clinically competent starts on the first day of medical school, and every institution strives to select the best students. The responsibility of medical schools is to train

  2. Safe operation of critical assemblies and research reactors

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1960-09-15

    Some countries have accumulated considerable experience in the operation of these reactors and have in the process developed safe practices. On the other hand, other countries which have recently acquired, or will soon acquire, such reactors do not have sufficient background of experience with them to have developed full knowledge regarding their safe operation. In this situation, the International Atomic Energy Agency has considered that it would be useful to make available to all its Member States a set of recommendations on the safe operation of these reactors, based on the accumulated experience and best practices. The Director General accordingly nominated a Pane Ion Safe Operation of Critical Assemblies and Research Reactors to assist the Agency's Secretariat in drafting such recommendations

  3. The development and evaluation of online stories to enhance clinical learning experiences across health professions in rural Australia.

    Science.gov (United States)

    Paliadelis, Penny Susan; Stupans, Leva; Parker, Vicki; Piper, Donella; Gillan, Pauline; Lea, Jackie; Jarrott, Helen Mary; Wilson, Rhonda; Hudson, Judith N; Fagan, Anthea

    2015-01-01

    Clinical placement learning experiences are integral to all health and medical curricula as a means of integrating theory into practice and preparing graduates to deliver safe, high-quality care to health consumers. A growing challenge for education providers is to access sufficient clinical placements with experienced supervisors who are skilled at maximising learning opportunities for students. This paper reports on the development and evaluation of an innovative online learning program aimed at enhancing student and clinical supervisors' preparedness for effective workplace-based learning. The evidence-based learning program used 'story-telling' as the learning framework. The stories, which were supported by a range of resources, aimed to engage the learners in understanding student and supervisor responsibilities, as well as the expectations and competencies needed to support effective learning in the clinical environment. Evaluation of this program by the learners and stakeholders clearly indicated that they felt authentically 'connected' with the characters in the stories and developed insights that suggested effective learning had occurred.

  4. The Role of Well Control Training in Developing Safe Onshore and Offshore Oil Drilling Operations

    Science.gov (United States)

    Abulhassn, Aber

    2016-01-01

    This research investigates the role of the International Well Control Forum (IWCF) Rotary Drilling Well Control Training Program in developing safe oil drilling operations from the perspective of onshore and offshore drilling crews. The research methodology is a qualitative case study. A total of 40 IWCF candidates were interviewed, with 10 from…

  5. Cool and Safe: Multiplicity in Safe Innovation at Unilever

    Science.gov (United States)

    Penders, Bart

    2011-01-01

    This article presents the making of a safe innovation: the application of ice structuring protein (ISP) in edible ices. It argues that safety is not the absence of risk but is an active accomplishment; innovations are not "made safe afterward" but "safe innovations are made". Furthermore, there are multiple safeties to be accomplished in the…

  6. Clinical supervision of nursing students: challenges and alternatives ...

    African Journals Online (AJOL)

    Clinical supervision is described as a formal process of professional learning support in the clinical practice. The goal of clinical practice is to prepare nursing students develop and apply the necessary theoretical and empirical knowledge and skills in order for them to practice as safely and effectively as professional nurses.

  7. USING THE SAFE SYSTEM APPROACH TO KEEP OLDER DRIVERS SAFELY MOBILE

    Directory of Open Access Journals (Sweden)

    Jim LANGFORD

    2006-01-01

    Full Text Available In 2003, Australian road transport jurisdictions collectively accepted that the greatest road safety gains would be achieved through adopting a Safe System approach, derived from Sweden's Vision Zero and the Netherlands' Sustainable Safety strategies. A key objective of all three approaches is to manage vehicles, the road infrastructure, speeds, road users and the interactions between these components, to ensure that in the event of crashes, crash energies will remain at levels that minimize the probability of death and serious injury. Older drivers pose a particular challenge to the Safe System approach, given particularly their greater physical frailty, their driving patterns and for some at least, their reduced fitness to drive. This paper has analyzed the so-called ‘older driver problem’ and identified a number of key factors underpinning their crash levels, for which countermeasures can be identified and implemented within a Safe System framework. The recommended countermeasures consist of: (1 safer roads, through a series of design improvements particularly governing urban intersections; (2 safer vehicles, through both the promotion of crashworthiness as a critical consideration when purchasing a vehicle and the wide use of developed and developing ITS technologies; (3 safer speeds especially at intersections; and (4 safer road users, through both improved assessment procedures to identify the minority of older drivers with reduced fitness to drive and educational efforts to encourage safer driving habits particularly but not only through self-regulation.

  8. The development and psychometric testing of a theory-based instrument to evaluate nurses' perception of clinical reasoning competence.

    Science.gov (United States)

    Liou, Shwu-Ru; Liu, Hsiu-Chen; Tsai, Hsiu-Min; Tsai, Ying-Huang; Lin, Yu-Ching; Chang, Chia-Hao; Cheng, Ching-Yu

    2016-03-01

    The purpose of the study was to develop and psychometrically test the Nurses Clinical Reasoning Scale. Clinical reasoning is an essential skill for providing safe and quality patient care. Identifying pre-graduates' and nurses' needs and designing training courses to improve their clinical reasoning competence becomes a critical task. However, there is no instrument focusing on clinical reasoning in the nursing profession. Cross-sectional design was used. This study included the development of the scale, a pilot study that preliminary tested the readability and reliability of the developed scale and a main study that implemented and tested the psychometric properties of the developed scale. The Nurses Clinical Reasoning Scale was developed based on the Clinical Reasoning Model. The scale includes 15 items using a Likert five-point scale. Data were collected from 2013-2014. Two hundred and fifty-one participants comprising clinical nurses and nursing pre-graduates completed and returned the questionnaires in the main study. The instrument was tested for internal consistency and test-retest reliability. Its validity was tested with content, construct and known-groups validity. One factor emerged from the factor analysis. The known-groups validity was confirmed. The Cronbach's alpha for the entire instrument was 0·9. The reliability and validity of the Nurses Clinical Reasoning Scale were supported. The scale is a useful tool and can be easily administered for the self-assessment of clinical reasoning competence of clinical nurses and future baccalaureate nursing graduates. Study limitations and further recommendations are discussed. © 2015 John Wiley & Sons Ltd.

  9. Feeling safe during an inpatient hospitalization: a concept analysis.

    Science.gov (United States)

    Mollon, Deene

    2014-08-01

    This paper aims to explore the critical attributes of the concept feeling safe. The safe delivery of care is a high priority; however; it is not really known what it means to the patient to 'feel safe' during an inpatient hospitalization. This analysis explores the topic of safety from the patient's perspective. Concept analysis. The data bases of CINAHL, Medline, PsychInfo and Google Scholar for the years 1995-2012 were searched using the terms safe and feeling safe. The eight-step concept analysis method of Walker and Avant was used to analyse the concept of feeling safe. Uses and defining attributes, as well as identified antecedents, consequences and empirical referents, are presented. Case examples are provided to assist in the understanding of defining attributes. Feeling safe is defined as an emotional state where perceptions of care contribute to a sense of security and freedom from harm. Four attributes were identified: trust, cared for, presence and knowledge. Relationship, environment and suffering are the antecedents of feeling safe, while control, hope and relaxed or calm are the consequences. Empirical referents and early development of a theory of feeling safe are explored. This analysis begins the work of synthesizing qualitative research already completed around the concept of feeling safe by defining the key attributes of the concept. Support for the importance of developing patient-centred models of care and creating positive environments where patients receive high-quality care and feel safe is provided. © 2014 John Wiley & Sons Ltd.

  10. Online Learning of Safe Patient Transfers in Occupational Therapy Education

    Directory of Open Access Journals (Sweden)

    Cynthia L. Hayden D. H. Ed., OTR/L, CHT

    2013-02-01

    Full Text Available Online higher education is steadily increasing. For programs in allied health to be offered effectively in an elearning format, clinical psychomotor skills need to be addressed. The aim of this research was to design, implement, and evaluate an online safe patient transfers module for occupational therapy assistant (OTAstudents. The efficacy of teaching safe patient transfers in an e-learning environment was appraised using both quantitative and qualitative analysis. The applied research project was completed at a Tennessee community college. A convenience sample of eighteen students participated in the pilot study. Twenty-five studentsparticipated in the subsequent study. The instructional design of the course was based on Mager’s CriterionReferenced Instruction model. Streaming video was used as the delivery method for course material. A pretest/posttest evaluated the students’ cognitive knowledge of safe patient transfers. A behavioral transferscompetency checklist was used to rate videotapes of students’ performance of assisted stand pivot and dependent sliding board transfers. Research findings indicated students were able to learn this psychomotor clinical skill online with beginning proficiency. A paired t-test showed marked improvement of cognitive knowledge. A student learning survey revealed the majority of students preferred at least one hands-on classroom session where instructor feedback and interaction with classmates confirmed safe and effectiveclinical technique.

  11. Inherently safe technologies-chemical and nuclear

    International Nuclear Information System (INIS)

    Weinberg, A.M.

    1984-01-01

    Probabilistic risk assessments show an inverse relationship between the likelihood and the consequences of nuclear and chemical plant accidents, but the Bhopal accident has change public complacency about the safety of chemical plants to such an extent that public confidence is now at the same low level as with nuclear plants. The nuclear industry's response was to strengthen its institutions and improve its technologies, but the public may not be convinced. One solution is to develop reactors which do not depend upon the active intervention of humans of electromechanical devices to deal with emergencies, but which have physical properties that limit the possible temperature and power of a reactor. The Process Inherent Ultimately Safe and the modular High-Temperature Gas-Cooled reactors are two possibilities. the chemical industry needs to develop its own inherently safe design precepts that incorporate smallness, safe processes, and hardening against sabotage. 5 references

  12. Prospects for inherently safe reactors

    International Nuclear Information System (INIS)

    Barkenbus, J.N.

    1988-01-01

    Public fears over nuclear safety have led some within the nuclear community to investigate the possibility of producing inherently safe nuclear reactors; that is, reactors that are transparently incapable of producing a core melt. While several promising designs of such reactors have been produced, support for large-scale research and development efforts has not been forthcoming. The prospects for commercialization of inherently safe reactors, therefore, are problematic; possible events such as further nuclear reactor accidents and superpower summits, could alter the present situation significantly. (author)

  13. Developing novel immunogens for a safe and effective Alzheimer's disease vaccine.

    Science.gov (United States)

    Lemere, Cynthia A

    2009-01-01

    , a safe and effective active Abeta vaccine would be more cost-effective and more readily available to a larger AD population. We have developed several novel short Abeta immunogens that target the Abeta N-terminus containing a strong B cell epitope while avoiding the Abeta mid-region and C-terminus containing T cell epitopes. These immunogens include dendrimeric Abeta1-15 (16 copies of Abeta1-15 on a lysine antigen tree), 2xAbeta1-15 (a tandem repeat of two lysine-linked Abeta1-15 peptides), and 2xAbeta1-15 with the addition of a three amino acid RGD motif (R-2xAbeta1-15). Intranasal immunization with our short Abeta fragment immunogens and a mucosal adjuvant, mutant Escherichia coli heat-labile enterotoxin LT(R192G), resulted in reduced cerebral Abeta levels, plaque deposition, and gliosis, as well as increased plasma Abeta levels and improved cognition in a transgenic mouse model of AD. Preclinical trials in nonhuman primates, and human clinical trials using similar Abeta immunogens, are now underway. Abeta immunotherapy looks promising but must be made safer and more effective at generating antibody titers in the elderly. It is hoped that these novel immunogens will enhance Abeta antibody generation across a broad population and avoid the adverse events seen in the earlier clinical trial.

  14. The development of the Czech Republic electric industry - Reliable, safe and responsible source mix

    Energy Technology Data Exchange (ETDEWEB)

    Vrba, Miroslav; Jez, Jiri; Ptacek, Jiri

    2010-09-15

    The paper focuses on the development of the Czech Republic electric industry in close perspective and the prediction of its expected future in period up to 2030. The goal of the paper is to specify methods and procedures applied within periodic assessment of Czech electric power sector balance outlook for the State authorities. A necessity to respect economic recession and politicization of the issue of power sector development has invoked that these items are added to commonly used procedures. A key criterion is the reliable and safe electricity supply by adequate source mix for acceptable prices and environmental aspects.

  15. Practical considerations in clinical strategy to support the development of injectable drug-device combination products for biologics

    Science.gov (United States)

    Easton, Rachael

    2018-01-01

    ABSTRACT The development of an injectable drug-device combination (DDC) product for biologics is an intricate and evolving process that requires substantial investments of time and money. Consequently, the commercial dosage form(s) or presentation(s) are often not ready when pivotal trials commence, and it is common to have drug product changes (manufacturing process or presentation) during clinical development. A scientifically sound and robust bridging strategy is required in order to introduce these changes into the clinic safely. There is currently no single developmental paradigm, but a risk-based hierarchical approach has been well accepted. The rigor required of a bridging package depends on the level of risk associated with the changes. Clinical pharmacokinetic/pharmacodynamic comparability or outcome studies are only required when important changes occur at a late stage. Moreover, an injectable DDC needs to be user-centric, and usability assessment in real-world clinical settings may be required to support the approval of a DDC. In this review, we discuss the common issues during the manufacturing process and presentation development of an injectable DDC and practical considerations in establishing a clinical strategy to address these issues, including key elements of clinical studies. We also analyze the current practice in the industry and review relevant and status of regulatory guidance in the DDC field. PMID:29035675

  16. Advancing clinical development pathways for new CFTR modulators in cystic fibrosis.

    Science.gov (United States)

    Mayer-Hamblett, Nicole; Boyle, Michael; VanDevanter, Donald

    2016-05-01

    Cystic fibrosis (CF) is a life-shortening genetic disease affecting approximately 70,000 individuals worldwide. Until recently, drug development efforts have emphasised therapies treating downstream signs and symptoms resulting from the underlying CF biological defect: reduced function of the CF transmembrane conductance regulator (CFTR) protein. The current CF drug development landscape has expanded to include therapies that enhance CFTR function by either restoring wild-type CFTR protein expression or increasing (modulating) the function of mutant CFTR proteins in cells. To date, two systemic small-molecule CFTR modulators have been evaluated in pivotal clinical trials in individuals with CF and specific mutant CFTR genotypes that have led to regulatory review and/or approval. Advances in the discovery of CFTR modulators as a promising new class of therapies have been impressive, yet work remains to develop highly effective, disease-modifying modulators for individuals of all CF genotypes. The objectives of this review are to outline the challenges and opportunities in drug development created by systemic genotype-specific CFTR modulators, highlight the advantages of sweat chloride as an established biomarker of CFTR activity to streamline early-phase development and summarise options for later phase clinical trial designs that respond to the adoption of approved genotype-specific modulators into standard of care. An optimal development framework will be needed to move the most promising therapies efficiently through the drug development pipeline and ultimately deliver efficacious and safe therapies to all individuals with CF. 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/

  17. Development of a National System to Regulate Safe Transport of Radioactive Materials in Ukraine

    International Nuclear Information System (INIS)

    Gashev, M.; Kutuzova, T.; Sakalo, V.

    2016-01-01

    The paper provides brief information on development of the legislative framework and regulatory requirements in transport of radioactive materials in Ukraine. The application of IAEA documents is demonstrated and their contribution to the improvement of the national regulatory control system and processes of its harmonization with international safety requirements is underlined. Proposals for coordination and interaction enhancement in order to improve safety in safe transport of radioactive materials are defined in the conclusion. (author)

  18. Development of Self-Remediating Packaging for Safe and Secure Transport of Infectious Substances.

    Energy Technology Data Exchange (ETDEWEB)

    Guilinger, Terry Rae; Gaudioso, Jennifer M; Aceto, Donato Gonzalo; Lowe, Kathleen M.; Tucker, Mark D; Salerno, Reynolds Mathewson; Souza, Caroline Ann

    2006-11-01

    As George W. Bush recognized in November 2001, "Infectious diseases make no distinctions among people and recognize no borders." By their very nature, infectious diseases of natural or intentional (bioterrorist) origins are capable of threatening regional health systems and economies. The best mechanism for minimizing the spread and impact of infectious disease is rapid disease detection and diagnosis. For rapid diagnosis to occur, infectious substances (IS) must be transported very quickly to appropriate laboratories, sometimes located across the world. Shipment of IS is problematic since many carriers, concerned about leaking packages, refuse to ship this material. The current packaging does not have any ability to neutralize or kill leaking IS. The technology described here was developed by Sandia National Laboratories to provide a fail-safe packaging system for shipment of IS that will increase the likelihood that critical material can be shipped to appropriate laboratories following a bioterrorism event or the outbreak of an infectious disease. This safe and secure packaging method contains a novel decontaminating material that will kill or neutralize any leaking infectious organisms; this feature will decrease the risk associated with shipping IS, making transport more efficient. 3 DRAFT4

  19. From safe yield to sustainable development of water resources - The Kansas experience

    Science.gov (United States)

    Sophocleous, M.

    2000-01-01

    This paper presents a synthesis of water sustainability issues from the hydrologic perspective. It shows that safe yield is a flawed concept and that sustainability is an idea that is broadly used but perhaps not well understood. In general, the sustainable yield of an aquifer must be considerably less than recharge if adequate amounts of water are to be available to sustain both the quantity and quality of streams, springs, wetlands, and ground-water-dependent ecosystems. To ensure sustainability, it is imperative that water limits be established based on hydrologic principles of mass balance. To establish water-use policies and planning horizons, the transition curves of aquifer systems from ground-water storage depletion to induced recharge of surface water need to be developed. Present-day numerical models are capable of generating such transition curves. Several idealized examples of aquifer systems show how this could be done. Because of the complexity of natural systems and the uncertainties in characterizing them, the current philosophy underlying sustainable management of water resources is based on the interconnected systems approach and on adaptive management. Examples of water-resources management from Kansas illustrate some of these concepts in a real-world setting. Some of the hallmarks of Kansas water management are the formation of local ground-water management districts, the adoption of minimum streamflow standards, the use of modified safe-yield policies in some districts, the implementation of integrated resource planning by the City of Wichita, and the subbasin water-resources management program in potential problem areas. These are all appropriate steps toward sustainable development. The Kansas examples show that local decision-making is the best way to fully account for local variability in water management. However, it is imperative that public education and involvement be encouraged, so that system complexities and constraints are better

  20. Safe Kids Worldwide

    Science.gov (United States)

    ... Blog Videos Newsletter facebook twitter instagram pinterest gplus youtube Search Menu Why It Matters Who We Are What We Do Find Your Safe Kids Safe Kids Day Main menu Keeping All Kids Safe Safety Tips Get Involved 4 Star Charity Donate Text Burns and Scalds 4 tips ...

  1. Technology development program for safe shipment of spent fuel from liquid metal fast breeder reactor

    International Nuclear Information System (INIS)

    Freedman, J.M.; Humphreys, J.R.

    1975-10-01

    A comprehensive plan to develop shipping cask technology is described. Technical programs in the disciplines of heat transfer, structures and containment, spent fuel characterization, hot laboratory verification, shielding, and hazards analysis are discussed. Both short- and long-term goals in each discipline are delineated and how the disciplines interrelate is shown. The technologies developed will be used in the design, fabrication, and testing of truck-mounted and rail-car casks. These casks will be used for safely transporting short-cooled, high-burnup Liquid Metal Fast Breeder Reactor (LMFBR) spent fuel from reactors to reprocessing plants

  2. Clinical Trials

    Medline Plus

    Full Text Available ... medical strategy, treatment, or device is safe and effective for humans. What Are Clinical Trials? Clinical trials ... and Centers sponsor clinical trials. Many other groups, companies, and organizations also sponsor clinical trials. Examples include ...

  3. Safe actinide disposition in molten salt reactors

    International Nuclear Information System (INIS)

    Gat, U.

    1997-01-01

    Safe molten salt reactors (MSR) can readily accommodate the burning of all fissile actinides. Only minor compromises associated with plutonium are required. The MSRs can dispose safely of actinides and long lived isotopes to result in safer and simpler waste. Disposing of actinides in MSRs does increase the source term of a safety optimized MSR. It is concluded that the burning and transmutation of actinides in MSRs can be done in a safe manner. Development is needed for the processing to handle and separate the actinides. Calculations are needed to establish the neutron economy and the fuel management. 9 refs

  4. The SafeBoosC Phase II Randomised Clinical Trial : A Treatment Guideline for Targeted Near-Infrared-Derived Cerebral Tissue Oxygenation versus Standard Treatment in Extremely Preterm Infants

    NARCIS (Netherlands)

    Pellicer, Adelina; Greisen, Gorm; Benders, Manon; Claris, Olivier; Dempsey, Eugene; Fumagalli, Monica; Gluud, Christian; Hagmann, Cornelia; Hellstroem-Westas, Lena; Hyttel-Sorensen, Simon; Lemmers, Petra; Naulaers, Gunnar; Pichler, Gerhard; Roll, Claudia; van Bel, Frank; van Oeveren, Wim; Skoog, Maria; Wolf, Martin; Austin, Topun

    2013-01-01

    Near-infrared spectroscopy-derived regional tissue oxygen saturation of haemoglobin (rSto(2)) reflects venous oxygen saturation. If cerebral metabolism is stable, rSto(2) can be used as an estimate of cerebral oxygen delivery. The SafeBoosC phase II randomised clinical trial hypothesises that the

  5. Children affected by HIV/AIDS: SAFE, a model for promoting their security, health, and development.

    Science.gov (United States)

    Betancourt, Theresa S; Fawzi, Mary K S; Bruderlein, Claude; Desmond, Chris; Kim, Jim Y

    2010-05-01

    A human security framework posits that individuals are the focus of strategies that protect the safety and integrity of people by proactively promoting children's well being, placing particular emphasis on prevention efforts and health promotion. This article applies this framework to a rights-based approach in order to examine the health and human rights of children affected by HIV/AIDS. The SAFE model describes sources of insecurity faced by children across four fundamental dimensions of child well-being and the survival strategies that children and families may employ in response. The SAFE model includes: Safety/protection; Access to health care and basic physiological needs; Family/connection to others; and Education/livelihoods. We argue that it is critical to examine the situation of children through an integrated lens that effectively looks at human security and children's rights through a holistic approach to treatment and care rather than artificially limiting our scope of work to survival-oriented interventions for children affected by HIV/AIDS. Interventions targeted narrowly at children, in isolation of their social and communal environment as outlined in the SAFE model, may in fact undermine protective resources in operation in families and communities and present additional threats to children's basic security. An integrated approach to the basic security and care of children has implications for the prospects of millions of children directly infected or indirectly affected by HIV/AIDS around the world. The survival strategies that young people and their families engage in must be recognized as a roadmap for improving their protection and promoting healthy development. Although applied to children affected by HIV/AIDS in the present analysis, the SAFE model has implications for guiding the care and protection of children and families facing adversity due to an array of circumstances from armed conflict and displacement to situations of extreme poverty.

  6. OR.NET: a service-oriented architecture for safe and dynamic medical device interoperability.

    Science.gov (United States)

    Kasparick, Martin; Schmitz, Malte; Andersen, Björn; Rockstroh, Max; Franke, Stefan; Schlichting, Stefan; Golatowski, Frank; Timmermann, Dirk

    2018-02-23

    Modern surgical departments are characterized by a high degree of automation supporting complex procedures. It recently became apparent that integrated operating rooms can improve the quality of care, simplify clinical workflows, and mitigate equipment-related incidents and human errors. Particularly using computer assistance based on data from integrated surgical devices is a promising opportunity. However, the lack of manufacturer-independent interoperability often prevents the deployment of collaborative assistive systems. The German flagship project OR.NET has therefore developed, implemented, validated, and standardized concepts for open medical device interoperability. This paper describes the universal OR.NET interoperability concept enabling a safe and dynamic manufacturer-independent interconnection of point-of-care (PoC) medical devices in the operating room and the whole clinic. It is based on a protocol specifically addressing the requirements of device-to-device communication, yet also provides solutions for connecting the clinical information technology (IT) infrastructure. We present the concept of a service-oriented medical device architecture (SOMDA) as well as an introduction to the technical specification implementing the SOMDA paradigm, currently being standardized within the IEEE 11073 service-oriented device connectivity (SDC) series. In addition, the Session concept is introduced as a key enabler for safe device interconnection in highly dynamic ensembles of networked medical devices; and finally, some security aspects of a SOMDA are discussed.

  7. "Same Room, Safe Place".

    Science.gov (United States)

    Keene Woods, Nikki

    2017-04-01

    There are many different professional stances on safe sleep and then there is the reality of caring for a newborn. There is a debate among professionals regarding safe sleep recommendations. The continum of recommendations vary from the American Academy of Pediatrics (AAP) Safe Sleep Guidelines to the bed-sharing recommendations from the Mother-Baby Behavioral Sleep Laboratory. The lack of consistent and uniform safe sleep recommendations from health professionals has been confusing for families but has more recently raised a real professional ethical dilemma. Despite years of focused safe sleep community education and interventions, sleep-related infant deaths are on the rise in many communities. This commentary calls for a united safe sleep message from all health professionals to improve health for mothers and infants most at-risk, "Same Room, Safe Place."

  8. Influencing behaviour for safe working environments

    OpenAIRE

    Boer, de, J. (Johannes); Teeuw, W.B. (Wouter)

    2011-01-01

    Safety at work The objective of the project Safety at Work is to increase safety at the workplace by applying and combining state of the art artefacts from personal protective equipment and ambient intelligence technology. In this state of the art document we focus on the developments with respect to how (persuasive) technology can help to influence behaviour in a natural, automatic way in order to make industrial environments safer. We focus on personal safety, safe environments and safe beh...

  9. Integrated Child Development Services (ICDS): harbinger of safe motherhood and child development.

    Science.gov (United States)

    Lal, S

    1993-01-01

    Editorial comment was provided on the features that made the Integrated Child Development Services (ICDS) program in India unique and on whether or not the system could focus on younger age groups (e.g., 2-3 years of age). As part of a worldwide effort, India's ICDS program has been directed to human resource development. Over the past 17 years, the program has expanded to include almost 50% of the country's most vulnerable and deprived population. The focus on children aimed to improve their nutrition and health by reducing the incidence of morbidity, mortality, malnutrition, and school dropouts. The concern encompassed physical, social, and psychological development. The focus on mothers stressed enabling them to better care for the health and nutrition of their children. The program included prenatal care, safe delivery, and post natal concern for lactation, breast feeding, and physical growth monitoring in the early years. The program's unique features were its voluntary membership of community health workers, integrated services, and targeted coverage of economically weaker and deprived populations during critical child development periods. Indigenous Indian resources provided the primary financial support. Nation coverage was given for universal immunization, family welfare, child and maternal health, diarrheal disease control, vitamin A supplementation, and anemia screening and treatment. The multisectoral nature of the program has been realized at the village, sector, block, and district levels with linkages within Health, Education, and Social Welfare sectors, and with the Medical Colleges and Home Science Colleges. Feedback from operations research studies and other research activities was provided at the local program level, and interactions occurred between students in training programs and health care delivery systems. The program will be expanded to include the entire country. Health and nutrition education were considered the weakest part of ICDS

  10. Cognitive development, clinical knowledge, and clinical experience related to diagnostic ability.

    Science.gov (United States)

    Aquilino, M L

    1997-01-01

    To examine the relationship among cognitive development, clinical knowledge, and clinical experience in nursing students. A survey of junior and senior baccalaureate nursing students from three Midwestern colleges (N = 55). Students' diagnostic ability increased as they gained clinical experience and clinical knowledge. However, students failed to identify many nursing diagnoses and demonstrated only moderate levels of cognitive development. Nurse educators and nursing students need to change their approaches to teaching and learning to enhance students' diagnostic ability and cognitive development.

  11. Leadership theory in clinical practice

    OpenAIRE

    Jie-Hui Xu

    2017-01-01

    In current clinical settings, effective clinical leadership ensures a high-quality health care system that consistently provides safe and efficient care. It is useful, then, for health care professionals to be able to identify the leadership styles and theories relevant to their nursing practice. Being adept in recognizing these styles not only enables nurses to develop their skills to become better leaders but also improves relationships with colleagues and leaders who have previously been c...

  12. From Safe Systems to Patient Safety

    DEFF Research Database (Denmark)

    Aarts, J.; Nøhr, C.

    2010-01-01

    for the third conference with the theme: The ability to design, implement and evaluate safe, useable and effective systems within complex health care organizations. The theme for this conference was "Designing and Implementing Health IT: from safe systems to patient safety". The contributions have reflected...... and implementation of safe systems and thus contribute to the agenda of patient safety? The contributions demonstrate how the health informatics community has contributed to the performance of significant research and to translating research findings to develop health care delivery and improve patient safety......This volume presents the papers from the fourth International Conference on Information Technology in Health Care: Socio-technical Approaches held in Aalborg, Denmark in June 2010. In 2001 the first conference was held in Rotterdam, The Netherlands with the theme: Sociotechnical' approaches...

  13. Clinical Trials

    Medline Plus

    Full Text Available ... or device is safe and effective for humans. What Are Clinical Trials? Clinical trials are research studies ... parents, clinicians, researchers, children, and the general public. What to Expect During a clinical trial, doctors, nurses, ...

  14. How safe are nuclear plants? How safe should they be?

    International Nuclear Information System (INIS)

    Kouts, H.

    1988-01-01

    It has become customary to think about safety of nuclear plants in terms of risk as defined by the WASH-1400 study that some of the implications for the non-specialist escape our attention. Yet it is known that a rational program to understand safety, to identify unsafe events, and to use this kind of information or analysis to improve safety, requires us to use the methods of quantitative risk assessment. How this process can be made more understandable to a broader group of nontechnical people and how can a wider acceptance of the results of the process be developed have been questions under study and are addressed in this report. These are questions that have been struggled with for some time in the world of nuclear plant safety. The Nuclear Regulatory Commission examined them for several years as it moved toward developing a position on safety goals for nuclear plants, a requirement that had been assigned it by Congress. Opinion was sought from a broad spectrum of individuals, within the field of nuclear power and outside it, on the topic that was popularly called, ''How safe is safe enough?'' Views were solicited on the answer to the question and also on the way the answer should be framed when it was adopted. This report discusses the public policy and its implementation

  15. Professional excellence and career advancement in nursing: a conceptual framework for clinical leadership development.

    Science.gov (United States)

    Adeniran, Rita Kudirat; Bhattacharya, Anand; Adeniran, Anthony A

    2012-01-01

    Increasingly, stakeholders in the health care community are recognizing nursing as key to solving the nation's health care issues. This acknowledgment provides a unique opportunity for nursing to demonstrate leadership by developing clinical nurse leaders to collaborate with the multidisciplinary care team in driving evidence-based, safe quality, cost-effective health care services. One approach for nursing success is standardizing the entry-level education for nurses and developing a uniform professional development and career advancement trajectory with appropriate incentives to encourage participation. A framework to guide and provide scientific evidence of how frontline nurses can be engaged will be paramount. The model for professional excellence and career advancement provides a framework that offers a clear path for researchers to examine variables influencing nurses' professional development and career advancement in a systematic manner. Professional Excellence and Career Advancement in Nursing underscores professional preparedness of a registered nurse as central to leadership development. It also describes the elements that influence nurses' participation in professional development and career advancement under 4 main categories emphasizing mentorship and self-efficacy as essential variables.

  16. Automatic discrimination between safe and unsafe swallowing using a reputation-based classifier

    Directory of Open Access Journals (Sweden)

    Nikjoo Mohammad S

    2011-11-01

    reputation-based algorithm outperformed the democratic majority voting algorithm on this clinical data set. Conclusion Given its computational efficiency and high sensitivity, reputation-based classification of dual-axis accelerometry ought to be considered in future developments of a point-of-care swallow assessment where clinical informatics are desired.

  17. DroidSafe

    Science.gov (United States)

    2016-12-01

    Massachusetts Avenue, Build E19-750 Cambridge , MA 02139-4307 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS...Activity objects illustrating the challenges of points-to and information flow analysis...measure how many malicious flows Droid- Safe was able to detect). As these results illustrate , DroidSafe implements an analysis of unprece- dented

  18. Definition of the «Economic Security of an Enterprise» and «Safe Development of an Enterprise» Notions

    Directory of Open Access Journals (Sweden)

    Yefimova Ganna V.

    2013-11-01

    Full Text Available The necessity of this study is explained by difference of opinions regarding understanding of the “economic security of an enterprise” notion, on the one hand, and the poorly studied issue of a combination of the process of enterprise development with a necessary task of ensuring a high level of its economic security, on the other hand. Analysing, systemising and generalising results of scientific studies, the article identifies that economic security of an enterprise is an economic category, which characterises the enterprise functioning conditions. Favourable conditions of functioning ensure a high level of stability and steadiness of an enterprise and its ability of self-realisation and expanded self-reproduction. This becomes possible if an enterprise is capable of resisting external threats and preventing internal ones. Since development of an enterprise is an objective process, which takes place under conditions of uncertainty and changeability of external and internal environments, it is accompanied with a system of threats, which the system of economic security should protect an enterprise from. Taking into account the above, safe development of an enterprise is a process of consecutive transitions of the economic system from one state to another, which is not of a poorer quality than a previous one, which envisages producing new goals and creation of safe conditions for transition from one specific goal, achieved in the process of enterprise functioning, to another. The proposed definitions allow consideration of such significant issues of methodology of management of safe development of an enterprise as the diagnostics of its level and planning.

  19. Safe havens in Europe

    DEFF Research Database (Denmark)

    Paldam, Martin

    2013-01-01

    Eleven safe havens exist in Europe providing offshore banking and low taxes. Ten of these states are very small while Switzerland is moderately small. All 11 countries are richer than their large neighbors. It is shown that causality is from small to safe haven to wealth, and that theoretically...... equilibriums are likely to exist where a certain regulation is substantially lower in a small country than in its big neighbor. This generates a large capital inflow to the safe havens. The pool of funds that may reach the safe havens is shown to be huge. It is far in excess of the absorptive capacity...... of the safe havens, but it still explains, why they are rich. Microstates offer a veil of anonymity to funds passing through, and Switzerland offers safe storage of funds....

  20. Traveling Safely with Medicines

    Science.gov (United States)

    ... Medications Safely My Medicine List How to Administer Traveling Safely with Medicines Planes, trains, cars – even boats ... your trip, ask your pharmacist about how to travel safely with your medicines. Make sure that you ...

  1. Sun Safe Mode Controller Design for LADEE

    Science.gov (United States)

    Fusco, Jesse C.; Swei, Sean S. M.; Nakamura, Robert H.

    2015-01-01

    This paper presents the development of sun safe controllers which are designed to keep the spacecraft power positive and thermally balanced in the event an anomaly is detected. Employed by NASA's Lunar Atmosphere and Dust Environment Explorer (LADEE), the controllers utilize the measured sun vector and the spacecraft body rates for feedback control. To improve the accuracy of sun vector estimation, the least square minimization approach is applied to process the sensor data, which is proven to be effective and accurate. To validate the controllers, the LADEE spacecraft model engaging the sun safe mode was first simulated and then compared with the actual LADEE orbital fight data. The results demonstrated the applicability of the proposed sun safe controllers.

  2. New Developments in FPGA: SEUs and Fail-Safe Strategies from the NASA Goddard Perspective

    Science.gov (United States)

    Berg, Melanie D.; Label, Kenneth A.; Pellish, Jonathan

    2016-01-01

    It has been shown that, when exposed to radiation environments, each Field Programmable Gate Array (FPGA) device has unique error signatures. Subsequently, fail-safe and mitigation strategies will differ per FPGA type. In this session several design approaches for safe systems will be presented. It will also explore the benefits and limitations of several mitigation techniques. The intention of the presentation is to provide information regarding FPGA types, their susceptibilities, and proven fail-safe strategies; so that users can select appropriate mitigation and perform the required trade for system insertion. The presentation will describe three types of FPGA devices and their susceptibilities in radiation environments.

  3. Clinical Trials

    Medline Plus

    Full Text Available ... Entire Site NHLBI Entire Site Health Topics News & Resources Intramural Research ... or device is safe and effective for humans. What Are Clinical Trials? Clinical trials are research ...

  4. Clinical development of Ebola vaccines

    Science.gov (United States)

    Sridhar, Saranya

    2015-01-01

    The ongoing outbreak of Ebola virus disease in West Africa highlighted the lack of a licensed drug or vaccine to combat the disease and has renewed the urgency to develop a pipeline of Ebola vaccines. A number of different vaccine platforms are being developed by assessing preclinical efficacy in animal models and expediting clinical development. Over 15 different vaccines are in preclinical development and 8 vaccines are now in different stages of clinical evaluation. These vaccines include DNA vaccines, virus-like particles and viral vectors such as live replicating vesicular stomatitis virus (rVSV), human and chimpanzee adenovirus, and vaccinia virus. Recently, in preliminary results reported from the first phase III trial of an Ebola vaccine, the rVSV-vectored vaccine showed promising efficacy. This review charts this rapidly advancing area of research focusing on vaccines in clinical development and discusses the future opportunities and challenges faced in the licensure and deployment of Ebola vaccines. PMID:26668751

  5. StaySafe: A self-administered android tablet application for helping individuals on probation make better decisions pertaining to health risk behaviors

    Directory of Open Access Journals (Sweden)

    Wayne E.K. Lehman

    2018-06-01

    Full Text Available This paper describes the development and protocol for feasibility and efficacy testing of a risk reduction intervention designed to improve behavioral health outcomes among drug offenders on probation under community supervision or in residential substance abuse treatment centers. StaySafe is a self-administered tablet-based intervention for teaching better decision-making skills regarding health risk behaviors, especially those involving HIV risks. We are using pre/post, experimental/control group randomized clinical trial (RCT in both community and residential probation settings with goals to 1 assess the feasibility and acceptance of StaySafe by examining participation rates and satisfaction measures, and 2 examine the impact of StaySafe on decision-making skills, confidence and motivation to avoid sex and drug risks, willingness to discuss health risks and concerns with helpful others, and engagement in health risk behaviors.StaySafe consists of 12 brief sessions and utilizes an evidence-based decision-making schema, called WORKIT, which guides participants through steps for identifying the problem and options, evaluating the options and making a decision about which option to carry out. Multiple sessions of StaySafe provide a practice effect so that the WORKIT steps become easily accessible to participants when making decisions. Three of the sessions provide participants a choice of activities designed to provide additional information about HIV and reinforce lessons learned during the WORKIT sessions. Preliminary data demonstrate feasibility and high levels of satisfaction with StaySafe. Keywords: Clinical trial, HIV, Probation, Tablet-based intervention, Decision-making

  6. Evolution and development of laws, regulations, criteria and human resources to ensure the safe decommissioning of nuclear facilities in Thailand

    International Nuclear Information System (INIS)

    Keinmeesuke, S.

    2006-01-01

    The Research Reactor, TRR-1 (renamed TRR-1/M1 after core replacement) in Thailand has been operated for more than 43 years. This ageing reactor will be facing shutdown in the near future. Laws and Regulations have been continually developed to assure the safe operation of nuclear facilities, particularly of the research reactor, and to ensure the safe decommissioning of the reactor after its operational life. However, the Thai nuclear legislation is still not applicable to a number of areas. Office of Atoms for Peace is working toward development of a new consolidated Act. In addition, the licensing steps for modification and decommissioning are added to the new Ministerial Regulation and to the new guidance documents on the licensing process for research reactors. Regulations, guidance and criteria for approval of decommissioning are being developed using the IAEA Safety Standards Series as the main basis for drafting. Human resource development is considered as one of the key important factor to ensure safe decommissioning of the installation. Staffing and training of the operating organization and the regulatory body personnel have been addressed to ensure the achievement of competency level. Simple methods and technologies are the best means for implementation while learning from experience of others will help and support us in our attempt to be the 'second First'. IAEA advice and assistance on the decommissioning of nuclear facilities in countries with limited resources is desirable. (author)

  7. Safe use of nanomaterials

    CERN Multimedia

    2013-01-01

    The use of nanomaterials  is on the increase worldwide, including at CERN. The HSE Unit has established a safety guideline to inform you of the main requirements for the safe handling and disposal of nanomaterials at CERN.   A risk assessment tool has also been developed which guides the user through the process of evaluating the risk for his or her activity. Based on the calculated risk level, the tool provides a list of recommended control measures.   We would therefore like to draw your attention to: Safety Guideline C-0-0-5 - Safe handling and disposal of nanomaterials; and Safety Form C-0-0-2 - Nanomaterial Risk Assessment   You can consult all of CERN’s safety rules and guidelines here. Please contact the HSE Unit for any questions you may have.   The HSE Unit

  8. Promoting Safe Motherhood in Jimma Zone, Ethiopia (IMCHA ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Technology, communication, skills development. This project will ... -developing healthcare worker skills for safe deliveries. The project ... Canada launches new funding opportunity to support Canadian-African research teams studying Ebola.

  9. Intrinsically Safe and Economical Reactor (ISER)

    International Nuclear Information System (INIS)

    Wakabayashi, Hiroaki; Asahi, Yoshiro

    1991-01-01

    The Intrinsically Safe and Economical Reactor (ISER) is designed based on the principle of a process inherent ultimate safe reactor, PIUS, a so-called inherently safe reactor (ISR). ISER has been developed joingly by the members of the Kanagawa Institute of Technology, the University of Tokyo, the Japan Atomic Energy Research Institute (JAERI) and several industrial firms in Japan. This paper describes the requirements for the next generation of power reactor, the safety design philosphy of ISR and ISER, the controllability of ISER and the results of analyses of some of the design-based accidents (DBA) of ISER, namely station blackout, accidents in which the pressurizer relief valve becomes jammed and stuck in open position and tube breaks in the steam generator. It is concluded that the ISER can ensure a wide range of contraollabitily and fuel integrity for all the analysed DBAs. (orig.)

  10. Fasting ramadan in kidney transplant patients is safe

    Directory of Open Access Journals (Sweden)

    Boobes Yousef

    2009-01-01

    Full Text Available Muslims with renal transplant often ask their doctors whether fasting Ramadan is safe. Scanty studies have addressed this question. This prospective study was undertaken to identify any clinical or biological changes with Muslim fasting. 22 kidney transplant patients with stable kidney functions, who were transplanted for more than one year, and voluntarily chose to fast during Ramadan in 1425 H (October-November 2004, were studied. Total of 22 subjects (10 men and 12 women with a mean age of 47 ± 11.6 years were studied. Full clinical and biological assessment was done before during and after the month of Ramadan fasting. Medications were taken in two divided doses at sunset (time of breaking the fast and pre dawn (before the fast. None of the patients experienced any undue fatigue, or symptoms. Body weight, blood pressure, kidney function tests, blood sugar, lipid profile, and cyclosporine levels remained stable. In conclusion it is safe for renal transplant recipients of more than one year and having stable graft function to fast during the month of Ramadan; however caution is advised for moderate to severe impaired renal function.

  11. Musings on genome medicine: is there hope for ethical and safe stem cell therapeutics?

    Science.gov (United States)

    Rao, Mahendra; Condic, Maureen L

    2009-07-14

    Although most stem cell therapy has been non-controversial, therapy based on pluripotent stem cells has raised both ethical and safety concerns. Despite these concerns, the use of cells derived from pluripotent stem cells has recently been approved for clinical trials. We suggest that recent advances in the field have provided avenues to develop pluripotent cells that raise far fewer ethical concerns. Moreover, advances in cell sorting, gene modification and screening have allowed the development of safer therapeutic approaches. Continued advances in this rapidly evolving field are likely to allow therapy to be delivered in a safe and effective manner without socially divisive ethical controversy in the not-so-distant future.

  12. Vitamins, Are They Safe?

    Directory of Open Access Journals (Sweden)

    Hadi Hamishehkar

    2016-12-01

    Full Text Available The consumption of a daily multivitamin among people all over the world is dramatically increasing in recent years. Most of the people believe that if vitamins are not effective, at least they are safe. However, the long term health consequences of vitamins consumption are unknown. This study aimed to assess the side effects and possible harmful and detrimental properties of vitamins and to discuss whether vitamins can be used as safe health products or dietary supplements. We performed a MEDLINE/PubMed, EMBASE, Scopus and Google Scholar search and assessed reference lists of the included studies which were published from 1993 through 2015. The studies, with an emphasis on RCTs (randomized controlled clinical trials, were reviewed. As some vitamins such as fat-soluble vitamins (vitamin A, vitamin D, vitamin E, and also some of the water-soluble vitamins like folic acid may cause adverse events and some like vitamin C is widely taken assuming that it has so many benefits and no harm, we included relevant studies with negative or undesired results regarding the effect of these vitamins on health. Our recommendation is that taking high-dose supplements of vitamins A, E, D, C, and folic acid is not always effective for prevention of disease, and it can even be harmful to the health.

  13. Clinical skill development for community pharmacists.

    Science.gov (United States)

    Barnette, D J; Murphy, C M; Carter, B L

    1996-09-01

    The importance of establishing clinical pharmacy services in the community cannot be understated in light of current challenges to the traditional dispensing role as the primary service of the community pharmacist. Advancements in automated dispensing technology and declining prescription fee reimbursement are rapidly forcing pharmacists to seek alternative sources of revenue. Providing pharmaceutical care is a viable option to increase customer loyalty job satisfaction, and reimbursement. To support the development of clinical services, academic institutions are forming partnerships with individual community practitioners to overcome perceived educational and training barriers. The authors describe the design and development of two unique clinical skill development programs at the University of Illinois at Chicago. This paper also outlines the patient focused services that the participants have established upon completing the training. These programs successfully enhanced participants' therapeutic knowledge base and facilitated development of the clinical skills necessary for direct patient care.

  14. Public Perception of the Millennium Development Goals on Access to Safe Drinking Water in Cross River State, Nigeria

    Science.gov (United States)

    Eni, David D.; Ojong, William M.

    2014-01-01

    This study evaluated the public perception of Millennium Development Goals (MDGs) of environmental sustainability with focus on the MDG target which has to do with reducing the proportion of people without access to safe drinking water in Cross River State, Nigeria. The stratified and systematic sampling techniques were adopted for the study,…

  15. Elaboration of Safe Community Assessment System

    Directory of Open Access Journals (Sweden)

    Birutė Mikulskienė

    2013-08-01

    Full Text Available The paper aims to design an assessment system to monitor and evaluate safety parameters and administrative efforts with the purpose to increase safety in municipalities. The safety monitoring system considered is to be the most important tool for creation and development of safe communities in Lithuania. Several methods were applied to achieve this purpose. In order to determine the role of local government in ensuring the safety of people, property and environment at the local level of a meta-analysis of research reports, the Lithuanian national legislation, strategic planning documents of the state and local government were carried out. Analysis of statistical data, structural analysis, comparative analysis and synthesis methods were used while investigating the areas of safety uncertainty, risk groups, identifying safety risk factors, determining their relationship, and creating a safe community assessment system. A safe community assessment system, which consists of two types of criteria, has been elaborated. The assessment system is based on the multi-level criteria for safety monitoring and the multi-level criteria for the evaluation of municipal activities in the field of building safety. Links between the criteria, peculiarities of their application and advantages in the process of safe community creation and development are analyzed. Design and implementation of the safe community assessment system is one of the most important stages to implement the idea of safe communities. The proposed system integrates a variety of risk areas, the safety achievement criteria are linked to the criteria used in the strategic planning. Periodic assessment of the safety situation using the proposed system ensures possibility to monitor current local safety conditions and assess the changes and the trends. A safe community assessment system is proposed to be used as a tool to unified municipalities safety comprehensiveness and compare safety level in

  16. [The development of clinical application of the rejuvenator and a study of its mechanism for the treatment of functional erectile dysfunction].

    Science.gov (United States)

    Meng, Z; Zou, Y; Luo, E; Zou, L

    2001-12-01

    In this paper, we describe the development and clinical application of the Rejuvenator and report the result of our study on its mechanism for the treatment of functional erectile dysfunction (FED). The Rejuvenator, which can be used both at home and in hospitals to treat patients with FED, was developed on the basis of our clinical practice in the light of the modern theory of traditional Chinese medicine and by integrating multiple techniques of engineering science. It works by means of the paraoral use of the special herbal medicine, electro-magnetic effects, thermal moxibustion and drug-ingression. 2250 patients with FED received the treatment. Using combined electro-neurophysiological techniques, pulsed ultrasound Doppler and microcomputer image-scanning, we further studied the mechanism of the Rejuvenator for the treatment of FED. The total effective rate was 92%. The clinical data and result of study indicate that the Rejuvenator for the patients with functional erectile dysfunction is a safe, effective and scientific new method.

  17. Clinical simulation practise framework.

    Science.gov (United States)

    Khalili, Hossein

    2015-02-01

    Historically, simulation has mainly been used to teach students hands-on skills in a relatively safe environment. With changes in the patient population, professional regulations and clinical environments, clinical simulation practise (CSP) must assist students to integrate and apply their theoretical knowledge and skills with their critical thinking, clinical judgement, prioritisation, problem solving, decision making, and teamwork skills to provide holistic care and treatment to their patients. CSP holds great potential to derive a positive transformation in students' transition into the workplace, by associating and consolidating learning from classrooms to clinical settings, and creating bridges between theory and practice. For CSP to be successful in filling the gap, the design and management of the simulation is crucial. In this article a new framework called 'Clinical simulation practise framework: A knowledge to action strategy in health professional education' is being introduced that aims to assist educators and curriculum developers in designing and managing their simulations. This CSP framework theorises that simulation as an experiential educational tool could improve students' competence, confidence and collaboration in performing professional practice in real settings if the CSP provides the following three dimensions: (1) a safe, positive, reflective and fun simulated learning environment; (2) challenging, but realistic, and integrated simulated scenarios; and (3) interactive, inclusive, interprofessional patient-centred simulated practise. © 2015 John Wiley & Sons Ltd.

  18. Clinical Trials

    Medline Plus

    Full Text Available ... are research studies that explore whether a medical strategy, treatment, or device is safe and effective for ... a Clinical Trial If you're interested in learning more about, or taking part in, clinical trials, ...

  19. SAFE Newsletter

    OpenAIRE

    2013-01-01

    The Center of Excellence SAFE – “Sustainable Architecture for Finance in Europe” – is a cooperation of the Center for Financial Studies and Goethe University Frankfurt. It is funded by the LOEWE initiative of the State of Hessen (Landes-Offensive zur Entwicklung wissenschaftlich-ökonomischer Exzellenz). SAFE brings together more than 40 professors and just as many junior researchers who are all dedicated to conducting research in support of a sustainable financial architecture. The Center has...

  20. Qualities and attributes of a safe practitioner: identification of safety skills in healthcare.

    Science.gov (United States)

    Long, S; Arora, S; Moorthy, K; Sevdalis, N; Vincent, C

    2011-06-01

    OBJECTIVES (1) To identify a range of safety skills (attributes of a safe practitioner) relevant across clinical specialities. 2) To obtain the views of clinicians regarding their importance and trainability. DESIGN We used a survey and focus group of 10 patient safety experts to extract a list of safety skills. 50 experienced clinicians rated the skills in terms of importance and trainability in an electronic questionnaire. SETTING A Clinical Safety Research Unit and its associated NHS Trust, within an Academic Health Science Centre. RESULTS 73 skills, in 18 broad categories, were identified from the focus group and survey. The majority of clinicians felt the skills were important (most important: technical skills (98%), crisis management (98%), honesty (97.5%); least important: open-mindedness (82%), patient awareness/empathy (81.7%), humility (81.2%)). There was less agreement about trainability (16/18 categories were felt to be trainable; most trainable: technical skills (98%), anticipation/preparedness (84%), organisational skills/efficiency (83%); least trainable: conscientiousness (56%), humility (40%), open-mindedness (30%)). More surgeons than physicians felt that team awareness and crisis management skills were trainable (p=0.0099, p=0.025, respectively). CONCLUSIONS We have identified a preliminary set of safety skills, which with further refinement could form the template for the development of a formal taxonomy of the qualities and attributes of the safe practitioner. Experts and practitioners agree about the importance of the individual skills. The fact that the majority of these were felt by experienced cross-speciality clinicians to be trainable is encouraging in terms of the possibility of developing generic safety curricula.

  1. Clinical Trials

    Medline Plus

    Full Text Available ... treatment, or device is safe and effective for humans. What Are Clinical Trials? Clinical trials are research ... are required to have an IRB. Office for Human Research Protections The U.S. Department of Health and ...

  2. Reflective journaling for clinical judgment development and evaluation.

    Science.gov (United States)

    Lasater, Kathie; Nielsen, Ann

    2009-01-01

    Reflective journaling is a strategy used often in clinical education to gain insight into students' clinical thinking; however, studies indicate that students may benefit from guided reflections. Numerous tools have been used to structure student reflection with varying results. This article describes the outcomes from using the Guide for Reflection based on Tanner's Clinical Judgment Model. The Lasater Clinical Judgment Rubric, created from the Model, is used to evaluate development of clinical judgment and provides language to communicate about clinical thinking with students. Senior immersion course competencies, also developed with language from Tanner's Clinical Judgment Model,offer a comprehensive package that fosters students' clinical judgment development, faculty-student communication about clinical judgment, and evaluation of students' clinical thinking.

  3. The safe use of radiation sources

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    As a means of promoting safety in the use of radiation sources, as well as encouraging consistency in regulatory control, the IAEA has from time to time organized training courses with the co-operation of Member State governments and organizations, to inform individuals from developing countries with appropriate responsibilities on the provisions for the safe use and regulation of radiation sources. Three such courses on the safe use of radiation sources have been held in both the USA, with the co-operation of the United States Government, and in Dublin, Ireland, with the co-operation of the Irish Government. The Training Course on the Safe Use and Regulation of Radiation Sources has been successfully given to over 77 participants from over 30 countries during the last years. The course is aimed at providing a basis of radiation protection knowledge in all aspects of the uses of radiation and of radiation sources that are used today. It is the intention of this course to provide a systematic enhancement of radioisotope safety in countries with developing radiological programmes through a core group of national authorities. The IAEA's training programmes provide an excellent opportunity for direct contact with lecturers that have extensive experience in resolving issues faced by developing countries and in providing guidance documents useful in addressing their problems. This document uses this collective experience and provides valuable technical information regarding the safety aspects of the uses not only of sealed and unsealed sources of radiation, but also for those machines that produce ionizing radiation. The first of these training courses, 'Safety and Regulation of Unsealed Sources' was held in Dublin, Ireland, June through July 1989 with the co-operation of the Nuclear Energy Board and Trinity College. This was an interregional training course, the participants came from all over the world. The second and third interregional courses, 'Safety and Regulation

  4. The safe use of radiation sources

    International Nuclear Information System (INIS)

    1995-01-01

    As a means of promoting safety in the use of radiation sources, as well as encouraging consistency in regulatory control, the IAEA has from time to time organized training courses with the co-operation of Member State governments and organizations, to inform individuals from developing countries with appropriate responsibilities on the provisions for the safe use and regulation of radiation sources. Three such courses on the safe use of radiation sources have been held in both the USA, with the co-operation of the United States Government, and in Dublin, Ireland, with the co-operation of the Irish Government. The Training Course on the Safe Use and Regulation of Radiation Sources has been successfully given to over 77 participants from over 30 countries during the last years. The course is aimed at providing a basis of radiation protection knowledge in all aspects of the uses of radiation and of radiation sources that are used today. It is the intention of this course to provide a systematic enhancement of radioisotope safety in countries with developing radiological programmes through a core group of national authorities. The IAEA's training programmes provide an excellent opportunity for direct contact with lecturers that have extensive experience in resolving issues faced by developing countries and in providing guidance documents useful in addressing their problems. This document uses this collective experience and provides valuable technical information regarding the safety aspects of the uses not only of sealed and unsealed sources of radiation, but also for those machines that produce ionizing radiation. The first of these training courses, 'Safety and Regulation of Unsealed Sources' was held in Dublin, Ireland, June through July 1989 with the co-operation of the Nuclear Energy Board and Trinity College. This was an interregional training course, the participants came from all over the world. The second and third interregional courses, 'Safety and Regulation

  5. Nonspecific abdominal pain is a safe diagnosis.

    Science.gov (United States)

    Pennel, David John Laurie; Goergen, Nina; Driver, Chris P

    2014-11-01

    The aim of this study is to assess if a clinical diagnosis of nonspecific abdominal pain (NSAP) is safe and if patients with this initial diagnosis are likely to require further investigation or surgical intervention. 3323 patients admitted with NSAP from July 1990 to September 2012 utilizing a prospective database of all surgical admissions were included. Readmission over the period of the study and specifically within 30 days of their initial presentation was identified together with any invasive investigation or surgical intervention. 319 children (9.6%) were subsequently readmitted with abdominal pain at some point during the study period. Of these, 78 (2.3%) were readmitted within 30 days. 118 (3.5%) children subsequently had an operation or invasive investigation some point following their initial admission. Of these 33 (0.6%) had the procedure within 3 months of the initial admission. 13 patients had an appendicectomy within 3 months of the initial presentation. Of these histology confirmed appendicitis in 8 patients. This gives an overall incidence of "missed" appendicitis of 0.2 % (8/3323). This study confirms that a clinical diagnosis of nonspecific abdominal pain (NSAP) is safe in a pediatric population and the risk of "missing" appendicitis is only 0.2%. Patients and/or parents can be confidently reassured that the risk of missing organic pathology is very low. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Rational use of medicines in older adults: Can we do better during clinical development?

    Science.gov (United States)

    Saeed, M A; Vlasakakis, G; Della Pasqua, O

    2015-05-01

    There is an evidence gap to ensuring safe/effective use of medicines in older adults. Generating clinical data in these patients poses ethical and operational challenges, yielding results that may not be generalizable to the overall population. Modeling and simulation (M&S) is proposed as a basis for assessing the impact of age-related changes and their clinical implications. M&S can be used in conjunction with bridging and extrapolation to ensure the selection of appropriate dose(s)/regimen(s) in this population. © 2015 ASCPT.

  7. New Developments in FPGA Devices: SEUs and Fail-Safe Strategies from the NASA Goddard Perspective

    Science.gov (United States)

    Berg, Melanie; LaBel, Kenneth; Pellish, Jonathan

    2016-01-01

    It has been shown that, when exposed to radiation environments, each Field Programmable Gate Array (FPGA) device has unique error signatures. Subsequently, fail-safe and mitigation strategies will differ per FPGA type. In this session several design approaches for safe systems will be presented. It will also explore the benefits and limitations of several mitigation techniques. The intention of the presentation is to provide information regarding FPGA types, their susceptibilities, and proven fail-safe strategies; so that users can select appropriate mitigation and perform the required trade for system insertion. The presentation will describe three types of FPGA devices and their susceptibilities in radiation environments.

  8. Synthesis of febrifugine derivatives and development of an effective and safe tetrahydroquinazoline-type antimalarial.

    Science.gov (United States)

    Kikuchi, Haruhisa; Horoiwa, Seiko; Kasahara, Ryota; Hariguchi, Norimitsu; Matsumoto, Makoto; Oshima, Yoshiteru

    2014-04-09

    Febrifugine, a quinazoline alkaloid isolated from Dichroa febrifuga roots, shows powerful antimalarial activity against Plasmodium falciparum. Although the use of ferifugine as an antimalarial drug has been precluded because of its severe side effects, its potent antimalarial activity has stimulated medicinal chemists to pursue its derivatives instead, which may provide valuable leads for novel antimalarial drugs. In the present study, we synthesized new derivatives of febrifugine and evaluated their in vitro and in vivo antimalarial activities to develop antimalarials that are more effective and safer. As a result, we proposed tetrahydroquinazoline-type derivative as a safe and effective antimalarial candidate. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  9. A Survey of Established Veterinary Clinical Skills Laboratories from Europe and North America: Present Practices and Recent Developments.

    Science.gov (United States)

    Dilly, Marc; Read, Emma K; Baillie, Sarah

    Developing competence in clinical skills is important if graduates are to provide entry-level care, but it is dependent on having had sufficient hands-on practice. Clinical skills laboratories provide opportunities for students to learn on simulators and models in a safe environment and to supplement training with animals. Interest in facilities for developing veterinary clinical skills has increased in recent years as many veterinary colleges face challenges in training their students with traditional methods alone. For the present study, we designed a survey to gather information from established veterinary clinical skills laboratories with the aim of assisting others considering opening or expanding their own facility. Data were collated from 16 veterinary colleges in North America and Europe about the uses of their laboratory, the building and associated facilities, and the staffing, budgets, equipment, and supporting learning resources. The findings indicated that having a dedicated veterinary clinical skills laboratory is a relatively new initiative and that colleges have adopted a range of approaches to implementing and running the laboratory, teaching, and assessments. Major strengths were the motivation and positive characteristics of the staff involved, providing open access and supporting self-directed learning. However, respondents widely recognized the increasing demands placed on the facility to provide more space, equipment, and staff. There is no doubt that veterinary clinical skills laboratories are on the increase and provide opportunities to enhance student learning, complement traditional training, and benefit animal welfare.

  10. Challenges of safe medication practice in paediatric care--a nursing perspective.

    Science.gov (United States)

    Star, Kristina; Nordin, Karin; Pöder, Ulrika; Edwards, I Ralph

    2013-05-01

    To explore nurses' experiences of handling medications in paediatric clinical practice, with a focus on factors that hinder and facilitate safe medication practices. Twenty nurses (registered nurses) from four paediatric wards at two hospitals in Sweden were interviewed in focus groups. The interviews were analysed using content analysis. Six themes emerged from the analysed interviews: the complexity specific for nurses working on paediatric wards is a hindrance to safe medication practices; nurses' concerns about medication errors cause a considerable psychological burden; the individual nurse works hard for safe medication practices and values support from other nurse colleagues; circumstances out of the ordinary are perceived as critical challenges for maintaining patient safety; nurses value clear instructions, guidelines and routines, but these are often missing, variable or changeable; management, other medical professionals, the pharmacy, the pharmaceutical industry and informatics support need to respond to the requirements of the nurses' working situations to improve safe medication practices. Weaknesses were apparent in the long chain of the medication-delivery process. A joint effort by different professions involved in that delivery process, and a nationwide collaboration between hospitals is recommended to increase safe medication practices in paediatric care. ©2013 Foundation Acta Paediatrica. Published by Blackwell Publishing Ltd.

  11. Vitamin D Status, Bone Mineral Density and Mental Health in Young Australian Women: The Safe-D Study.

    Science.gov (United States)

    Callegari, Emma T; Reavley, Nicola; Garland, Suzanne M; Gorelik, Alexandra; Wark, John D

    2015-11-17

    Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study). Part A of the Safe-D study is a cross-sectional study aiming to recruit 468 young females aged 16-25 years living in Victoria, Australia, through Facebook advertising. Participants are required to complete an extensive, online questionnaire, wear an ultra-violet dosimeter for 14 consecutive days and attend a study site visit. Outcome measures include areal bone mineral measures at the lumbar spine, total hip and whole body, as well as soft tissue composition using dual energy x-ray absorptiometry. Trabecular and cortical volumetric bone density at the tibia is measured using peripheral quantitative computed tomography. Other tests include serum 25-hydroxyvitamin D, serum biochemistry and a range of health markers. Details of mood disorder/s and depressive and anxiety symptoms are obtained by self-report. Cutaneous melanin density is measured by spectrophotometry. The findings of this cross-sectional study will have implications for health promotion in young women and for clinical care of those with vitamin D deficiency and/or mental ill-health. Optimising both vitamin D status and mental health may protect against poor bone health and fractures in later life. Significance for public healthVitamin D deficiency, depression and osteoporosis are all major public health issues. Vitamin D deficiency has been associated with both reduced bone mineral density and depressive symptoms. Moreover, cohort studies have found that subjects with depression have lower bone mineral density when compared to healthy controls. Early adulthood is a critical

  12. Accounting for water quality in monitoring access to safe drinking-water as part of the Millennium Development Goals: lessons from five countries.

    Science.gov (United States)

    Bain, Rob E S; Gundry, Stephen W; Wright, Jim A; Yang, Hong; Pedley, Steve; Bartram, Jamie K

    2012-03-01

    To determine how data on water source quality affect assessments of progress towards the 2015 Millennium Development Goal (MDG) target on access to safe drinking-water. Data from five countries on whether drinking-water sources complied with World Health Organization water quality guidelines on contamination with thermotolerant coliform bacteria, arsenic, fluoride and nitrates in 2004 and 2005 were obtained from the Rapid Assessment of Drinking-Water Quality project. These data were used to adjust estimates of the proportion of the population with access to safe drinking-water at the MDG baseline in 1990 and in 2008 made by the Joint Monitoring Programme for Water Supply and Sanitation, which classified all improved sources as safe. Taking account of data on water source quality resulted in substantially lower estimates of the percentage of the population with access to safe drinking-water in 2008 in four of the five study countries: the absolute reduction was 11% in Ethiopia, 16% in Nicaragua, 15% in Nigeria and 7% in Tajikistan. There was only a slight reduction in Jordan. Microbial contamination was more common than chemical contamination. The criterion used by the MDG indicator to determine whether a water source is safe can lead to substantial overestimates of the population with access to safe drinking-water and, consequently, also overestimates the progress made towards the 2015 MDG target. Monitoring drinking-water supplies by recording both access to water sources and their safety would be a substantial improvement.

  13. New developments in short-pulse eye safe lasers pay the way for future LADARs and 3D mapping performances

    Science.gov (United States)

    Pasmanik, Guerman; Latone, Kevin; Shilov, Alex; Shklovsky, Eugeni; Spiro, Alex; Tiour, Larissa

    2005-06-01

    We have demonstrated that direct excitation of 3rd Stokes Raman emission in crystal can produce short (few nanosecond) eye-safe pulses. Produced beam has very high quality and the pulse energy can be as high as tens of millijoules. For pulsed diode pumped solid state lasers the demonstrated repetition rate was 250 Hz but higher repetition rates are certainly achievable. It is important that tested schemes do not have strict requirements on laser pump parameters, namely beam divergence and frequency bandwidth. The obtained results are very relevant to the development of eye-safe lasers, such as the new generation of rangefinders, target designators, and laser tracking and pin-pointing devices, as well as remote 2D and 3D imaging systems.

  14. 75 FR 81556 - Solicitation of New Safe Harbors and Special Fraud Alerts

    Science.gov (United States)

    2010-12-28

    ... statute (section 1128B(b) of the Social Security Act), as well as developing new OIG Special Fraud Alerts... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... the public on recommendations for developing new or revised safe harbors and Special Fraud Alerts...

  15. Safe drinking water production in rural areas: a comparison between developed and less developed countries.

    Science.gov (United States)

    Cotruvo, J A; Trevant, C

    2000-01-01

    At the fundamental level, there are remarkable parallels between developed and less developed countries in problems of providing safe drinking water in rural areas, but of course, they differ greatly in degree and in the opportunities for resolution. Small water supplies frequently encounter difficulty accessing sufficient quantities of drinking water for all domestic uses. If the water must be treated for safety reasons, then treatment facilities and trained operating personnel and finances are always in short supply. Ideally, each solution should be sustainable within its own cultural, political and economic context, and preferably with local personnel and financial resources. Otherwise, the water supply will be continuously dependent on outside resources and thus will not be able to control its destiny, and its future will be questionable. The history of success in this regard has been inconsistent, particularly in less developed but also in some developed countries. The traditional and ideal solution in developing countries has been central water treatment and a piped distribution network, however, results have had a mixed history primarily due to high initial costs and operation and maintenance, inadequate access to training, management and finance sufficient to support a fairly complex system for the long term. These complete systems are also slow to be implemented so waterborne disease continues in the interim. Thus, non-traditional, creative, cost-effective practical solutions that can be more rapidly implemented are needed. Some of these options could involve: small package central treatment coupled with non piped distribution, e.g. community supplied bottled water; decentralized treatment for the home using basic filtration and/or disinfection; higher levels of technology to deal with chemical contaminants e.g. natural fluoride or arsenic. These technological options coupled with training, technical support and other essential elements like community

  16. Developing clinical teaching capacities of midwifery students.

    Science.gov (United States)

    Rance, Sharon; Sweet, Linda

    2016-06-01

    Competency Standards in Australia articulate that the midwife must be able to contribute to the professional development of themselves and others. Few undergraduate health professional curricula currently incorporate content for the development of specific knowledge and skills required for clinical teaching. This project aimed to understand and enhance midwifery students' preparedness to assume their future clinical teaching responsibilities. Design-based research was used to implement an educational intervention aimed at developing clinical teaching skills through a peer education session between 1st and 3rd year students. The perspectives of 30 undergraduate midwifery students about their preparedness for their teaching role and the intervention were obtained through 3 focus groups. A thematic analysis of the data was undertaken. Three themes were identified encompassing the research aims and objectives; 'Co-creating a culture for learning', 'reciprocal teaching and learning' and 'developing clinical teaching capacities'. The findings indicate that the midwifery students had a holistic understanding of their responsibilities in clinical teaching in the workplace. They were able to identify ways in which their teaching capacities were being developed through their clinical experiences and the curriculum, both intended and hidden. Despite limited educational activities for clinical teaching, the midwifery students made explicit connections of the relational interdependence of workplace-based experiences and their learning. Students were clearly able to identify ways in which their own learning experiences and the culture in which this learning is embedded, assists them to develop clinical teaching skills, ready to support the next generation of midwifery students. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  17. Development of the Huddle Observation Tool for structured case management discussions to improve situation awareness on inpatient clinical wards.

    Science.gov (United States)

    Edbrooke-Childs, Julian; Hayes, Jacqueline; Sharples, Evelyn; Gondek, Dawid; Stapley, Emily; Sevdalis, Nick; Lachman, Peter; Deighton, Jessica

    2018-05-01

    'Situation Awareness For Everyone' (SAFE) was a 3-year project which aimed to improve situation awareness in clinical teams in order to detect potential deterioration and other potential risks to children on hospital wards. The key intervention was the 'huddle', a structured case management discussion which is central to facilitating situation awareness. This study aimed to develop an observational assessment tool to assess the team processes occurring during huddles, including the effectiveness of the huddle. A cross-sectional observational design was used to psychometrically develop the 'Huddle Observation Tool' (HOT) over three phases using standardised psychometric methodology. Huddles were observed across four NHS paediatric wards participating in SAFE by five researchers; two wards within specialist children hospitals and two within district general hospitals, with location, number of beds and length of stay considered to make the sample as heterogeneous as possible. Inter-rater reliability was calculated using the weighted kappa and intraclass correlation coefficient. Inter - rater reliability was acceptable for the collaborative culture (weighted kappa=0.32, 95% CI 0.17 to 0.42), environment items (weighted kappa=0.78, 95% CI 0.52 to 1) and total score (intraclass correlation coefficient=0.87, 95% CI 0.68 to 0.95). It was lower for the structure and risk management items, suggesting that these were more variable in how observers rated them. However, agreement on the global score for huddles was acceptable. We developed an observational assessment tool to assess the team processes occurring during huddles, including the effectiveness of the huddle. Future research should examine whether observational evaluations of huddles are associated with other indicators of safety on clinical wards (eg, safety climate and incidents of patient harm), and whether scores on the HOT are associated with improved situation awareness and reductions in deterioration and adverse

  18. Outlooks for the development of ozone-safe refrigerant production at the Minatom facilities

    International Nuclear Information System (INIS)

    Shatalov, V.V.; Orekhov, V.T.; Dedov, A.S.; Zakharov, V.Yu.; Golubev, A.N.; Tsarev, V.A.

    2001-01-01

    Results of activities undertaken at the All-Russian Research Institute of Chemical Technology since 1988, which were aimed at search of new methods of synthesis of ozone-safe refrigerants, using depleted uranium hexafluoride waste formed at gas-diffusion plants as fluorinating agent, are considered. It is pointed out that major advantages of the flowsheets making use of UF 6 versus traditional method consist in the fact that the processes are conducted in gas phase under normal pressure and moderate temperatures with UF 6 transfer into a more environmentally friendly form. Outlooks for expansion of production of ozone-safe refrigerants by the method described are discussed [ru

  19. Cost-competitive, inherently safe LFMBR pool plant

    International Nuclear Information System (INIS)

    McDonald, J.S.; Brunings, J.E.; Chang, Y.I.; Hren, R.R.; Seidensticker, R.W.

    1984-01-01

    The Cost-Competitive, Inherently Safe LMFBR Pool Plant design was prepared in GFY 1983 under a DOE-sponsored program. This plant design was developed as a joint effort by Rockwell International and the Argonne National Laboratory with major contributions from the Bechtel Group, Inc.; Combustion engineering, Inc.; the Chicago Bridge and Iron Company; and the General Electric Company. Using current LMFBR technology, many innovative features were developed and incorporated into the design to meet the ultimate objectives of the Breeder Program, i.e., energy costs competitive with LWRs and inherent safety features to maintain the plant in a safe condition following assumed accidents without requiring operator action. This paper provides a description of the principal features that were incorporated into the design to achieve low cost and inherent safety

  20. Strategy Escalation: An emerging paradigm for safe clinical development of T cell gene therapies

    Directory of Open Access Journals (Sweden)

    Junghans Richard

    2010-06-01

    Full Text Available Abstract Gene therapy techniques are being applied to modify T cells with chimeric antigen receptors (CARs for therapeutic ends. The versatility of this platform has spawned multiple options for their application with new permutations in strategies continually being invented, a testimony to the creative energies of many investigators. The field is rapidly expanding with immense potential for impact against diverse cancers. But this rapid expansion, like the Big Bang, comes with a somewhat chaotic evolution of its therapeutic universe that can also be dangerous, as seen by recently publicized deaths. Time-honored methods for new drug testing embodied in Dose Escalation that were suitable for traditional inert agents are now inadequate for these novel "living drugs". In the following, I propose an approach to escalating risk for patient exposures with these new immuno-gene therapy agents, termed Strategy Escalation, that accounts for the molecular and biological features of the modified cells and the methods of their administration. This proposal is offered not as a prescriptive but as a discussion framework that investigators may wish to consider in configuring their intended clinical applications.

  1. Implications of inherent safe nuclear power system

    International Nuclear Information System (INIS)

    Song, Yo-Taik

    1987-01-01

    The safety of present day nuclear power reactors and research reactors depends on a combination of design features of passive and active systems, and the alert judgement of their operators. A few inherently safe designs of nuclear reactors for power plants are currently under development. In these designs, the passive systems are emphasized, and the active systems are minimized. Also efforts are made to eliminate the potential for human failures that initiate the series of accidents. If a major system fails in these designs, the core is flooded automatically with coolants that flow by gravity, not by mechanical pumps or electromagnetic actuators. Depending on the choice of the coolants--water, liquid metal and helium gas--there are three principal types of inherently safe reactors. In this paper, these inherently safe reactor designs are reviewed and their implications are discussed. Further, future perspectives of their acceptance by nuclear industries are discussed. (author)

  2. Adapting Certified Safe Farm to North Carolina Agriculture: An Implementation Study.

    Science.gov (United States)

    Storm, Julia F; LePrevost, Catherine E; Tutor-Marcom, Robin; Cope, W Gregory

    2016-01-01

    Certified Safe Farm (CSF) is a multimodal safety and health program developed and assessed through multiple controlled intervention studies in Iowa. Although developed with the intent to be broadly applicable to agriculture, CSF has not been widely implemented outside the midwestern United States. This article describes the CSF implementation process in North Carolina (NC), as piloted on a large-scale in three agriculturally diverse and productive counties of NC, and reports its effectiveness using the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. Implementation involved (1) capacity building through safety and health training, (2) adaptation of components of Iowa's CSF model to NC agriculture, (3) marketing and recruitment, and (4) formative evaluation, including an online survey and focus group discussion. From 2009 to 2012, 113 farms participated in at least one component of the CSF intervention, representing a NC farm participation rate of 3.1% in the study area. A major adaptation of NC implementation was the utilization of NC Cooperative Extension as the local driver of implementation in contrast to local AgriSafe clinics in Iowa. The most innovative adaptation to CSF components was the development of a defined economic incentive in the form of a cost-share program. The RE-AIM framework was found to be useful and relevant to the field of agricultural health and safety translational research. This study provides effectiveness measures and implementation alternatives useful for those considering implementing CSF. It informs current efforts to move CSF from research to practice through the National Sustainable Model CSF Program initiative.

  3. The struggle for safe nuclear expansion in China

    International Nuclear Information System (INIS)

    Xu, Y.C.

    2014-01-01

    After a temporary halt following the Fukushima nuclear disaster in March 2011, China resumed its fast, yet cautious, expansion of nuclear energy programme. Nuclear energy is considered as part of the general strategy to deal with the challenges of energy security and climate change and to advance with ‘state of the art’ technology in its development. This article briefly discusses recent development in and driving forces behind nuclear industry in China, and several challenges it has been facing: how to adopt, adapt, standardise and indigenise whose technologies, and how to address the shortage of qualified nuclear engineers, scientists, skilled labour force and qualified regulators. More importantly, it argues that safe and secure nuclear development requires consistent policies and effective regulations. Therefore, it is crucial to build policy and regulatory capacities based on coordination, planning and management of government agencies and the industry. - Highlights: • Nuclear energy development in China. • Nuclear technology selection. • Human capital. • Regulatory regime. • Safe and secure development

  4. Development of a clinical data warehouse from an intensive care clinical information system.

    Science.gov (United States)

    de Mul, Marleen; Alons, Peter; van der Velde, Peter; Konings, Ilse; Bakker, Jan; Hazelzet, Jan

    2012-01-01

    There are relatively few institutions that have developed clinical data warehouses, containing patient data from the point of care. Because of the various care practices, data types and definitions, and the perceived incompleteness of clinical information systems, the development of a clinical data warehouse is a challenge. In order to deal with managerial and clinical information needs, as well as educational and research aims that are important in the setting of a university hospital, Erasmus Medical Center Rotterdam, The Netherlands, developed a data warehouse incrementally. In this paper we report on the in-house development of an integral part of the data warehouse specifically for the intensive care units (ICU-DWH). It was modeled using Atos Origin Metadata Frame method. The paper describes the methodology, the development process and the content of the ICU-DWH, and discusses the need for (clinical) data warehouses in intensive care. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  5. Bioreducible Fluorinated Peptide Dendrimers Capable of Circumventing Various Physiological Barriers for Highly Efficient and Safe Gene Delivery.

    Science.gov (United States)

    Cai, Xiaojun; Jin, Rongrong; Wang, Jiali; Yue, Dong; Jiang, Qian; Wu, Yao; Gu, Zhongwei

    2016-03-09

    Polymeric vectors have shown great promise in the development of safe and efficient gene delivery systems; however, only a few have been developed in clinical settings due to poor transport across multiple physiological barriers. To address this issue and promote clinical translocation of polymeric vectors, a new type of polymeric vector, bioreducible fluorinated peptide dendrimers (BFPDs), was designed and synthesized by reversible cross-linking of fluorinated low generation peptide dendrimers. Through masterly integration all of the features of reversible cross-linking, fluorination, and polyhedral oligomeric silsesquioxane (POSS) core-based peptide dendrimers, this novel vector exhibited lots of unique features, including (i) inactive surface to resist protein interactions; (ii) virus-mimicking surface topography to augment cellular uptake; (iii) fluorination-mediated efficient cellular uptake, endosome escape, cytoplasm trafficking, and nuclear entry, and (iv) disulfide-cleavage-mediated polyplex disassembly and DNA release that allows efficient DNA transcription. Noteworthy, all of these features are functionally important and can synergistically facilitate DNA transport from solution to the nucleus. As a consequences, BFPDs showed excellent gene transfection efficiency in several cell lines (∼95% in HEK293 cells) and superior biocompatibility compared with polyethylenimine (PEI). Meanwhile BFPDs provided excellent serum resistance in gene delivery. More importantly, BFPDs offer considerable in vivo gene transfection efficiency (in muscular tissues and in HepG2 tumor xenografts), which was approximately 77-fold higher than that of PEI in luciferase activity. These results suggest bioreducible fluorinated peptide dendrimers are a new class of highly efficient and safe gene delivery vectors and should be used in clinical settings.

  6. Mifrenz: Safe email for children

    Directory of Open Access Journals (Sweden)

    Tim Hunt

    Full Text Available Products currently available for monitoring children\\'s email usage are either considered to encourage dubious ethical behaviour or are time consuming for parents to administer. This paper describes the development of a new email client application for children called Mifrenz. This new application gives parents the ability to let their children safely use email, with the minimum of intervention. It was developed using mostly free software and also with the desire to provide real first hand programming examples to demonstrate to students.

  7. Be-safe travel, a web-based geographic application to explore safe-route in an area

    Science.gov (United States)

    Utamima, Amalia; Djunaidy, Arif

    2017-08-01

    In large cities in developing countries, the various forms of criminality are often found. For instance, the most prominent crimes in Surabaya, Indonesia is 3C, that is theft with violence (curas), theft by weighting (curat), and motor vehicle theft (curanmor). 3C case most often occurs on the highway and residential areas. Therefore, new entrants in an area should be aware of these kind of crimes. Route Planners System or route planning system such as Google Maps only consider the shortest distance in the calculation of the optimal route. The selection of the optimal path in this study not only consider the shortest distance, but also involves other factors, namely the security level. This research considers at the need for an application to recommend the safest road to be passed by the vehicle passengers while drive an area. This research propose Be-Safe Travel, a web-based application using Google API that can be accessed by people who like to drive in an area, but still lack of knowledge of the pathways which are safe from crime. Be-Safe Travel is not only useful for the new entrants, but also useful for delivery courier of valuables goods to go through the safest streets.

  8. Accounting for water quality in monitoring access to safe drinking-water as part of the Millennium Development Goals: lessons from five countries

    Science.gov (United States)

    Bain, Rob ES; Wright, Jim A; Yang, Hong; Pedley, Steve; Bartram, Jamie K

    2012-01-01

    Abstract Objective To determine how data on water source quality affect assessments of progress towards the 2015 Millennium Development Goal (MDG) target on access to safe drinking-water. Methods Data from five countries on whether drinking-water sources complied with World Health Organization water quality guidelines on contamination with thermotolerant coliform bacteria, arsenic, fluoride and nitrates in 2004 and 2005 were obtained from the Rapid Assessment of Drinking-Water Quality project. These data were used to adjust estimates of the proportion of the population with access to safe drinking-water at the MDG baseline in 1990 and in 2008 made by the Joint Monitoring Programme for Water Supply and Sanitation, which classified all improved sources as safe. Findings Taking account of data on water source quality resulted in substantially lower estimates of the percentage of the population with access to safe drinking-water in 2008 in four of the five study countries: the absolute reduction was 11% in Ethiopia, 16% in Nicaragua, 15% in Nigeria and 7% in Tajikistan. There was only a slight reduction in Jordan. Microbial contamination was more common than chemical contamination. Conclusion The criterion used by the MDG indicator to determine whether a water source is safe can lead to substantial overestimates of the population with access to safe drinking-water and, consequently, also overestimates the progress made towards the 2015 MDG target. Monitoring drinking-water supplies by recording both access to water sources and their safety would be a substantial improvement. PMID:22461718

  9. Inherently safe in situ uranium recovery

    International Nuclear Information System (INIS)

    Krumhansl, James Lee; Beauheim, Richard Louis; Brady, Patrick Vane; Arnold, Bill Walter; Kanney, Joseph F.; McKenna, Sean Andrew

    2009-01-01

    Expansion of uranium mining in the United States is a concern to some environmental groups and sovereign Native American Nations. An approach which may alleviate some problems is to develop inherently safe in situ uranium recovery ('ISR') technologies. Current ISR technology relies on chemical extraction of trace levels of uranium from aquifers that, once mined, can still contain dissolved uranium and other trace metals that are a health concern. Existing ISR operations are few in number; however, high uranium prices are driving the industry to consider expanding operations nation-wide. Environmental concerns and enforcement of the new 30 ppb uranium drinking water standard may make opening new mining operations more difficult and costly. Here we propose a technological fix: the development of inherently safe in situ recovery (ISISR) methods. The four central features of an ISISR approach are: (1) New 'green' leachants that break down predictably in the subsurface, leaving uranium, and associated trace metals, in an immobile form; (2) Post-leachant uranium/metals-immobilizing washes that provide a backup decontamination process; (3) An optimized well-field design that increases uranium recovery efficiency and minimizes excursions of contaminated water; and (4) A combined hydrologic/geochemical protocol for designing low-cost post-extraction long-term monitoring. ISISR would bring larger amounts of uranium to the surface, leave fewer toxic metals in the aquifer, and cost less to monitor safely - thus providing a 'win-win-win' solution to all stakeholders.

  10. Questions of the clinical estimation of bronchopulmonary system status of the personnel which will participate in works on transformation 'Shelter object' in radioecologically safe condition

    International Nuclear Information System (INIS)

    Sushko, V.A.; Shvajko, L.I.

    2002-01-01

    The given data indicate that for victims of the ChNPP accident (primarily clean-up workers) presence of bronchological pathology in the form of chronic obstructive pulmonary disease with some special clinical, endoscopes, pathomorphological and immunological features appeared typical. That requires the adequate methodology elaboration of diagnostics and treatment of bronchopulmonary diseases for the given contingent. Thus, the personnel directed on works, connected with transformation 'Shelter Object' (ShO) in radioecologically safe condition should have complex pulmonological maintenance at all stages of medicosanitary support

  11. Dose-dependent effect of fluoride on clinical and subclinical indices of fluorosis in school going children and its mitigation by supply of safe drinking water for 5 years: an Indian study.

    Science.gov (United States)

    Khandare, Arjun L; Validandi, Vakdevi; Gourineni, Shankar Rao; Gopalan, Viswanathan; Nagalla, Balakrishna

    2018-02-02

    Fluorosis is a public health problem in India; to know its prevalence and severity along with its mitigation measures is very important. The present study has been undertaken with the aim to assess the F dose-dependent clinical and subclinical symptoms of fluorosis and reversal of the disease by providing safe drinking water. For this purpose, a cross-sectional study was undertaken in 1934 schoolgoing children, Nalgonda district. Study villages were categorized into control (category I, F = 0.87 mg/L), affected (category II, F = 2.53 mg/L, and category III, F = 3.77 mg/L), and intervention categories (category IV, F = water and urinary fluoride (UF) in different categories. However, there was a significant decrease in the UF levels in the intervention category IV compared to affected group (category III). Fluoride altered the clinical (dental fluorosis and stunting) and subclinical indices (urine and blood) of fluorosis in a dose-dependent manner. In conclusion, the biochemical indices were altered in a dose-dependent manner and intervention with safe drinking water for 5 years in intervention group-mitigated clinical and subclinical symptoms of fluorosis.

  12. Serum 25-hydroxyvitamin D and mental health in young Australian women: Results from the Safe-D study.

    Science.gov (United States)

    Callegari, Emma T; Reavley, Nicola; Gorelik, Alexandra; Garland, Suzanne M; Wark, John D

    2017-12-15

    While there is evidence linking vitamin D status with mood, this association and its clinical significance remain uncertain. Moreover, few studies have focused on young, community-dwelling females. The Safe-D study examined the association between serum 25-hydroxyvitamin D (25OHD) levels and mental health in young women. Participants completed an online questionnaire, wore a UV dosimeter to measure personal sun exposure and underwent a comprehensive health assessment. Serum 25OHD was measured by liquid chromatography-tandem mass spectrometry in 353 healthy women aged 16-25 years, living in Victoria, Australia. Mental health measures included: Patient Health Questionnaire (PHQ-9), 7-item Generalized Anxiety Disorder Scale (GAD-7), Kessler psychological distress scale (K10) and 12-item short-form health survey (SF-12), plus any self-reported mental disorder diagnoses or medication use. The prevalence of self-reported mental disorder was 26% and of vitamin D deficiency 27%. The median (Q1, Q3) scores for the PHQ-9, GAD-7, K10 and SF-12 MCS were 6 (3, 9), 5 (2, 8), 19 (15, 25) and 43 (34, 49), respectively. Serum 25OHD levels were not associated with mental health scores. Vitamin D status was not associated with a reported diagnosis of depression or anxiety. There was a low prevalence of severe vitamin D deficiency and mental health symptoms, which may reduce study power. Our findings do not support an association between serum 25OHD levels and mental health status in young women. Longitudinal studies and randomized clinical trials investigating vitamin D and mood in young women are needed to confirm and extend these results. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Early biomarkers of brain injury and cerebral hypo- and hyperoxia in the SafeBoosC II trial

    DEFF Research Database (Denmark)

    Plomgaard, Anne M.; Alderliesten, Thomas; Austin, Topun

    2017-01-01

    Background The randomized clinical trial, SafeBoosC II, examined the effect of monitoring of cerebral oxygenation by near-infrared spectroscopy combined with a guideline on treatment when cerebral oxygenation was out of the target range. Data on cerebral oxygenation was collected in both the inte......Background The randomized clinical trial, SafeBoosC II, examined the effect of monitoring of cerebral oxygenation by near-infrared spectroscopy combined with a guideline on treatment when cerebral oxygenation was out of the target range. Data on cerebral oxygenation was collected in both......, and the biomarkers of brain injury from birth till term equivalent age that was collected as secondary and explorative outcomes in the SafeBoosC II trial. Methods Cerebral oxygenation was continuously monitored during the first 72h of life in 166 extremely preterm infants. Cranial ultrasound was performed at day 1...

  14. Are Detox Diets Safe?

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Are Detox Diets Safe? KidsHealth / For Teens / Are Detox Diets ... seguras las dietas de desintoxicación? What Is a Detox Diet? The name sounds reassuring — everyone knows that ...

  15. Mathematical model for choosing the nuclear safe matrix compositions for fissile material immobilization

    International Nuclear Information System (INIS)

    Gorshtein, A.I.; Matyunin, Yu.I.; Poluehktov, P.P.

    2000-01-01

    A mathematical model is proposed for preliminary choice of the nuclear safe matrix compositions for fissile material immobilization. The IBM PC computer software for nuclear safe matrix composition calculations is developed. The limiting concentration of fissile materials in the some used and perspective nuclear safe matrix compositions for radioactive waste immobilization is calculated [ru

  16. Clinical Trials

    Medline Plus

    Full Text Available ... from other clinical trials show what doesn't work or may cause harm. For example, the NHLBI Women's Health Initiative ... safe a treatment is or how well it works. Children (aged 18 and younger) get ... legal consent for their child to take part in a clinical trial. When ...

  17. How safe is 1% alum irrigation in controlling intractable vesical hemorrhage?

    Science.gov (United States)

    Goswami, A K; Mahajan, R K; Nath, R; Sharma, S K

    1993-02-01

    A prospective study was done to evaluate the efficacy and safety of intravesical instillation of 1% alum solution in 12 cases of hematuria of vesical origin, uncontrolled by saline irrigation for 24 hours via a 3-way Foley catheter. There were 10 cases of transitional cell carcinoma and 2 of radiation cystitis. Complete response was noted in 6 patients and a partial response in 4. Local side effects included suprapubic pain and vesical tenesmus, which were controlled by antispasmodic and/or analgesic drugs. Transient low grade pyrexia (maximum up to 38.2C) was noted in 4 patients. Among the other various clinical and biochemical parameters, serum aluminum level and prothrombin time showed statistically highly significant changes. Serum aluminum increased from an average baseline value of 1.68 to 3.36 mumol./l. without clinical evidence of aluminum toxicity and with levels well below the recommended safe limit. Prothrombin time increased parallel with the increase in serum aluminum level to a maximum of 1 1/2 times the control. Prothrombin values, therefore, can be used clinically, since they are readily obtainable whereas serum aluminum levels are not. Vesical irrigation with 1% alum solution is a safe method to control hematuria of vesical origin in properly selected cases.

  18. Elementare Bildungseinrichtungen als safe spaces für (religiöse) Differenz

    OpenAIRE

    Helena Stockinger

    2016-01-01

    ENGLISH: Educational institutions sometimes do not offer a space for (religious) difference. Based on this fact the term safe space is theoretically specified. It seems important to develop kindergartens as safe spaces in wich learning, belonging and recognizing are possible. As one characteristic of the culture of safe spaces the recognition of (religious) difference is pointed out, especially being sensitive about and broaching the issue of difference. DEUTSCH: Bildungseinrichtungen stellen...

  19. School Counselors: Untapped Resources for Safe Schools.

    Science.gov (United States)

    Callahan, Connie J.

    2000-01-01

    Principals should consider redirecting school counselors' responsibilities to include directing safe-school teams; establishing networks to identify at-risk students and violent behavior signs; developing conflict-resolution activities; assessing and counseling misbehaving students; devising crisis- management plans; and helping staff predict and…

  20. Safe Anesthesia For Every Tot

    DEFF Research Database (Denmark)

    Weiss, Markus; Vutskits, Laszlo; Hansen, Tom G

    2015-01-01

    PURPOSE OF REVIEW: The term 'safe use of anesthesia in children is ill-defined and requires definition of and focus on the 'safe conduct of pediatric anesthesia'. RECENT FINDINGS: The Safe Anesthesia For Every Tot initiative (www.safetots.org) has been set up during the last year to focus...... on the safe conduct of pediatric anesthesia. This initiative aims to provide guidance on markers of quality anesthesia care. The introduction and implementation of national regulations of 'who, where, when and how' are required and will result in an improved perioperative outcome in vulnerable children....... The improvement of teaching, training, education and supervision of the safe conduct of pediatric anesthesia are the main goals of the safetots.org initiative. SUMMARY: This initiative addresses the well known perioperative risks in young children, perioperative causes for cerebral morbidity as well as gaps...

  1. Safe structural food bolus in elderly: the relevant parameters

    OpenAIRE

    Vandenberghe-Descamps, Mathilde; Septier, Chantal; Prot, Aurélie; Tournier, Carole; Hennequin, Martine; Vigneau, Evelyne; Feron, Gilles; Labouré, Hélène

    2017-01-01

    Mastication is essential to prepare food into a bolus ready to be swallowed safely, with no choking risk. Based on food bolus properties, a masticatory normative indicator was developed by Woda et al. (2010) to identify impaired masticatory function within good oral health population. The aim of the present study was to identify relevant parameters of bolus' structure to differentiate safe to unsafe bolus among elderly contrasting by their dental status.93 elderly, 58% with at least 7 posteri...

  2. A qualitative study of safe abortion and post-abortion family planning service experiences of women attending private facilities in Kenya.

    Science.gov (United States)

    Penfold, Suzanne; Wendot, Susy; Nafula, Inviolata; Footman, Katharine

    2018-04-24

    To inform improvements in safe abortion and post-abortion family planning (PAFP) services, this study aimed to explore the pathways, decision-making, experiences and preferences of women receiving safe abortion and post-abortion family planning (PAFP) at private clinics in western Kenya. We conducted semi-structured interviews with 22 women who had recently used a safe abortion service from a private clinic. Interviews explored abortion-seeking behaviour and decision-making, abortion experience, use and knowledge of contraception, experience of PAFP counselling, and perceived facilitators of and challenges to family planning use. Respondents discovered their pregnancies due to physical symptoms, which were confirmed using pregnancy testing kits, often purchased from pharmacies. Respondents usually discussed their abortion decision with their partner, and, sometimes, carefully-selected friends or family members. Some reported being referred to private clinics for abortion services directly from other providers. Others had more complex pathways, first seeking care from unsafe providers, trying to self-induce abortion, being turned away from alternative safe facilities that were closed or too busy, or taking time to gather financial resources to pay for care. Participants wanted to use abortion services at facilities reputed for being accessible, clean, medically safe, and offering quick, respectful, private and courteous services. Awareness of reputable clinics was gained through personal experience, and recommendations from contacts and other health providers. Most participants had previously used contraception, with some reports of incorrect use and many reports of side effects. PAFP counselling was valued by clients, but some accounts suggested the counselling lacked comprehensive information. Many women chose contraception immediately following PAFP counselling; but others wanted to delay decision-making about contraception until the abortion was complete

  3. Safe transport of radioactive material

    International Nuclear Information System (INIS)

    1990-01-01

    Recently the Agency redefined its policy for education and training in radiation safety. The emphasis is now on long-term strategic planning of general education and training programmes. In line with this general policy the Agency's Standing Advisory Group for the Safe Transport of Radioactive Material (SAGSTRAM) in its 7th meeting (April 1989) agreed that increased training activity should be deployed in the area of transport. SAGSTRAM specifically recommended the development of a standard training programme on this subject area, including audio-visual aids, in order to assist Member States in the implementation of the Agency's Regulations for the Safe Transport of Radioactive Material. This training programme should be substantiated by a biennial training course which is thought to be held either as an Interregional or a Regional Course depending on demand. This training manual, issued as a first publication in the Training Course Series, represents the basic text material for future training courses in transport safety. The topic areas covered by this training manual and most of the texts have been developed from the course material used for the 1987 Bristol Interregional Course on Transport Safety. The training manual is intended to give guidance to the lecturers of a course and will be provided to the participants for retention. Refs, figs and tabs

  4. The safe home project.

    Science.gov (United States)

    Arphorn, Sara; Jiraniratisai, Sopaphan; Rungtakul, Rungsri; Phutta, Nikom

    2011-12-01

    The Thai Health Promotion Foundation supported the Improvement of Quality of Life of Informal Workers project in Ban Luang District, Amphur Photaram, Ratchaburi Province. There were many informal workers in Ban Luang District. Sweet-crispy fish producers in Ban Luang were the largest group among the sweet-crispy fish producers in Thailand. This project was aimed at improving living and working conditions of informal workers, with a focus on the sweet-crispy fish group. Good practices of improved living and working conditions were used to help informal workers build safe, healthy and productive work environments. These informal workers often worked in substandard conditions and were exposed to various hazards in the working area. These hazards included risk of exposure to hot work environment, ergonomics-related injuries, chemical hazards, electrical hazards etc. Ergonomics problems were commonly in the sweet-crispy fish group. Unnatural postures such as prolonged sitting were performed dominantly. One hundred and fifty informal workers participated in this project. Occupational health volunteers were selected to encourage occupational health and safety in four groups of informal workers in 2009. The occupational health volunteers trained in 2008 were farmers, beauty salon workers and doll makers. The occupational health and safety knowledge is extended to a new informal worker group: sweet-crispy fish producer, in 2009. The occupational health and safety training for sweet-crispy fish group is conducted by occupational health volunteers. The occupational health volunteers increased their skills and knowledge assist in to make safe home and safe community through participatory oriented training. The improvement of living and working condition is conducted by using a modified WISH, Work Improvement for Safe Home, checklist. The plans of improvement were recorded. The informal workers showed improvement mostly on material handling and storage. The safe uses and safe

  5. Manufacturing development for the SAFE 100 kW core

    International Nuclear Information System (INIS)

    Carter, Robert; Roman, Jose; Salvail, Pat

    2002-01-01

    In stark contrast to what is sometimes considered the norm in traditional manufacturing processes, engineers at the Marshall Space Flight Center (MSFC) arc in the practice of altering the standard in an effort to realize other potential methods in core manufacturing. While remaining within the bounds of the materials database, we are researching into core manufacturing techniques that may have been overlooked in the past due to funding and/or time constraints. To augment proven core fabrication capabilities we are pursuing plating processes as another possible method for core build-up and assembly. Although brazing and a proprietary HIP cycle are used for module assembly (proven track record for stability and endurance), it is prudent to pursue secondary or backup methods of module and core assembly. For this reason heat tube manufacture and module assembly by means of plating is being investigated. Potentially, the plating processes will give engineers the ability to manufacture replacement modules for any module that might fail to perform nominally, and to assemble/disassemble a complete core in much less time than would be required for the conventional Braze-HIP process. Another area of improvement in core manufacturing capabilities is the installation of a sodium and lithium liquid metal heat pipe fill machine. This, along with the ability to Electron Beam Weld heat pipe seals and wet-in the pipes in the necessary vacuum atmosphere, will eliminate the need to ship potentially hazardous components outside for processing. In addition to developing core manufacturing techniques, the SAFE manufacturing team has been evaluating the thermal heat transfer characteristics, and manufacturability of several heat exchanger design concepts

  6. Small intrinsically safe reactor implications

    International Nuclear Information System (INIS)

    Wakabayashi, Hiroaki

    1985-01-01

    Reviewing the history of nuclear power, it is found that peaceful uses of nuclear power are children of the war-like atom. Importance of special growth in a shielded environment is emphasized to exploit fully the advantages of nuclear power. Nuclear power reactors must be safe for their assimilation into society from the points of view of both technology and social psychology. ISR/ISER is identified as a missing link in the development of nuclear power reactors from this perspective and advocated for international development and utilization, being unleashed from the concerns of politicization, safety, and proliferation

  7. Transforming RN education: clinical learning and clinical knowledge development.

    Science.gov (United States)

    Benner, P

    1993-04-01

    Transforming RN education has the potential for transforming clinical teaching and learning for all students. The returning RN student offers possibilities for clinical learning that the generic student does not have, but this should not cause us to limit the returning RN student to the generic level. Where possible innovative programs should be developed to move the RN student from baccalaureate level to the Master's level. As educators, we should take the opportunity to increase the numbers of nurses who are educationally prepared to move into advanced levels of practice. The returning RN student offers a rich human resource for the profession, and a rich resource for improving our clinical teaching as well as our practice.

  8. Type-safe pattern combinators

    DEFF Research Database (Denmark)

    Rhiger, Morten

    2009-01-01

    Macros still haven't made their way into typed higher-order programming languages such as Haskell and Standard ML. Therefore, to extend the expressiveness of Haskell or Standard ML, one must express new linguistic features in terms of functions that fit within the static type systems of these lan...... of these languages. This is particularly challenging when introducing features that span across multiple types and that bind variables. We address this challenge by developing, in a step by step manner, mechanisms for encoding patterns and pattern matching in Haskell in a type-safe way....

  9. Enhancing Critical Thinking Via a Clinical Scholar Approach.

    Science.gov (United States)

    Simpson, Vicki; McComb, Sara A; Kirkpatrick, Jane M

    2017-11-01

    Safety, quality improvement, and a systems perspective are vital for nurses to provide quality evidence-based care. Responding to the call to prepare nurses with these perspectives, one school of nursing used a clinical scholar approach, enhanced by systems engineering to more intentionally develop the ability to clinically reason and apply evidence-based practice. A two-group, repeated-measures control trial was used to determine the effects of systems engineering content and support on nursing students' clinical judgment and critical thinking skills. Findings indicated this approach had a positive effects on student's clinical judgment and clinical reasoning skills. This approach helped students view health care issues from a broader perspective and use evidence to guide solution development, enhancing the focus on evidence-based practice, and quality improvement. Intentional integration of an evidence-based, systems perspective by nursing faculty supports development of nurses who can function safely and effectively in the current health care system. [J Nurs Educ. 2017;56(11):679-682.]. Copyright 2017, SLACK Incorporated.

  10. Development of clinical application of radiation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Sook; Yoo, Seoung Yul; Yoo, Hyung Jun [and others

    2000-04-01

    The aim is to develop the clinical radiation therapy techniques, which increase local control and cure rate of cancer. The contents were 1. technique of stereotactic radiotherapy 2. technique of intraoperative radiation therapy(IORT) 3. technique of fractionated radiotherapy 4. technique of 3D conformal therapy 5. chemoradiotherapy in lung cancer, rectal cancer and biliopancreatic cancer 6. network based information communication system of radiation oncology 7. animal studies for the best application of chemoradiotherapy and for elucidating mechanism of slide effect in radiotherapy. The results were 1. completion of quality assurance protocol, frame and mounting system 2. completion of applicator of IORT 3. clinical protocol of fractionated radiotherapy 4. clinical protocol of 3D conformal therapy for brain, head and neck, breast and lung cancer 5. completion of multimodality treatment protocol for lung, rectal and biliopancreatic cancer 6. completion of database system for patient information and simulation image 7. standardization of estimation for radiation induced pneumonitis in animal model. Future plans are (1) developed fractionated stereotactic radiotherapy system will be commercialized (2) developed applicator of brachytherapy for IORT will be commercialized (3) 3D conformal therapy will increase local control rate for brain tumor and decrease complications such as zerostomia after treatment for nasopharygeal cancer (4) training manpower and skills for randomized clinical trial (5) suggest possibility of clinical usefulness of oral 5-fluorouracil (6) to provide basic technique for electric chart (7) promote developing database system for image information (8) also in view of double edge sword effect of NO, it is possible to modify the NO production from irradiation to increase the tolerance to radiation.

  11. Development of clinical application of radiation

    International Nuclear Information System (INIS)

    Kim, Mi Sook; Yoo, Seoung Yul; Yoo, Hyung Jun

    2000-04-01

    The aim is to develop the clinical radiation therapy techniques, which increase local control and cure rate of cancer. The contents were 1. technique of stereotactic radiotherapy 2. technique of intraoperative radiation therapy(IORT) 3. technique of fractionated radiotherapy 4. technique of 3D conformal therapy 5. chemoradiotherapy in lung cancer, rectal cancer and biliopancreatic cancer 6. network based information communication system of radiation oncology 7. animal studies for the best application of chemoradiotherapy and for elucidating mechanism of slide effect in radiotherapy. The results were 1. completion of quality assurance protocol, frame and mounting system 2. completion of applicator of IORT 3. clinical protocol of fractionated radiotherapy 4. clinical protocol of 3D conformal therapy for brain, head and neck, breast and lung cancer 5. completion of multimodality treatment protocol for lung, rectal and biliopancreatic cancer 6. completion of database system for patient information and simulation image 7. standardization of estimation for radiation induced pneumonitis in animal model. Future plans are 1) developed fractionated stereotactic radiotherapy system will be commercialized 2) developed applicator of brachytherapy for IORT will be commercialized 3) 3D conformal therapy will increase local control rate for brain tumor and decrease complications such as zerostomia after treatment for nasopharygeal cancer 4) training manpower and skills for randomized clinical trial 5) suggest possibility of clinical usefulness of oral 5-fluorouracil 6) to provide basic technique for electric chart 7) promote developing database system for image information 8) also in view of double edge sword effect of NO, it is possible to modify the NO production from irradiation to increase the tolerance to radiation

  12. SAFE/SNAP application to shipboard security

    International Nuclear Information System (INIS)

    Grady, L.M.; Walker, J.L.; Polito, J.

    1981-11-01

    An application of the combined Safeguards Automated Facility Evaluation/Safeguards Network Analysis Procedure (SAFE/SNAP) modeling technique to a physical protection system (PPS) aboard a generic ship is described. This application was performed as an example of how the SAFE and SNAP techniques could be used. Estimates of probability of interruption and neutralization for the example shipboard PPS are provided by SAFE as well as an adversary scenario, which serves as input to SNAP. This adversary scenario is analyzed by SNAP through four cases which incorporate increasingly detailed security force tactics. Comparisons between the results of the SAFE and SNAP analyses are made and conclusions drawn on the validity of each technique. Feedback from SNAP to SAFE is described, and recommendations for upgrading the ship based on the results of the SAFE/SNAP application are also discussed

  13. International conference on safe decommissioning for nuclear activities: Assuring the safe termination of practices involving radioactive materials. Contributed papers

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    Thousands of operations involving the use of radioactive substances will end during the current century. While there is considerable regulatory experience in the 'front end' of the regulatory system for practices, the experience at the back end is more limited as fewer practices have actually been terminated. When a practice is terminated because the facility has reached the end of its useful life, action has to betaken to ensure the safe shutdown of the facility and allow the removal of regulatory controls. There are many issues involved in the safe termination of practices. These include setting criteria for the release of material and sites from regulatory control; determining the suitability of the various options for decommissioning nuclear facilities, managing the waste and material released from control (recycling, reuse or disposal), and the eventual remediation of the site. Some countries have put in place regulatory infrastructures and have developed programmes to manage the associated decommissioning and remediation activities. Other countries are at the stage of assessing what is involved in terminating such practices. The purpose of this Conference is to foster an information exchange on the safe an orderly termination of practices that involve the use of radioactive substances, including both decommissioning and environmental remediation, and to promote improved coherence internationally on strategies and criteria for the safe termination of practices.

  14. International conference on safe decommissioning for nuclear activities: Assuring the safe termination of practices involving radioactive materials. Contributed papers

    International Nuclear Information System (INIS)

    2002-01-01

    Thousands of operations involving the use of radioactive substances will end during the current century. While there is considerable regulatory experience in the 'front end' of the regulatory system for practices, the experience at the back end is more limited as fewer practices have actually been terminated. When a practice is terminated because the facility has reached the end of its useful life, action has to betaken to ensure the safe shutdown of the facility and allow the removal of regulatory controls. There are many issues involved in the safe termination of practices. These include setting criteria for the release of material and sites from regulatory control; determining the suitability of the various options for decommissioning nuclear facilities, managing the waste and material released from control (recycling, reuse or disposal), and the eventual remediation of the site. Some countries have put in place regulatory infrastructures and have developed programmes to manage the associated decommissioning and remediation activities. Other countries are at the stage of assessing what is involved in terminating such practices. The purpose of this Conference is to foster an information exchange on the safe an orderly termination of practices that involve the use of radioactive substances, including both decommissioning and environmental remediation, and to promote improved coherence internationally on strategies and criteria for the safe termination of practices

  15. Elaboration of Safe Community Assessment System

    Directory of Open Access Journals (Sweden)

    Algirdas Astrauskas

    2011-12-01

    Full Text Available The paper aims to design an assessment system to monitor and evaluate safety parameters and administrative efforts with the purpose to increase safety in municipalities. The safety monitoring system considered is to be the most important tool for creation anddevelopment of safe communities in Lithuania. Several methods were applied to achieve this purpose. In order to determine the role of local government in ensuring the safety of people, property and environment at the local level of a meta-analysis of research reports,the Lithuanian national legislation, strategic planning documents of the state and local government were carried out. Analysis of statistical data, structural analysis, comparative analysis and synthesis methods were used while investigating the areas of safety uncertainty, risk groups, identifying safety risk factors, determining their relationship, and creating a safe community assessment system.A safe community assessment system, which consists of two types of criteria, has been elaborated. The assessment system is based on the multi-level criteria for safety monitoring and the multi-level criteria for the evaluation of municipal activities in the field of building safety. Links between the criteria, peculiarities of their application and advantages in the process of safe community creation and development are analyzed.Design and implementation of the safe community assessment system is one of the most important stages to implement the idea of safe communities. The proposed system integrates a variety of risk areas, the safety achievement criteria are linked to the criteria used in thestrategic planning. Periodic assessment of the safety situation using the proposed system ensures possibility to monitor current local safety conditions and assess the changes and the trends. A safe community assessment system is proposed to be used as a tool to unified municipalities safety comprehensiveness and compare safety level in

  16. Professional Development Strategies to Enhance Nurses' Knowledge and Maintain Safe Practice.

    Science.gov (United States)

    Bindon, Susan L

    2017-08-01

    Maintaining competence is a professional responsibility for nurses. Individual nurses are accountable for their practice, as outlined in the American Nurses Association's Nursing: Scope and Standards of Practice. Nurses across clinical settings face the sometimes daunting challenge of staying abreast of regulatory mandates, practice changes, equipment updates, and other workplace expectations. In the complex, evolving perioperative setting, professional development is a priority, and the need for ongoing education is critical. However, nurses' efforts to engage in their own development can be hampered by a lack of time, limited access to educational resources, or cost concerns. This article provides an overview of nursing professional development and offers some resources to help individual nurses maintain or enhance their knowledge, skills, and attitudes. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  17. Developing a web page: bringing clinics online.

    Science.gov (United States)

    Peterson, Ronnie; Berns, Susan

    2004-01-01

    Introducing clinical staff education, along with new policies and procedures, to over 50 different clinical sites can be a challenge. As any staff educator will confess, getting people to attend an educational inservice session can be difficult. Clinical staff request training, but no one has time to attend training sessions. Putting the training along with the policies and other information into "neat" concise packages via the computer and over the company's intranet was the way to go. However, how do you bring the clinics online when some of the clinical staff may still be reluctant to turn on their computers for anything other than to gather laboratory results? Developing an easy, fun, and accessible Web page was the answer. This article outlines the development of the first training Web page at the University of Wisconsin Medical Foundation, Madison, WI.

  18. Improving clinical drug development regulatory procedures for anticonvulsants

    Directory of Open Access Journals (Sweden)

    Janković Slobodan

    2015-01-01

    Full Text Available Background: Clinical development of antiepileptic drugs is demanding due to complex character of the disorder and to diversity of its forms and etiologies. Objective: The aim of this review was to suggest improvements in regulatory procedures for clinical development of antiepileptic drugs. Methods: The following databases of scientific articles were searched: MEDLINE, SCOPUS and SCINDEKS. In total 558 publications were retrieved. The types of articles selected were reviews, reports on clinical trials and letters to the Editor. Results: There are several changes of regulatory documents necessary for improving process of clinical development of antiepileptic drugs: preference of parallel groups design for add-on trials should be explicit; the noninferiority design for monotherapy clinical trials should be acceptable; restrictive formulations when trials of antiepileptic drugs in children are in question should be avoided; requirements in regard to the efficacy measures should be harmonized among the regulatory bodies; proactive attitude towards discovery of adverse events; and precise requirements for clinical trials specifically designed to prove anti-epileptogenic effects should be made clear. Conclusion: Current regulatory documents are incomplete in many aspects; an international effort to improve and harmonize guidelines for clinical development of antiepileptic drugs is necessary for improvement of this process.

  19. Iser: an international inherently safe reactor concept

    International Nuclear Information System (INIS)

    Wakabayashi, Hiroaki

    1988-01-01

    Iser is a modular standardised 200-300 MWe power reactor based on the PIUS principle. It differs from PIUS in being simpler, and making full use of existing steel-vessel-based LWR technology. Iser is an inherently safe reactor concept under development in Japan. It is a generic concept, not a patented commodity, and it is expected that an international association to develop the concept will be formed. (U.K.)

  20. When the Safe Alternative Is Not That Safe: Tramadol Prescribing in Children

    Directory of Open Access Journals (Sweden)

    Frédérique Rodieux

    2018-03-01

    Full Text Available Children represent a vulnerable population in which management of nociceptive pain is complex. Drug responses in children differ from adults due to age-related differences. Moreover, therapeutic choices are limited by the lack of indication for a number of analgesic drugs due to the challenge of conducting clinical trials in children. Furthermore the assessment of efficacy as well as tolerance may be complicated by children’s inability to communicate properly. According to the World Health Organization, weak opioids such as tramadol and codeine, may be used in addition to paracetamol and ibuprofen for moderate nociceptive pain in both children and adults. However, codeine prescription has been restricted for the last 5 years in children because of the risk of fatal overdoses linked to the variable activity of cytochrome P450 (CYP 2D6 which bioactivates codeine. Even though tramadol has been considered a safe alternative to codeine, it is well established that tramadol pharmacodynamic opioid effects, efficacy and safety, are also largely influenced by CYP2D6 activity. For this reason, the US Food and Drug Administration recently released a boxed warning regarding the use of tramadol in children. To provide safe and effective tramadol prescription in children, a personalized approach, with dose adaptation according to CYP2D6 activity, would certainly be the safest method. We therefore recommend this approach in children requiring chronic or recurrent nociceptive pain treatment with tramadol. In case of acute inpatients nociceptive pain management, prescribing tramadol at the minimal effective dose, in a child appropriate dosage form and after clear instructions are given to the parents, remains reasonable based on current data. In all other situations, morphine should be preferred for moderate to severe nociceptive pain conditions.

  1. Chernobyl new safe confinement

    International Nuclear Information System (INIS)

    Dodd, L.

    2011-01-01

    The author presents the new safe confinement that will be commissioned at Unit 4 of the Chernobyl NPP in 2015. The confinement will ensure that Chernobyl Unit 4 will be placed in an environmentally safe condition for at least next 100 years. The article highlights the current work status, future perspectives and the feasibility of confinement concept [ru

  2. Asymptotically Safe Dark Matter

    DEFF Research Database (Denmark)

    Sannino, Francesco; Shoemaker, Ian M.

    2015-01-01

    We introduce a new paradigm for dark matter (DM) interactions in which the interaction strength is asymptotically safe. In models of this type, the coupling strength is small at low energies but increases at higher energies, and asymptotically approaches a finite constant value. The resulting...... searches are the primary ways to constrain or discover asymptotically safe dark matter....

  3. 76 FR 81904 - Solicitation of New Safe Harbors and Special Fraud Alerts

    Science.gov (United States)

    2011-12-29

    ... Medicaid Patient and Program Protection Act of 1987, Public Law 100-93 Sec. 14, the Act, Sec. 1128B(b), 42...-called ``safe harbor'' provisions, specifying various payment and business practices that, although... basis for administrative sanctions. OIG safe harbor provisions have been developed ``to limit the reach...

  4. Mitigating prolonged QT interval in cancer nanodrug development for accelerated clinical translation.

    Science.gov (United States)

    Ranjan, Amalendu P; Mukerjee, Anindita; Helson, Lawrence; Vishwanatha, Jamboor K

    2013-12-14

    Cardiac toxicity is the foremost reason for drug discontinuation from development to clinical evaluation and post market surveillance [Fung 35:293-317, 2001; Piccini 158:317-326 2009]. The Food and Drug Administration (FDA) has rejected many potential pharmaceutical agents due to QT prolongation effects. Since drug development and FDA approval takes an enormous amount of time, money and effort with high failure rates, there is an increased focus on rescuing drugs that cause QT prolongation. If these otherwise safe and potent drugs were formulated in a unique way so as to mitigate the QT prolongation associated with them, these potent drugs may get FDA approval for clinical use. Rescuing these compounds not only benefit the patients who need them but also require much less time and money thus leading to faster clinical translation. In this study, we chose curcumin as our drug of choice since it has been shown to posses anti-tumor properties against various cancers with limited toxicity. The major limitations with this pharmacologically active drug are (a) its ability to prolong QT by inhibiting the hERG channel and (b) its low bioavailability. In our previous studies, we found that lipids have protective actions against hERG channel inhibition and therefore QT prolongation. Results of the manual patch clamp assay of HEK 293 cells clearly illustrated that our hybrid nanocurcumin formulation prevented the curcumin induced inhibition of hERG K+ channel at concentrations higher than the therapeutic concentrations of curcumin. Comparing the percent inhibition, the hybrid nanocurcumin limited inhibition to 24.8% at a high curcumin equivalent concentration of 18 μM. Liposomal curcumin could only decrease this inhibition upto 30% only at lower curcumin concentration of 6 μM but not at 18 μM concentration. Here we show a curcumin encapsulated lipopolymeric hybrid nanoparticle formulation which could protect against QT prolongation and also render increased

  5. Clinical reasoning in nursing: teaching strategies and assessment tools

    Directory of Open Access Journals (Sweden)

    Emília Campos de Carvalho

    Full Text Available ABSTRACT Objective: To present the concept and development of teaching strategies and the assessment tools regarding clinical reasoning for accurate practice. Method: This is a theoretical reflection based on scientific studies. Results: Comprehension of the essential concepts of the thought process and its articulation with the different teaching strategies and the assessment tools which has allowed presenting ways to improve the process of diagnostic or therapeutic clinical reasoning. Conclusion: The use of new strategies and assessment tools should be encouraged in order to contribute to the development of skills that lead to safe and effective decision making.

  6. Oral Challenge without Skin Testing Safely Excludes Clinically Significant Delayed-Onset Penicillin Hypersensitivity.

    Science.gov (United States)

    Confino-Cohen, Ronit; Rosman, Yossi; Meir-Shafrir, Keren; Stauber, Tali; Lachover-Roth, Idit; Hershko, Alon; Goldberg, Arnon

    Penicillins are the drug family most commonly associated with hypersensitivity reactions. Current guidelines recommend negative skin tests (ST) before re-administering penicillins to patients with previous nonimmediate reactions (NIR). The objective of this study was to examine whether ST are necessary before re-administering penicillin to patients with NIR. Patients with NIR to penicillins starting longer than 1 hour after last dose administration or starting any time after the first treatment day or patients with vague recollection of their reaction underwent penicillin ST. Disregarding ST results, patients were challenged with the relevant penicillins. One-tenth of the therapeutic dose followed by the full dose was administered at 1-hour interval and patients continued taking the full dose for 5 days. A total of 710 patients with alleged BL allergy were evaluated. Patients with a history of immediate reaction (52, 7.3%) or cephalosporin allergy (16, 2.2%) were excluded. Of the remaining 642 patients, 62.3% had negative ST, 5.3% positive ST, and 32.4% equivocal ST. A total of 617 (96.1%) patients were challenged. Immediate reaction was observed in 9 patients (1.5%): 1-positive ST, 7-negative ST, and 1-equivocal ST (P = .7). Late reaction to the first-day challenge occurred in 24 patients (4%). An at-home challenge was continued by 491 patients. Complete 5-day and partial challenges were well tolerated by 417 (85%) and 44 patients (8.9%), respectively, disregarding ST results. Thirty patients (6.1%) developed mild reactions to the home challenge regardless of their ST results. A 5-day oral challenge without preceding ST is safe and sufficient to exclude penicillin allergy after NIR developing during penicillin treatment. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. Data safe havens to combine health and genomic data: benefits and challenges

    Directory of Open Access Journals (Sweden)

    Kerina H Jones

    2017-04-01

    Genomic data sets contain vast amounts of valuable information, some of which is currently undefined, but which may have direct bearing on individual health at some point. The use of these data in combination with health-related data has the potential to bring great benefits, better clinical trial stratification, epidemiology project design and clinical improvements. It is, therefore, essential that such data are surrounded by a properly-designed, robust governance framework including technical and procedural access controls that enable the data to be used safely.

  8. Safe prescribing: a titanic challenge.

    Science.gov (United States)

    Routledge, Philip A

    2012-10-01

    The challenge to achieve safe prescribing merits the adjective 'titanic'. The organisational and human errors leading to poor prescribing (e.g. underprescribing, overprescribing, misprescribing or medication errors) have parallels in the organisational and human errors that led to the loss of the Titanic 100 years ago this year. Prescribing can be adversely affected by communication failures, critical conditions, complacency, corner cutting, callowness and a lack of courage of conviction, all of which were also factors leading to the Titanic tragedy. These issues need to be addressed by a commitment to excellence, the final component of the 'Seven C's'. Optimal prescribing is dependent upon close communication and collaborative working between highly trained health professionals, whose role is to ensure maximum clinical effectiveness, whilst also protecting their patients from avoidable harm. Since humans are prone to error, and the environments in which they work are imperfect, it is not surprising that medication errors are common, occurring more often during the prescribing stage than during dispensing or administration. A commitment to excellence in prescribing includes a continued focus on lifelong learning (including interprofessional learning) in pharmacology and therapeutics. This should be accompanied by improvements in the clinical working environment of prescribers, and the encouragement of a strong safety culture (including reporting of adverse incidents as well as suspected adverse drug reactions whenever appropriate). Finally, members of the clinical team must be prepared to challenge each other, when necessary, to ensure that prescribing combines the highest likelihood of benefit with the lowest potential for harm. © 2012 The Author. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

  9. 75 FR 1734 - Children’s Online Privacy Protection Rule Safe Harbor Proposed Self-Regulatory Guidelines; i-SAFE...

    Science.gov (United States)

    2010-01-13

    ... Proposed Self-Regulatory Guidelines; i-SAFE, Inc. Application for Safe Harbor AGENCY: Federal Trade... for public comment concerning proposed self-regulatory guidelines submitted by i-SAFE, Inc. under the... approval self-regulatory guidelines that would implement the Rule's protections.\\3\\ \\1\\ 64 FR 59888 (1999...

  10. Digital image monitoring to optimise safe port operation

    CSIR Research Space (South Africa)

    Phelp, D

    2008-11-01

    Full Text Available This paper describes a low cost video system ‘Harbour Watch’, which can be used to support safe port operations, especially in developing countries. Preset digital images are geo-referenced and then archived for later analysis to improve...

  11. Development and implementation of intranasal naloxone opioid overdose response protocol at a homeless health clinic.

    Science.gov (United States)

    Dahlem, Chin Hwa Y; Horstman, Molly J; Williams, Brent C

    2016-01-01

    To describe the development, implementation, and preliminary evaluation of Opioid Overdose Response Protocol using intranasal (IN) naloxone in a homeless shelter. Opioid Overdose Response Protocol and training curriculum were developed using the Massachusetts Department of Public Health Opioid Overdose Education and Naloxone Distribution (OEND) flow chart, the American Heart Association (AHA) simplified adult basic life support algorithm, and resources through Harms Reduction Coalition. Intranasal naloxone offers a safe and effective method for opioid reversal. To combat the rising incidence of opioid overdose, IN naloxone should be made available at homeless shelters and other facilities with high frequency of opioid overdose, including the training of appropriate staff. This project has demonstrated the effective training and implementation of an Opioid Overdose Response Protocol, based on feedback received from cardiopulmonary resuscitation (CPR) trained nonhealthcare staff. Nurse practitioners (NPs), with our focus on patient care, prevention, and education, are well suited to the deployment of this life-saving protocol. NPs are in critical positions to integrate opioid overdose prevention education and provide naloxone rescue kits in clinical practices. ©2015 American Association of Nurse Practitioners.

  12. IMP3 RNP safe houses prevent miRNA-directed HMGA2 mRNA decay in cancer and development

    DEFF Research Database (Denmark)

    Jønson, Lars; Christiansen, Jan; Hansen, Thomas van Overeem

    2014-01-01

    by let-7, and let-7 antagomiRs make HMGA2 refractory to IMP3. Removal of let-7 target sites eliminates IMP3-dependent stabilization, and IMP3-containing bodies are depleted of Ago1-4 and miRNAs. The relationship between Hmga2 mRNA and IMPs also exists in the developing limb bud, where IMP1-deficient...... that IMP3 RNPs may function as cytoplasmic safe houses and prevent miRNA-directed mRNA decay of oncogenes during tumor progression....

  13. Excellence in clinical teaching: knowledge transformation and development required.

    Science.gov (United States)

    Irby, David M

    2014-08-01

    Clinical teachers in medicine face the daunting task of mastering the many domains of knowledge needed for practice and teaching. The breadth and complexity of this knowledge continue to increase, as does the difficulty of transforming the knowledge into concepts that are understandable to learners. Properly targeted faculty development has the potential to expedite the knowledge transformation process for clinical teachers. Based on my own research in clinical teaching and faculty development, as well as the work of others, I describe the unique forms of clinical teacher knowledge, the transformation of that knowledge for teaching purposes and implications for faculty development. The following forms of knowledge for clinical teaching in medicine need to be mastered and transformed: (i) knowledge of medicine and patients; (ii) knowledge of context; (iii) knowledge of pedagogy and learners, and (iv) knowledge integrated into teaching scripts. This knowledge is employed and conveyed through the parallel processes of clinical reasoning and clinical instructional reasoning. Faculty development can facilitate this knowledge transformation process by: (i) examining, deconstructing and practising new teaching scripts; (ii) focusing on foundational concepts; (iii) demonstrating knowledge-in-use, and (iv) creating a supportive organisational climate for clinical teaching. To become an excellent clinical teacher in medicine requires the transformation of multiple forms of knowledge for teaching purposes. These domains of knowledge allow clinical teachers to provide tailored instruction to learners at varying levels in the context of fast-paced and demanding clinical practice. Faculty development can facilitate this knowledge transformation process. © 2014 John Wiley & Sons Ltd.

  14. Infant Development: Milestones from 4 to 6 Months

    Science.gov (United States)

    ... safe, secure and loved. When you hold or rock your baby, talk quietly or sing soothing songs. ... infant-and-toddler-health/in-depth/infant-development/art-20048178 . Mayo Clinic Footer Legal Conditions and Terms ...

  15. Providing safe drinking water to 1.2 billion unserved people

    Energy Technology Data Exchange (ETDEWEB)

    Gadgil, Ashok J.; Derby, Elisabeth A.

    2003-06-01

    Despite substantial advances in the past 100 years in public health, technology and medicine, 20% of the world population, mostly comprised of the poor population segments in developing countries (DCs), still does not have access to safe drinking water. To reach the United Nations (UN) Millennium Goal of halving the number of people without access to safe water by 2015, the global community will need to provide an additional one billion urban residents and 600 million rural residents with safe water within the next twelve years. This paper examines current water treatment measures and implementation methods for delivery of safe drinking water, and offers suggestions for making progress towards the goal of providing a timely and equitable solution for safe water provision. For water treatment, based on the serious limitations of boiling water and chlorination, we suggest an approach based on filtration coupled with ultraviolet (UV) disinfection, combined with public education. Additionally, owing to the capacity limitations for non-governmental organizations (NGOs) to take on this task primarily on their own, we suggest a strategy based on financially sustainable models that include the private sector as well as NGOs.

  16. A report on developing a checklist to assess company plans focused on improving safety awareness, safe behaviour and safety culture: final report

    NARCIS (Netherlands)

    Steijger, N.; Starren, H.; Keus, M.; Gort, J.; Vervoort, M.

    2003-01-01

    This report describes the process of developing a checklist to asses company plans focused on improving safety awareness, safe behaviour and safety culture. These plans are part of a programme initiated by the Ministry of Social Affairs and Employment aiming at improving the safety performance of

  17. Design and development of a low-cost biphasic charge-balanced functional electric stimulator and its clinical validation.

    Science.gov (United States)

    Shendkar, Chandrashekhar; Lenka, Prasanna K; Biswas, Abhishek; Kumar, Ratnesh; Mahadevappa, Manjunatha

    2015-10-01

    Functional electric stimulators that produce near-ideal, charge-balanced biphasic stimulation waveforms with interphase delay are considered safer and more efficacious than conventional stimulators. An indigenously designed, low-cost, portable FES device named InStim is developed. It features a charge-balanced biphasic single channel. The authors present the complete design, mathematical analysis of the circuit and the clinical evaluation of the device. The developed circuit was tested on stroke patients affected by foot drop problems. It was tested both under laboratory conditions and in clinical settings. The key building blocks of this circuit are low dropout regulators, a DC-DC voltage booster and a single high-power current source OP-Amp with current-limiting capabilities. This allows the device to deliver high-voltage, constant current, biphasic pulses without the use of a bulky step-up transformer. The advantages of the proposed design over the currently existing devices include improved safety features (zero DC current, current-limiting mechanism and safe pulses), waveform morphology that causes less muscle fatigue, cost-effectiveness and compact power-efficient circuit design with minimal components. The device is also capable of producing appropriate ankle dorsiflexion in patients having foot drop problems of various Medical Research Council scale grades.

  18. Safe and effective use of medicines for ethnic minorities

    DEFF Research Database (Denmark)

    Dam, Pernille; El-Souri, Mira Mahmoud; Herborg, Hanne

    2015-01-01

    , there was a need to adapt a previously developed and validated medicine-based intervention “safe and effective use of medicines” to this vulnerable group of unemployed ethnic minority patients. Methods: The objective of this before-after study was to improve medicines adherence, health status and work ability...... of the target group through an individualized pharmacist delivered intervention with focus on safe and effective implementation of medical treatments. The target group was ethnic minorities of non-western origin affiliated with a job center. Results: At baseline, 35.7 % of the patients had a potential adherence...... to the intervention. Conclusion: The counseling program “Safe and effective use of medicines” was successfully adapted to unemployed ethnic minority patients, and tested in a new collaboration between job centers and community pharmacies. The counseling program resulted in statistically significant improvements...

  19. 77 FR 76434 - Solicitation of New Safe Harbors and Special Fraud Alerts

    Science.gov (United States)

    2012-12-28

    ... statute (section 1128B(b) of the Social Security Act), as well as developing new OIG Special Fraud Alerts... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... revised safe harbors and Special Fraud Alerts. Please assist us by referencing the file code OIG-121-N...

  20. 78 FR 78807 - Solicitation of New Safe Harbors and Special Fraud Alerts

    Science.gov (United States)

    2013-12-27

    ... statute (section 1128B(b) of the Social Security Act), as well as developing new OIG Special Fraud Alerts... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... revised safe harbors and Special Fraud Alerts. Please assist us by referencing the file code OIG-122-N...

  1. Vacuum-Assisted Abdominal Closure Is Safe and Effective

    DEFF Research Database (Denmark)

    Jensen, R O; Buchbjerg, T; Simonsen, R M

    2017-01-01

    less likely to develop large hernias and had better self-evaluated physical health score (p mental health was found. CONCLUSION: The abdominal VAC treatment in patients with abdominal catastrophes is safe and with a relative low complication rate. Whether it might be superior...

  2. Development of safe mechanism for surgical robots using equilibrium point control method.

    Science.gov (United States)

    Park, Shinsuk; Lim, Hokjin; Kim, Byeong-sang; Song, Jae-bok

    2006-01-01

    This paper introduces a novel mechanism for surgical robotic systems to generate human arm-like compliant motion. The mechanism is based on the idea of the equilibrium point control hypothesis which claims that multi-joint limb movements are achieved by shifting the limbs' equilibrium positions defined by neuromuscular activity. The equilibrium point control can be implemented on a robot manipulator by installing two actuators at each joint of the manipulator, one to control the joint position, and the other to control the joint stiffness. This double-actuator mechanism allows us to arbitrarily manipulate the stiffness (or impedance) of a robotic manipulator as well as its position. Also, the force at the end-effector can be estimated based on joint stiffness and joint angle changes without using force transducers. A two-link manipulator and a three-link manipulator with the double-actuator units have been developed, and experiments and simulation results show the potential of the proposed approach. By creating the human arm-like behavior, this mechanism can improve the performance of robot manipulators to execute stable and safe movement in surgical environments by using a simple control scheme.

  3. Developing a stone database for clinical practice.

    Science.gov (United States)

    Turney, Benjamin W; Noble, Jeremy G; Reynard, John M

    2011-09-01

    Our objective was to design an intranet-based database to streamline stone patient management and data collection. The system developers used a rapid development approach that removed the need for laborious and unnecessary documentation, instead focusing on producing a rapid prototype that could then be altered iteratively. By using open source development software and website best practice, the development cost was kept very low in comparison with traditional clinical applications. Information about each patient episode can be entered via a user-friendly interface. The bespoke electronic stone database removes the need for handwritten notes, dictation, and typing. From the database, files may be automatically generated for clinic letters, operation notes. and letters to family doctors. These may be printed or e-mailed from the database. Data may be easily exported for audits, coding, and research. Data collection remains central to medical practice, to improve patient safety, to analyze medical and surgical outcomes, and to evaluate emerging treatments. Establishing prospective data collection is crucial to this process. In the current era, we have the opportunity to embrace available technology to facilitate this process. The database template could be modified for use in other clinics. The database that we have designed helps to provide a modern and efficient clinical stone service.

  4. Low cost technology for the rapid and safe in-house (hospital-based) preparation of dual - radiotherapeutic (Rx) and radiodiagnostic (Dx) - dosage forms of high specific activity 131I-mIBG for clinical application

    International Nuclear Information System (INIS)

    Noronha, O.P.D.; Sonawane, G.A.; Samuel, A.M.

    1998-01-01

    Radioiodinated mIBG is finding increasing utility in nuclear medicine. However, its widespread use in developing countries is precluded by logistic constraints owing to the relative instability of the labelled molecule with respect to time and temp., and high costs. This prompted us to develop a low cost in-house batch process technology that could be used for the small-scale preparation of 131 I-mIBG even in a less equipped hospital-based radiopharmacy. The production of large amounts of 131 I-mIBG for clinical use requires sophisticated infrastructure (a scarce resource) to contain / safeguard against internal and external radiation exposures. We have indigenously designed a semi-automated, self-shielded, remote-controlled and safe microplant + process assemblies using easily accessible and cheap inputs, and developed the complete technology for the rapid and safe production of dual dosage forms of 131 I-mIBG, a radiotherapeutic (R x ) single dosage form of high activity along with 1-3 low activity radiodiagnostics (D x ) as multidosage forms. The radioiodide exchange reaction was effected in the solid / melt phase at 190 deg. C in 1.0 h. The radiolabelling yield was ∼80.0-86.0%, and the radiochemical purity > 99.5% and specific activity of R x /D x =900-1300/60-800 MBq ( x dosage forms at 3 weeks. The dosage forms (especially R x ) were only made against firm patient appointment(s). Thus far we have prepared 14 R x (49.0 GBq) and 70 + 14 batches (43.43 GBq) of (∼150 nos.) D x forms, and used them in 14 and > 1100 patients respectively. (author)

  5. Elementare Bildungseinrichtungen als safe spaces für (religiöse Differenz

    Directory of Open Access Journals (Sweden)

    Helena Stockinger

    2016-12-01

    Full Text Available ENGLISH: Educational institutions sometimes do not offer a space for (religious difference. Based on this fact the term safe space is theoretically specified. It seems important to develop kindergartens as safe spaces in wich learning, belonging and recognizing are possible. As one characteristic of the culture of safe spaces the recognition of (religious difference is pointed out, especially being sensitive about and broaching the issue of difference. DEUTSCH: Bildungseinrichtungen stellen teilweise keinen Artikulationsraum für (religiöse Differenz bereit, wodurch einzelne Kinder organisational benachteiligt werden. Elementare Bildungseinrichtungen könnten aber Räume sein, in denen Lernen, Zugehörigkeit und Anerkennung möglich sind. Hierzu wird der Begriff des safe space beleuchtet und auf elementare Bildungseinrichtungen übertragen. Als ein Merkmal der Kultur der safe spaces gilt die Anerkennung der (religiösen Differenz, indem diese sensibel wahrgenommen und thematisiert wird.

  6. Manpower development for safe operation of nuclear power plant. China. Emergency operating procedures. Activity: 5.1.4-Task-11. Technical report

    International Nuclear Information System (INIS)

    Walsh, L.A.

    1994-01-01

    This report covers the period of engagement from July 11, 1994 through July 22, 1994. The events and topics of discussion are as follows: History of Emergency Operating Procedure EOP Development; Emergency Operating Procedures (Event Based, Critical Safe Function Status Trees and Functional Recovery Response Procedures); Transition from Emergency Operating Procedures to Severe Accident Management Guidelines

  7. Safety Analysis For Evaluating (SAFE) sUAS, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA's Unmanned Aircraft Systems Integration in the NAS (UAS in the NAS) project is aimed at developing new technologies to enable safe operations of UAS in the NAS....

  8. Safe practices and financial considerations in using oral chemotherapeutic agents.

    Science.gov (United States)

    Bartel, Sylvia B

    2007-05-01

    Safe handling practices and financial concerns associated with oral chemotherapy in non-traditional settings are discussed. Oral chemotherapy may pose a risk to patients because of a narrow therapeutic index, complex dosing regimen, dispensing by community pharmacists without prescription order review by an oncology pharmacist or nurse, or self-administration in the home or another nontraditional setting, where patient monitoring is infrequent. Errors in prescribing, dispensing, and administration and patient or caregiver misunderstandings are potential problems with the use of oral chemotherapy that need to be addressed when developing safe practices. Changes in Medicare pharmaceutical reimbursement rates and rules need to be monitored because they have the potential to affect patient care and outcomes. Patient assistance programs and advocacy groups can help alleviate financial concerns associated with oral chemotherapy. Consensus guidelines specific to safe handling of oral chemotherapy in the home or other nontraditional setting need to be developed. Also, healthcare providers must understand reimbursement and provide direction to patients when patient assistance programs or advocacy groups can assist with the financial challenges of oral chemotherapy.

  9. Safeguards Automated Facility Evaluation (SAFE) methodology

    International Nuclear Information System (INIS)

    Chapman, L.D.; Grady, L.M.; Bennett, H.A.; Sasser, D.W.; Engi, D.

    1978-08-01

    An automated approach to facility safeguards effectiveness evaluation has been developed. This automated process, called Safeguards Automated Facility Evaluation (SAFE), consists of a collection of a continuous stream of operational modules for facility characterization, the selection of critical paths, and the evaluation of safeguards effectiveness along these paths. The technique has been implemented on an interactive computer time-sharing system and makes use of computer graphics for the processing and presentation of information. Using this technique, a comprehensive evaluation of a safeguards system can be provided by systematically varying the parameters that characterize the physical protection components of a facility to reflect the perceived adversary attributes and strategy, environmental conditions, and site operational conditions. The SAFE procedure has broad applications in the nuclear facility safeguards field as well as in the security field in general. Any fixed facility containing valuable materials or components to be protected from theft or sabotage could be analyzed using this same automated evaluation technique

  10. Is irradiation of food stuffs safe?

    International Nuclear Information System (INIS)

    Maheshwari, Raaz K.; Yadav, Rajesh K.

    2014-01-01

    Many advanced and several developing countries have abundant supplies of fresh, safe and nutritious food stuffs. Yet, despite the many precautions and processes in place to ensure safe food supply, microbial contamination is still a concern. There are a number of food processing tools available that provide additional protection for the food we consume. One very promising tool is food irradiation, which is a process of imparting ionizing energy to food to kill microorganisms. Food irradiation is the process of exposing food to a controlled source of ionising radiation for the purposes of reduction of microbial Ioad, destruction of pathogens, extension of product shelf life, and/or disinfection of produce. The term irradiation often evokes fears of nuclear radioactivity and cancer among consumers. The process seems frightening because it is powerful and invisible. Consequently questions and concerns exist particularly about the safety or wholesomeness of irradiated food. The paper highlights food irradiation as a food safety measure and the issues of concerns for consumers. (author)

  11. Conducting clinical trials in Singapore.

    Science.gov (United States)

    Woo, K T

    1999-04-01

    All clinical trials in Singapore will now have to conform to the Medicines (Clinical Trials) Amended Regulations 1998 and the Singapore Good Clinical Practice (GCP) Guidelines 1998. The Medical Clinical Research Committee (MCRC) has been established to oversee the conduct of clinical drug trials in Singapore and together with the legislations in place, these will ensure that clinical trials conducted in Singapore are properly controlled and the well-being of trial subjects are safe guarded. All clinical drug trials require a Clinical Trial Certificate from the MCRC before the trial can proceed. The hospital ethics committee (EC) vets the application for a trial certificate before it is sent to MCRC. The drug company sponsoring the trial has to indemnify the trial investigators and the hospital for negligence arising from the trial. The MCRC, apart from ensuring the safety of trial subjects, has to provide continuing review of the clinical trial and monitors adverse events in the course of the trial. The EC will conduct continuing review of clinical trials. When a non-drug clinical trial is carried out, the EC will ensure that the proposed protocol addresses ethical concerns and meets regulatory requirements for such trials. There is great potential for pharmaceutical Research & Development (R&D) in Singapore. We must develop our skills and infrastructure in clinical trials to enable Singapore to be a regional hub for R&D of drugs in Asia.

  12. Safe Minimum Internal Temperature Chart

    Science.gov (United States)

    ... Internal Temperature Chart Safe steps in food handling, cooking, and storage are essential in preventing foodborne illness. You can't see, smell, or taste harmful bacteria that may cause illness. In every step of food preparation, follow the four guidelines to keep food safe: ...

  13. C-SAFE: A Computer-Delivered Sexual Health Promotion Program for Latinas.

    Science.gov (United States)

    Klein, Charles H; Kuhn, Tamara; Altamirano, Midori; Lomonaco, Carmela

    2017-07-01

    This article describes the development and evaluation of C-SAFE (Sexual Awareness for Everyone), a computer-delivered sexual health promotion program for Latinas. We first describe the process of adapting an evidence-based, group-level intervention into an individually administered computer-delivered program. We then present the methods and results of a randomized control trial with 321 Latinas in California and Florida to test C-SAFE's preliminary efficacy in reducing sexual health risk. We found no statistically significant differences between the two conditions at a six-month follow-up in terms of sexual behaviors or attitudes toward sexually transmitted infections and condoms, although C-SAFE women reported fewer days in the past month when their mental health was not good (p = .02). C-SAFE condition women also reported more satisfaction than control condition women in their assessment of information presentation (on a scale of 1 = poor and 5 = excellent; C-SAFE = 4.45 vs. control = 4.25, p = .053) and having learned something new (C-SAFE = 95.1% vs. control = 79.3%, χ 2 importance of teachable moments, matching of delivery modalities to implementation contexts, and possible directions for evidence-based sexual health promotion programs given the current sexual health landscape.

  14. Integrated vehicle's lateral safety: the LATERAL SAFE experience

    NARCIS (Netherlands)

    Amditis, A.; Floudas, N.; Kaiser-Dieckhoff, U.; Hackbarth, T.; Broek, S.P. van den; Miglietta, M.; Danielson, L.; Gemou, M.; Bekiaris, E.

    2008-01-01

    The applications developed and the evaluation results of the EU funded automotive safety PReVENT IP subproject LATERAL SAFE are described. The data synthesis algorithms that aim at achieving a reliable representation of the objects and their kinematics, in the lateral and rear fields of the host

  15. Safe prescribing: a titanic challenge

    Science.gov (United States)

    Routledge, Philip A

    2012-01-01

    The challenge to achieve safe prescribing merits the adjective ‘titanic’. The organisational and human errors leading to poor prescribing (e.g. underprescribing, overprescribing, misprescribing or medication errors) have parallels in the organisational and human errors that led to the loss of the Titanic 100 years ago this year. Prescribing can be adversely affected by communication failures, critical conditions, complacency, corner cutting, callowness and a lack of courage of conviction, all of which were also factors leading to the Titanic tragedy. These issues need to be addressed by a commitment to excellence, the final component of the ‘Seven C's’. Optimal prescribing is dependent upon close communication and collaborative working between highly trained health professionals, whose role is to ensure maximum clinical effectiveness, whilst also protecting their patients from avoidable harm. Since humans are prone to error, and the environments in which they work are imperfect, it is not surprising that medication errors are common, occurring more often during the prescribing stage than during dispensing or administration. A commitment to excellence in prescribing includes a continued focus on lifelong learning (including interprofessional learning) in pharmacology and therapeutics. This should be accompanied by improvements in the clinical working environment of prescribers, and the encouragement of a strong safety culture (including reporting of adverse incidents as well as suspected adverse drug reactions whenever appropriate). Finally, members of the clinical team must be prepared to challenge each other, when necessary, to ensure that prescribing combines the highest likelihood of benefit with the lowest potential for harm. PMID:22738396

  16. EHDViz: clinical dashboard development using open-source technologies.

    Science.gov (United States)

    Badgeley, Marcus A; Shameer, Khader; Glicksberg, Benjamin S; Tomlinson, Max S; Levin, Matthew A; McCormick, Patrick J; Kasarskis, Andrew; Reich, David L; Dudley, Joel T

    2016-03-24

    To design, develop and prototype clinical dashboards to integrate high-frequency health and wellness data streams using interactive and real-time data visualisation and analytics modalities. We developed a clinical dashboard development framework called electronic healthcare data visualization (EHDViz) toolkit for generating web-based, real-time clinical dashboards for visualising heterogeneous biomedical, healthcare and wellness data. The EHDViz is an extensible toolkit that uses R packages for data management, normalisation and producing high-quality visualisations over the web using R/Shiny web server architecture. We have developed use cases to illustrate utility of EHDViz in different scenarios of clinical and wellness setting as a visualisation aid for improving healthcare delivery. Using EHDViz, we prototyped clinical dashboards to demonstrate the contextual versatility of EHDViz toolkit. An outpatient cohort was used to visualise population health management tasks (n=14,221), and an inpatient cohort was used to visualise real-time acuity risk in a clinical unit (n=445), and a quantified-self example using wellness data from a fitness activity monitor worn by a single individual was also discussed (n-of-1). The back-end system retrieves relevant data from data source, populates the main panel of the application and integrates user-defined data features in real-time and renders output using modern web browsers. The visualisation elements can be customised using health features, disease names, procedure names or medical codes to populate the visualisations. The source code of EHDViz and various prototypes developed using EHDViz are available in the public domain at http://ehdviz.dudleylab.org. Collaborative data visualisations, wellness trend predictions, risk estimation, proactive acuity status monitoring and knowledge of complex disease indicators are essential components of implementing data-driven precision medicine. As an open-source visualisation

  17. [Overview of the Ebola vaccines in pre-clinical and clinical development].

    Science.gov (United States)

    Buchy, P

    2016-10-01

    The Ebola epidemic that occurred in West Africa between 2013-2016 significantly accelerated the research and development of Ebola vaccines. Few dozens of clinical trials have been recently conducted leading to opportunities to test several new vaccine candidates. Other vaccines are still in early development phases (table 1). This paper provides an overview of the new developments in that area.

  18. Clinical Trials

    Medline Plus

    Full Text Available ... safe a treatment is or how well it works. Children (aged 18 and younger) get special protection as research subjects. Almost always, parents must give legal consent for their child to take part in a clinical trial. When ...

  19. Safe affordable fission engine (SAFE 30) module conductivity test thermal model correlation

    International Nuclear Information System (INIS)

    Roman, Jose

    2001-01-01

    The SAFE 30 is a simple, robust space fission power system that is comprised of several independent modules. Each module contains 4 fuel tubes bonded to a central heatpipe. Fission energy is conducted from the fuel tubes to the heatpipe, which in turn transfers the energy to a power conversion system. This paper benchmarks a thermal model of the SAFE 30 with actual test data from simulated SAFE 30 module tests. Two 'dummy' SAFE 30 modules were fabricated - each consisted of 4 1-inch dia. tubes (simulating the fuel tubes) bonded to a central '1' dia. tube (simulating the heatpipe). In the first module the fuel tubes were simply brazed to the heatpipe along the line of contact (leaving void space in the interstices), and in the second module the tubes and heatpipe were brazed via tri-cusps that completely fill the interstices between the tubes. In these tests, fission energy is simulated by placing resistance heaters within each of the 4 fuel tubes. The tests were conducted in a vacuum chamber in 4 configurations: tri-cusps filled with and without an outer insulation wrap, and no tri-cusps with and without an outer insulation wrap. The baseline SAFE 30 configuration uses the brazed tri-cusps. During the tests, the power applied to the heaters was varied in a stepwise fashion, until a steady-state temperature profile was reached. These temperature levels varied between 773 K and 1073 K. To benchmark the thermal model, the input energy and chamber surface temperature were used as boundary conditions for the model. The analytical results from the nodes at the same location as the test thermocouples were plotted again test data to determinate the accuracy of the analysis. The unknown variables on the analysis are the radiation emissivity of the pipe and chamber and the radiation view factor between the module and the chamber. A correlation was determined using a parametric analysis by varying the surface emissivity and view factor until a good match was reached. This

  20. Clinical Research Careers: Reports from a NHLBI Pediatric Heart Network Clinical Research Skills Development Conference

    Science.gov (United States)

    Lai, Wyman W.; Richmond, Marc; Li, Jennifer S.; Saul, J. Philip; Mital, Seema; Colan, Steven D.; Newburger, Jane W.; Sleeper, Lynn A.; McCrindle, Brain W.; Minich, L. LuAnn; Goldmuntz, Elizabeth; Marino, Bradley S.; Williams, Ismee A.; Pearson, Gail D.; Evans, Frank; Scott, Jane D.; Cohen, Meryl S.

    2013-01-01

    Background Wyman W. Lai, MD, MPH, and Victoria L. Vetter, MD, MPH. The Pediatric Heart Network (PHN), funded under the U.S. National Institutes of Health-National Heart, Lung, and Blood Institute (NIH–NHLBI), includes two Clinical Research Skills Development (CRSD) Cores, which were awarded to The Children's Hospital of Philadelphia and to the Morgan Stanley Children's Hospital of New York–Presbyterian. To provide information on how to develop a clinical research career to a larger number of potential young investigators in pediatric cardiology, the directors of these two CRSD Cores jointly organized a one-day seminar for fellows and junior faculty from all of the PHN Core sites. The participants included faculty members from the PHN and the NHLBI. The day-long seminar was held on April 29, 2009, at the NHLBI site, immediately preceding the PHN Steering Committee meeting in Bethesda, MD. Methods The goals of the seminar were 1) to provide fellows and early investigators with basic skills in clinical research 2) to provide a forum for discussion of important research career choices 3) to introduce attendees to each other and to established clinical researchers in pediatric cardiology, and 4) to publish a commentary on the future of clinical research in pediatric cardiology. Results The following chapters are compilations of the talks given at the 2009 PHN Clinical Research Skills Development Seminar, published to share the information provided with a broader audience of those interested in learning how to develop a clinical research career in pediatric cardiology. The discussions of types of clinical research, research skills, career development strategies, funding, and career management are applicable to research careers in other areas of clinical medicine as well. Conclusions The aim of this compilation is to stimulate those who might be interested in the research career options available to investigators. PMID:21167335

  1. Staying Safe in the Water

    Centers for Disease Control (CDC) Podcasts

    In this podcast, Dr. Julie Gilchrist, a pediatrician and medical epidemiologist from CDC’s Injury Center, talks about staying safe in the water. Tips are for all audiences, with a focus on preventing drownings and keeping children safe in and around the pool, lake, or ocean.

  2. Two-phase anaerobic digestion of partially acidified sewage sludge: a pilot plant study for safe sludge disposal in developing countries.

    Science.gov (United States)

    Passio, Luca; Rizzoa, Luigi; Fuchs, Stephan

    2012-09-01

    The unsafe disposal of wastewater and sludge in different areas of developing countries results in significant environmental pollution, particularly for groundwater, thus increasing the risk of waterborne diseases spreading. In this work, a two-phase anaerobic digestion process for post-treatment of partially acidified sewage sludge was investigated to evaluate its feasibility as a safe sludge disposal system. Pilot tests showed that an effective sludge stabilization can be achieved (total volatile solids content <65%, organic acid concentration <200 mg/L at flow rate = 50 L/d and hydraulic residence time = 18 d) as well as a relative low faecal coliform density (<1000 most probable number per g total solids), showing that land application of the sludge without restrictions is possible according to US Environmental Protection Agency criteria for safe sludge disposal. A biogas production as high as 390 L/d with a 60% methane content by volume was achieved, showing that energy production from biogas may be achieved as well.

  3. Choosing and Using Safe Water Technologies: Evidence from a Field Experiment in Kenya

    OpenAIRE

    Luoto, Jill Emily

    2010-01-01

    This dissertation examines the decision-making of poor rural Kenyan households with respect to the adoption of point-of-use (POU) safe water technologies designed to expand access to safe drinking water in the developing world. Low-cost POU products such as chlorine and filters substantially reduce diarrhea, which kills two million children in poor countries each year. Nevertheless, POU products remain little used in many parts of the developing world, even when they are widely available at s...

  4. Safe biodegradable fluorescent particles

    Science.gov (United States)

    Martin, Sue I [Berkeley, CA; Fergenson, David P [Alamo, CA; Srivastava, Abneesh [Santa Clara, CA; Bogan, Michael J [Dublin, CA; Riot, Vincent J [Oakland, CA; Frank, Matthias [Oakland, CA

    2010-08-24

    A human-safe fluorescence particle that can be used for fluorescence detection instruments or act as a safe simulant for mimicking the fluorescence properties of microorganisms. The particle comprises a non-biological carrier and natural fluorophores encapsulated in the non-biological carrier. By doping biodegradable-polymer drug delivery microspheres with natural or synthetic fluorophores, the desired fluorescence can be attained or biological organisms can be simulated without the associated risks and logistical difficulties of live microorganisms.

  5. Collaborative translational research leading to multicenter clinical trials in Duchenne muscular dystrophy: the Cooperative International Neuromuscular Research Group (CINRG).

    Science.gov (United States)

    Escolar, Diana M; Henricson, Erik K; Pasquali, Livia; Gorni, Ksenija; Hoffman, Eric P

    2002-10-01

    Progress in the development of rationally based therapies for Duchenne muscular dystrophy has been accelerated by encouraging multidisciplinary, multi-institutional collaboration between basic science and clinical investigators in the Cooperative International Research Group. We combined existing research efforts in pathophysiology by a gene expression profiling laboratory with the efforts of animal facilities capable of conducting high-throughput drug screening and toxicity testing to identify safe and effective drug compounds that target different parts of the pathophysiologic cascade in a genome-wide drug discovery approach. Simultaneously, we developed a clinical trial coordinating center and an international network of collaborating physicians and clinics where those drugs could be tested in large-scale clinical trials. We hope that by bringing together investigators at these facilities and providing the infrastructure to support their research, we can rapidly move new bench discoveries through animal model screening and into therapeutic testing in humans in a safe, timely and cost-effective setting.

  6. Safe Haven.

    Science.gov (United States)

    Bush, Gail

    2003-01-01

    Discusses school libraries as safe havens for teenagers and considers elements that foster that atmosphere, including the physical environment, lack of judgments, familiarity, leisure, and a welcoming nature. Focuses on the importance of relationships, and taking the time to listen to teens and encourage them. (LRW)

  7. Teaching clinical reasoning and decision-making skills to nursing students: Design, development, and usability evaluation of a serious game.

    Science.gov (United States)

    Johnsen, Hege Mari; Fossum, Mariann; Vivekananda-Schmidt, Pirashanthie; Fruhling, Ann; Slettebø, Åshild

    2016-10-01

    Serious games (SGs) are a type of simulation technology that may provide nursing students with the opportunity to practice their clinical reasoning and decision-making skills in a safe and authentic environment. Despite the growing number of SGs developed for healthcare professionals, few SGs are video based or address the domain of home health care. This paper aims to describe the design, development, and usability evaluation of a video based SG for teaching clinical reasoning and decision-making skills to nursing students who care for patients with chronic obstructive pulmonary disease (COPD) in home healthcare settings. A prototype SG was developed. A unified framework of usability called TURF (Task, User, Representation, and Function) and SG theory were employed to ensure a user-centered design. The educational content was based on the clinical decision-making model, Bloom's taxonomy, and a Bachelor of Nursing curriculum. A purposeful sample of six participants evaluated the SG prototype in a usability laboratory. Cognitive walkthrough evaluations, a questionnaire, and individual interviews were used for the usability evaluation. The data were analyzed using qualitative deductive content analysis based on the TURF framework elements and related usability heuristics. The SG was perceived as being realistic, clinically relevant, and at an adequate level of complexity for the intended users. Usability issues regarding functionality and the user-computer interface design were identified. However, the SG was perceived as being easy to learn, and participants suggested that the SG could serve as a supplement to traditional training in laboratory and clinical settings. Using video based scenarios with an authentic COPD patient and a home healthcare registered nurse as actors contributed to increased realism. Using different theoretical approaches in the SG design was considered an advantage of the design process. The SG was perceived as being useful, usable, and

  8. Organising a safe space for navigating social-ecological transformations to sustainability.

    Science.gov (United States)

    Pereira, Laura; Karpouzoglou, Timothy; Doshi, Samir; Frantzeskaki, Niki

    2015-05-28

    The need for developing socially just living conditions for the world's growing population whilst keeping human societies within a 'safe operating space' has become a modern imperative. This requires transformative changes in the dominant social norms, behaviours, governance and management regimes that guide human responses in areas such as urban ecology, public health, resource security (e.g., food, water, energy access), economic development and biodiversity conservation. However, such systemic transformations necessitate experimentation in public arenas of exchange and a deepening of processes that can widen multi-stakeholder learning. We argue that there is an emergent potential in bridging the sustainability transitions and resilience approaches to create new scientific capacity that can support large-scale social-ecological transformations (SETs) to sustainability globally, not just in the West. In this article, we elucidate a set of guiding principles for the design of a 'safe space' to encourage stronger interactions between these research areas and others that are relevant to the challenges faced. We envisage new opportunities for transdisciplinary collaboration that will develop an adaptive and evolving community of practice. In particular, we emphasise the great opportunity for engaging with the role of emerging economies in facilitating safe space experimentation.

  9. The development of an observational screening tool to assess safe, effective and appropriate walking aid use in people with multiple sclerosis.

    Science.gov (United States)

    Eitzen, Abby; Finlayson, Marcia; Carolan-Laing, Leanne; Nacionales, Arthur Junn; Walker, Christie; O'Connor, Josephine; Asano, Miho; Coote, Susan

    2017-08-01

    The purpose of this study was to identify potential items for an observational screening tool to assess safe, effective and appropriate walking aid use among people with multiple sclerosis (MS). Such a tool is needed because of the association between fall risk and mobility aid use in this population. Four individuals with MS were videotaped using a one or two straight canes, crutches or a rollator in different settings. Seventeen health care professionals from Canada, Ireland and the United States were recruited, and viewed the videos, and were then interviewed about the use of the devices by the individuals in the videos. Interview questions addressed safety, effectiveness and appropriateness of the device in the setting. Data were analyzed qualitatively. Coding consistency across raters was evaluated and confirmed. Nineteen codes were identified as possible items for the screening tool. The most frequent issues raised regardless of setting and device were "device used for duration/abandoned", "appropriate device", "balance and stability", "device technique", "environmental modification" and "hands free." With the identification of a number of potential tool items, researchers can now move forward with the development of the tool. This will involve consultation with both healthcare professionals and people with MS. Implications for rehabilitation Falls among people with multiple sclerosis are associated with mobility device use and use of multiple devices is associated with greater falls risk. The ability to assess for safe, effective and efficient use of walking aids is therefore important, no tools currently exist for this purpose. The codes arising from this study will be used to develop a screening tool for safe, effective and efficient walking aid use with the aim of reducing falls risk.

  10. Zambia Communications Support for Health Safe Love Campaign Outcome Evaluation

    Data.gov (United States)

    US Agency for International Development — The Safe Love campaign was a three-year comprehensive HIV prevention behavior change and communication (BCC) initiative implemented between June 2011 and June 2014....

  11. Development of clinical practice guidelines.

    Science.gov (United States)

    Hollon, Steven D; Areán, Patricia A; Craske, Michelle G; Crawford, Kermit A; Kivlahan, Daniel R; Magnavita, Jeffrey J; Ollendick, Thomas H; Sexton, Thomas L; Spring, Bonnie; Bufka, Lynn F; Galper, Daniel I; Kurtzman, Howard

    2014-01-01

    Clinical practice guidelines (CPGs) are intended to improve mental, behavioral, and physical health by promoting clinical practices that are based on the best available evidence. The American Psychological Association (APA) is committed to generating patient-focused CPGs that are scientifically sound, clinically useful, and informative for psychologists, other health professionals, training programs, policy makers, and the public. The Institute of Medicine (IOM) 2011 standards for generating CPGs represent current best practices in the field. These standards involve multidisciplinary guideline development panels charged with generating recommendations based on comprehensive systematic reviews of the evidence. The IOM standards will guide the APA as it generates CPGs that can be used to inform the general public and the practice community regarding the benefits and harms of various treatment options. CPG recommendations are advisory rather than compulsory. When used appropriately, high-quality guidelines can facilitate shared decision making and identify gaps in knowledge.

  12. Developments in statistical evaluation of clinical trials

    CERN Document Server

    Oud, Johan; Ghidey, Wendimagegn

    2014-01-01

    This book describes various ways of approaching and interpreting the data produced by clinical trial studies, with a special emphasis on the essential role that biostatistics plays in clinical trials. Over the past few decades the role of statistics in the evaluation and interpretation of clinical data has become of paramount importance. As a result the standards of clinical study design, conduct and interpretation have undergone substantial improvement. The book includes 18 carefully reviewed chapters on recent developments in clinical trials and their statistical evaluation, with each chapter providing one or more examples involving typical data sets, enabling readers to apply the proposed procedures. The chapters employ a uniform style to enhance comparability between the approaches.

  13. More than a Safe Space

    Science.gov (United States)

    Sadowski, Michael

    2016-01-01

    Over the past three decades, much of the conversation about LGBTQ students in schools has centered on safety--anti-bullying policies, the "safe space" of gay-straight alliances, and "safe zones" marked by rainbow-colored stickers on classroom doors. In this article, Michael Sadowski argues that it's time to move beyond safety…

  14. Safe Handover : Safe Patients - The Electronic Handover System.

    Science.gov (United States)

    Till, Alex; Sall, Hanish; Wilkinson, Jonathan

    2014-01-01

    Failure of effective handover is a major preventable cause of patient harm. We aimed to promote accurate recording of high-quality clinical information using an Electronic Handover System (EHS) that would contribute to a sustainable improvement in effective patient care and safety. Within our hospital the human factors associated with poor communication were compromising patient care and unnecessarily increasing the workload of staff due to the poor quality of handovers. Only half of handovers were understood by the doctors expected to complete them, and more than half of our medical staff felt it posed a risk to patient safety. We created a standardised proforma for handovers that contained specific sub-headings, re-classified patient risk assessments, and aided escalation of care by adding prompts for verbal handover. Sources of miscommunication were removed, accountability for handovers provided, and tasks were re-organised to reduce the workload of staff. Long-term, three-month data showed that each sub-heading achieved at least 80% compliance (an average improvement of approximately 40% for the overall quality of handovers). This translated into 91% of handovers being subjectively clear to junior doctors. 87% of medical staff felt we had reduced a risk to patient safety and 80% felt it increased continuity of care. Without guidance, doctors omit key information required for effective handover. All organisations should consider implementing an electronic handover system as a viable, sustainable and safe solution to handover of care that allows patient safety to remain at the heart of the NHS.

  15. Safe injection procedures, injection practices, and needlestick ...

    African Journals Online (AJOL)

    Results: Safe injection procedures regarding final waste disposal were sufficiently adopted, while measures regarding disposable injection equipment, waste containers, hand hygiene, as well as injection practices were inadequately carried out. Lack of job aid posters that promote safe injection and safe disposal of ...

  16. Strategies for safe motherhood.

    Science.gov (United States)

    Chatterjee, A

    1995-02-01

    The Safe Motherhood Initiative was launched in 1988 as a global effort to halve maternal mortality and morbidity by the year 2000. The program uses a combination of health and nonhealth strategies to emphasize the need for maternal health services, extend family planning services, and improve the status of women. The maternal mortality rate (per 100,000 live births) is 390 for the world, 20-30 for developed countries, 450 for developing countries, and 420 for Asia. This translates into 308,000 maternal deaths in Asia, of which 100,000 occur in India. The direct causes of maternal mortality include sepsis, hemorrhage, eclampsia, and ruptured uterus. Indirect causes occur when associated medical conditions, such as anemia and jaundice, are exacerbated by pregnancy. Underlying causes are ineffective health services, inadequate obstetric care, unregulated fertility, infections, illiteracy, early marriage, poverty, malnutrition, and ignorance. India's Child Survival and Safe Motherhood Program seeks to achieve immediate improvements by improving health care. Longterm improvements will occur as nutrition, income, education, and the status of women improve. Improvements in health care will occur in through the provision of 1) essential obstetric care for all women (which will be essentially designed for low-risk women), 2) early detection of complications during pregnancy and labor, and 3) emergency services. Services will be provided to pregnant women at their door by field staff, at a first referral hospital, perhaps at maternity villages where high risk cases can be housed in the latter part of their pregnancies, and through the continual accessibility of government vehicles. In addition, family planning services will be improved so that fertility regulation can have its expected beneficial effect on the maternal mortality rate. The professional health organizations in India will also play a vital role in the success of this effort to reduce maternal mortality.

  17. Clinical Inquiry: Is megestrol acetate safe and effective for malnourished nursing home residents?

    Science.gov (United States)

    Wen, Frances K; Millar, James; Oberst-Walsh, Linda; Nashelsky, Joan

    2018-02-01

    No. Megestrol acetate (MA) is neither safe nor effective for stimulating appetite in malnourished nursing home residents. It increases the risk of deep vein thrombosis (strength of recommendation [SOR]: C, 2 retrospective chart reviews), but isn't associated with other new or worsening events or disorders (SOR: B, single randomized controlled trial [RCT]). Over a 25-week period, MA wasn't associated with increased mortality (SOR: B, single RCT). After 44 months, however, MA-treated patients showed decreased median survival (SOR: B, single case-control study). Consistent, meaningful weight gain was not observed with MA treatment (SOR: B, single case-control study, single RCT, 2 retrospective chart reviews, single prospective case-series).

  18. How to Develop a Cardio-Oncology Clinic.

    Science.gov (United States)

    Snipelisky, David; Park, Jae Yoon; Lerman, Amir; Mulvagh, Sharon; Lin, Grace; Pereira, Naveen; Rodriguez-Porcel, Martin; Villarraga, Hector R; Herrmann, Joerg

    2017-04-01

    Cardiovascular demands to the care of cancer patients are common and important given the implications for morbidity and mortality. As a consequence, interactions with cardiovascular disease specialists have intensified to the point of the development of a new discipline termed cardio-oncology. As an additional consequence, so-called cardio-oncology clinics have emerged, in most cases staffed by cardiologists with an interest in the field. This article addresses this gap and summarizes key points in the development of a cardio-oncology clinic. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Safe semi-supervised learning based on weighted likelihood.

    Science.gov (United States)

    Kawakita, Masanori; Takeuchi, Jun'ichi

    2014-05-01

    We are interested in developing a safe semi-supervised learning that works in any situation. Semi-supervised learning postulates that n(') unlabeled data are available in addition to n labeled data. However, almost all of the previous semi-supervised methods require additional assumptions (not only unlabeled data) to make improvements on supervised learning. If such assumptions are not met, then the methods possibly perform worse than supervised learning. Sokolovska, Cappé, and Yvon (2008) proposed a semi-supervised method based on a weighted likelihood approach. They proved that this method asymptotically never performs worse than supervised learning (i.e., it is safe) without any assumption. Their method is attractive because it is easy to implement and is potentially general. Moreover, it is deeply related to a certain statistical paradox. However, the method of Sokolovska et al. (2008) assumes a very limited situation, i.e., classification, discrete covariates, n(')→∞ and a maximum likelihood estimator. In this paper, we extend their method by modifying the weight. We prove that our proposal is safe in a significantly wide range of situations as long as n≤n('). Further, we give a geometrical interpretation of the proof of safety through the relationship with the above-mentioned statistical paradox. Finally, we show that the above proposal is asymptotically safe even when n(')

  20. Managing Cassini Safe Mode Attitude at Saturn

    Science.gov (United States)

    Burk, Thomas A.

    2010-01-01

    The Cassini spacecraft was launched on October 15, 1997 and arrived at Saturn on June 30, 2004. It has performed detailed observations and remote sensing of Saturn, its rings, and its satellites since that time. In the event safe mode interrupts normal orbital operations, Cassini has flight software fault protection algorithms to detect, isolate, and recover to a thermally safe and commandable attitude and then wait for further instructions from the ground. But the Saturn environment is complex, and safety hazards change depending on where Cassini is in its orbital trajectory around Saturn. Selecting an appropriate safe mode attitude that insures safe operation in the Saturn environment, including keeping the star tracker field of view clear of bright bodies, while maintaining a quiescent, commandable attitude, is a significant challenge. This paper discusses the Cassini safe table management strategy and the key criteria that must be considered, especially during low altitude flybys of Titan, in deciding what spacecraft attitude should be used in the event of safe mode.

  1. HRS Clinical Document Development Methodology Manual and Policies: Executive summary.

    Science.gov (United States)

    Indik, Julia H; Patton, Kristen K; Beardsall, Marianne; Chen-Scarabelli, Carol A; Cohen, Mitchell I; Dickfeld, Timm-Michael L; Haines, David E; Helm, Robert H; Krishnan, Kousik; Nielsen, Jens Cosedis; Rickard, John; Sapp, John L; Chung, Mina

    2017-10-01

    The Heart Rhythm Society (HRS) has been developing clinical practice documents in collaboration and partnership with other professional medical societies since 1996. The HRS formed a Scientific and Clinical Documents Committee (SCDC) with the sole purpose of managing the development of these documents from conception through publication. The SCDC oversees the process for developing clinical practice documents, with input and approval from the HRS Executive Committee and the Board of Trustees. As of May 2017, the HRS has produced more than 80 publications with other professional organizations. This process manual is produced to publicly and transparently declare the standards by which the HRS develops clinical practice documents, which include clinical practice guidelines, expert consensus statements, scientific statements, clinical competency statements, task force policy statements, and proceedings statements. The foundation for this process is informed by the Institute of Medicine's standards for developing trustworthy clinical practice guidelines; the new criteria from the National Guidelines Clearinghouse, effective June 2014; SCDC member discussions; and a review of guideline policies and methodologies used by other professional organizations. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  2. Determination of a safe INR for joint injections in patients taking warfarin.

    Science.gov (United States)

    Bashir, M A; Ray, R; Sarda, P; Li, S; Corbett, S

    2015-11-01

    With an increase in life expectancy in 'developed' countries, the number of elderly patients receiving joint injections for arthritis is increasing. There are legitimate concerns about an increased risk of thromboembolism if anticoagulation is stopped or reversed for such an injection. Despite being a common dilemma, the literature on this issue is scarce. We undertook 2,084 joint injections of the knee and shoulder in 1,714 patients between August 2008 and December 2013. Within this cohort, we noted 41 patients who were taking warfarin and followed them immediately after joint injection in the clinic or radiology department, looking carefully for complications. Then, we sought clinical follow-up, correspondence, and imaging evidence for 4 weeks, looking for complications from these joint injections. We recorded International Normalised Ratio (INR) values before injection. No complications were associated with the procedure after any joint injection. The radiologists who undertook ultrasound-guided injections to shoulders re-scanned the joints looking for haemarthroses: they found none. A similar outcome was noted clinically after injections in the outpatient setting. With a mean INR of 2.77 (range, 1.7-5.5) and a maximum INR within this group of 5.5, joint injections to the shoulder and knee can be undertaken safely in primary or secondary care settings despite the patient taking warfarin.

  3. Detection of some safe plant-derived foods for LTP-allergic patients.

    Science.gov (United States)

    Asero, Riccardo; Mistrello, Gianni; Roncarolo, Daniela; Amato, Stefano

    2007-01-01

    Lipid transfer protein (LTP) is a widely cross-reacting plant pan-allergen. Adverse reactions to Rosaceae, tree nuts, peanut, beer, maize, mustard, asparagus, grapes, mulberry, cabbage, dates, orange, fig, kiwi, lupine, fennel, celery, tomato, eggplant, lettuce, chestnut and pineapple have been recorded. To detect vegetable foods to be regarded as safe for LTP-allergic patients. Tolerance/intolerance to a large spectrum of vegetable foods other than Rosaceae, tree nuts and peanut was assessed by interview in 49 subjects monosensitized to LTP and in three distinct groups of controls monosensitized to Bet v 1 (n = 24) or Bet v 2 (n = 18), or sensitized to both LTP and birch pollen (n = 16), all with a history of vegetable food allergy. Patients and controls underwent skin prick test (SPT) with a large spectrum of vegetable foods. The absence of IgE reactivity to foods that were negative in both clinical history and SPT was confirmed by immunoblot analysis and their clinical tolerance was finally assessed by open oral challenge (50 g per food). All patients reported tolerance and showed negative SPT to carrot, potato, banana and melon; these foods scored positive in SPT and elicited clinical symptoms in a significant proportion of patients from all three control groups. All patients tolerated these four foods on oral challenge. Immunoblot analysis confirmed the lack of IgE reactivity to these foods by LTP-allergic patients. Carrot, potato, banana and melon seem safe for LTP-allergic patients. This finding may be helpful for a better management of allergy to LTP.

  4. Inherently safe light water reactors

    International Nuclear Information System (INIS)

    Ise, Takeharu

    1987-01-01

    Today's large nuclear power reactors of world-wise use have been designed based on the philosophy. It seems that recent less electricity demand rates, higher capital cost and the TMI accident let us acknowledge relative small and simplified nuclear plants with safer features, and that Chernobyl accident in 1983 underlines the needs of intrinsic and passive safety characteristics. In such background, several inherently safe reactor concepts have been presented abroad and domestically. First describing 'Can inherently safe reactors be designed,' then I introduce representative reactor concepts of inherently safe LWRs advocated abroad so far. All of these innovative reactors employ intrinsic and passive features in their design, as follows: (1) PIUS, an acronym for Process Inherent Ultimate Safety, or an integral PWR with passive heat sink and passive shutdown mechanism, advocated by ASEA-ATOM of Sweden. (2) MAP(Minimum Attention Plant), or a self-pressurized, natural circulation integral PWR, promoted by CE Inc. of the U.S. (3) TPS(TRIGA Power System), or a compact PWR with passive heat sink and inherent fuel characteristics of large prompt temperature coefficient, prompted by GA Technologies Inc. of the U.S. (4) PIUS-BWR, or an inherently safe BWR employing passively actuated fluid valves, in competition with PIUS, prompted by ORNL of the U.S. Then, I will describe the domestic trends in Japan and the innovative inherently safe LWRs presented domestically so far. (author)

  5. The Conceptual Design of Innovative Safe PWR

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Han-Gon [Centural Research Institute, Daejeon (Korea, Republic of); Heo, Sun [Korea Hydro and Nuclear Power Co., Daejeon (Korea, Republic of)

    2016-10-15

    Most of countries operating NPPs have been performed post-Fukushima improvements as short-term countermeasure to enhance the safety of operating NPPs. Separately, vendors have made efforts on developing passive safety systems as long-term and ultimate countermeasures. AP1000 designed by Westinghouse Electric Company has passive safety systems including the passive emergency core cooling system (PECCS), the passive residual heat removal system (PRHRS), and the passive containment cooling system (PCCS). ESBWR designed by GE-Hitachi also has passive safety systems consisting of the isolation condenser system, the gravity driven cooling system and the PCCS. Other countries including China and Russia have made efforts on developing passive safety systems for enhancing the safety of their plants. In this paper, we summarize the design goals and main design feature of innovative safe PWR, iPOWER which is standing for Innovative Passive Optimized World-wide Economical Reactor, and show the developing status and results of research projects. To mitigate an accident without electric power and enhance the safety level of PWR, the conceptual designs of passive safety system and innovative safe PWR have been performed. It includes the PECCS for core cooling and the PCCS for containment cooling. Now we are performing the small scale and separate effect tests for the PECCS and the PCCS and preparing the integral effect test for the PECCS and real scale test for the PCCS.

  6. Dementia - keeping safe in the home

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000031.htm Dementia - keeping safe in the home To use the ... make sure the homes of people who have dementia are safe for them. Safety Tips for the ...

  7. Safeguards Automated Facility Evaluation (SAFE) methodology

    International Nuclear Information System (INIS)

    Chapman, L.D.; Grady, L.M.; Bennett, H.A.; Sasser, D.W.; Engi, D.

    1978-01-01

    The SAFE procedure is an efficient method of evaluating the physical protection system of a nuclear facility. Since the algorithms used in SAFE for path generation and evaluation are analytical, many paths can be evaluated with a modest investment in computer time. SAFE is easy to use because the information required is well-defined and the interactive nature of this procedure lends itself to straightforward operation. The modular approach that has been taken allows other functionally equivalent modules to be substituted as they become available. The SAFE procedure has broad applications in the nuclear facility safeguards field as well as in the security field in general. Any fixed facility containing valuable materials or components to be protected from theft or sabotage could be analyzed using this same automated evaluation technique

  8. Closed-system drug-transfer devices plus safe handling of hazardous drugs versus safe handling alone for reducing exposure to infusional hazardous drugs in healthcare staff.

    Science.gov (United States)

    Gurusamy, Kurinchi Selvan; Best, Lawrence Mj; Tanguay, Cynthia; Lennan, Elaine; Korva, Mika; Bussières, Jean-François

    2018-03-27

    Occupational exposure to hazardous drugs can decrease fertility and result in miscarriages, stillbirths, and cancers in healthcare staff. Several recommended practices aim to reduce this exposure, including protective clothing, gloves, and biological safety cabinets ('safe handling'). There is significant uncertainty as to whether using closed-system drug-transfer devices (CSTD) in addition to safe handling decreases the contamination and risk of staff exposure to infusional hazardous drugs compared to safe handling alone. To assess the effects of closed-system drug-transfer of infusional hazardous drugs plus safe handling versus safe handling alone for reducing staff exposure to infusional hazardous drugs and risk of staff contamination. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, OSH-UPDATE, CINAHL, Science Citation Index Expanded, economic evaluation databases, the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov to October 2017. We included comparative studies of any study design (irrespective of language, blinding, or publication status) that compared CSTD plus safe handling versus safe handling alone for infusional hazardous drugs. Two review authors independently identified trials and extracted data. We calculated the risk ratio (RR) and mean difference (MD) with 95% confidence intervals (CI) using both fixed-effect and random-effects models. We assessed risk of bias according to the risk of bias in non-randomised studies of interventions (ROBINS-I) tool, used an intracluster correlation coefficient of 0.10, and we assessed the quality of the evidence using GRADE. We included 23 observational cluster studies (358 hospitals) in this review. We did not find any randomised controlled trials or formal economic evaluations. In 21 studies, the people who used the intervention (CSTD plus safe handling) and control (safe handling alone) were pharmacists or pharmacy

  9. Design of clinical trials for therapeutic cancer vaccines development.

    Science.gov (United States)

    Mackiewicz, Jacek; Mackiewicz, Andrzej

    2009-12-25

    Advances in molecular and cellular biology as well as biotechnology led to definition of a group of drugs referred to as medicinal products of advanced technologies. It includes gene therapy products, somatic cell therapeutics and tissue engineering. Therapeutic cancer vaccines including whole cell tumor cells vaccines or gene modified whole cells belong to somatic therapeutics and/or gene therapy products category. The drug development is a multistep complex process. It comprises of two phases: preclinical and clinical. Guidelines on preclinical testing of cell based immunotherapy medicinal products have been defined by regulatory agencies and are available. However, clinical testing of therapeutic cancer vaccines is still under debate. It presents a serious problem since recently clinical efficacy of the number of cancer vaccines has been demonstrated that focused a lot of public attention. In general clinical testing in the current form is very expensive, time consuming and poorly designed what may lead to overlooking of products clinically beneficial for patients. Accordingly regulatory authorities and researches including Cancer Vaccine Clinical Trial Working Group proposed three regulatory solutions to facilitate clinical development of cancer vaccines: cost-recovery program, conditional marketing authorization, and a new development paradigm. Paradigm includes a model in which cancer vaccines are investigated in two types of clinical trials: proof-of-principle and efficacy. The proof-of-principle trial objectives are: safety; dose selection and schedule of vaccination; and demonstration of proof-of-principle. Efficacy trials are randomized clinical trials with objectives of demonstrating clinical benefit either directly or through a surrogate. The clinical end points are still under debate.

  10. Ranking of healthcare programmes based on health outcome, health costs and safe delivery of care in hospital pharmacy practice.

    Science.gov (United States)

    Brisseau, Lionel; Bussières, Jean-François; Bois, Denis; Vallée, Marc; Racine, Marie-Claude; Bonnici, André

    2013-02-01

    To establish a consensual and coherent ranking of healthcare programmes that involve the presence of ward-based and clinic-based clinical pharmacists, based on health outcome, health costs and safe delivery of care. This descriptive study was derived from a structured dialogue (Delphi technique) among directors of pharmacy department. We established a quantitative profile of healthcare programmes at five sites that involved the provision of ward-based and clinic-based pharmaceutical care. A summary table of evidence established a unique quality rating per inpatient (clinic-based) or outpatient (ward-based) healthcare programme. Each director rated the perceived impact of pharmaceutical care per inpatient or outpatient healthcare programme on three fields: health outcome, health costs and safe delivery of care. They agreed by consensus on the final ranking of healthcare programmes. A ranking was assigned for each of the 18 healthcare programmes for outpatient care and the 17 healthcare programmes for inpatient care involving the presence of pharmacists, based on health outcome, health costs and safe delivery of care. There was a good correlation between ranking based on data from a 2007-2008 Canadian report on hospital pharmacy practice and the ranking proposed by directors of pharmacy department. Given the often limited human and financial resources, managers should consider the best evidence available on a profession's impact to plan healthcare services within an organization. Data are few on ranking healthcare programmes in order to prioritize which healthcare programme would mostly benefit from the delivery of pharmaceutical care by ward-based and clinic-based pharmacists. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

  11. Clinical leadership development and education for nurses: prospects and opportunities

    Directory of Open Access Journals (Sweden)

    Joseph ML

    2015-07-01

    Full Text Available M Lindell Joseph, Diane L Huber College of Nursing, The University of Iowa, Iowa City, IA, USA Abstract: With the implementation of the Affordable Care Act, elevated roles for nurses of care coordinator, clinical nurse leader, and advanced practice registered nurse have come to the forefront. Because change occurs so fast, matching development and education to job requirements is a challenging forecasting endeavor. The purpose of this article is to envision clinical leadership development and education opportunities for three emerging roles. The adoption of a common framework for intentional leadership development is proposed for clinical leadership development across the continuum of care. Solutions of innovation and interdependency are framed as core concepts that serve as an opportunity to better inform clinical leadership development and education. Additionally, strategies are proposed to advance knowledge, skills, and abilities for crucial implementation of improvements and new solutions at the point of care. Keywords: clinical leadership, nursing leadership, CNL, care coordination, innovation, interdependency

  12. Do Leadership Style, Unit Climate, and Safety Climate Contribute to Safe Medication Practices?

    Science.gov (United States)

    Farag, Amany; Tullai-McGuinness, Susan; Anthony, Mary K; Burant, Christopher

    2017-01-01

    This study aims at: examining if leadership style and unit climate predict safety climate; and testing the direct, indirect, and total effect of leadership style, unit climate, and safety climate on nurses' safe medication practices. The Institute of Medicine and nursing scholars propose that safety climate is a prerequisite to safety practices. However, there is limited empirical evidence about factors contributing to the development of safety climate and about the association with nurses' safe medication practices. This cross-sectional study used survey data from 246 RNs working in a Magnet® hospital. Leadership style and unit climate predicted 20% to 50% of variance on all safety climate dimensions. Model testing revealed the indirect impact of leadership style and unit climate on nurses' safe medication practices. Our hypothesized model explained small amount of the variance on nurses' safe medication practices. This finding suggests that nurses' safe medication practices are influenced by multiple contextual and personal factors that should be further examined.

  13. Breastfeeding FAQs: Safely Storing Breast Milk

    Science.gov (United States)

    ... Search English Español Breastfeeding FAQs: Safely Storing Breast Milk KidsHealth / For Parents / Breastfeeding FAQs: Safely Storing Breast ... may have. How do I store my breast milk? You can freeze and/or refrigerate your pumped ( ...

  14. [The informed consent in international clinical trials including developing countries].

    Science.gov (United States)

    Montenegro Surís, Alexander; Monreal Agüero, Magda Elaine

    2008-01-01

    The informed consent procedure has been one of the most important controversies of ethical debates about clinical trials in developing countries. In this essay we present our recommendations about important aspects to consider in the informed consent procedure for clinical trials in developing countries. We performed a full publications review identified by MEDLINE using these terms combinations: informed consent, developing countries, less developed countries and clinical trials. To protect volunteers in less developed countries should be valuated the importance of the community in the informed consent proceeding. The signing and dating of the informed consent form is not always the best procedure to document the informed consent. The informed consent form should be written by local translators. Alternative medias of communications could be needed for communicatios of the information to volunteers. Comparing with developed countries the informed consent proceeding in clinical trials in developing countries frequently require additional efforts. The developing of pragmatic researches is needed to implement informed consent proceedings assuring subjects voluntarily in each developing country. The main aspects to define in each clinical trial for each country are the influence of the community, the effective communication of the information, the documentation of the informed consent and local authority's control.

  15. Organising a Safe Space for Navigating Social-Ecological Transformations to Sustainability

    Directory of Open Access Journals (Sweden)

    Laura Pereira

    2015-05-01

    Full Text Available The need for developing socially just living conditions for the world’s growing population whilst keeping human societies within a ‘safe operating space’ has become a modern imperative. This requires transformative changes in the dominant social norms, behaviours, governance and management regimes that guide human responses in areas such as urban ecology, public health, resource security (e.g., food, water, energy access, economic development and biodiversity conservation. However, such systemic transformations necessitate experimentation in public arenas of exchange and a deepening of processes that can widen multi-stakeholder learning. We argue that there is an emergent potential in bridging the sustainability transitions and resilience approaches to create new scientific capacity that can support large-scale social-ecological transformations (SETs to sustainability globally, not just in the West. In this article, we elucidate a set of guiding principles for the design of a ‘safe space’ to encourage stronger interactions between these research areas and others that are relevant to the challenges faced. We envisage new opportunities for transdisciplinary collaboration that will develop an adaptive and evolving community of practice. In particular, we emphasise the great opportunity for engaging with the role of emerging economies in facilitating safe space experimentation.

  16. Organising a Safe Space for Navigating Social-Ecological Transformations to Sustainability

    Science.gov (United States)

    Pereira, Laura; Karpouzoglou, Timothy; Doshi, Samir; Frantzeskaki, Niki

    2015-01-01

    The need for developing socially just living conditions for the world’s growing population whilst keeping human societies within a ‘safe operating space’ has become a modern imperative. This requires transformative changes in the dominant social norms, behaviours, governance and management regimes that guide human responses in areas such as urban ecology, public health, resource security (e.g., food, water, energy access), economic development and biodiversity conservation. However, such systemic transformations necessitate experimentation in public arenas of exchange and a deepening of processes that can widen multi-stakeholder learning. We argue that there is an emergent potential in bridging the sustainability transitions and resilience approaches to create new scientific capacity that can support large-scale social-ecological transformations (SETs) to sustainability globally, not just in the West. In this article, we elucidate a set of guiding principles for the design of a ‘safe space’ to encourage stronger interactions between these research areas and others that are relevant to the challenges faced. We envisage new opportunities for transdisciplinary collaboration that will develop an adaptive and evolving community of practice. In particular, we emphasise the great opportunity for engaging with the role of emerging economies in facilitating safe space experimentation. PMID:26030471

  17. Adoption of the B2SAFE EUDAT replication service by the EPOS community

    Science.gov (United States)

    Cacciari, Claudio; Fares, Massimo; Fiameni, Giuseppe; Michelini, Alberto; Danecek, Peter; Wittenburg, Peter

    2014-05-01

    for B2SAFE, presents new developments towards a common service layer interface and a data policy management framework.

  18. [Historic Development of Clinical Biology Laboratories in Luxembourg].

    Science.gov (United States)

    Wennig R; Humbel R-L

    2014-01-01

    After a short overview on the development of diagnostic tools in clinical biology at an international level from Antiquity towards today, a history of the clinical biology including public and private institutions in Luxembourg will be outlined.

  19. Curiosity's Autonomous Surface Safing Behavior Design

    Science.gov (United States)

    Neilson, Tracy A.; Manning, Robert M.

    2013-01-01

    The safing routines on all robotic deep-space vehicles are designed to put the vehicle in a power and thermally safe configuration, enabling communication with the mission operators on Earth. Achieving this goal is made a little more difficult on Curiosity because the power requirements for the core avionics and the telecommunication equipment exceed the capability of the single power source, the Multi-Mission Radioisotope Thermoelectric Generator. This drove the system design to create an operational mode, called "sleep mode", where the vehicle turns off most of the loads in order to charge the two Li-ion batteries. The system must keep the vehicle safe from over-heat and under-heat conditions, battery cell failures, under-voltage conditions, and clock failures, both while the computer is running and while the system is sleeping. The other goal of a safing routine is to communicate. On most spacecraft, this simply involves turning on the receiver and transmitter continuously. For Curiosity, Earth is above the horizon only a part of the day for direct communication to the Earth, and the orbiter overpass opportunities only occur a few times a day. The design must robustly place the Rover in a communicable condition at the correct time. This paper discusses Curiosity's autonomous safing behavior and describes how the vehicle remains power and thermally safe while sleeping, as well as a description of how the Rover communicates with the orbiters and Earth at specific times.

  20. Removing Hair Safely

    Science.gov (United States)

    ... For Consumers Home For Consumers Consumer Updates Removing Hair Safely Share Tweet Linkedin Pin it More sharing ... related to common methods of hair removal. Laser Hair Removal In this method, a laser destroys hair ...

  1. Power control of SAFE reactor using fuzzy logic

    International Nuclear Information System (INIS)

    Irvine, Claude

    2002-01-01

    Controlling the 100 kW SAFE (Safe Affordable Fission Engine) reactor consists of design and implementation of a fuzzy logic process control system to regulate dynamic variables related to nuclear system power. The first phase of development concentrates primarily on system power startup and regulation, maintaining core temperature equilibrium, and power profile matching. This paper discusses the experimental work performed in those areas. Nuclear core power from the fuel elements is simulated using resistive heating elements while heat rejection is processed by a series of heat pipes. Both axial and radial nuclear power distributions are determined from neuronic modeling codes. The axial temperature profile of the simulated core is matched to the nuclear power profile by varying the resistance of the heating elements. The SAFE model establishes radial temperature profile equivalence by establishing 32 control zones as the nodal coordinates. Control features also allow for slow warm up, since complete shutoff can occur in the heat pipes if heat-source temperatures drop/rise below a certain minimum value, depending on the specific fluid and gas combination in the heat pipe. The entire system is expected to be self-adaptive, i.e., capable of responding to long-range changes in the space environment. Particular attention in the development of the fuzzy logic algorithm shall ensure that the system process remains at set point, virtually eliminating overshoot on start-up and during in-process disturbances. The controller design will withstand harsh environments and applications where it might come in contact with water, corrosive chemicals, radiation fields, etc

  2. Clinical professional governance for detailed clinical models.

    Science.gov (United States)

    Goossen, William; Goossen-Baremans, Anneke

    2013-01-01

    This chapter describes the need for Detailed Clinical Models for contemporary Electronic Health Systems, data exchange and data reuse. It starts with an explanation of the components related to Detailed Clinical Models with a brief summary of knowledge representation, including terminologies representing clinic relevant "things" in the real world, and information models that abstract these in order to let computers process data about these things. Next, Detailed Clinical Models are defined and their purpose is described. It builds on existing developments around the world and accumulates in current work to create a technical specification at the level of the International Standards Organization. The core components of properly expressed Detailed Clinical Models are illustrated, including clinical knowledge and context, data element specification, code bindings to terminologies and meta-information about authors, versioning among others. Detailed Clinical Models to date are heavily based on user requirements and specify the conceptual and logical levels of modelling. It is not precise enough for specific implementations, which requires an additional step. However, this allows Detailed Clinical Models to serve as specifications for many different kinds of implementations. Examples of Detailed Clinical Models are presented both in text and in Unified Modelling Language. Detailed Clinical Models can be positioned in health information architectures, where they serve at the most detailed granular level. The chapter ends with examples of projects that create and deploy Detailed Clinical Models. All have in common that they can often reuse materials from earlier projects, and that strict governance of these models is essential to use them safely in health care information and communication technology. Clinical validation is one point of such governance, and model testing another. The Plan Do Check Act cycle can be applied for governance of Detailed Clinical Models

  3. Calculations on safe storage and transportation of radioactive materials

    Energy Technology Data Exchange (ETDEWEB)

    Hathout, A M; El-Messiry, A M; Amin, E [National Center for Nuclear Safety and Radiation Control and AEA, Cairo (Egypt)

    1997-12-31

    In this work the safe storage and transportation of fresh fuel as a radioactive material studied. Egypt planned ET RR 2 reactor which is of relatively high power and would require adequate handling and transportation. Therefore, the present work is initiated to develop a procedure for safe handling and transportation of radioactive materials. The possibility of reducing the magnitude of radiation transmitted on the exterior of the packages is investigated. Neutron absorbers are used to decrease the neutron flux. Criticality calculations are carried out to ensure the achievement of subcriticality so that the inherent safety can be verified. The discrete ordinate transport code ANISN was used. The results show good agreement with other techniques. 2 figs., 2 tabs.

  4. Developing a leadership pipeline: the Cleveland Clinic experience

    OpenAIRE

    Hess, Caryl A.; Barss, Christina; Stoller, James K.

    2014-01-01

    The complexity of health care requires excellent leadership to address the challenges of access, quality, and cost of care. Because competencies to lead differ from clinical or research skills, there is a compelling need to develop leaders and create a talent pipeline, perhaps especially in physician-led organizations like Cleveland Clinic. In this context, we previously reported on a cohort-based physician leadership development course called Leading in Health Care and, in the current report...

  5. Pediatric primary care to help prevent child maltreatment: the Safe Environment for Every Kid (SEEK) Model.

    Science.gov (United States)

    Dubowitz, Howard; Feigelman, Susan; Lane, Wendy; Kim, Jeongeun

    2009-03-01

    Effective strategies for preventing child maltreatment are needed. Few primary care-based programs have been developed, and most have not been well evaluated. Our goal was to evaluate the efficacy of the Safe Environment for Every Kid model of pediatric primary care in reducing the occurrence of child maltreatment. A randomized trial was conducted from June 2002 to November 2005 in a university-based resident continuity clinic in Baltimore, Maryland. The study population consisted of English-speaking parents of children (0-5 years) brought in for child health supervision. Of the 1118 participants approached, 729 agreed to participate, and 558 of them completed the study protocol. Resident continuity clinics were cluster randomized by day of the week to the model (intervention) or standard care (control) groups. Model care consisted of (1) residents who received special training, (2) the Parent Screening Questionnaire, and (3) a social worker. Risk factors for child maltreatment were identified and addressed by the resident physician and/or social worker. Standard care involved routine pediatric primary care. A subset of the clinic population was sampled for the evaluation. Child maltreatment was measured in 3 ways: (1) child protective services reports using state agency data; (2) medical chart documentation of possible abuse or neglect; and (3) parental report of harsh punishment via the Parent-Child Conflict Tactics scale. Model care resulted in significantly lower rates of child maltreatment in all the outcome measures: fewer child protective services reports, fewer instances of possible medical neglect documented as treatment nonadherence, fewer children with delayed immunizations, and less harsh punishment reported by parents. One-tailed testing was conducted in accordance with the study hypothesis. The Safe Environment for Every Kid (SEEK) model of pediatric primary care seems promising as a practical strategy for helping prevent child maltreatment

  6. Integrated vehicle’s lateral safety: the LATERAL SAFE experience

    NARCIS (Netherlands)

    Amditis, A.; Floudas, N.; Kaiser-Dieckhoff, U.; Hackbarth, T.; Broek, S.P. van den; Miglietta, M.; Danielson, L.; Gemou, M.; Bekiaris, E.

    2008-01-01

    The applications developed and the evaluation results of the EU funded automotive safety PReVENT IP subproject LATERAL SAFE are described. The data synthesis algorithms that aim at achieving a reliable representation of the objects and their kinematics, in the lateral and rear fields of the host

  7. 836: Developing a Cooperative Communication System for Safe, Effective, and Efficient Patient Care

    Science.gov (United States)

    2014-01-01

    cally ill patients (pts) for hemodynamic monitoring using novel VPS’s can be performed efficiently and safely. Methods: In an adult academic medical...for hemodynamic monitoring was selected. Open ended PICCs were inserted using a novel Dop- pler and intravascular EKG positioning system and CXR was...unclear responsibility for task comple- tion; time spent tracking down in-process items like meds and labs; reliance on nurses to track and fix

  8. Safe percutaneous suprapubic catheterisation.

    Science.gov (United States)

    Goyal, N K; Goel, A; Sankhwar, S N

    2012-11-01

    We describe our technique of percutaneous suprapubic catheter insertion with special reference to steps that help to avoid common complications of haematuria and catheter misplacement. The procedure is performed using a stainless steel reusable trocar under local infiltrative anaesthesia, usually at the bedside. After clinical confirmation of a full bladder, the trocar is advanced into the bladder through a skin incision. Once the bladder is entered, the obturator is removed and the assistant inserts a Foley catheter followed by rapid balloon inflation. Slight traction is applied to the catheter for about five minutes. Patients with previous lower abdominal surgery, an inadequately distended bladder or acute pelvic trauma do not undergo suprapubic catheterisation using this method. The procedure was performed in 72 men (mean age: 42.4 years, range: 18-78 years) with urinary retention with a palpable bladder. The average duration of the procedure was less than five minutes. No complications were noted in any of the patients. Trocar suprapubic catheter insertion is a safe and effective bedside procedure for emergency bladder drainage and can be performed by resident surgeons. The common complications associated with the procedure can be avoided with a few careful steps.

  9. Quality assurance for the safe transport of radioactive material

    International Nuclear Information System (INIS)

    1994-01-01

    All activities related to the safe transport of radioactive material should be covered by a quality assurance programme. This publication recognizes that a single transport operation often involves several different organizations, each having specific responsibilities. Hence, it is unlikely that the operation will be covered by a single quality assurance programme. Each quality assurance programme should be tailored to the specific organizational structure for which the programme is prepared, with account taken of the particular transport activities of that organization and the interfaces with other organizations. The aim of this publication is to give a detailed interpretation of what must be done by whom to produce a quality assurance programme for radioactive material transport. This publication provides guidance on methods and practical examples to develop QA programmes for the safe transport of radioactive material. It provides information on how to develop the programme, the standards and the common features of a QA programme

  10. A descriptive survey investigating pre-registration student nurses' perceptions of clinical skill development in clinical placements.

    Science.gov (United States)

    Stayt, Louise C; Merriman, Clair

    2013-04-01

    Clinical skill development is essential to nurse education. Clinical skills are frequently taught in higher education institutions using clinical simulation. It is unclear if clinical skills are subsequently consolidated and developed in clinical placements. The aim of this survey was to evaluate pre-registration student nurses perceptions of the frequency of opportunities to practise, the level of supervision and assessment of, clinical skills in their clinical placements. This was a cross-sectional survey design using an online, self-report questionnaire including a Likert-type scale and open ended comments. Four hundred and twenty one students, from all year groups, from a university in the south of England on a wide variety of clinical placements participated. Participants evaluated the frequency of opportunity to practise, level of supervision and assessment of and feedback on performance of specific clinical skills. Clinical skills evaluated were measurement of vital signs, aseptic non-touch technique, assisting with eating and drinking, and assisting with comfort and hygiene. Data were analysed utilising Statistical Package for the Social Sciences Version 19. The frequency of opportunities to practise skills in clinical placement was variable with some participants reporting that they never had opportunity to practise essential skills. Similarly the level of supervision and assessment was also inconsistent suggesting that participants frequently practised clinical skills unsupervised without being assessed as competent. Inconsistencies in clinical skill development may lead to graduates who are not work ready and as a result, insufficient clinical competence potentially leads to unsafe practice and poor patient care. This calls for stronger partnerships between educators and clinical areas and the prioritisation of mentor preparation and education as well as organisational support in terms of mentor workload planning. Copyright © 2012 Elsevier Ltd. All

  11. Risk management for assuring safe drinking water.

    Science.gov (United States)

    Hrudey, Steve E; Hrudey, Elizabeth J; Pollard, Simon J T

    2006-12-01

    Millions of people die every year around the world from diarrheal diseases much of which is caused by contaminated drinking water. By contrast, drinking water safety is largely taken for granted by many citizens of affluent nations. The ability to drink water that is delivered into households without fear of becoming ill may be one of the key defining characteristics of developed nations in relation to the majority of the world. Yet there is well-documented evidence that disease outbreaks remain a risk that could be better managed and prevented even in affluent nations. A detailed retrospective analysis of more than 70 case studies of disease outbreaks in 15 affluent nations over the past 30 years provides the basis for much of our discussion [Hrudey, S.E. and Hrudey, E.J. Safe Drinking Water--Lessons from Recent Outbreaks in Affluent Nations. London, UK: IWA Publishing; 2004.]. The insights provided can assist in developing a better understanding within the water industry of the causes of drinking water disease outbreaks, so that more effective preventive measures can be adopted by water systems that are vulnerable. This preventive feature lies at the core of risk management for the provision of safe drinking water.

  12. Towards Safe Robotic Surgical Systems

    DEFF Research Database (Denmark)

    Sloth, Christoffer; Wisniewski, Rafael

    2015-01-01

    a controller for motion compensation in beating-heart surgery, and prove that it is safe, i.e., the surgical tool is kept within an allowable distance and orientation of the heart. We solve the problem by simultaneously finding a control law and a barrier function. The motion compensation system is simulated...... from several initial conditions to demonstrate that the designed control system is safe for every admissible initial condition....

  13. Safe use of ionizing radiations

    Energy Technology Data Exchange (ETDEWEB)

    1973-01-01

    Based on the ''Code of Practice for the protection of persons against ionizing radiations arising from medical and dental use'' (CIS 74-423), this handbook shows how hospital staff can avoid exposing themselves and others to these hazards. It is designed particularly for junior and student nurses. Contents: ionizing radiations, their types and characteristics; their uses and dangers; basic principles in their safe use; safe use in practice; explanation of terms.

  14. Staying Safe in the Water

    Centers for Disease Control (CDC) Podcasts

    2008-05-15

    In this podcast, Dr. Julie Gilchrist, a pediatrician and medical epidemiologist from CDC’s Injury Center, talks about staying safe in the water. Tips are for all audiences, with a focus on preventing drownings and keeping children safe in and around the pool, lake, or ocean.  Created: 5/15/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 5/19/2008.

  15. Irreversible electroporation of the pancreas is feasible and safe in a porcine survival model.

    Science.gov (United States)

    Fritz, Stefan; Sommer, Christof M; Vollherbst, Dominik; Wachter, Miguel F; Longerich, Thomas; Sachsenmeier, Milena; Knapp, Jürgen; Radeleff, Boris A; Werner, Jens

    2015-07-01

    Use of thermal tumor ablation in the pancreatic parenchyma is limited because of the risk of pancreatitis, pancreatic fistula, or hemorrhage. This study aimed to evaluate the feasibility and safety of irreversible electroporation (IRE) in a porcine model. Ten pigs were divided into 2 study groups. In the first group, animals received IRE of the pancreatic tail and were killed after 60 minutes. In the second group, animals received IRE at the head of the pancreas and were followed up for 7 days. Clinical parameters, computed tomography imaging, laboratory results, and histology were obtained. All animals survived IRE ablation, and no cardiac adverse effects were noted. Sixty minutes after IRE, a hypodense lesion on computed tomography imaging indicated the ablation zone. None of the animals developed clinical signs of acute pancreatitis. Only small amounts of ascites fluid, with a transient increase in amylase and lipase levels, were observed, indicating that no pancreatic fistula occurred. This porcine model shows that IRE is feasible and safe in the pancreatic parenchyma. Computed tomography imaging reveals significant changes at 60 minutes after IRE and therefore might serve as an early indicator of therapeutic success. Clinical studies are needed to evaluate the efficacy of IRE in pancreatic cancer.

  16. Food Safety Posters for Safe Handling of Leafy Greens

    Science.gov (United States)

    Rajagopal, Lakshman; Arendt, Susan W.; Shaw, Angela M.; Strohbehn, Catherine H.; Sauer, Kevin L.

    2016-01-01

    This article describes food safety educational tools depicting safe handling of leafy greens that are available as downloadable posters to Extension educators and practitioners (www.extension.iastate.edu). Nine visual-based minimal-text colored posters in English, Chinese, and Spanish were developed for use when formally or informally educating…

  17. Safe Is Not Enough: Better Schools for LGBTQ Students

    Science.gov (United States)

    Sadowski, Michael

    2016-01-01

    "Safe Is Not Enough" illustrates how educators can support the positive development of LGBTQ students in a comprehensive way so as to create truly inclusive school communities. Using examples from classrooms, schools, and districts across the country, Michael Sadowski identifies emerging practices such as creating an LGBTQ-inclusive…

  18. Pre-clinical and clinical development of the first placental malaria vaccine

    DEFF Research Database (Denmark)

    Pehrson, Caroline; Salanti, Ali; Theander, Thor G

    2017-01-01

    the condition.  Areas covered: Pub Med was searched using the broad terms 'malaria parasite placenta' to identify studies of interactions between parasite and host, 'prevention of placental malaria' to identify current strategies to prevent placental malaria, and 'placental malaria vaccine' to identify pre-clinical...... vaccine development. However, all papers from these searches were not systematically included.  Expert commentary: The first phase I clinical trials of vaccines are well underway. Trials testing efficacy are more complicated to carry out as only women that are exposed to parasites during pregnancy...

  19. Safe Handover : Safe Patients – The Electronic Handover System

    Science.gov (United States)

    Till, Alex; Sall, Hanish; Wilkinson, Jonathan

    2014-01-01

    Failure of effective handover is a major preventable cause of patient harm. We aimed to promote accurate recording of high-quality clinical information using an Electronic Handover System (EHS) that would contribute to a sustainable improvement in effective patient care and safety. Within our hospital the human factors associated with poor communication were compromising patient care and unnecessarily increasing the workload of staff due to the poor quality of handovers. Only half of handovers were understood by the doctors expected to complete them, and more than half of our medical staff felt it posed a risk to patient safety. We created a standardised proforma for handovers that contained specific sub-headings, re-classified patient risk assessments, and aided escalation of care by adding prompts for verbal handover. Sources of miscommunication were removed, accountability for handovers provided, and tasks were re-organised to reduce the workload of staff. Long-term, three-month data showed that each sub-heading achieved at least 80% compliance (an average improvement of approximately 40% for the overall quality of handovers). This translated into 91% of handovers being subjectively clear to junior doctors. 87% of medical staff felt we had reduced a risk to patient safety and 80% felt it increased continuity of care. Without guidance, doctors omit key information required for effective handover. All organisations should consider implementing an electronic handover system as a viable, sustainable and safe solution to handover of care that allows patient safety to remain at the heart of the NHS. PMID:26734244

  20. Developing clinical piano improvisation skills

    DEFF Research Database (Denmark)

    Wigram, Anthony Lewis

    2003-01-01

    Teaching piano improvisation skills for use in clinical work relies on the development of a range of musical techniques and therapeutic methods that are combined and integrated. Simple musical styles of playing such as melody dialogues, two chord accompaniments, walking basses (tonal and atonal), 6...... skilful way of helping a client or group of clients move, or develop their musical expression (Wigram & Bonde 2002 pp 278-279). Frame-working is a method that offers a musical structure to the music of a client. This structure could have the goal of enhancing the music aesthetically, or guiding the client...

  1. Development of Bioethics and Clinical Ethics in Bulgaria.

    Science.gov (United States)

    Aleksandrova-Yankulovska, Silviya S

    2017-03-01

    Bioethics and clinical ethics emerged from the classical medical ethics in the 1970s of the 20th century. Both fields are new for the Bulgarian academic tradition. The aims of this paper were to demarcate the subject fields of medical ethics, bioethics, and clinical ethics, to present the developments in the field of medical ethics in Bulgaria, to delineate the obstacles to effective ethics education of medical professionals, and to present the results of the application of an adapted bottom-up methodology for clinical ethics consultation in several clinical units in Bulgaria. Extended literature review and application of an adapted METAP methodology for clinical ethics consultation in six clinical units in the Northern Bulgaria between May 2013 and December 2014. Teaching of medical ethics in Bulgaria was introduced in the 1990s and still stands mainly as theoretical expertise without sufficient dilemma training in clinical settings. Earlier studies revealed need of clinical ethics consultation services in our country. METAP methodology was applied in 69 ethics meetings. In 31.9% of them non-medical considerations affected the choice of treatment and 34.8% resulted in reaching consensus between the team and the patient. Participants' opinion about the meetings was highly positive with 87.7% overall satisfaction. Development of bioethics in Bulgaria follows recent worldwide trends. Several ideas could be applied towards increasing the effectiveness of ethics education. Results of the ethics meetings lead to the conclusion that it is a successful and well accepted approach for clinical ethics consultation with a potential for wider introduction in our medical practice.

  2. Ensuring safe access to medication for palliative care while preventing prescription drug abuse: innovations for American inner cities, rural areas, and communities overwhelmed by addiction.

    Science.gov (United States)

    Francoeur, Richard B

    2011-01-01

    This article proposes and develops novel components of community-oriented programs for creating and affording access to safe medication dispensing centers in existing retail pharmacies and in permanent or travelling pharmacy clinics that are guarded by assigned or off-duty police officers. Pharmacists at these centers would work with police, medical providers, social workers, hospital administrators, and other professionals in: planning and overseeing the safe storage of controlled substance medications in off-site community safe-deposit boxes; strengthening communication and cooperation with the prescribing medical provider; assisting the prescribing medical provider in patient monitoring (checking the state prescription registry, providing pill counts and urine samples); expanding access to lower-cost, and in some cases, abuse-resistant formulations of controlled substance medications; improving transportation access for underserved patients and caregivers to obtain prescriptions; and integrating community agencies and social networks as resources for patient support and monitoring. Novel components of two related community-oriented programs, which may be hosted outside of safe medication dispensing centers, are also suggested and described: (1) developing medication purchasing cooperatives (ie, to help patients, families, and health institutions afford the costs of medications, including tamper-or abuse-resistant/deterrent drug formulations); and (2) expanding the role of inner-city methadone maintenance treatment programs in palliative care (ie, to provide additional patient monitoring from a second treatment team focusing on narcotics addiction, and potentially, to serve as an untapped source of opioid medication for pain that is less subject to abuse, misuse, or diversion).

  3. Safe operating envelope

    Energy Technology Data Exchange (ETDEWEB)

    Oliva, N [Ontario Hydro, Toronto, ON (Canada)

    1997-12-01

    Safe Operating Envelope is described representing: The outer bound of plant conditions within which day-to-day plant operation must be maintained in order to comply with regulatory requirements, associated safety design criteria and corporate nuclear safety goals. Figs.

  4. Safe operating envelope

    International Nuclear Information System (INIS)

    Oliva, N.

    1997-01-01

    Safe Operating Envelope is described representing: The outer bound of plant conditions within which day-to-day plant operation must be maintained in order to comply with regulatory requirements, associated safety design criteria and corporate nuclear safety goals. Figs

  5. TRENDS AND ISSUES IN SAFE DRIVER ASSISTANCE SYSTEMS

    Directory of Open Access Journals (Sweden)

    Sadayuki TSUGAWA

    2006-01-01

    Full Text Available In recent years, ITS projects in Japan, Europe and the US have been characterized by a strong emphasis on safe driver assistance systems designed to prevent traffic accidents. As it has become clear that eradicating accidents will be impossible by means of vehicle passive safety and single-vehicle active safety efforts alone, research and development of systems for preventing accidents through road-vehicle cooperation and vehicle-vehicle cooperation have been promoted in Japan (ASV, AHS, Europe (PReVENT, SAFESPOT and the US (VII. The key to such technology is road-to-vehicle communications and inter-vehicle communications. On the other hand, a number of driver assistance systems have been brought to market, including lidar-based forward collision warnings, ACC, lane keeping support and drowsiness warnings, but their penetration rates in Japan are extremely low. Furthermore, one major challenge is that safe driver assistance systems based on road-vehicle and vehicle-vehicle cooperation are premised upon a high penetration rate. Finally, we introduce a system for improving driver acceptance of safe driver assistance systems based on driver monitoring and forward monitoring as well as cooperative driver assistance systems for elderly drivers, an issue now receiving attention in Japan.

  6. Clinical Research Nursing: Development of a Residency Program
.

    Science.gov (United States)

    Showalter, Brandi L; Cline, Debbie; Yungclas, Jan; Frentz, Kelly; Stafford, Susan R; Maresh, Kelly J

    2017-10-01

    Clinical research nurses are essential in the coordination of clinical trials and the management of research participants. Without a stable, knowledgeable research nurse workforce, the conduct of research is affected. A research nurse residency is a novel approach to preparing new graduate nurses for the oncology research nurse role. This article will describe the development and content of the research nurse residency and how this approach is being used to address a need for clinical research nurses to support burgeoning clinical trials at a National Cancer Institute-designated comprehensive cancer center.
.

  7. Development of an early memories of warmth and safeness scale and its relationship to psychopathology.

    Science.gov (United States)

    Richter, A; Gilbert, P; McEwan, K

    2009-06-01

    Experiences of early childhood have a major impact on physiological, psychological, and social aspects of maturation and functioning. One avenue of work explores the recall and memory of positive or negative rearing experiences and their association with psychopathology measures. However, while many self-report studies have focused on the recall of parental behaviours this study developed a new measure called the early memories of warmth and safeness scale (EMWSS), which focuses on recall of one's own inner positive feelings, emotions and experiences in childhood. Student participants (N = 180) completed the new scale and a series of self-report scales measuring different types of early recall, psychopathology, types of positive affect, and self-criticism/reassurance. The EMWSS was found to have good psychometric properties and reliability. Recall of parental behaviour and recall of positive emotional memories were highly related, but recall of positive emotional memories was a better predictor of psychopathology, styles of self-criticism/self-reassurance and disposition to experience positive affect, than recall of parental behaviour.

  8. Safe decommissioning of the Romanian VVR-S research reactor

    International Nuclear Information System (INIS)

    Garlea, C.; Garlea, I.; Kelerman, C.; Rodna, A.

    2002-01-01

    The VVR-S Romania research reactor was operated between 1957-1997, at 2 MW nominal power, for research and radioisotopical production. The detailed decommissioning plan was developed between 1995-1998, in the frame of the International Atomic Energy Agency Technical assistance project ROM/9/017. The proposed strategy agreed by the counterpart as well as international experts was stage 1. In 1997, an independent analysis performed by European Commission experts, in the frame of PHARE project PH04.1/1994 was dedicated to the 'Study of Soviet Design Research Reactors', had consolidated the development of the project emphasizing technical options of safe management for radioactive wastes and VVR-S spent fuel. The paper presents the main technical aspects as well as those of social impact, which lead to the establishment of strategy for safe management of decommissioning. Technical analysis of the VVR-S reactor and associated radwaste facilities (Radioactive Waste Treatment Plant - Magurele and National Repository Baita-Bihor) proved the possibility of the classical method utilization for dismantling of the facility and treatment-conditioning-disposal of the arrised wastes in safe conditions. The decommissioning plan at stage 2 has been developed based on radiological safety assessment, evaluation of radwaste inventory (removed as well as preserved on site), cost analysis and environmental impact. Technical data were provided by the R and D programme including neutron calculations and experiments, radiological characterizing (for facility and its influence area), seismic analysis and environmental balance during the operation and after shut down of the reactor. A special chapter is dedicated to regulatory issues concerning the development of decommissioning under nuclear safety. Based on the Fundamental Norms of Radiological Safety, the Regulatory Body defined the clearance levels and safety criteria for the process. The development of National Norms for the

  9. Systems for the safe operation of the JET tokamak with tritium

    International Nuclear Information System (INIS)

    Stork, D.; Ageladarakis, P.; Bell, A.C.

    1999-01-01

    In 1997, the JET device was operated for an extensive campaign with deuterium-tritium (D-T) plasmas (the DTE1 campaign). A comprehensive network of machine protection systems was necessary so that this experimental campaign could be executed safely without damage to the machine or release of activated material. This network had been developed over many years of JET deuterium plasma operation and therefore the modifications for D-T operation was not a significant problem. The DTE1 campaign was executed successfully and safely and the machine protection systems proved reliable and robust and, in the limited cases where they were required to act, functioned correctly. The machine protection systems at JET are described and their categorisation and development over time are summarised. The management, commissioning and operational experience during DTE1 are discussed and some examples of fault scenarios are described. The experience with protection systems at JET highlights the importance of correct design and philosophy decisions being taken at an early stage. It is shown that this experience will be invaluable data input to the safe operation of future large fusion machines. (orig.)

  10. Limbal Fibroblasts Maintain Normal Phenotype in 3D RAFT Tissue Equivalents Suggesting Potential for Safe Clinical Use in Treatment of Ocular Surface Failure.

    Science.gov (United States)

    Massie, Isobel; Dale, Sarah B; Daniels, Julie T

    2015-06-01

    Limbal epithelial stem cell deficiency can cause blindness, but transplantation of these cells on a carrier such as human amniotic membrane can restore vision. Unfortunately, clinical graft manufacture using amnion can be inconsistent. Therefore, we have developed an alternative substrate, Real Architecture for 3D Tissue (RAFT), which supports human limbal epithelial cells (hLE) expansion. Epithelial organization is improved when human limbal fibroblasts (hLF) are incorporated into RAFT tissue equivalent (TE). However, hLF have the potential to transdifferentiate into a pro-scarring cell type, which would be incompatible with therapeutic transplantation. The aim of this work was to assess the scarring phenotype of hLF in RAFT TEs in hLE+ and hLE- RAFT TEs and in nonairlifted and airlifted RAFT TEs. Diseased fibroblasts (dFib) isolated from the fibrotic conjunctivae of ocular mucous membrane pemphigoid (Oc-MMP) patients were used as a pro-scarring positive control against which hLF were compared using surrogate scarring parameters: matrix metalloproteinase (MMP) activity, de novo collagen synthesis, α-smooth muscle actin (α-SMA) expression, and transforming growth factor-β (TGF-β) secretion. Normal hLF and dFib maintained different phenotypes in RAFT TE. MMP-2 and -9 activity, de novo collagen synthesis, and α-SMA expression were all increased in dFib cf. normal hLF RAFT TEs, although TGF-β1 secretion did not differ between normal hLF and dFib RAFT TEs. Normal hLF do not progress toward a scarring-like phenotype during culture in RAFT TEs and, therefore, may be safe to include in therapeutic RAFT TE, where they can support hLE, although in vivo work is required to confirm this. dFib RAFT TEs (used in this study as a positive control) may be useful toward the development of an ex vivo disease model of Oc-MMP.

  11. Safe motherhood -- from advocacy to action.

    Science.gov (United States)

    Tinker, A

    1991-12-01

    Every minute a woman dies from complications related to pregnancy or childbirth. That translates to 500,000 annually, of which, 99% live in developing countries. A woman in Africa has a 1:18 lifetime chance of dying from pregnancy-related causes, compared with a northern European woman who has a 1:10,000 chance. Thus, in 1987 international and regional agencies and national governments started a global program titled the Safe Motherhood Initiative. Its goal is to reduce maternal morbidity and mortality 50% by 2000. The death of a woman during pregnancy or child birth means that her surviving children are much more likely to die. In a bangladesh study it was found that the death of the mother was associated with a 200% increase in mortality for her sons and 350% for her daughters for children up to 10. Family planning is the key, since it is the single best tool of preventing these deaths, by reducing the number of times a woman gets pregnant. Family planning also reduces the number of abortions which are estimated to kill 200,000 women annually in developing countries. Trained midwives who can provide obstetrical emergency assistance will also make a large impact. Risk assessment was once considered very important, but studies have shown that the majority of pregnancy complications develop without being detected. Further, the number of women with risk factors that develop complications is much lower than the number of women who develop complications during pregnancy. So monitoring women with risk factors misses most complications. Regular monitoring and medical examinations are much more effective for preventing complications. Safe motherhood can only be achieved if each program is tailored to the needs of the community. Donor nations are necessary for this program to succeed, but ultimate success rests in the hands of each country. National priorities must be set, resources must be allocated, and programs must be designed to be effective.

  12. A Study on Visibility Rating of Several Representative Web-Safe Colors

    Science.gov (United States)

    Saito, Daisuke; Saito, Keiichi; Notomi, Kazuhiro; Saito, Masao

    This paper presents the visibility ordering of several web-safe colors. The research of web site visibility is important because of the rapid dissemination of the World Wide Web. The combination of a foreground color and a background color is an important factor in providing sufficient visibility. Therefore, the rating of color combination visibility is necessary when developing accessible web sites. In this study, the visibility of several web-safe color combinations was examined using psychological methodology, i.e., a paired comparison. Eighteen chromatic web-safe colors were employed for visual stimuli. Nine students ranging from ages 21 to 29 (average 23.7) were recruited, and all were with normal color sensation. These nine subjects looked at two different colored characters simultaneously on the white background and were instructed to identify which one enabled them to see more clearly. In examining the relationship between the psychological rankings of the color combinations and the visual sensations, each color combination was first scored as to the visibility by Thurstone's paired comparisons technique. Secondly, the visual sensation was deduced by applying Weber-Fechner's law to the luminance of the foreground colors. As results, the luminance of a foreground color influenced the visibility; however the visibility rating is difficult only using the luminance of web-safe colors. These indicate that the chromaticity and chroma saturation are necessary in rating of chromatic web-safe color visibility.

  13. Development of the siriraj clinical asthma score.

    Science.gov (United States)

    Vichyanond, Pakit; Veskitkul, Jittima; Rienmanee, Nuanphong; Pacharn, Punchama; Jirapongsananuruk, Orathai; Visitsunthorn, Nualanong

    2013-09-01

    Acute asthmatic attack in children commonly occurs despite the introduction of effective controllers such as inhaled corticosteroids and leukotriene modifiers. Treatment of acute asthmatic attack requires proper evaluation of attack severity and appropriate selection of medical therapy. In children, measurement of lung function is difficult during acute attack and thus clinical asthma scoring may aid physician in making further decision regarding treatment and admission. We enrolled 70 children with acute asthmatic attack with age range from 1 to 12 years (mean ± SD = 51.5 ± 31.8 months) into the study. Twelve selected asthma severity items were assessed by 2 independent observers prior to administration of salbutamol nebulization (up to 3 doses at 20 minutes interval). Decision for further therapy and admission was made by emergency department physician. Three different scoring systems were constructed from items with best validity. Sensitivity, specificity and accuracy of these scores were assessed. Inter-rater reliability was assessed for each score. Review of previous scoring systems was also conducted and reported. Three severity items had poor validity, i.e., cyanosis, depressed cerebral function, and I:E ratio (p > 0.05). Three items had poor inter-rater reliability, i.e., breath sound quality, air entry, and I:E ratio. These items were omitted and three new clinical scores were constructed from the remaining items. Clinical scoring system comprised retractions, dyspnea, O2 saturation, respiratory rate and wheezing (rangeof score 0-10) gave the best accuracy and inter-rater variability and were chosen for clinical use-Siriraj Clinical Asthma Score (SCAS). A Clinical Asthma Score that is simple, relatively easy to administer and with good validity and variability is essential for treatment of acute asthma in children. Several good candidate scores have been introduced in the past. We described the development of the Siriraj Clinical Asthma Score (SCAS) in

  14. Development of a balance, safe mobility and falls management programme for people with multiple sclerosis.

    Science.gov (United States)

    Gunn, Hilary; Endacott, Ruth; Haas, Bernhard; Marsden, Jonathan; Freeman, Jennifer

    2017-08-07

    To utilise stakeholder input to inform the structure, format and approach of a multiple sclerosis (MS) balance, safe mobility and falls management programme. Using a three-round nominal group technique, participants individually rated their agreement with 20 trigger statements, followed by a facilitated group discussion and re-rating. Three mixed groups included service users (n = 15) and providers (n = 19). Quantitative analysis determined agreement, whilst qualitative responses were analysed thematically. Median scores for each of the 20 trigger statements did not change significantly over sequential rounds, however, deviations around the medians indicated more agreement amongst participants over time. Key recommendations were: Aims and approach: The programme should be tailored to the needs of people with MS. Falls and participation-based outcomes are equally important. Structure and format: The programme should balance expected burden and anticipated benefit, moving away from models requiring weekly attendance and promoting and supporting self-efficacy. Optimising engagement: Support to maintain engagement and intensity of practice over the long term is essential. Sustainability: Adequate funding is necessary. Staff should have MS specific knowledge and experience. Participants collaboratively identified critical components of a MS balance, safe mobility and falls management programme. They also highlighted the importance of a collaborative, user-centred, MS-specific approach. Implications for Rehabilitation People with multiple sclerosis need condition-specific interventions focussed on maximising balance and safe mobility and reducing falls. Programme design should support self-efficacy and flexible engagement. Adequate support and funding are seen as essential by both service users and providers.

  15. Quantitative imaging of the human upper airway: instrument design and clinical studies

    Science.gov (United States)

    Leigh, M. S.; Armstrong, J. J.; Paduch, A.; Sampson, D. D.; Walsh, J. H.; Hillman, D. R.; Eastwood, P. R.

    2006-08-01

    Imaging of the human upper airway is widely used in medicine, in both clinical practice and research. Common imaging modalities include video endoscopy, X-ray CT, and MRI. However, no current modality is both quantitative and safe to use for extended periods of time. Such a capability would be particularly valuable for sleep research, which is inherently reliant on long observation sessions. We have developed an instrument capable of quantitative imaging of the human upper airway, based on endoscopic optical coherence tomography. There are no dose limits for optical techniques, and the minimally invasive imaging probe is safe for use in overnight studies. We report on the design of the instrument and its use in preliminary clinical studies, and we present results from a range of initial experiments. The experiments show that the instrument is capable of imaging during sleep, and that it can record dynamic changes in airway size and shape. This information is useful for research into sleep disorders, and potentially for clinical diagnosis and therapies.

  16. Creating Safe Spaces for Music Learning

    Science.gov (United States)

    Hendricks, Karin S.; Smith, Tawnya D.; Stanuch, Jennifer

    2014-01-01

    This article offers a practical model for fostering emotionally safe learning environments that instill in music students a positive sense of self-belief, freedom, and purpose. The authors examine the implications for music educators of creating effective learning environments and present recommendations for creating a safe space for learning,…

  17. Keeping Food Safe

    Centers for Disease Control (CDC) Podcasts

    2009-05-27

    This CDC Kidtastics podcast discusses things kids and parents can do to help prevent illness by keeping food safe.  Created: 5/27/2009 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 5/27/2009.

  18. Challenges in the clinical development of new antiepileptic drugs.

    Science.gov (United States)

    Franco, Valentina; French, Jacqueline A; Perucca, Emilio

    2016-01-01

    Despite the current availability in the market of over two dozen antiepileptic drugs (AEDs), about one third of people with epilepsy fail to achieve complete freedom from seizures with existing medications. Moreover, currently available AEDs have significant limitations in terms of safety, tolerability and propensity to cause or be a target for clinically important adverse drug interactions. A review of the evidence shows that there are many misperceptions about the viability of investing into new therapies for epilepsy. In fact, there are clear incentives to develop newer and more efficacious medications. Developing truly innovative drugs requires a shift in the paradigms for drug discovery, which is already taking place by building on greatly expanded knowledge about the mechanisms involved in epileptogenesis, seizure generation, seizure spread and development of co-morbidities. AED development can also benefit by a review of the methodology currently applied in clinical AED development, in order to address a number of ethical and scientific concerns. As discussed in this article, many processes of clinical drug development, from proof-of-concept-studies to ambitious programs aimed at demonstrating antiepileptogenesis and disease-modification, can be facilitated by a greater integration of preclinical and clinical science, and by application of knowledge acquired during decades of controlled epilepsy trials. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Plutonium safe handling

    International Nuclear Information System (INIS)

    Tvehlov, Yu.

    2000-01-01

    The abstract, prepared on the basis of materials of the IAEA new leadership on the plutonium safe handling and its storage (the publication no. 9 in the Safety Reports Series), aimed at presenting internationally acknowledged criteria on the radiation danger evaluation and summarizing the experience in the safe management of great quantities of plutonium, accumulated in the nuclear states, is presented. The data on the weapon-class and civil plutonium, the degree of its danger, the measures for provision of its safety, including the data on accident radiation consequences with the fission number 10 18 , are presented. The recommendations, making it possible to eliminate the super- criticality danger, as well as ignition and explosion, to maintain the tightness of the facility, aimed at excluding the radioactive contamination and the possibility of internal irradiation, to provide for the plutonium security, physical protection and to reduce irradiation are given [ru

  20. Safety analysis to support a safe operating envelope for fuel

    International Nuclear Information System (INIS)

    Gibb, R.A.; Reid, P.J.

    1998-01-01

    This paper presents an approach for defining a safe operating envelope for fuel. 'Safe operating envelope' is defined as an envelope of fuel parameters defined for application in safety analysis that can be related to, or used to define, the acceptable range of fuel conditions due to operational transients or deviations in fuel manufacturing processes. The paper describes the motivation for developing such a methodology. The methodology involved four steps: the update of fission product inventories, the review of sheath failure criteria, a review of input parameters to be used in fuel modelling codes, and the development of an improved fission product release code. This paper discusses the aspects of fuel sheath failure criteria that pertain to operating or manufacturing conditions and to the evaluation and selection of modelling input data. The other steps are not addressed in this paper since they have been presented elsewhere. (author)

  1. Health impact of supplying safe drinking water on patients having various clinical manifestations of fluorosis in an endemic village of West Bengal

    Directory of Open Access Journals (Sweden)

    Kunal K Majumdar

    2013-01-01

    Full Text Available Background: Excessive fluoride in drinking water causes dental, skeletal and non-skeletal fluorosis which is encountered in endemic proportions in several parts of the world. The World Health Organization (WHO guideline value and the permissible limit of fluoride as per the Bureau of Indian Standards (BIS is 1.5 mg/L. Studies showed that withdrawal of sources identified for fluoride, often leads to reduction of fluoride in the body fluids (re-testing urine and serum after a week or ten days and results in the disappearance of non-skeletal fluorosis within a short duration of 10-15 days. Objective: To determine the prevalence of signs and symptoms of suspected dental, skeletal and non-skeletal fluorosis along with food habits, addictions and use of fluoride-containing toothpaste among participants taking water with fluoride concentration above permissible limit and to assess the changes in clinical manifestations of the above participants after consumption of safe drinking water with fluoride concentration below permissible limit. Materials and Methods: A longitudinal intervention study was conducted from October 2010 to December 2011 in a village selected randomly in Purulia District of West Bengal which is endemic for fluorosis. Thirty-six families with 104 family members in the above village having history of taking unsafe water containing high level of fluoride were selected for the study. The occurrence of various dental, skeletal and non-skeletal manifestations of fluorosis along with food habits, addictions and use of fluoride-containing toothpaste among the study population was assessed; the impact of taking safe water with fluoride concentration below permissible limit from a supplied community filter on these clinical manifestations was studied by follow-up examination of the above participants for six months. The data obtained is compared with the collected data from the baseline survey. Results: The prevalence of signs and symptoms of

  2. Health impact of supplying safe drinking water on patients having various clinical manifestations of fluorosis in an endemic village of west bengal.

    Science.gov (United States)

    Majumdar, Kunal K; Sundarraj, Shunmuga N

    2013-01-01

    Excessive fluoride in drinking water causes dental, skeletal and non-skeletal fluorosis which is encountered in endemic proportions in several parts of the world. The World Health Organization (WHO) guideline value and the permissible limit of fluoride as per the Bureau of Indian Standards (BIS) is 1.5 mg/L. Studies showed that withdrawal of sources identified for fluoride, often leads to reduction of fluoride in the body fluids (re-testing urine and serum after a week or ten days) and results in the disappearance of non-skeletal fluorosis within a short duration of 10-15 days. To determine the prevalence of signs and symptoms of suspected dental, skeletal and non-skeletal fluorosis along with food habits, addictions and use of fluoride-containing toothpaste among participants taking water with fluoride concentration above permissible limit and to assess the changes in clinical manifestations of the above participants after consumption of safe drinking water with fluoride concentration below permissible limit. A longitudinal intervention study was conducted from October 2010 to December 2011 in a village selected randomly in Purulia District of West Bengal which is endemic for fluorosis. Thirty-six families with 104 family members in the above village having history of taking unsafe water containing high level of fluoride were selected for the study. The occurrence of various dental, skeletal and non-skeletal manifestations of fluorosis along with food habits, addictions and use of fluoride-containing toothpaste among the study population was assessed; the impact of taking safe water with fluoride concentration below permissible limit from a supplied community filter on these clinical manifestations was studied by follow-up examination of the above participants for six months. The data obtained is compared with the collected data from the baseline survey. The prevalence of signs and symptoms of dental, skeletal and non-skeletal fluorosis was (18.26%), (18

  3. Pharmacometrics in early clinical drug development

    NARCIS (Netherlands)

    Keizer, R.J.

    2010-01-01

    Pharmacometrics, the science of quantitative clinical pharmacology, has been recognized as one of the main research fields able to improve efficiency in drug development, and to reduce attrition rates on the route from drug discovery to approval. This field of drug research, which builds heavily on

  4. A dynamic fail-safe approach to the design of computer-based safety systems

    International Nuclear Information System (INIS)

    Smith, I.C.; Miller, M.

    1994-01-01

    For over 30 years AEA Technology has carried out research and development in the field of nuclear instrumentation and protection systems. Throughout the course of this extensive period of research and development the dominant theme has been the achievement of fully fail-safe designs. These are defined as designs in which the failure of any single component will result in the unit output reverting to a demand for trip action status. At an early stage it was recognized that the use of dynamic rather than static logic could ease the difficulties inherent in achieving a fail-safe design. The first dynamic logic systems coupled logic elements magnetically. The paper outlines the evolution from these early concepts of a dynamic fail-safe approach to the design of computer-based safety systems. Details are given of collaboration between AEA Technology and Duke Power Co. to mount an ISAT TM demonstration at Duke's Oconee Nuclear Power Station

  5. SIR - small is safe [in reactor design

    International Nuclear Information System (INIS)

    Hayns, M.

    1989-01-01

    A joint USA-UK venture has been initiated to design a small nuclear reactor which offers low capital cost, greater flexibility and a potentially lower environmental impact. Called Safe Integral Reactor (SIR), the lead unit could be built in the United Kingdom Atomic Energy Authority's (UKAEA's) Winfrith site if the design is accepted by the UK Nuclear Installations Inspectorate (NII). This article describes the 320 MWe reactor unit that is the basis of the design being developed. (author)

  6. The importance of life cycle concepts for the development of safe nanoproducts

    International Nuclear Information System (INIS)

    Som, Claudia; Berges, Markus; Chaudhry, Qasim; Dusinska, Maria; Fernandes, Teresa F.; Olsen, Stig I.; Nowack, Bernd

    2010-01-01

    Whilst the global players in industry are rapidly moving forward to take advantage of the new opportunities and prospects offered by nanotechnologies, it is imperative that such developments take place in a safe and sustainable manner. The increasing use of engineered nanomaterials (ENMs) in consumer products has raised certain concerns over their safety to human health and the environment. There are currently a number of major uncertainties and knowledge gaps in regard to behavior, chemical and biological interactions and toxicological properties of ENMs. As dealing with these uncertainties will require the generation of new basic knowledge, it is unlikely that they will be resolved in the immediate future. One has to consider the whole life cycle of nanoproducts to ensure that possible impacts can be systematically discovered. For example, life cycle assessment (LCA) - a formalized life cycle concept - may be used to assess the relative environmental sustainability performance of nanoproducts in comparison with their conventional equivalents. Other less formalized life cycle concepts in the framework of prospective technology assessment may uncover further detailed and prospective knowledge for human and environmental exposure to ENMs during the life cycle of nanoproducts. They systematically reveal impacts such as cross product contamination or dissipation of scarce materials among others. The combination of different life cycle concepts with the evolving knowledge from toxicology and risk assessment can mitigate uncertainties and can provide an early basis for informed decision making by the industry and regulators.

  7. [Innovative Prenatal Testing: Clinical Applications and Ethical Considerations].

    Science.gov (United States)

    Huang, Mei-Chih; Lin, Shio-Jean; Chen, Chih-Ling; Huang, Tzu-Jung

    2017-10-01

    The biomedical technology related to prenatal screen/diagnosis has developed rapidly in recent decades. Many prenatal genetic examinations are now available to assist pregnant women to better understand the status and development of their fetus. Moreover, many commercial advertisements for innovative prenatal examinations are now shown in the media. Cell-free DNA Screening (cfDNA screening), a non-invasive prenatal testing (NIPT) procedure, is a safe and high accuracy test that may be done at an earlier gestational age to screen for fetal aneuploidy. The following questions should be considered when applying cfDNA screening in clinical practice: 1. what is cfDNA screening, 2. who are its potential users, and 3. what ethical and policy considerations are associated with this examination? This article provides relevant information, clinical practice guidelines, and ethical / policy considerations related to cfDNA screening. Discussing cases involving different clinical situations helps promote understanding of cfDNA screening and maternal-care quality.

  8. Design and Development of Intracavity Optical Parametric Oscillator-based Eye Safe Laser Operating at 20 Hz without Forced Air Cooling

    OpenAIRE

    Atul Bhardwaj; Lalita Agrawal; A. K. Maini

    2013-01-01

    In this paper we report the design and development of an electro-optically Q-switched diode pumped Nd:YAG laser with intracavity optical parametric oscillator, generating ~ 5 ns laser pulses of ~8 mJ energy at eye safe wavelength of 1534 nm. A Z-shaped laser resonator has been designed with porro prism end reflector in Q-switch arm containing RTP Q-Switch and a suitably oriented waveplate. The gain arm consists of a Ø3 x 72 mm Nd: YAG laser rod, pumped from one side by 3 x 5 bar laser diode a...

  9. SAFE Journal. Volume 35, Number 1, Spring 2007

    Science.gov (United States)

    2007-01-01

    Division Eye Tactical, Inc. - Sales and Marketing Division First Technology Safety Systems, Inc. Fujikura Parachute Co., Ltd. FXC Corporation... markets for environmentally friendly products. The E.PA is considering using Section 6 of the Toxic Substances Control Act (TSCA) to regulate...CH,OH 0,N SAFE Journal - Vol 35(1) - Spring 2007 15 RESEARC H, DEVELOPMENT. TEST & EVALUATION SECTION Figure 2. Preparation of KDNP (1) using a

  10. Clinical solid waste management practices and its impact on human health and environment - A review

    International Nuclear Information System (INIS)

    Hossain, Md. Sohrab; Santhanam, Amutha; Nik Norulaini, N.A.; Omar, A.K. Mohd

    2011-01-01

    Research highlights: → Appropriate waste management technology for safe handling and disposal of clinical solid waste. → Infectious risk assessment on unsafe handling of clinical solid waste. → Recycling-reuse program of clinical solid waste materials. → Effective sterilization technology to reduce exposure of infectious risk. - Abstract: The management of clinical solid waste (CSW) continues to be a major challenge, particularly, in most healthcare facilities of the developing world. Poor conduct and inappropriate disposal methods exercised during handling and disposal of CSW is increasing significant health hazards and environmental pollution due to the infectious nature of the waste. This article summarises a literature review into existing CSW management practices in the healthcare centers. The information gathered in this paper has been derived from the desk study of open literature survey. Numerous researches have been conducted on the management of CSW. Although, significant steps have been taken on matters related to safe handling and disposal of the clinical waste, but improper management practice is evident from the point of initial collection to the final disposal. In most cases, the main reasons of the mismanagement of CSW are the lack of appropriate legislation, lack of specialized clinical staffs, lack of awareness and effective control. Furthermore, most of the healthcare centers of the developing world have faced financial difficulties and therefore looking for cost effective disposal methods of clinical waste. This paper emphasizes to continue the recycle-reuse program of CSW materials after sterilization by using supercritical fluid carbon dioxide (SF-CO2) sterilization technology at the point of initial collection. Emphasis is on the priority to inactivate the infectious micro-organisms in CSW. In that case, waste would not pose any threat to healthcare workers. The recycling-reuse program would be carried out successfully with the non

  11. The pressurized suit and some considerations leading to the development of physiologically safe working conditions

    International Nuclear Information System (INIS)

    Evans, J.C.

    1980-01-01

    The safe working environment of men wearing pressurized suits in the U.K.A.E.A. is based on the results of two experimental programmes, the first investigated the respiratory hazards, the second the assessment and control of the level of thermal stress. Both are described. (author)

  12. Safe injection practice among health care workers, Gharbiya, Egypt.

    Science.gov (United States)

    Ismail, Nanees A; Aboul Ftouh, Aisha M; El Shoubary, Waleed H

    2005-01-01

    A cross-sectional study was conducted in 25 health care facilities in Gharbiya governorate to assess safe injection practices among health care workers (HCWs). Two questionnaires, one to collect information about administrative issues related to safe injection and the other to collect data about giving injections, exposure to needle stick injuries, hepatitis B vaccination status and safe injection training. Practices of injections were observed using a standardized checklist. The study revealed that there was lack of both national and local infection control policies and lack of most of the supplies needed for safe injection practices. Many safe practices were infrequent as proper needle manipulation before disposal (41%), safe needle disposal (47.5%), reuse of used syringe & needle (13.2%) and safe syringe disposal (0%). Exposure to needle stick injuries were common among the interviewed HCWs (66.2%) and hand washing was the common post exposure prophylaxis measure (63.4%). Only 11.3% of HCWs had full course hepatitis B vaccination. Infection control -including safe injections- training programs should be afforded to all HCWs.

  13. The journey from safe yield to sustainability.

    Science.gov (United States)

    Alley, William M; Leake, Stanley A

    2004-01-01

    Safe-yield concepts historically focused attention on the economic and legal aspects of ground water development. Sustainability concerns have brought environmental aspects more to the forefront and have resulted in a more integrated outlook. Water resources sustainability is not a purely scientific concept, but rather a perspective that can frame scientific analysis. The evolving concept of sustainability presents a challenge to hydrologists to translate complex, and sometimes vague, socioeconomic and political questions into technical questions that can be quantified systematically. Hydrologists can contribute to sustainable water resources management by presenting the longer-term implications of ground water development as an integral part of their analyses.

  14. Engineering safe and secure cyber-physical systems the specification PEARL approach

    CERN Document Server

    Gumzej, Roman

    2016-01-01

    This book introduces the concept of holistic design and development of cyber physical systems to achieve their safe and secure operation. It shows that by following the standards for embedded system’s safety and using appropriate hardware and software components inherently safe system’s architectures can be devised and certified. While the standards already enable testing and certification of inherently safe and sound hardware, this is still not the case with software. The book demonstrates that Specification PEARL(SPEARL) addresses this issue and proposes appropriate solutions from the viewpoints of software engineering as well as concrete program components. By doing so it reduces the complexity of cyber physical systems design in an innovative way. Three ultimate goals are being followed in the course of defining this new PEARL standard, namely: 1. simplicity over complexity, 2. inherent real-time ability, and 3. conformity to safety integrity and security capability levels.

  15. Using intervention mapping for the development of a targeted secure web-based outreach strategy named SafeFriend, for Chlamydia trachomatis testing in young people at risk.

    Science.gov (United States)

    Theunissen, Kevin A T M; Hoebe, Christian J P A; Crutzen, Rik; Kara-Zaïtri, Chakib; de Vries, Nanne K; van Bergen, Jan E A M; van der Sande, Marianne A B; Dukers-Muijrers, Nicole H T M

    2013-10-22

    Many young people at high risk for Chlamydia trachomatis (Ct) are not reached by current sexual health care systems, such as general practitioners and public sexual health care centres (sexually transmitted infection clinics).Ct is the most frequently diagnosed bacterial sexually transmitted infection (STI) among sexually active people and in particular young heterosexuals. Innovative screening strategies are needed to interrupt the transmission of Ct among young people and connect the hidden cases to care. Intervention Mapping (IM), a systematic approach to develop theory- and evidence-based interventions, was used to develop a strategy to target Ct testing towards young people who are currently hidden to care in The Netherlands. Both clinical users (i.e. sexual health care nurses) and public users (i.e., young people at risk for Ct) were closely involved in the IM process. A needs assessment study was carried out using semi-structured interviews among users (N = 21), a literature search and by taking lessons learned from existing screening programmes. Theoretical methods and practical applications to reach high risk young people and influence testing were selected and translated into specific programme components. The IM approach resulted in the development of a secure and web-based outreach Ct screening strategy, named SafeFriend. It is developed to target groups of high-risk young people who are currently hidden to care. Key methods include web-based Respondent Driven Sampling, starting from young Ct positive sexual health care centre clients, to reach and motivate peers (i.e., sex partners and friends) to get tested for Ct. Testing and the motivation of peers were proposed as the desired behavioural outcomes and the Precaution Adoption Process Model was chosen as theoretical framework. End users, i.e., young people and sexual health care nurses were interviewed and included in the development process to increase the success of implementation. IM proved useful

  16. Enabling professional development in mental health nursing: the role of clinical leadership.

    Science.gov (United States)

    Ennis, G; Happell, B; Reid-Searl, K

    2015-10-01

    Clinical leadership is acknowledged as important to the nursing profession. While studies continue to identify its significance in contributing to positive outcomes for consumers, the role that clinical leadership has in enabling and supporting professional development in mental health nursing is poorly understood. This study utilized a grounded theory methodology to explore the characteristics clinicians consider important for clinical leadership and its significance for mental health nursing in day-to-day clinical practice. Individual face-to-face, semi-structured interviews were conducted with nurses working in mental health settings. Participants described the important role that clinical leaders play in enabling professional development of others through role modelling and clinical teaching. They describe how nurses, whom they perceive as clinical leaders, use role modelling and clinical teaching to influence the professional development of nursing staff and undergraduate nursing students. Attributes such as professionalism and honesty were seen, by participants, as enablers for clinical leaders in effectively and positively supporting the professional development of junior staff and undergraduate nurses in mental health nursing. This paper examines clinical leadership from the perspective of mental health nurses delivering care, and highlights the important role of clinical leaders in supporting professional development in mental health nursing. © 2015 John Wiley & Sons Ltd.

  17. CDC Kerala 1: Organization of clinical child development services (1987-2013).

    Science.gov (United States)

    Nair, M K C; George, Babu; Nair, G S Harikumaran; Bhaskaran, Deepa; Leena, M L; Russell, Paul Swamidhas Sudhakar

    2014-12-01

    The main objective of establishing the Child Development Centre (CDC), Kerala for piloting comprehensive child adolescent development program in India, has been to understand the conceptualization, design and scaling up of a pro-active positive child development initiative, easily replicable all over India. The process of establishing the Child Development Centre (CDC) Kerala for research, clinical services, training and community extension services over the last 25 y, has been as follows; Step 1: Conceptualization--The life cycle approach to child development; Step 2: Research basis--CDC model early stimulation is effective; Step 3: Development and validation of seven simple developmental screening tools; Step 4: CDC Diagnostic services--Ultrasonology and genetic, and metabolic laboratory; Step 5: Developing seven intervention packages; Step 6: Training--Post graduate diploma in clinical child development; Step 7: CDC Clinic Services--seven major ones; Step 8: CDC Community Services--Child development referral units; Step 9: Community service delivery models--Childhood disability and for adolescent care counselling projects; Step 10: National capacity building--Four child development related courses. CDC Kerala follow-up and clinic services are offered till 18 y of age and premarital counselling till 24 y of age as shown in "CDC Kerala Clinic Services Flow Chart" and 74,291 children have availed CDC clinic services in the last 10 y. CDC Kerala is the first model for comprehensive child adolescent development services using a lifecycle approach in the Government sector and hence declared as the collaborative centre for Rashtriya Bal Swasthya Karyakram (RBSK), in Kerala.

  18. Safe Re-use Practices in Wastewater-Irrigated Urban Vegetable Farming in Ghana

    DEFF Research Database (Denmark)

    Keraita, Bernard; Abaidoo, R.C; Beernaerts, I.

    2012-01-01

    of stakeholders at different levels along the food chain. This paper presents an overview of safe re-use practices including farm-based water treatment methods, water application techniques, post-harvest handling practices, and washing methods. The overview is based on a comprehensive analysis of the literature......Irrigation using untreated wastewater poses health risks to farmers and consumers of crop products, especially vegetables. With hardly any wastewater treatment in Ghana, a multiple-barrier approach was adopted and safe re-use practices were developed through action research involving a number...... and our own specific studies, which used data from a broad range of research methods and approaches. Identifying, testing, and assessment of safe practices were done with the active participation of key actors using observations, extensive microbiological laboratory assessments, and field...

  19. OverView of Space Applications for Environment (SAFE) initiative

    Science.gov (United States)

    Hamamoto, Ko; Fukuda, Toru; Tajima, Yoshimitsu; Takeuchi, Wataru; Sobue, Shinichi; Nukui, Tomoyuki

    2014-06-01

    Climate change and human activities have a direc or indirect influence on the acceleration of environmental problems and natural hazards such as forest fires, draughts and floods in the Asia-Pacific countries. Satellite technology has become one of the key information sources in assessment, monitoring and mitigation of these disasters and related phenomenon. However, there are still gaps between science and application of satellite technology in real-world usage. Asia-Pacific Regional Space Agency Forum (APRSAF) recommended to initiate the Space Applications for Environment (SAFE) proposal providing opportunity to potential user agencies in the Asia Pacific region to develop prototype applications of satellite technology for number of key issues including forest resources management, coastal monitoring and management, agriculture and food security, water resource management and development user-friendly tools for application of satellite technology. This paper describes the overview of SAFE initiative and outcomes of two selected prototypes; agricultural drought monitoring in Indonesia and coastal management in Sri Lanka, as well as the current status of on-going prototypes.

  20. OverView of Space Applications for Environment (SAFE) initiative

    International Nuclear Information System (INIS)

    Hamamoto, Ko; Fukuda, Toru; Nukui, Tomoyuki; Tajima, Yoshimitsu; Takeuchi, Wataru; Sobue, Shinichi

    2014-01-01

    Climate change and human activities have a direc or indirect influence on the acceleration of environmental problems and natural hazards such as forest fires, draughts and floods in the Asia-Pacific countries. Satellite technology has become one of the key information sources in assessment, monitoring and mitigation of these disasters and related phenomenon. However, there are still gaps between science and application of satellite technology in real-world usage. Asia-Pacific Regional Space Agency Forum (APRSAF) recommended to initiate the Space Applications for Environment (SAFE) proposal providing opportunity to potential user agencies in the Asia Pacific region to develop prototype applications of satellite technology for number of key issues including forest resources management, coastal monitoring and management, agriculture and food security, water resource management and development user-friendly tools for application of satellite technology. This paper describes the overview of SAFE initiative and outcomes of two selected prototypes; agricultural drought monitoring in Indonesia and coastal management in Sri Lanka, as well as the current status of on-going prototypes

  1. Clinical chemistry since 1800: growth and development.

    Science.gov (United States)

    Rosenfeld, Louis

    2002-01-01

    The 19th and 20th centuries witnessed the growth and development of clinical chemistry. Many of the individuals and the significance of their contributions are not very well known, especially to new members of the profession. This survey should help familiarize them with the names and significance of the contributions of physicians and chemists such as Fourcroy, Berzelius, Liebig, Prout, Bright, and Rees. Folin and Van Slyke are better known, and it was their work near the end of the second decade of the 20th century that brought the clinical chemist out of the annex of the mortuary and into close relationship with the patient at the bedside. However, the impact on clinical chemistry and the practice of medicine by the 1910 exposé written by Abraham Flexner is not as well known as it deserves to be, nor is the impetus that World War I gave to the spread of laboratory medicine generally known. In the closing decades of the 20th century, automated devices produced an overabundance, and an overuse and misuse, of testing to the detriment of careful history taking and bedside examination of the patient. This is attributable in part to a fascination with machine-produced data. There was also an increased awareness of the value of chemical methods of diagnosis and the need to bring clinician and clinical chemist into a closer partnership. Clinical chemists were urged to develop services into dynamic descriptions of the diagnostic values of laboratory results and to identify medical relevance in interpreting significance for the clinician.

  2. Design and implementation of a radiotherapy programme: Clinical, medical physics, radiation protection and safety aspects

    International Nuclear Information System (INIS)

    1998-09-01

    It is widely acknowledged that the clinical aspects (diagnosis, decision, indication for treatment, follow-up) as well as the procedures related to the physical and technical aspects of patient treatment must be subjected to careful control and planning in order to ensure safe, high quality radiotherapy. Whilst it has long been recognized that the physical aspects of quality assurance in radiotherapy are vital to achieve and effective and safe treatment, it has been increasingly acknowledged only recently that a systematic approach is absolutely necessary to all steps within clinical and technical aspects of a radiotherapy programme as well. The need to establish general guidelines at the IAEA, taking into account clinical medical physics, radiation protection and safety considerations, for designing and implementing radiotherapy programmes in Member States has been identified through the Member States' increased interest in the efficient and safe application of radiation in health care. Several consultants and advisory group meetings were convened to prepare a report providing a basis for establishing a programme in radiotherapy. The present TECDOC is addressed to all professionals and administrators involved in the development, implementation and management of a radiotherapy programme in order to establish a common and consistent framework where all steps and procedures in radiotherapy are taken into account

  3. Implicit attitudes towards risky and safe driving

    DEFF Research Database (Denmark)

    Martinussen, Laila Marianne; Sømhovd, Mikael Julius; Møller, Mette

    ; further, self-reports of the intention to drive safely (or not) are socially sensitive. Therefore, we examined automatic preferences towards safe and risky driving with a Go/No-go Association Task (GNAT). The results suggest that (1) implicit attitudes towards driving behavior can be measured reliably...... with the GNAT; (2) implicit attitudes towards safe driving versus towards risky driving may be separable constructs. We propose that research on driving behavior may benefit from routinely including measures of implicit cognition. A practical advantage is a lesser susceptibility to social desirability biases......, compared to self-report methods. Pending replication in future research, the apparent dissociation between implicit attitudes towards safe versus risky driving that we observed may contribute to a greater theoretical understanding of the causes of unsafe and risky driving behavior....

  4. Inherently safe high temperature gas-cooled reactor

    International Nuclear Information System (INIS)

    Yamada, Masao; Hayakawa, Hitoshi

    1987-01-01

    It is recognized in general that High Temperature Gas-cooled Reactors have remarkable characteristics in inherent safety and it is well known that credits of the time margin have been admitted for accident evaluation in the licensing of the currently operating prototype HTGRs (300 MWe class). Recently, more inherently safe HTGRs are being developed in various countries and drawing attention on their possibility for urban siting. The inherent safety characteristics of these HTRs differ each other depending on their design philosophy and on the features of the components/structures which constitute the plant. At first, the specific features/characteristics of the elemental components/structures of the HTRs are explained one by one and then the overall safety features/characteristics of these HTR plants are explained in connection with their design philosophy and combination of the elemental features. Taking the KWU/Interatom Modular Reactor System as an example, the particular design philosophy and safety characteristics of the inherently safe HTR are explained with a result of preliminary evaluation on the possibility of siting close to densely populated area. (author)

  5. The Pathway to a Safe and Effective Medication Formulary for Exploration Spaceflight

    Science.gov (United States)

    Daniels, V. R.; Bayuse, T. M.; Mulcahy, R. A.; Mcguire, R. K. M.; Antonsen, E. L.

    2017-01-01

    PURPOSE: Exploration space missions pose several challenges to providing a comprehensive medication formulary designed to accommodate the size and space limitations of the spacecraft; while addressing the individual medications needs and preferences of the Crew; the negative outcome of a degrading inventory over time, the inability to resupply before expiration dates; and the need to properly forecast the best possible medication candidates to treat conditions that will occur in the future. METHODS: The Pharmacotherapeutics Discipline has partnered with the Exploration Medical Capabilities (ExMC) Element to develop and propose a research pathway that is comprehensively focused on evidence-based models and theories, as well as on new diagnostic tools and treatments or preventive measures aimed at closure of the Med02 “Pharmacy” Gap; defined in the Human Research Program’s (HRP) risk-based research strategy. The Med02 Gap promotes the challenge to identify a strategy to ensure that medications used to treat medical conditions during exploration space missions are available, safe, and effective. It is abundantly clear that pharmaceutical intervention is an essential component of risk management planning for astronaut healthcare during exploration space. However, the quandary still remains of how to assemble a formulary that is comprehensive enough to prevent or treat anticipated medical events; and is also chemically stable, safe, and robust enough to have sufficient potency to last for the duration of an exploration space mission. In cases where that is not possible, addressing this Gap requires exploration of novel drug development techniques, dosage forms, and dosage delivery platforms that enhance chemical stability as well as therapeutic effectiveness. RESULTS: The proposed research pathway outlines the steps, processes, procedures, and a research portfolio aimed at identifying a capability that will provide a safe and effective pharmacy for any specific

  6. Safe school task force: University-community partnership to promote student development and a safer school environment.

    Science.gov (United States)

    Adler, Corey; Chung-Do, Jane; Ongalibang, Ophelia

    2008-01-01

    The Asian/Pacific Islander Youth Violence Prevention Center (APIYVPC) focuses its youth violence prevention efforts on community mobilization by partnering with Kailua High School and other local community groups. This paper describes the development and activities of the Safe School Task Force (SSTF) and the lessons learned. In response to concerns of school, community members, and students, the SSTF was organized to promote student leadership in raising awareness about problems related to violence. Collaboration among the school, community, and the university places students in leadership roles to reduce school violence and enhances their self-efficacy to improve their school environment. To increase SSTF effectiveness, more attention must be paid to student recruitment, consistent community partnerships, and gaining teacher buy-in. This partnership may be useful in multicultural communities to provide students the opportunities to learn about violence prevention strategies, community mobilization, and leadership skills.

  7. Developing Federal Clinical Care Recommendations for Women.

    Science.gov (United States)

    Godfrey, Emily M; Tepper, Naomi K; Curtis, Kathryn M; Moskosky, Susan B; Gavin, Loretta E

    2015-08-01

    The provision of family planning services has important health benefits for the U.S. Approximately 25 million women in the U.S. receive contraceptive services annually and 44 million make at least one family planning-related clinical visit each year. These services are provided by private clinicians, as well as publicly funded clinics, including specialty family planning clinics, health departments, Planned Parenthoods, community health centers, and primary care clinics. Recommendations for providing quality family planning services have been published by CDC and the Office of Population Affairs of the DHHS. This paper describes the process used to develop the women's clinical services portion of the new recommendations and the rationale underpinning them. The recommendations define family planning services as contraceptive care, pregnancy testing and counseling, achieving pregnancy, basic infertility care, sexually transmitted disease services, and preconception health. Because many women who seek family planning services have no other source of care, the recommendations also include additional screening services related to women's health, such as cervical cancer screening. These clinical guidelines are aimed at providing the highest-quality care and are designed to establish a national standard for family planning in the U.S. Published by Elsevier Inc.

  8. Safe drinking water act: Amendments, regulations and standards

    International Nuclear Information System (INIS)

    Calabrese, E.J.; Gilbert, C.E.; Pastides, H.

    1989-01-01

    This book approaches the topic of safe drinking water by communicating how the EPA has responded to the mandates of Congress. Chapter 1 summarizes what is and will be involved in achieving safe drinking water. Chapter 2 describes the historical development of drinking water regulations. Chapter 3 summarizes the directives of the Safe Drinking Water Act Amendments of 1986. Chapters 4 through 9 discuss each phase of the regulatory program in turn. Specific problems associated with volatile organic chemicals, synthetic organics, inorganic chemicals, and microbiological contaminants are assessed in Chapter 4 and 5. The unique characteristics of radionuclides and their regulation are treated in Chapter 6. The disinfection process and its resultant disinfection by-products are presented in Chapter 7. The contaminant selection process and the additional contaminants to be regulated by 1989 and 1991 and in future years are discussed in Chapters 8 and 9. EPA's Office of Drinking Water's Health Advisory Program is explained in Chapter 10. The record of public water system compliance with the primary drinking water regulations is detailed in Chapter 11. Chapter 12 offers a nongovernmental perspective on the general quality of drinking water and how this is affected by a wide range of drinking water treatment technologies. Separate abstracts are processed for 5 chapters in this book for inclusion in the appropriate data bases

  9. Knowledge Creation in Clinical Product Development Management Research

    DEFF Research Database (Denmark)

    Karlsson, Christer; Sköld, Martin

    2012-01-01

    This paper explores the clinical approach to management research and positions it in relation to other similar approaches. It achieves this by pointing out the most important historical milestones in the development of such approaches. The literature on the approach is mapped, including that on t......This paper explores the clinical approach to management research and positions it in relation to other similar approaches. It achieves this by pointing out the most important historical milestones in the development of such approaches. The literature on the approach is mapped, including...... of the approaches, the paper discusses the research issues to which clinical research is relevant and how the research framework should be designed, then practical issues relating to how to approach the study objects, the design of the research instruments, and the conducting of the field research. Finally...

  10. 50 CFR 216.91 - Dolphin-safe labeling standards.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Dolphin-safe labeling standards. 216.91... MAMMALS Dolphin Safe Tuna Labeling § 216.91 Dolphin-safe labeling standards. (a) It is a violation of... include on the label of those products the term “dolphin-safe” or any other term or symbol that claims or...

  11. Antibiotics in late clinical development.

    Science.gov (United States)

    Fernandes, Prabhavathi; Martens, Evan

    2017-06-01

    Most pharmaceutical companies have stopped or have severely limited investments to discover and develop new antibiotics to treat the increasing prevalence of infections caused by multi-drug resistant bacteria, because the return on investment has been mostly negative for antibiotics that received marketing approved in the last few decades. In contrast, a few small companies have taken on this challenge and are developing new antibiotics. This review describes those antibiotics in late-stage clinical development. Most of them belong to existing antibiotic classes and a few with a narrow spectrum of activity are novel compounds directed against novel targets. The reasons for some of the past failures to find new molecules and a path forward to help attract investments to fund discovery of new antibiotics are described. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Comparison of Psychomotor Development Screening Test and Clinical Assessment of Psychomotor Development

    Science.gov (United States)

    Radmilović, Goranka; Matijević, Valentina; Zavoreo, Iris

    2016-12-01

    Numerous adverse factors are acting in the prenatal, perinatal and postnatal period of life and may be the cause of later mild or severe deviations from normal psychomotor development. Therefore, it is crucial to identify infants with neurological risk factors and infants that already have a delay from orderly development, in order to immediately initiate the rehabilitation process. The aim of this study was to determine whether there is difference in the assessment of psychomotor development in neurological risk children based on the psychomotor development test (Croatian, Razvoj psihomotorike, RPM test) and clinical evaluation of neuromotor development. RPM test is designed for rough estimate of psychomotor development in children in the first two years of life. The study included 15 full term children (8 male and 7 female) with clinical diagnosis of mild paraparesis and mild deviation from normal psychological and social development, and 15 full term children (8 male and 7 female) without neurological risk factors and deviations from normal psychomotor development, all at the age of 12-24 months. Of the 15 children diagnosed with mild paraparesis, none had delayed psychomotor development, 6.7% had suspect development and 93.3% had normal development on RPM test. All children in the control group had normal development on RPM test. According to the results, the RPM test is not sensitive enough to detect mild neurodevelopmental disorders.

  13. Clinical Simulation: For What and How Can It Be Used in Design and Evaluation of Health IT

    DEFF Research Database (Denmark)

    Jensen, Sanne

    2015-01-01

    The usability of health information technology (IT) is increasingly recognized as critically important to the development of systems that are both safe to use and acceptable to end-users. The substantial complexity of organizations, work practice and physical environments within the healthcare...... sector influences the development and application of health IT. When health IT is introduced in local clinical work practices, potential patient safety hazards and insufficient support of work practices need to be examined. Qualitative methods, such as clinical simulation, may be used to support Techno...

  14. Medications: Using Them Safely

    Science.gov (United States)

    ... to Safely Give Ibuprofen Childproofing and Preventing Household Accidents Medicines for Diabetes Complementary and Alternative Medicine How Do Pain Relievers Work? What Medicines Are and What They Do Medicines ...

  15. Developing a leadership pipeline: the Cleveland Clinic experience.

    Science.gov (United States)

    Hess, Caryl A; Barss, Christina; Stoller, James K

    2014-11-01

    The complexity of health care requires excellent leadership to address the challenges of access, quality, and cost of care. Because competencies to lead differ from clinical or research skills, there is a compelling need to develop leaders and create a talent pipeline, perhaps especially in physician-led organizations like Cleveland Clinic. In this context, we previously reported on a cohort-based physician leadership development course called Leading in Health Care and, in the current report, detail an expanded health care leadership development programme called the Cleveland Clinic Academy (CCA). CCA consists of a broad suite of offerings, including cohort-based learning and 'a la carte' half- or full-day courses addressing specific competencies to manage and to lead. Academy attendance is optional and is available to all physicians, nurses, and administrators with the requisite experience. Course selection is guided by competency matrices which map leadership competencies to specific courses. As of December 2012, a total of 285 course sessions have been offered to 6,050 attendees with uniformly high ratings of course quality and impact. During the past 10 years, Cleveland Clinic's leadership and management curriculum has successfully created a pipeline of health care leaders to fill executive positions, search committees, board openings, and various other organizational leadership positions. Health care leadership can be taught and learned.

  16. Clinical implications of determination of safe surgical margins by using a combination of CT and 18FDG-positron emission tomography in soft tissue sarcoma

    Directory of Open Access Journals (Sweden)

    Yoshioka Takako

    2011-07-01

    Full Text Available Abstract Background To determine safe surgical margins for soft tissue sarcoma, it is essential to perform a general evaluation of the extent of tumor, responses to auxiliary therapy, and other factors preoperatively using multiple types of diagnostic imaging. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT is a tool for diagnostic imaging that has recently spread rapidly in clinical use. At present, the roles played by FDG-PET/CT in determination of margins for surgical resection of sarcoma are unclear. The present study was undertaken to explore the roles of FDG-PET/CT in determination of surgical margins for soft tissue sarcoma and to examine whether PET can serve as a standard means for setting the margins of surgical resection during reduced surgery. Methods The study involved 7 patients with sarcoma who underwent surgery in our department and in whom evaluation with FDG-PET/CT was possible. Sarcoma was histologically rated as MFH in 6 cases and leiomyosarcoma in 1 case. In all cases, sarcoma was superficial (T1a or T2a. The tumor border was defined by contrast-enhanced MRI, and SUVs were measured at intervals of 1 cm over a 5-cm long area from the tumor border. Mapping of viable tumor cells was carried out on whole-mount sections of resected tissue, and SUVs were compared with histopathological findings. Results Preoperative maximum SUVs (SUV-max of the tumor averaged 11.7 (range: 3.8-22.1. Mean SUV-max was 2.2 (range: 0.3-3.8 at 1 cm from the tumor border, 1.1 (0.85-1.47 at 2 cm, 0.83 (0.65-1.15 at 3 cm, 0.7 (0.42-0.95 at 4 cm, and 0.64 (0.45-0.82 at 5 cm. When resected tissue was mapped, tumor cells were absent in the areas where SUV-max was below 1.0. Conclusions Our findings suggest that a safe surgical margin free of viable tumor cells can be ensured if the SUV cut-off level is set at 1.0. FDG-PET/CT is promising as a diagnostic imaging technique for setting of safe minimal margins for surgical

  17. Low-temperature thermionics in space nuclear power systems with the safe-type fast reactor

    International Nuclear Information System (INIS)

    Zrodnikov, A.V.; Yarygin, V.I.; Lazarenko, G.E.; Zabudko, A.N.; Ovcharenko, M.K.; Pyshko, A.P.; Mironov, V.S.; Kuznetsov, R.V.

    2007-01-01

    The potentialities of the use of the low-temperature thermionic converters (TIC) with the emitter temperature ≤ 1500 K in the space nuclear power system (SNPS) with the SAFE-type (Safe Affordable Fission Engine) fast reactor proposed and developed by common efforts of American experts have been considered. The main directions of the 'SAFE-300-TEG' SNPS (300 kW(thermal)) design update by replacing the thermoelectric converters with the low-temperature high-performance thermionic converters (with the barrier index V B ≤ 1.9 eV and efficiency ≥ 10%) meant for a long-term operation (5 years at least) as the components of the SAFE-300-TIC SNPS for a Lunar base have been discussed. The concept of the SNPS with the SAFE-type fast reactor and low-temperature TICs with specific electric power of about 1.45 W/cm 2 as the components of the SAFE-300-TIC system meeting the Nasa's initial requirements to a Lunar base with the electric power demand of about 30 kW(electrical) for robotic mission has been considered. The results, involving optimization and mass-and-size estimation, show that the SAFE-300-TIC system meets the initial requirements by Nasa to the lunar base power supply. The main directions of the system update aimed at the output electric power increase up to 100 kW(electrical) have also been presented. (authors)

  18. Individual-level outcomes from a national clinical leadership development programme.

    Science.gov (United States)

    Patton, Declan; Fealy, Gerard; McNamara, Martin; Casey, Mary; Connor, Tom O; Doyle, Louise; Quinlan, Christina

    2013-08-01

    A national clinical leadership development programme was instituted for Irish nurses and midwives in 2010. Incorporating a development framework and leadership pathway and a range of bespoke interventions for leadership development, including workshops, action-learning sets, mentoring and coaching, the programme was introduced at seven pilot sites in the second half of 2011. The programme pilot was evaluated with reference to structure, process and outcomes elements, including individual-level programme outcomes. Evaluation data were generated through focus groups and group interviews, individual interviews and written submissions. The data provided evidence of nurses' and midwives' clinical leadership development through self and observer-reported behaviours and dispositions including accounts of how the programme participants developed and displayed particular clinical leadership competencies. A key strength of the new programme was that it involved interventions that focussed on specific leadership competencies to be developed within the practice context.

  19. Tranexamic Acid Safely Reduced Blood Loss in Hemi- and Total Hip Arthroplasty for Acute Femoral Neck Fracture: A Randomized Clinical Trial.

    Science.gov (United States)

    Watts, Chad D; Houdek, Matthew T; Sems, S Andrew; Cross, William W; Pagnano, Mark W

    2017-07-01

    We aimed to determine whether (1) tranexamic acid (TXA) reduces the incidence of transfusion (2) TXA reduces the calculated blood loss, and (3) there are any observable differences in 30- and 90-day complications with TXA administration during arthroplasty for femoral neck fracture (FNF). Prospective, double-blinded, randomized controlled trial. Level 1 Academic Trauma Center. One hundred thirty-eight patients who presented with a low-energy, isolated, FNF (AO 31B) treated with either hemi- or total hip arthroplasty within 72 hours of injury were randomized to either the TXA group (69 patients) or placebo group (69 patients). In the TXA group, patients received 2 doses of 15 mg/kg intravenous TXA dissolved in 100 mL of saline, each administered over 10 minutes; 1 dose just before incision, and the second at wound closure. In the placebo group, 100 mL of saline solution was administered in a similar fashion. Perioperative care was otherwise standardized including conservative transfusion criteria. Our primary outcome was to determine the proportion of patients who underwent blood transfusion during hospitalization. Secondary outcomes were calculated blood loss, number of units transfused during hospitalization, and incidence of adverse events at 30 and 90 days including thromboembolic event, wound complications, reoperation, hospital readmission, and all-cause mortality. TXA reduced mean incidence of transfusion by 305 mL (P = 0.0005). There was a trend toward decreased transfusion rate in the TXA group (17% vs. 26%, P = 0.22). TXA was safe with no differences in adverse events at 30 and 90 days. This randomized clinical trial found that TXA administration safely reduced blood loss with a tendency for decreased transfusion rate and total blood product consumption for patients undergoing hip arthroplasty for acute FNF. More studies are needed to further ascertain the role of TXA in the management of patients with FNF. Therapeutic Level I. See Instructions for Authors

  20. A National Strategy to Develop Pragmatic Clinical Trials Infrastructure

    Science.gov (United States)

    Guise, Jeanne‐Marie; Dolor, Rowena J.; Meissner, Paul; Tunis, Sean; Krishnan, Jerry A.; Pace, Wilson D.; Saltz, Joel; Hersh, William R.; Michener, Lloyd; Carey, Timothy S.

    2014-01-01

    Abstract An important challenge in comparative effectiveness research is the lack of infrastructure to support pragmatic clinical trials, which compare interventions in usual practice settings and subjects. These trials present challenges that differ from those of classical efficacy trials, which are conducted under ideal circumstances, in patients selected for their suitability, and with highly controlled protocols. In 2012, we launched a 1‐year learning network to identify high‐priority pragmatic clinical trials and to deploy research infrastructure through the NIH Clinical and Translational Science Awards Consortium that could be used to launch and sustain them. The network and infrastructure were initiated as a learning ground and shared resource for investigators and communities interested in developing pragmatic clinical trials. We followed a three‐stage process of developing the network, prioritizing proposed trials, and implementing learning exercises that culminated in a 1‐day network meeting at the end of the year. The year‐long project resulted in five recommendations related to developing the network, enhancing community engagement, addressing regulatory challenges, advancing information technology, and developing research methods. The recommendations can be implemented within 24 months and are designed to lead toward a sustained national infrastructure for pragmatic trials. PMID:24472114

  1. Non-clinical development of CER-001.

    Science.gov (United States)

    Barbaras, Ronald

    2015-01-01

    Cardiovascular disease remains the most pressing healthcare issue for the developed world and is becoming so for developing countries. There are no currently approved therapies that can rapidly reduce the burden of unstable, inflamed plaque in the overall coronary vascular bed. High-density lipoprotein (HDL) has multiple actions that could lead to plaque stabilization, such as rapid removal of large quantities of cholesterol from the vasculature through the process of reverse lipid transport, improvement in endothelial function, protection against oxidative damage, and reduction in inflammation. Short-term infusion of HDL-mimetics in animal models as well as in humans has shown promising effects on the plaque size and morphology. Cerenis Therapeutics has developed CER-001, a negatively charged lipoprotein complex consisting of phospholipid and recombinant human apoA-I that mimics the structure and function of natural HDL. Three clinical trials using CER-001 infusions have demonstrated improvements in the carotid wall thickness of patients with familial hypercholesterolaemia and in patients with hypo-alphalipoproteinaemia, as well as an impact on coronary plaque burden measured by intravascular ultrasonography at the lowest tested dose (3 mg/kg) in post-ACS patients. Here, we reviewed the non-clinical data leading to the demonstration that CER-001 is a full HDL mimetic.

  2. Intentional Modelling: A Process for Clinical Leadership Development in Mental Health Nursing.

    Science.gov (United States)

    Ennis, Gary; Happell, Brenda; Reid-Searl, Kerry

    2016-05-01

    Clinical leadership is becoming more relevant for nurses, as the positive impact that it can have on the quality of care and outcomes for consumers is better understood and more clearly articulated in the literature. As clinical leadership continues to become more relevant, the need to gain an understanding of how clinical leaders in nursing develop will become increasingly important. While the attributes associated with effective clinical leadership are recognized in current literature there remains a paucity of research on how clinical leaders develop these attributes. This study utilized a grounded theory methodology to generate new insights into the experiences of peer identified clinical leaders in mental health nursing and the process of developing clinical leadership skills. Participants in this study were nurses working in a mental health setting who were identified as clinical leaders by their peers as opposed to identifying them by their role or organizational position. A process of intentional modeling emerged as the substantive theory identified in this study. Intentional modeling was described by participants in this study as a process that enabled them to purposefully identify models that assisted them in developing the characteristics of effective clinical leaders as well as allowing them to model these characteristics to others. Reflection on practice is an important contributor to intentional modelling. Intentional modelling could be developed as a framework for promoting knowledge and skill development in the area of clinical leadership.

  3. Development of an online clinical trial recruitment portal for the NIHR mental health BRC.

    Science.gov (United States)

    Markham, Sarah

    2016-01-01

    In order to test whether or not new treatments for mental health disorders help patients get better according to clinician/patient selected criteria, it is often necessary to test them on patients under safe, carefully monitored conditions called clinical trials. It is necessary to find enough patients to take part in a clinical trial so that the results of the trial are reliable. The NIHR Mental Health BRC (here after abbreviated to BRC) is a centre for research in London which seeks to find out better ways to treat patients with mental health difficulties. The BRC has experienced problems trying to find sufficient numbers of patients to participate in its clinical trials as it appears that insufficient patients were being told by their doctor about opportunities to participate in clinical research. In order to help the BRC find enough patients to volunteer to take part in its clinical trials, the author (a patient representative) of this article and a clinical researcher in the nearby Institute of Psychiatry, Psychology and Neuroscience (IoPPN) decided to work together to try to find the best way to let patients know more about what clinical trials are, what it is like to take part in them and which clinical trials are seeking patients to take part. The author and researcher used a report by the Association of Medical Research Charities (AMRC) on patient difficulties in finding clinical trials to take part in, and the recommendations it made, to guide them in building a website to give such patients the information on clinical trials they wanted (including clinical trials run by the BRC). The author and researcher also asked patients, carers, staff at the IoPPN and BRC what they thought of the website and how to make it better. They used the ideas, suggestions and criticisms to improve the website. The author and researcher also asked mental health charities and research organisations if they would advertise the final version of this website on their own websites

  4. Producing Competent Doctors - The Art and Science of Teaching Clinical Skills.

    Science.gov (United States)

    Dhaliwal, Upreet; Supe, Avinash; Gupta, Piyush; Singh, Tejinder

    2017-05-15

    For a doctor to provide medical care with competence, he must not only have knowledge but must also be able to translate that knowledge into action. It is his competence in clinical skills that will enable him to practice safely and effectively in the real world. To ensure acquisition of clinical skills, medical teachers must adopt teaching methods that prioritise observation, practice, feedback; and more practice. We try to elucidate the meaning of clinical skills, the challenges inherent in clinical skills training in India, training models that have shown success in practice and can be adopted in the Indian context, and various techniques to enhance skill-training, including the giving of feedback, which is a critically important component of skills development.

  5. Safe havens in Europe: Switzerland and the ten dwarfs

    Directory of Open Access Journals (Sweden)

    Martin Paldam

    2013-12-01

    Full Text Available Eleven safe havens exist in Europe providing offshore banking and low taxes. Ten of these states are very small while Switzerland is moderately small. All 11countries are richer than their large neighbors. It is shown that causality is from small to safe haven towealth, and that theoretically equilibriums are likely to exist where a certain regulation is substantially lower in a small country than in its big neighbor. This generates a large capital inflow to the safe havens. The pool of funds that may reach the safe havens is shown to be huge. It is far in excess of the absorptive capacity of the safe havens, but it still explains, why they are rich. Microstates offer a veil of anonymity to funds passing through, and Switzerland offers safe storage of funds.

  6. Safe and Liquid Mortgage Bonds

    DEFF Research Database (Denmark)

    Dick-Nielsen, Jens; Gyntelberg, Jacob; Lund, Jesper

    This paper shows that strict match pass-through funding of covered bonds provides safe and liquid mortgage bonds. Despite a 30% drop in house prices during the 2008 global crisis Danish mortgage bonds remained as liquid as most European government bonds. The Danish pass-through system effectively...... eliminates credit risk from the investor's perspective. Similar to other safe bonds, funding liquidity becomes the main driver of mortgage bond liquidity and this creates commonality in liquidity across markets and countries. These findings have implications for how to design a robust mortgage bond system...

  7. Understanding the occupational and organizational boundaries to safe hospital discharge.

    Science.gov (United States)

    Waring, Justin; Marshall, Fiona; Bishop, Simon

    2015-01-01

    Safe hospital discharge relies upon communication and coordination across multiple occupational and organizational boundaries. Our aim was to understand how these boundaries can exacerbate health system complexity and represent latent sociocultural threats to safe discharge. An ethnographic study was conducted in two local health and social care systems (health economies) in England, focusing on two clinical areas: stroke and hip fracture patients. Data collection involved 345 hours of observations and 220 semi-structured interviews with health and social care professionals, patients and their lay carers. Hospital discharge involves a dynamic network of interactions between heterogeneous health and social care actors, each characterized by divergent ways of organizing discharge activities; cultures of collaboration and interaction and understanding of what discharge involves and how it contributes to patient recovery. These interrelated dimensions elaborate the occupational and organisational boundaries that can influence communication and coordination in hospital discharge. Hospital discharge relies upon the coordination of multiple actors working across occupational and organizational boundaries. Attention to the sociocultural boundaries that influence communication and coordination can help inform interventions that might support enhanced discharge safety. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  8. Implementation of an Improved Safe Operating Envelope

    International Nuclear Information System (INIS)

    Prime, Robyn; McIntyre, Mark; Reeves, David

    2008-01-01

    This paper is a continuation of the paper presented at IYNC 2004 on 'The Definition of a Safe Operating Envelope'. The current paper concentrates on the implementation process of the Safe Operating Envelope employed at the Point Lepreau Generating Station. (authors)

  9. Effect of Intrafix® SafeSet infusion apparatus on phlebitis in a neurological intensive care unit: a case-control study.

    Science.gov (United States)

    Liu, F; Chen, D; Liao, Y; Diao, L; Liu, Y; Wu, M; Xue, X; You, C; Kang, Y

    2012-01-01

    To investigate the effect of the Intrafix(®) SafeSet infusion apparatus on the incidence of phlebitis in patients being intravenously infused in a neurological intensive care unit (ICU). Patients aged > 12 years, with no history of diabetes mellitus and no existing phlebitis, requiring a daily peripheral intravenous infusion of ≥ 8 h with the total period lasting ≥ 3 days, were enrolled. Infusions were performed using the Intrafix(®) SafeSet or normal infusion apparatus. Incidence of phlebitis (scored according to the Infusion Nursing Standards of Practice of the American Infusion Nurses Society) was analysed. Patients (n = 1545) were allocated to Intrafix(®) SafeSet (n = 709) or normal infusion (n = 836) groups, matched for age, gender and preliminary diagnosis. Incidence of phlebitis was significantly higher using normal infusion apparatus compared with the Intrafix(®) SafeSet (23.4% versus 17.9%, respectively). Intrafix(®) SafeSet infusion apparatus significantly reduced the incidence of phlebitis in patients in the neurological ICU, compared with normal infusion apparatus, and may be suitable for use in routine clinical practice.

  10. [Latest development in mass spectrometry for clinical application].

    Science.gov (United States)

    Takino, Masahiko

    2013-09-01

    Liquid chromatography-tandem mass spectrometry (LC-MS/MS) has seen enormous growth in special clinical chemistry laboratories. It significantly increases the analytic potential in clinical chemistry, especially in the field of low molecular weight biomarker analysis. This review summarizes the state of the art in mass spectrometry and related techniques for clinical application with a main focus on recent developments in LC-MS. Current trends in ionization techniques, automated online sample preparation techniques coupled with LC-MS, and ion mobility spectrometry are discussed. Emerging mass spectrometric approaches complementary to LC-MS are discussed as well.

  11. Safe handling of potential peroxide forming compounds and their corresponding peroxide yielded derivatives.

    Energy Technology Data Exchange (ETDEWEB)

    Sears, Jeremiah Matthew; Boyle, Timothy J.; Dean, Christopher J.

    2013-06-01

    This report addresses recent developments concerning the identification and handling of potential peroxide forming (PPF) and peroxide yielded derivative (PYD) chemicals. PPF chemicals are described in terms of labeling, shelf lives, and safe handling requirements as required at SNL. The general peroxide chemistry concerning formation, prevention, and identification is cursorily presented to give some perspective to the generation of peroxides. The procedure for determining peroxide concentrations and the proper disposal methods established by the Hazardous Waste Handling Facility are also provided. Techniques such as neutralization and dilution are provided for the safe handling of any PYD chemicals to allow for safe handling. The appendices are a collection of all available SNL documentation pertaining to PPF/PYD chemicals to serve as a single reference.

  12. Developing a general ward nursing dashboard.

    Science.gov (United States)

    Russell, Margot; Hogg, Maggie; Leach, Stuart; Penman, Mags; Friel, Susan

    2014-12-15

    The seventh and final article in the series on Leading Better Care explores some of the challenges in clinical practice relating to the use of data and making information meaningful to senior charge nurses and ward sisters. It describes the collaborative approach taken by NHS Lanarkshire, which involved nursing staff, programme leads and the eHealth team in the development of a general ward nursing dashboard as a means of ensuring safe, effective person-centred care. The article also illustrates how this web-based data-reporting programme is used to support clinical practice.

  13. Obesity and Pediatric Drug Development.

    Science.gov (United States)

    Vaughns, Janelle D; Conklin, Laurie S; Long, Ying; Zheng, Panli; Faruque, Fahim; Green, Dionna J; van den Anker, John N; Burckart, Gilbert J

    2018-05-01

    There is a lack of dosing guidelines for use in obese children. Moreover, the impact of obesity on drug safety and clinical outcomes is poorly defined. The paucity of information needed for the safe and effective use of drugs in obese patients remains a problem, even after drug approval. To assess the current incorporation of obesity as a covariate in pediatric drug development, the pediatric medical and clinical pharmacology reviews under the Food and Drug Administration (FDA) Amendments Act of 2007 and the FDA Safety and Innovation Act (FDASIA) of 2012 were reviewed for obesity studies. FDA labels were also reviewed for statements addressing obesity in pediatric patients. Forty-five drugs studied in pediatric patients under the FDA Amendments Act were found to have statements and key words in the medical and clinical pharmacology reviews and labels related to obesity. Forty-four products were identified similarly with pediatric studies under FDASIA. Of the 89 product labels identified, none provided dosing information related to obesity. The effect of body mass index on drug pharmacokinetics was mentioned in only 4 labels. We conclude that there is little information presently available to provide guidance related to dosing in obese pediatric patients. Moving forward, regulators, clinicians, and the pharmaceutical industry should consider situations in drug development in which the inclusion of obese patients in pediatric trials is necessary to facilitate the safe and effective use of new drug products in the obese pediatric population. © 2018, The American College of Clinical Pharmacology.

  14. FAST and SAFE Passive Safety Devices for Sodium-cooled Fast Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Hartanto, Donny; Kim, Chihyung; Kim, In-Hyung; Kim, Yonghee [KAIST, Daejeon (Korea, Republic of)

    2015-05-15

    The major factor is the impact of the neutron spectral hardening. The second factor that affects the CVR is reduced capture by the coolant when the coolant voiding occurs. To improve the CVR, many ideas and concepts have been proposed, which include introduction of an internal blanket, spectrum softening, or increasing the neutron leakage. These ideas may reduce the CVR, but they deteriorate the neutron economy. Another potential solution is to adopt a passive safety injection device such as the ARC (autonomous reactivity control) system, which is still under development. In this paper, two new concepts of passive safety devices are proposed. The devices are called FAST (Floating Absorber for Safety at Transient) and SAFE (Static Absorber Feedback Equipment). Their purpose is to enhance the negative reactivity feedback originating from the coolant in fast reactors. SAFE is derived to balance the positive reactivity feedback due to sodium coolant temperature increases. It has been demonstrated that SAFE allows a low-leakage SFR to achieve a self-shutdown and self-controllability even though the generic coolant temperature coefficient is quite positive and the coolant void reactivity can be largely managed by the new FAST device. It is concluded that both FAST and SAFE devices will improve substantially the fast reactor safety and they deserve more detailed investigations.

  15. Implementation of an Improved Safe Operating Envelope

    Energy Technology Data Exchange (ETDEWEB)

    Prime, Robyn; McIntyre, Mark [NB Power Nuclear, P.O. Box 600, Lepreau, NB (Canada); Reeves, David [Atlantic Nuclear Services Ltd., PO Box 1268 Fredericton, NB (Canada)

    2008-07-01

    This paper is a continuation of the paper presented at IYNC 2004 on 'The Definition of a Safe Operating Envelope'. The current paper concentrates on the implementation process of the Safe Operating Envelope employed at the Point Lepreau Generating Station. (authors)

  16. Development of job standards for clinical nutrition therapy for dyslipidemia patients.

    Science.gov (United States)

    Kang, Min-Jae; Seo, Jung-Sook; Kim, Eun-Mi; Park, Mi-Sun; Woo, Mi-Hye; Ju, Dal-Lae; Wie, Gyung-Ah; Lee, Song-Mi; Cha, Jin-A; Sohn, Cheong-Min

    2015-04-01

    Dyslipidemia has significantly contributed to the increase of death and morbidity rates related to cardiovascular diseases. Clinical nutrition service provided by dietitians has been reported to have a positive effect on relief of medical symptoms or reducing the further medical costs. However, there is a lack of researches to identify key competencies and job standard for clinical dietitians to care patients with dyslipidemia. Therefore, the purpose of this study was to analyze the job components of clinical dietitian and develop the standard for professional practice to provide effective nutrition management for dyslipidemia patients. The current status of clinical nutrition therapy for dyslipidemia patients in hospitals with 300 or more beds was studied. After duty tasks and task elements of nutrition care process for dyslipidemia clinical dietitians were developed by developing a curriculum (DACUM) analysis method. The developed job standards were pretested in order to evaluate job performance, difficulty, and job standards. As a result, the job standard included four jobs, 18 tasks, and 53 task elements, and specific job description includes 73 basic services and 26 recommended services. When clinical dietitians managing dyslipidemia patients performed their practice according to this job standard for 30 patients the job performance rate was 68.3%. Therefore, the job standards of clinical dietitians for clinical nutrition service for dyslipidemia patients proposed in this study can be effectively used by hospitals.

  17. Beam interlock system and safe machine parameters system 2010 and beyond

    CERN Document Server

    Todd, B

    2010-01-01

    The Beam Interlock System (BIS) and Safe Machine Parameters (SMP) system are central to the protection of the Large Hadron Collider (LHC) machine. The BIS has been critical for the safe operation of LHC from the first day of operation. It has been installed and commissioned, only minor enhancements are required in order to accommodate all future LHC machine protection requirements. At reduced intensity, the SMP system is less critical for LHC operation. As such, the current system satisfies the 2010 operational requirements. Further developments are required, both at the SMP Controller level, and at the system level, in order to accommodate the requirements of the LHC beyond 2010.

  18. The first safe country

    Directory of Open Access Journals (Sweden)

    Raffaela Puggioni

    2012-06-01

    Full Text Available The Dublin II Regulation makes the first safe country of refuge solelyresponsible for refugees and asylum seekers. In the case of Italy, thefirst responsible country has not been acting responsibly.

  19. Karate: Keep It Safe.

    Science.gov (United States)

    Jordan, David

    1981-01-01

    Safety guidelines for each phase of a karate practice session are presented to provide an accident-free and safe environment for teaching karate in a physical education or traditional karate training program. (JMF)

  20. Clinical audit: Development of the criteria of good practices

    International Nuclear Information System (INIS)

    Soimakallio, S.; Alanen, A.; Jaervinen, H.; Ahonen, A.; Ceder, K.; Lyyra-Laitinen, T.; Paunio, M.; Sinervo, T.; Wigren, T.

    2011-01-01

    Clinical audit is a systematic review of the procedures in order to improve the quality and the outcome of patient care, whereby the procedures are examined against agreed standards for good medical Radiological procedures. The criteria of good procedures (i.e. the good practice) are thus the cornerstones for development of clinical audits: these should be the basis of assessments regardless of the type of the audit-external, internal, comprehensive or partial. A lot of criteria for good practices are available through the recommendations and publications by international and national professional societies and other relevant organisations. For practical use in clinical audits, the criteria need to be compiled, sorted out and agreed on for the particular aims of an audit (comprehensive or partial, external or internal). The national professional and scientific societies can provide valuable contribution to this development. For examination-or treatment-specific criteria- preliminary consensus needs to be obtained with the help of clinical experts, while clinical audits can be useful as a benchmarking tool to improve the criteria. (authors)

  1. Implementation of Ray Safe i2 System for staff dose measuring in interventional radiology

    International Nuclear Information System (INIS)

    Gershan, Vesna; Atsovska, Violeta

    2013-01-01

    Interventional radiology procedures usually delivered the highest radiation dose to the patients as well as to medical personal. Beside another factors like patient size, fluoroscopy time, machine calibration etc., a good clinical practice has strong effects to staff and patient’s radiation dose. Materials and methods: In August 2012, a Ray Safe i2 system was installed in a private hospital in Skopje. The main purpose of this dosimetry system is to provide real time indication for the current exposure level of the medical personal. Knowing that, the staff has prerequisites to adjust their behavior to minimize unnecessary exposure like changing distance from exposed volume, C-ram angulations, field of view etc. and on this way to develop a good clinical practice. The Ray Safe i2 system is consisted by ten digital dosimeters, two dock stations, real time display, dose viewer and dose manager software. During interventional procedures, each involved staff wears dosimeter which measures and records X-Ray exposure every second and transfer the data wirelessly to the real time display. Color indication bars (green, yellow, red) represents the intensity of the currently received exposure, whereas green zone indicates < 0.2 mSv/h, yellow zone from 0.2 to 2 mSv/h and red zone indications from 2 to 20 mSv/h. Additionally, accumulated dose per individual is displayed next to the color indication bars. By using the software, information about personal dose history, such as annual dose, dose per particular session, hour, day or week, can be viewed and analyzed. Results: In this work it was found that staff accumulated doses were constantly increased over time, but reported number of procedures does not correspond to this tendency. Our assumption is that there is a misleading between reported number and actual performed procedures. Doctor1 received 55 times more dose than Doctor2 and Nurse1 received 11 to 3 times more dose than another Nurses. It was found a correlation of R2

  2. Clinical staff nurse leadership: Identifying gaps in competency development.

    Science.gov (United States)

    Franks-Meeks, Sherron

    2018-01-01

    To date, there has been no development of a complete, applicable inventory of clinical staff nurse (CSN) leadership role competencies through a valid and reliable methodology. Further, the CSN has not been invited to engage in the identification, definition, or development of their own leadership competencies. Compare existing leadership competencies to identify and highlight gaps in clinical staff nurse leadership role competency development and validation. Literature review. The CSN has not participated in the development of CSN leadership role competencies, nor have the currently identified CSN leadership role competencies been scientifically validated through research. Finally, CSN leadership role competencies are incomplete and do not reflect the CSN perspective. © 2017 Wiley Periodicals, Inc.

  3. [Development of Autogenic Training Clinical Effectiveness Scale (ATCES)].

    Science.gov (United States)

    Ikezuki, Makoto; Miyauchi, Yuko; Yamaguchi, Hajime; Koshikawa, Fusako

    2002-02-01

    The purpose of the present study was to develop a scale measuring clinical effectiveness of autogenic training. In Study 1, 167 undergraduates completed a survey of items concerning physical and mental states, which were thought to vary in the course of autogenic training. With item and factor analyses, 20 items were selected, and the resulting scale (ATCES) had high discrimination and clear factor structure. In Study 2, reliability and concurrent and clinical validity of the scale were examined with three groups of respondents: 85 mentally healthy, 31 control, 13 clinical persons. The scale showed a high test-retest correlation (r = .83) and alpha coefficient (alpha = .86). ATCES had a Pearson correlation coefficient of r = .56 with General Health Questionnaire (GHQ-12), and r = .73 with trait anxiety (STAI-T). And ATCES successfully discriminated the mentally healthy and clinical groups in terms of clinical effectiveness. These results demonstrated high reliability and sufficient concurrent and clinical validity of the new scale.

  4. Development of sulfur- and nitrogen- free hydrogen odorants - An important step toward a safe hydrogen society -

    International Nuclear Information System (INIS)

    Nakamura, N.; Oshikawa, K.; Hasegawa, H.; Le Lay, M.; Iwase, M.; Braun, N.A.; Eilers, J.; Walz, A.; Vogt, M.; Herr, M.

    2006-01-01

    We have developed four sulfur-free and nitrogen-free odorants, which can be effectively used to odorize hydrogen. The odors were described through an olfactory test as alarming, strange, and chemical, giving sense of danger to the person who smells the odor. The safety of the material has been assessed and has been shown to be safe for usage. Testing the stability of odorized hydrogen in 80 MPa pressurized state, it was shown for a period of 13 weeks that the odorant retained its warning odor. Using the odorized hydrogen, FC duration test at 0.2 A/cm 2 was carried out for over 900 h without significant decrease in performance or the detectable degradation of MEA. The outlet of the fuel cell had no warning odor, suggesting deodorization on the catalyst. Use of activated charcoal as an adsorbent showed that the deodorization could be effectively carried out, ensuring that normal operation conditions are not perceived as a hydrogen leakage. (authors)

  5. Safe-sex belief and sexual risk behaviours among adolescents from three developing countries: a cross-sectional study.

    Science.gov (United States)

    Osorio, Alfonso; Lopez-del Burgo, Cristina; Ruiz-Canela, Miguel; Carlos, Silvia; de Irala, Jokin

    2015-04-27

    This study intends to evaluate whether the belief that condoms are 100% effective in protecting against HIV infection is associated with sexual risk behaviours among youth. A cross-sectional study was performed in representative samples of high-school students in the Philippines, El Salvador and Peru. Participants completed a self-administered questionnaire. Students were asked about the risk of HIV transmission if one has sex using condoms. They were also asked to indicate whether they had ever had sexual relations and whether they used a condom in their first sexual relation. The sample was composed of 8994 students, aged 13-18. One out of seven adolescents believed condoms are 100% effective (safe-sex believers). Those adolescents were 82% more likely to have had sex than those without such belief, after adjusting for confounders (OR=1.82; 95% CI 1.51 to 2.21). On the contrary, no association was found between risk perception and condom use. Subgroup and sensitivity analyses produced similar results. This is, to the best of our knowledge, the first study conducted specifically to evaluate this phenomenon and that has used the same questionnaire and the same data collection protocol in three different developing countries from Asia, Central and South America. These results reasonably suggest that there could be an association between safe sex beliefs and sexual initiation. Longitudinal studies are needed to better understand this possible association as it could influence how to better promote sexual health. 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.

  6. Use of biomarkers in ALS drug development and clinical trials.

    Science.gov (United States)

    Bakkar, Nadine; Boehringer, Ashley; Bowser, Robert

    2015-05-14

    The past decade has seen a dramatic increase in the discovery of candidate biomarkers for ALS. These biomarkers typically can either differentiate ALS from control subjects or predict disease course (slow versus fast progression). At the same time, late-stage clinical trials for ALS have failed to generate improved drug treatments for ALS patients. Incorporation of biomarkers into the ALS drug development pipeline and the use of biologic and/or imaging biomarkers in early- and late-stage ALS clinical trials have been absent and only recently pursued in early-phase clinical trials. Further clinical research studies are needed to validate biomarkers for disease progression and develop biomarkers that can help determine that a drug has reached its target within the central nervous system. In this review we summarize recent progress in biomarkers across ALS model systems and patient population, and highlight continued research directions for biomarkers that stratify the patient population to enrich for patients that may best respond to a drug candidate, monitor disease progression and track drug responses in clinical trials. It is crucial that we further develop and validate ALS biomarkers and incorporate these biomarkers into the ALS drug development process. This article is part of a Special Issue entitled ALS complex pathogenesis. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Prepare to protect: Operating and maintaining a tornado safe room.

    Science.gov (United States)

    Herseth, Andrew; Goldsmith-Grinspoon, Jennifer; Scott, Pataya

    2017-06-01

    Operating and maintaining a tornado safe room can be critical to the effective continuity of business operations because a firm's most valuable asset is its people. This paper describes aspects of operations and maintenance (O&M) for existing tornado safe rooms as well as a few planning and design aspects that affect the ultimate operation of a safe room for situations where a safe room is planned, but not yet constructed. The information is based on several Federal Emergency Management Agency safe room publications that provide guidance on emergency management and operations, as well as the design and construction of tornado safe rooms.

  8. A Leadership Education and Development Program for Clinical Nurses.

    Science.gov (United States)

    Fitzpatrick, Joyce J; Modic, Mary Beth; Van Dyk, Jennifer; Hancock, K Kelly

    2016-11-01

    The Leadership Education and Development (LEAD) Program was designed to transform care at the bedside by empowering clinical nurses as leaders. The heart of LEAD was enhancing communication skills of clinical nurses with clinical colleagues and, most importantly, patients and families. Key concepts of leadership/management were included: personal awareness, personal leadership skills/abilities, leading change, leading others individually and in teams, enhancing the patient/provider experience, and the leadership role in outcomes management. A quantitative, longitudinal, survey design was used with 2 cohorts. The program consisted of six 4-hour sessions for 3 to 6 months. Leadership practices were measured before program implementation, at the end of the program, and 3 months after program completion. There were significant increases in leadership practices sustained 3 months after program completion. A range of other outcome measures was included. There is a need for additional leadership development programs for clinical nurses.

  9. Ordeals of Chernobyl and the rejustification of the inherently safe reactors

    International Nuclear Information System (INIS)

    Lu, Y.

    1989-01-01

    This paper presents the necessity of developing inherently safe economic reactors (ISERs). Two characteristics which define inherent safety are discussed on the basis of various applications of such a principle in practice. Different design concepts of ISERs are then evaluated and their possible role in the future nuclear program of PRC discussed. A three-stage development strategy of ISERs in PRC is proposed

  10. Safe Sleep for Babies

    Science.gov (United States)

    ... 5 MB] Read the MMWR Science Clips Safe Sleep for Babies Eliminating hazards Recommend on Facebook Tweet ... Page Problem Every year, there are thousands of sleep-related deaths among babies. View large image and ...

  11. Clinical reasoning of Filipino physical therapists: Experiences in a developing nation.

    Science.gov (United States)

    Rotor, Esmerita R; Capio, Catherine M

    2018-03-01

    Clinical reasoning is essential for physical therapists to engage in the process of client care, and has been known to contribute to professional development. The literature on clinical reasoning and experiences have been based on studies from Western and developed nations, from which multiple influencing factors have been found. A developing nation, the Philippines, has distinct social, economic, political, and cultural circumstances. Using a phenomenological approach, this study explored experiences of Filipino physical therapists on clinical reasoning. Ten therapists working in three settings: 1) hospital; 2) outpatient clinic; and 3) home health were interviewed. Major findings were: a prescription-based referral system limited clinical reasoning; procedural reasoning was a commonly experienced strategy while diagnostic and predictive reasoning were limited; factors that influenced clinical reasoning included practice setting and the professional relationship with the referring physician. Physical therapists' responses suggested a lack of autonomy in practice that appeared to stifle clinical reasoning. Based on our findings, we recommend that the current regulations governing PT practice in the Philippines may be updated, and encourage educators to strengthen teaching approaches and strategies that support clinical reasoning. These recommendations are consistent with the global trend toward autonomous practice.

  12. Developing a mentoring program in clinical nutrition.

    Science.gov (United States)

    Martindale, Robert G; McClave, Stephen; Heyland, Daren; August, David

    2010-01-01

    Mentoring programs in nutrition are essential to the survival of clinical nutrition as we know it today. The best method known to maintain an influx of talent to a discipline is by developing an active mentoring program. This paper describes 1 concept for development of a viable mentor program. Mentoring should be flexible and based on mentees' training background. Realistic goals should be set, with written and verbal feedback, to sustain a successful program. Programs should incorporate the Socratic Method whenever possible. Factors that leave doubt about the survival of nutrition as a viable area of focus for physicians include the inability to generate adequate funds to support oneself and limited numbers of mentors available with dedicated time to be a mentor. A healthy, sustainable mentoring program in clinical nutrition will ensure survival of physician-based nutrition programs.

  13. Access to safe legal abortion in Malaysia: women's insights and health sector response.

    Science.gov (United States)

    Low, Wah-Yun; Tong, Wen-Ting; Wong, Yut-Lin; Jegasothy, Ravindran; Choong, Sim-Poey

    2015-01-01

    Malaysia has an abortion law, which permits termination of pregnancy to save a woman's life and to preserve her physical and mental health (Penal Code Section 312, amended in 1989). However, lack of clear interpretation and understanding of the law results in women facing difficulties in accessing abortion information and services. Some health care providers were unaware of the legalities of abortion in Malaysia and influenced by their personal beliefs with regard to provision of abortion services. Accessibility to safer abortion techniques is also an issue. The development of the 2012 Guidelines on Termination of Pregnancy and Guidelines for Management of Sexual and Reproductive Health among Adolescents in Health Clinics by the Ministry of Health, Malaysia, is a step forward toward increasing women's accessibility to safe abortion services in Malaysia. This article provides an account of women's accessibility to abortion in Malaysia and the health sector response in addressing the barriers. © 2014 APJPH.

  14. Implementation of the NANoREG Safe-by-Design approach for different nanomaterial applications

    International Nuclear Information System (INIS)

    Micheletti, C; Roman, M; Tedesco, E; Olivato, I; Benetti, F

    2017-01-01

    The Safe-by-Design (SbD) concept is already in use in different industrial sectors as an integral part of the innovation process management. However, the adopted approach is often limited to design solutions aiming at hazard reduction. Safety is not always considered during the innovation process, mainly due to the lack of knowledge (e.g. in small and medium companies, SMEs) and the lack of dialogue between actors along the innovation chain. The net result is that safety is considered only at the end of the innovation process at the market authorization phase, with potential loss of time and money. This is especially valid for manufactured nanomaterials (MNM) for which the regulatory context is not completely developed, and the safety knowledge is not readily available. In order to contribute to a sustainable innovation process in the nanotechnology field by maximising both benefits and safety, the NANoREG project developed a Safe Innovation approach, based on two elements: the Safe-by-Design approach which aims at including risk assessment into all innovation stages; and the Regulatory Preparedness, focused on the dialogue with stakeholders along the innovation chain. In this work we present some examples about the implementation in our Laboratory of this approach for different MNM applications, covering different steps of the innovation chain. The case studies include: the feasibility study of a medical device including substances, for topical application; the testing of two potential nanotech solutions for the consolidation of cultural heritage artifacts; the testing of coatings already on the market for other uses, which was tested as food contact materials (FCM) to evaluate the conformity to food applications. These three examples represent a good opportunity to show the importance of NANoREG SbD and Safe Innovation Approach in general, for developing new nanotechnology-based products, also highlighting the crucial role of EU ProSafe project in promoting this

  15. Implementation of the NANoREG Safe-by-Design approach for different nanomaterial applications

    Science.gov (United States)

    Micheletti, C.; Roman, M.; Tedesco, E.; Olivato, I.; Benetti, F.

    2017-06-01

    The Safe-by-Design (SbD) concept is already in use in different industrial sectors as an integral part of the innovation process management. However, the adopted approach is often limited to design solutions aiming at hazard reduction. Safety is not always considered during the innovation process, mainly due to the lack of knowledge (e.g. in small and medium companies, SMEs) and the lack of dialogue between actors along the innovation chain. The net result is that safety is considered only at the end of the innovation process at the market authorization phase, with potential loss of time and money. This is especially valid for manufactured nanomaterials (MNM) for which the regulatory context is not completely developed, and the safety knowledge is not readily available. In order to contribute to a sustainable innovation process in the nanotechnology field by maximising both benefits and safety, the NANoREG project developed a Safe Innovation approach, based on two elements: the Safe-by-Design approach which aims at including risk assessment into all innovation stages; and the Regulatory Preparedness, focused on the dialogue with stakeholders along the innovation chain. In this work we present some examples about the implementation in our Laboratory of this approach for different MNM applications, covering different steps of the innovation chain. The case studies include: the feasibility study of a medical device including substances, for topical application; the testing of two potential nanotech solutions for the consolidation of cultural heritage artifacts; the testing of coatings already on the market for other uses, which was tested as food contact materials (FCM) to evaluate the conformity to food applications. These three examples represent a good opportunity to show the importance of NANoREG SbD and Safe Innovation Approach in general, for developing new nanotechnology-based products, also highlighting the crucial role of EU ProSafe project in promoting this

  16. Safe Reentry for False Aneurysm Operations in High-Risk Patients.

    Science.gov (United States)

    Martinelli, Gian Luca; Cotroneo, Attilio; Caimmi, Philippe Primo; Musica, Gabriele; Barillà, David; Stelian, Edmond; Romano, Angelo; Novelli, Eugenio; Renzi, Luca; Diena, Marco

    2017-06-01

    In the absence of a standardized safe surgical reentry strategy for high-risk patients with large or anterior postoperative aortic false aneurysm (PAFA), we aimed to describe an effective and safe approach for such patients. We prospectively analyzed patients treated for PAFA between 2006 and 2015. According to the preoperative computed tomography scan examination, patients were divided into two groups according to the anatomy and extension of PAFA: in group A, high-risk PAFA (diameter ≥3 cm) developed in the anterior mediastinum; in group B, low-risk PAFA (diameter <3 cm) was situated posteriorly. For group A, a safe surgical strategy, including continuous cerebral, visceral, and coronary perfusion was adopted before resternotomy; group B patients underwent conventional surgery. We treated 27 patients (safe reentry, n = 13; standard approach, n = 14). Mean age was 60 years (range, 29 to 80); 17 patients were male. Mean interval between the first operation and the last procedure was 4.3 years. Overall 30-day mortality rate was 7.4% (1 patient in each group). No aorta-related mortality was observed at 1 and 5 years in either group. The Kaplan-Meier overall survival estimates at 1 and 5 years were, respectively, 92.3% ± 7.4% and 73.4% ± 13.4% in group A, and 92.9% ± 6.9% and 72.2% ± 13.9% in group B (log rank test, p = 0.830). Freedom from reoperation for recurrent aortic disease was 100% at 1 year and 88% at 5 years. The safe reentry technique with continuous cerebral, visceral, and coronary perfusion for high-risk patients resulted in early and midterm outcomes similar to those observed for low-risk patients undergoing conventional surgery. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Organising a safe space for navigating social-ecological transformations to sustainability

    NARCIS (Netherlands)

    L. Pereira (Laura); T. Karpouzoglou (Timothy); S. Doshi (Samir); N. Frantzeskaki (Niki)

    2015-01-01

    textabstractThe need for developing socially just living conditions for the world’s growing population whilst keeping human societies within a ‘safe operating space’ has become a modern imperative. This requires transformative changes in the dominant social norms, behaviours, governance and

  18. Organising a safe space for navigating social-ecological transformations to sustainability

    NARCIS (Netherlands)

    Pereira, L.; Karpouzoglou, T.D.; Doshi, S.; Frantzeskaki, N.

    2015-01-01

    The need for developing socially just living conditions for the world’s growing population whilst keeping human societies within a ‘safe operating space’ has become a modern imperative. This requires transformative changes in the dominant social norms, behaviours, governance and management regimes

  19. Safe and Effective Gene Therapy for Murine Wiskott-Aldrich Syndrome Using an Insulated Lentiviral Vector

    Directory of Open Access Journals (Sweden)

    Swati Singh

    2017-03-01

    Full Text Available Wiskott-Aldrich syndrome (WAS is a life-threatening immunodeficiency caused by mutations within the WAS gene. Viral gene therapy to restore WAS protein (WASp expression in hematopoietic cells of patients with WAS has the potential to improve outcomes relative to the current standard of care, allogeneic bone marrow transplantation. However, the development of viral vectors that are both safe and effective has been problematic. While use of viral transcriptional promoters may increase the risk of insertional mutagenesis, cellular promoters may not achieve WASp expression levels necessary for optimal therapeutic effect. Here we evaluate a self-inactivating (SIN lentiviral vector combining a chromatin insulator upstream of a viral MND (MPSV LTR, NCR deleted, dl587 PBS promoter driving WASp expression. Used as a gene therapeutic in Was−/− mice, this vector resulted in stable WASp+ cells in all hematopoietic lineages and rescue of T and B cell defects with a low number of viral integrations per cell, without evidence of insertional mutagenesis in serial bone marrow transplants. In a gene transfer experiment in non-human primates, the insulated MND promoter (driving GFP expression demonstrated long-term polyclonal engraftment of GFP+ cells. These observations demonstrate that the insulated MND promoter safely and efficiently reconstitutes clinically effective WASp expression and should be considered for future WAS therapy.

  20. Improving Safe Sleep Modeling in the Hospital through Policy Implementation.

    Science.gov (United States)

    Heitmann, Rachel; Nilles, Ester K; Jeans, Ashley; Moreland, Jackie; Clarke, Chris; McDonald, Morgan F; Warren, Michael D

    2017-11-01

    Introduction Sleep-related infant deaths are major contributors to Tennessee's high infant mortality rate. The purpose of this initiative was to evaluate the impact of policy-based efforts to improve modeling of safe sleep practices by health care providers in hospital settings across Tennessee. Methods Safe sleep policies were developed and implemented at 71 hospitals in Tennessee. Policies, at minimum, were required to address staff training on the American Academy of Pediatrics' safe sleep recommendations, correct modeling of infant safe sleep practices, and parent education. Hospital data on process measures related to training and results of crib audits were compiled for analysis. Results The overall observance of infants who were found with any risk factors for unsafe sleep decreased 45.6% (p ≤ 0.001) from the first crib audit to the last crib audit. Significant decreases were noted for specific risk factors, including infants found asleep not on their back, with a toy or object in the crib, and not sleeping in a crib. Significant improvements were observed at hospitals where printed materials or video were utilized for training staff compared to face-to-face training. Discussion Statewide implementation of the hospital policy intervention resulted in significant reductions in infants found in unsafe sleep situations. The most common risk factors for sleep-related infant deaths can be modeled in hospitals. This effort has the potential to reduce sleep-related infant deaths and ultimately infant mortality.

  1. Escola segura Safe school

    Directory of Open Access Journals (Sweden)

    Edson Ferreira Liberal

    2005-11-01

    Full Text Available OBJETIVO: Revisão das estratégias para tornar o ambiente escolar seguro. Inicialmente os autores contextualizam a violência e os acidentes no ambiente escolar e fazem recomendações, baseadas em dados da literatura, para a implantação de escolas seguras. FONTE DE DADOS: Artigos publicados entre 1993 e 2005 na base de dados MEDLINE. Dados nacionais epidemiológicos e da literatura também foram pesquisados. SÍNTESE DOS DADOS: Há evidência crescente de que a intervenção tem múltiplos componentes. O foco político é a prática em educação em saúde com o envolvimento de toda a comunidade. O norte dessas intervenções é ajudar estudantes e toda a comunidade a adotar um comportamento seguro e saudável. As escolas estão assumindo um envolvimento crescente na promoção da saúde, prevenção de doenças e prevenção de trauma. Nesse contexto de prevenção de causas externas de morbimortalidade, é importante reconhecer o risco ambiental, locais e comportamentos de risco como favoráveis ao trauma e à violência, além de um novo conceito de acidentes como algo que possa ser evitado. CONCLUSÃO: A implementação da escola segura representa uma nova direção promissora para o trabalho preventivo baseado na escola. É importante notar que uma escola segura deve intervir não meramente na sua estrutura física, mas também torná-la tão segura quanto possível, trabalhando com a comunidade escolar por meio de educação em saúde, discutindo principalmente o comportamento saudável.OBJECTIVE: To review the strategies to make school a safe environment. The paper first addresses the social context of accidents and violence in the school environment, and makes recommendations, based on the literature data, for the implementation of safe schools. SOURCE OF DATA: Articles published between 1993 and 2005 in the MEDLINE database. Brazilian epidemiological and literature data have also been searched. SUMMARY OF THE FINDINGS: There is

  2. Economics of place-based monitoring under the safe drinking water act, part II: design and development of place-based monitoring strategies.

    Science.gov (United States)

    Brands, Edwin; Rajagopal, R

    2008-08-01

    The goals of environmental legislation and associated regulations are to protect public health, natural resources, and ecosystems. In this context, monitoring programs should provide timely and relevant information so that the regulatory community can implement legislation in a cost-effective and efficient manner. The Safe Drinking Water Act (SDWA) of 1974 attempts to ensure that public water systems (PWSs) supply safe water to its consumers. As is the case with many other federal environmental statutes, SDWA monitoring has been implemented in relatively uniform fashion across the United States. In this three part series, spatial and temporal patterns in water quality data are utilized to develop, compare, and evaluate the economic performance of alternative place-based monitoring approaches to current monitoring practice. Part II: Several factors affect the performance of monitoring strategies, including: measurable objectives, required precision in estimates, acceptable confidence levels of such estimates, available budget for sampling. In this paper, we develop place-based monitoring strategies based on extensive analysis of available historical water quality data (1960-1994) of 19 Iowa community water systems. These systems supply potable water to over 350,000 people. In the context of drinking water, the objective is to protect public health by utilizing monitoring resources to characterize contaminants that are detectable, and are close to exceeding health standards. A place-based monitoring strategy was developed in which contaminants were selected based on their historical occurrence, rather than their appearance on the SDWA contaminant list. In a subset of the water systems, the temporal frequency of monitoring for one ubiquitous contaminant, nitrate, was tailored to patterns in its historical occurrence and concentration. Three sampling allocation models (linear, quadratic, and cubic) based on historic patterns in peak occurrence were developed and

  3. Buying & Using Medicine Safely

    Science.gov (United States)

    ... Reducers Safe Daily Use of Aspirin Medication Health Fraud Resources for You FDA Consumer Updates (Drugs) Page ... feeds Follow FDA on Twitter Follow FDA on Facebook View FDA videos on YouTube View FDA photos ...

  4. Materials for Nuclear Plants From Safe Design to Residual Life Assessments

    CERN Document Server

    Hoffelner, Wolfgang

    2013-01-01

    The clamor for non-carbon dioxide emitting energy production has directly  impacted on the development of nuclear energy. As new nuclear plants are built, plans and designs are continually being developed to manage the range of challenging requirement and problems that nuclear plants face especially when managing the greatly increased operating temperatures, irradiation doses and extended design life spans. Materials for Nuclear Plants: From Safe Design to Residual Life Assessments  provides a comprehensive treatment of the structural materials for nuclear power plants with emphasis on advanced design concepts.   Materials for Nuclear Plants: From Safe Design to Residual Life Assessments approaches structural materials with a systemic approach. Important components and materials currently in use as well as those which can be considered in future designs are detailed, whilst the damage mechanisms responsible for plant ageing are discussed and explained. Methodologies for materials characterization, material...

  5. Recommended Practices for the Safe Design and Operation of Flywheels

    Energy Technology Data Exchange (ETDEWEB)

    Bender, Donald Arthur [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-12-01

    Flywheel energy storage systems are in use globally in increasing numbers . No codes pertaining specifically to flywheel energy storage exist. A number of industrial incidents have occurred. This protocol recommends a technical basis for safe flywheel de sign and operation for consideration by flywheel developers, users of flywheel systems and standards setting organizations.

  6. Characterization of critical physical and mechanical properties of freeze-dried grape powder for development of a clinical patient delivery system.

    Science.gov (United States)

    Hu, Daniel; Haware, Rahul V; Hamad, Mazen L; Morris, Kenneth R

    2013-02-01

    Grapes are hypothesized to be a "food medicine." Freeze-dried grape powder (FDGP) is being used to test clinical activity for a variety of applications and a reproducible and reliable delivery system was required. The FDGP was characterized using traditional physico-chemical methods to generate the data needed to identify its primary liability, i.e. moisture sorption. Above a threshold level of moisture content (~25% w/w, at RT), the material becomes both difficult to handle and exhibits significant degradation of several potentially clinically important chemical components (catechin, epicatechin, resveratrol). A moisture sorption isotherm was then used to tie the threshold to the exposure relative humidity above which this occurs. Kinetic uptake studies were used to estimate the maximum safe exposure time at a given humidity (a square root time dependence of moisture uptake was observed). Armed with this knowledge, a FDGP compact coated with a compression coat [100% bees wax or combinations of carnauba wax (70%) with HPC (30%) or Avicel(®) PH 102 (30%) or lactose monohydrate (30%)] was developed that will insure the shelf life of the material without the need for special handling for approximately more than 3 months.

  7. METHODOLOGICAL APPROACHES TO ORGANIZATION OF SAFE INFORMATION AND EDUCATIONAL ENVIRONMENT OF THE UNIVERSITY

    Directory of Open Access Journals (Sweden)

    A. N. Privalov

    2017-01-01

    Full Text Available Introduction. One of the tendencies of modern higher education is the ubiquitous use of information and communication technologies. At the same time, the functioning of the electronic information and educational environment (IEE of the university should be based on the means of IEE and the condition of its information security.The aim of the research is conceptualization of a problem of the rational organization of the safe information and education environment of higher education institution wherein reliable protection of its infrastructure, the personal and unique information of a pupil and teacher and virtual space of their educational interaction is provided.Methodology and research methods. System-based approach is a key approach to organization of safe educational environment of the university. From the point of view of authors, personal-activity and functional approaches are expedient while designing and development of a safe IEE. Socio-historical and theoretical-methodological analysis, modeling, research and synthesis of experience of effective application of the systems approach in educational professional organizations are used.Results and scientific novelty. The concept «safe information educational environment of the university» is specified wherein the first word has to express a predominant quality of the system. Creating a safe information environment in educational professional organizations provides a convenient and safe educational environment in the process of professional training of university students. The components and directions for the organization of the safe IEE are highlighted. Practical recommendations for its design and successful functioning are given.Practical significance. The materials of the present research can be demanded by managers and administrative employees of educational organizations. 

  8. Dose-Reduced Trastuzumab Emtansine: Active and Safe in Acute Hepatic Dysfunction

    Directory of Open Access Journals (Sweden)

    Adam Sharp

    2015-02-01

    Full Text Available Breast cancer is the most common cancer in women worldwide. The majority of deaths attributed to breast cancer are a result of metastatic disease, and 30% of early breast cancers (EBC will develop distant disease. The 5-year survival of patients with metastatic disease is estimated at 23%. Breast cancer subtypes continue to be stratified histologically on oestrogen, progesterone and human epidermal growth factor-2 (HER2 receptor expression. HER2-positive breast cancers represent 25% of all breast cancer diagnoses. The therapies available for metastatic breast cancer (MBC are expanding, in particular within the field of HER2-positive disease, with the approval of trastuzumab, pertuzumab, lapatinib and trastuzumab emtansine (TDM-1. Recently, TDM-1 has been shown to improve progression-free survival in HER2 MBC when compared to capecitabine and lapatinib in clinical studies. Its main toxicities are deranged liver function tests and thrombocytopenia. There have also been cases of acute liver failure. Therefore, its use in acute hepatic dysfunction, to our knowledge, has been neither studied nor reported. We report a patient with progressive HER2-positive MBC who had previously responded to multiple HER2-targeted therapies that presented with acute hepatic dysfunction. She was treated with dose-reduced TDM-1 safely, with clear evidence of rapid biochemical, clinical and radiological response. This allowed dose escalation of TDM-1, and the patient maintains an ongoing response.

  9. Is hydroxyethyl starch 130/0.4 safe?

    DEFF Research Database (Denmark)

    Haase, Nicolai; Perner, Anders

    2012-01-01

    ABSTRACT: It is heavily debated whether or not treatment with hydroxyethyl starch 130/0.4 contributes to the development of acute kidney failure in patients with severe sepsis. In the previous issue of Critical Care, Muller and colleagues report no association between initial resuscitation...... with hydroxyethyl starch 130/0.4 and renal impairment in a cohort of septic patients. Can we then consider hydroxyethyl starch 130/0.4 a safe intervention? The answer is no - observational data should be interpreted with caution and should mainly be used to identify risks, while safety must be assessed...

  10. Virus Alert: Ten Steps to Safe Computing.

    Science.gov (United States)

    Gunter, Glenda A.

    1997-01-01

    Discusses computer viruses and explains how to detect them; discusses virus protection and the need to update antivirus software; and offers 10 safe computing tips, including scanning floppy disks and commercial software, how to safely download files from the Internet, avoiding pirated software copies, and backing up files. (LRW)

  11. Safe and effective error rate monitors for SS7 signaling links

    Science.gov (United States)

    Schmidt, Douglas C.

    1994-04-01

    This paper describes SS7 error monitor characteristics, discusses the existing SUERM (Signal Unit Error Rate Monitor), and develops the recently proposed EIM (Error Interval Monitor) for higher speed SS7 links. A SS7 error monitor is considered safe if it ensures acceptable link quality and is considered effective if it is tolerant to short-term phenomena. Formal criteria for safe and effective error monitors are formulated in this paper. This paper develops models of changeover transients, the unstable component of queue length resulting from errors. These models are in the form of recursive digital filters. Time is divided into sequential intervals. The filter's input is the number of errors which have occurred in each interval. The output is the corresponding change in transmit queue length. Engineered EIM's are constructed by comparing an estimated changeover transient with a threshold T using a transient model modified to enforce SS7 standards. When this estimate exceeds T, a changeover will be initiated and the link will be removed from service. EIM's can be differentiated from SUERM by the fact that EIM's monitor errors over an interval while SUERM's count errored messages. EIM's offer several advantages over SUERM's, including the fact that they are safe and effective, impose uniform standards in link quality, are easily implemented, and make minimal use of real-time resources.

  12. Safe driving for teens

    Science.gov (United States)

    Driving and teenagers; Teens and safe driving; Automobile safety - teenage drivers ... months before taking friends as passengers. Teenage-related driving deaths occur more often in certain conditions. OTHER SAFETY TIPS FOR TEENS Reckless driving is still a ...

  13. Materials for passively safe reactors

    International Nuclear Information System (INIS)

    Simnad, T.

    1993-01-01

    Future nuclear power capacity will be based on reactor designs that include passive safety features if recent progress in advanced nuclear power developments is realized. There is a high potential for nuclear systems that are smaller and easier to operate than the current generation of reactors, especially when passive or intrinsic characteristics are applied to provide inherent stability of the chain reaction and to minimize the burden on equipment and operating personnel. Taylor, has listed the following common generic technical features as the most important goals for the principal reactor development systems: passive stability, simplification, ruggedness, case of operation, and modularity. Economic competitiveness also depends on standardization and assurance of licensing. The performance of passively safe reactors will be greatly influenced by the successful development of advanced fuels and materials that will provide lower fuel-cycle costs. A dozen new designs of advanced power reactors have been described recently, covering a wide spectrum of reactor types, including pressurized water reactors, boiling water reactors, heavy-water reactors, modular high-temperature gas-cooled reactors (MHTGRs), and fast breeder reactors. These new designs address the need for passive safety features as well as the requirement of economic competitiveness

  14. 77 FR 31072 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2012-05-24

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative... Development Officer through the Director of the Clinical Science Research and Development Service on the... notice under Public Law 92-463 (Federal Advisory Committee Act) that a meeting of the Clinical Science...

  15. Il sistema EGNOS a supporto della navigazione sicura nei porti: il progetto SafePort

    Directory of Open Access Journals (Sweden)

    Antonio Casoria

    2012-09-01

    Full Text Available Il progetto SafePort, sviluppato all’interno del 7° Programma Quadro promosso dalla Unione Europea con la supervisione di European GNSS Agency (GSA che segue tutti i programmi applicativi inerenti ai sistemi GNSS europei, Galileo ed EGNOS, ha l’obbiettivo di migliorare la capacità recettiva dei porti europei, aumentando al contempo la sicurezza delle operazioni di navigazione, di attracco e di ormeggio. The EGNOS system to support safe navigation in ports: the project SafePORT SafePORT The project, developed within the 7 th Framework Programme  sponsored  by  European  Union  under  the  super-vision of European GNSS Agency (GSA, which follows all ap-plications relating to the European GNSS systems, Galileo and EGNOS, has the aim to improve receptive capacity of Europe-an ports, while increasing the safety of operations, navigation, docking and mooring.

  16. 25 CFR 700.55 - Decent, safe, and sanitary dwelling.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Decent, safe, and sanitary dwelling. 700.55 Section 700... PROCEDURES General Policies and Instructions Definitions § 700.55 Decent, safe, and sanitary dwelling. (a) General. The term decent, safe, and sanitary dwelling means a dwelling which— (1) Meets applicable federal...

  17. 78 FR 70102 - Clinical Science Research and Development Service Cooperative Studies; Scientific Evaluation...

    Science.gov (United States)

    2013-11-22

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative... notice under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and... Development Officer through the Director of the Clinical Science Research and Development Service on the...

  18. Transfer pricing and safe harbours

    Directory of Open Access Journals (Sweden)

    Veronika Solilová

    2013-01-01

    Full Text Available Transfer prices are significant for both taxpayers and tax administrations because they determine in large part taxable profits of associated enterprises in different tax jurisdictions. Moreover, in the context of taxation, transfer prices must be complied with the arm’s length principle. However, Multinational Enterprises have been faced daily by conflicting rules and approaches to applying the arm’s length principle, burdensome documentation requirements, inconsistent audit standards and unpredictable competent authority outcomes. Therefore, the Committee on Fiscal Affairs launched another project on the administrative aspects of transfer pricing in 2010. On 16 May 2013 as a partial solution of this project was approved by the OECD Council the Revised Section E on Safe Harbours in Chapter IV of the Transfer Pricing Guidelines for Multinational Enterprises and Tax Authorities. The paper is focused on significant changes of newly approved chapter IV of the Transfer Pricing Guidelines for Multinational Enterprises and Tax Authorities, further on analysis of practice in this area, on advantages and disadvantages of safe harbours for taxpayers and competent authorities with aim to suggest recommendations on use of safe harbours in the Czech Republic.

  19. Malarone (atovaquone and proguanil hydrochloride): a review of its clinical development for treatment of malaria. Malarone Clinical Trials Study Group.

    Science.gov (United States)

    Looareesuwan, S; Chulay, J D; Canfield, C J; Hutchinson, D B

    1999-04-01

    The continuing spread of drug-resistant malaria emphasizes the need for new antimalarial drugs. Atovaquone is a broad-spectrum antiprotozoal drug with a novel mechanism of action, via inhibition of parasite mitochondrial electron transport, and a favorable safety profile. Early studies with atovaquone alone for treatment of malaria demonstrated good initial control of parasitemia but an unacceptable rate of recrudescent parasitemia. Parasites isolated during recrudescence after treatment with atovaquone alone were resistant to atovaquone in vitro. The combination of atovaquone and proguanil is synergistic in vitro, and clinical studies demonstrated enhanced efficacy of the combination compared to either drug alone for treatment of malaria. Malarone, a fixed-dose combination of 250 mg of atovaquone and 100 mg of proguanil hydrochloride, is available in many countries for treatment of acute, uncomplicated malaria caused by Plasmodium falciparum. At the recommended dose (in adults, four tablets once a day for three days), the overall cure rate was > 98% in more than 500 patients with falciparum malaria. In four randomized, controlled clinical trials, treatment with atovaquone and proguanil hydrochloride was significantly more effective than mefloquine (Thailand), amodiaquine (Gabon), chloroquine (Peru and the Philippines) or chloroquine plus pyrimethamine/sulfadoxine (Philippines). In clinical trials where the comparator drug was highly effective, treatment with atovaquone and proguanil hydrochloride was equally effective. Parasites isolated during recrudescence after treatment with the combination of atovaquone and proguanil were not resistant to atovaquone in vitro. The most commonly reported adverse events in clinical trials (abdominal pain, anorexia, nausea, vomiting, diarrhea and coughing) occurred with similar frequency in patients treated with a comparator drug. Malarone is a safe and effective new agent for treatment of malaria.

  20. Considerations in the development of circulating tumor cell technology for clinical use

    Directory of Open Access Journals (Sweden)

    Parkinson David R

    2012-07-01

    Full Text Available Abstract This manuscript summarizes current thinking on the value and promise of evolving circulating tumor cell (CTC technologies for cancer patient diagnosis, prognosis, and response to therapy, as well as accelerating oncologic drug development. Moving forward requires the application of the classic steps in biomarker development–analytical and clinical validation and clinical qualification for specific contexts of use. To that end, this review describes methods for interactive comparisons of proprietary new technologies, clinical trial designs, a clinical validation qualification strategy, and an approach for effectively carrying out this work through a public-private partnership that includes test developers, drug developers, clinical trialists, the US Food & Drug Administration (FDA and the US National Cancer Institute (NCI.

  1. Principles for the Safe Moving and Handling of Patients

    Directory of Open Access Journals (Sweden)

    Wanless Stephen

    2016-12-01

    Full Text Available Human movement when walking or running is a widely researched area. However, there is an increased incidence of musculoskeletal injury from poor positioning when moving and handling patients amongst healthcare professionals and is one of the main causes of long term musculoskeletal health problems. In the clinical area, an individual’s musculoskeletal health system is subjected to mechanical loading, increasing the body’s stress and strain limits, and once these are exceeded injury occurs. The risk of pain and injury has a direct relation from the over use of poor posture from poor moving and handling, which in turn can cause loss of strength and reduce musculoskeletal function. This can be changed through healthcare workers adopting safe biomechanical body movements during patient handling tasks.

  2. Biomarkers in the clinical development of asthma therapies.

    Science.gov (United States)

    Staton, Tracy L; Choy, David F; Arron, Joseph R

    2016-01-01

    Here we review how biomarkers have been used in the design, execution and interpretation of recent clinical studies of therapeutic candidates targeting cytokine-mediated inflammatory pathways in asthma. This review focuses on type 2 inflammation, as there are multiple therapeutics and/or clinical studies that can be compared within that specific pathway. Comparative analyses of data from these clinical studies illustrate the utility of biomarkers to quantify pharmacodynamic effects, clarify mechanism of action and stratify patients, which may facilitate the interpretation of outcomes in the development of molecularly targeted therapies. These case examples provide a basis for biomarker considerations in the design of future studies in the asthma setting.

  3. A safe inexpensive method to isolate high quality plant and fungal ...

    African Journals Online (AJOL)

    The most commonly used plant DNA isolation methods use toxic and hazardous chemicals (phenol, chloroform), which require special equipment to minimize exposure and may limit their use in certain environments. Commercial DNA extraction kits are convenient and usually safe, but their availability to certain developing ...

  4. Impact Of The Ban On Uncovered SCDS Trade On the Interdependencies Between The CDS Market And Other Sectors Of Financial Markets. The Case Of Safe And Developed Versus Risky And Developing European Markets

    Directory of Open Access Journals (Sweden)

    Kliber Agata

    2016-03-01

    Full Text Available The aim of the article is to verify the impact of the ban on uncovered sCDS trade in Europe on the interdependencies between the sCDS market and other sectors of financial markets. We analyse two European markets: the safe and developed Swedish market, and the risky and developing Hungarian one. The study covers the period from October 2008 to October 2013. We analyse changes in the interdependencies between the sCDS market and the bond market, as well as between the sCDS market and the stock exchange. We found out that in the case of the safe Swedish market, the strength of relationships of each sector of financial markets with the sCDS one was much weaker than in the case of Hungary, which may suggest that the Swedish market is less prone to crisis transmission arising from herd behaviour or speculative attacks. In the end we show that in the two economies, the influence of the sCDS market on the other sectors of financial market indeed diminished following introduction of the ban on uncovered sCDS trade.

  5. Regulations for the safe transport of radioactive material

    International Nuclear Information System (INIS)

    1995-01-01

    Regulations and rules for the safe transport of radioactive materials by all kinds of conveyance are offered. Different types of packages and the conditions associated with the methods of safe packaging are given

  6. [The ISP (Safe Insertion of PICCs) protocol: a bundle of 8 recommendations to minimize the complications related to the peripherally inserted central venous catheters (PICC)].

    Science.gov (United States)

    Emoli, Alessandro; Cappuccio, Serena; Marche, Bruno; Musarò, Andrea; Scoppettuolo, Giancarlo; Pittiruti, Mauro

    2014-01-01

    The ISP (Safe Insertion of PICCs) protocol: a bundle of 8 recommendations to minimize the complications related to the peripherally inserted central venous catheters (PICC). The insertion of a peripherally inserted central venous catheter (PICC) is not without risks. The Italian Group for the Study of Long-Term Central Venous Access Devices (GAVeCeLT) has developed a protocol (SIP: Safe Implantation of PICCs) with the aim of minimizing the risks which may be associated with the placement of PICCs. The protocol is based on recommendations available in the literature and on the main clinical practice guidelines. The SIP protocol, a bundle of evidence-based recommendations, it is is easy to use, inexpensive, and cost-effective. If routinely used and carefully inplemented, it greatly reduces complications such as failure of venipuncture, accidental arterial puncture, damage of median nerve, infection and catheter related venous thrombosis.

  7. Software development for specific geometry and safe design of isotropic material multicell beams

    International Nuclear Information System (INIS)

    Tariq, M.M.; Ahmed, M.A.

    2011-01-01

    Comparison of analytical results with finite element results for analysis of isotropic material multicell beams subjected to free torsion case is the main idea of this paper. Progress in the fundamentals and applications of advanced materials and their processing technologies involves costly experiments and prototype testing for reliability. The software development for design analysis of structures with advanced materials is a low cost but challenging research. Multicell beams have important industrial applications in the aerospace and automotive sectors. This paper explains software development to test different materials in design of a multicell beam. Objective of this paper is to compute the torsional loading of multicell beams of isotropic materials for safe design in both symmetrical and asymmetrical geometries. Software has been developed in Microsoft Visual Basic. Distribution of Saint Venant shear flows, shear stresses, factors of safety, volume, mass, weight, twist, polar moment of inertia and aspect ratio for free torsion in multicell beam have been calculated using this software. The software works on four algorithms, these are, Specific geometry algorithm, material selection algorithm, factor of safety algorithm and global algorithm. User can specify new materials analytically, or choose a pre-defined material from the list, which includes, plain carbon steels, low alloy steels, stainless steels, cast irons, aluminum alloys, copper alloys, magnesium alloys, titanium alloys, precious metals and refractory metals. Although this software is restricted to multicell beam comprising of three cells, however future versions can have ability to address more complicated shapes and cases of multicell beams. Software also describes nomenclature and mathematical formulas applied to help user understand the theoretical background. User can specify geometry of multicell beam for three rectangular cells. Software computes shear flows, shear stresses, safety factors

  8. Challenges and opportunities in clinical translation of biomedical optical spectroscopy and imaging

    Science.gov (United States)

    Wilson, Brian C.; Jermyn, Michael; Leblond, Frederic

    2018-03-01

    Medical devices face many hurdles before they enter routine clinical practice to address unmet clinical needs. This is also the case for biomedical optical spectroscopy and imaging systems that are used here to illustrate the opportunities and challenges involved. Following initial concept, stages in clinical translation include instrument development, preclinical testing, clinical prototyping, clinical trials, prototype-to-product conversion, regulatory approval, commercialization, and finally clinical adoption and dissemination, all in the face of potentially competing technologies. Optical technologies face additional challenges from their being extremely diverse, often targeting entirely different diseases and having orders-of-magnitude differences in resolution and tissue penetration. However, these technologies can potentially address a wide variety of unmet clinical needs since they provide rich intrinsic biochemical and structural information, have high sensitivity and specificity for disease detection and localization, and are practical, safe (minimally invasive, nonionizing), and relatively affordable.

  9. Clinical Utility of Epstein-Barr Virus Viral Load Monitoring and Risk Factors for Posttransplant Lymphoproliferative Disorders After Kidney Transplantation: A Single-Center, 10-Year Observational Cohort Study

    Directory of Open Access Journals (Sweden)

    Erica Franceschini, MD

    2017-07-01

    Conclusions. Our results suggest that the keystone of PTLD diagnosis is the clinical suspicion. Our study suggests that, in line with guidelines, EBV-VL assays may be avoided in low-risk patients in the absence of a strong clinical PTLD suspicion without increasing patients' risk of developing PTLD. This represents a safe and cost-saving clinical strategy for our center.

  10. Safe Transport of Radioactive Material, Philosophy and Overview

    Energy Technology Data Exchange (ETDEWEB)

    EL-Shinawy, R M.K. [Radiation Protection Dept., Nuclear Rasearch Center, Atomic Energy Authority, Cairo (Egypt)

    2008-07-01

    Safe transport of radioactive material regulations issued by IAEA since 1961, provide standards for insuring a high level of safety of people,transport workers, property and environment against radiation, contamination and criticality hazards as well as thermal effects associated with the transport of the radioactive wastes and material. The history ,development, philosophy and scope of these international and national regulations were mentioned as well as the different supporting documents to the regulations for safe transport of radioactive material were identified.The first supporting document , namely TS - G-1.1(ST-2) ,Advisory material is also issued by the IAEA.It contains both the advisory and explanatory materials previously published in safety series Nos 7and 37 and therefore TS-G-1.1 (ST-2) will supersede safety series Nos 7 and 37. The second supporting document namely TS-G-1.2 (ST-3), planning and preparing for emergency response to transport accidents involving radioactive material ,which will supersede safety series No 87. In addition to quality assurance (SS no.113), compliance assurance (SS no. 112), the training manual and others.

  11. Safe Transport of Radioactive Material, Philosophy and Overview

    International Nuclear Information System (INIS)

    EL-Shinawy, R.M.K.

    2008-01-01

    Safe transport of radioactive material regulations issued by IAEA since 1961, provide standards for insuring a high level of safety of people,transport workers, property and environment against radiation, contamination and criticality hazards as well as thermal effects associated with the transport of the radioactive wastes and material. The history ,development, philosophy and scope of these international and national regulations were mentioned as well as the different supporting documents to the regulations for safe transport of radioactive material were identified.The first supporting document , namely TS - G-1.1(ST-2) ,Advisory material is also issued by the IAEA.It contains both the advisory and explanatory materials previously published in safety series Nos 7and 37 and therefore TS-G-1.1 (ST-2) will supersede safety series Nos 7 and 37. The second supporting document namely TS-G-1.2 (ST-3), planning and preparing for emergency response to transport accidents involving radioactive material ,which will supersede safety series No 87. In addition to quality assurance (SS no.113), compliance assurance (SS no. 112), the training manual and others

  12. THE CONSEQUENCES OF GLOBALIZATION UPON SAFE TOURISM

    Directory of Open Access Journals (Sweden)

    Svetlana Mihić

    2009-11-01

    Full Text Available Globalization, a phenomenon on the rise, is characterized by the free cross-bor- der movement of individuals, technologies, and capital. It has far- reaching consequen- ces for tourism, too, as it implies travel for leisure and business, and correspondingly, financial transfers between various nation states. Startinf from the status quo in the field, the current paper sets out to analyze the consequences and implications of globalization upon safe tourism and conduct a marketing research into the perceptions of consumers upon Serbia as a safe vacation destination for the purpose of safe tourism. Finally the research results will be presented and several solutions will be provided for improving security in tourism zones

  13. SU-C-BRA-06: Developing Clinical and Quantitative Guidelines for a 4DCT-Ventilation Functional Avoidance Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Vinogradskiy, Y; Waxweiler, T; Diot, Q; Kavanagh, B; Schubert, L; Miften, M [University of Colorado Denver, Aurora, CO (United States); Castillo, R [University of Texas Medical Branch of Galveston, Pearland, TX (United States); Guerrero, T; Castillo, E [Beaumont Health System, Royal Oak, MI (United States)

    2015-06-15

    Purpose: 4DCT-ventilation is an exciting new imaging modality that uses 4DCTs to calculate lung ventilation. Because 4DCTs are acquired as part of routine care, calculating 4DCT-ventilation allows for lung function evaluation without additional cost or inconvenience to the patient. Development of a clinical trial is underway at our institution to use 4DCT-ventilation for thoracic functional avoidance with the idea that preferential sparing of functional lung regions can decrease pulmonary toxicity. The purpose of our work was to develop the practical aspects of a 4DCT-ventilation functional avoidance clinical trial including: 1.assessing patient eligibility 2.developing trial inclusion criteria and 3.developing treatment planning and dose-function evaluation strategies. Methods: 96 stage III lung cancer patients from 2 institutions were retrospectively reviewed. 4DCT-ventilation maps were calculated using the patient’s 4DCTs, deformable image registrations, and a density-change-based algorithm. To assess patient eligibility and develop trial inclusion criteria we used an observer-based binary end point noting the presence or absence of a ventilation defect and developed an algorithm based on the percent ventilation in each lung third. Functional avoidance planning integrating 4DCT-ventilation was performed using rapid-arc and compared to the patient’s clinically used plan. Results: Investigator-determined clinical ventilation defects were present in 69% of patients. Our regional/lung-thirds ventilation algorithm identified that 59% of patients have lung functional profiles suitable for functional avoidance. Compared to the clinical plan, functional avoidance planning was able to reduce the mean dose to functional lung by 2 Gy while delivering comparable target coverage and cord/heart doses. Conclusions: 4DCT-ventilation functional avoidance clinical trials have great potential to reduce toxicity, and our data suggest that 59% of lung cancer patients have lung

  14. Mathematical modeling of efficacy and safety for anticancer drugs clinical development.

    Science.gov (United States)

    Lavezzi, Silvia Maria; Borella, Elisa; Carrara, Letizia; De Nicolao, Giuseppe; Magni, Paolo; Poggesi, Italo

    2018-01-01

    Drug attrition in oncology clinical development is higher than in other therapeutic areas. In this context, pharmacometric modeling represents a useful tool to explore drug efficacy in earlier phases of clinical development, anticipating overall survival using quantitative model-based metrics. Furthermore, modeling approaches can be used to characterize earlier the safety and tolerability profile of drug candidates, and, thus, the risk-benefit ratio and the therapeutic index, supporting the design of optimal treatment regimens and accelerating the whole process of clinical drug development. Areas covered: Herein, the most relevant mathematical models used in clinical anticancer drug development during the last decade are described. Less recent models were considered in the review if they represent a standard for the analysis of certain types of efficacy or safety measures. Expert opinion: Several mathematical models have been proposed to predict overall survival from earlier endpoints and validate their surrogacy in demonstrating drug efficacy in place of overall survival. An increasing number of mathematical models have also been developed to describe the safety findings. Modeling has been extensively used in anticancer drug development to individualize dosing strategies based on patient characteristics, and design optimal dosing regimens balancing efficacy and safety.

  15. Safe management of waste from health-care activities

    International Nuclear Information System (INIS)

    Pruess, A.; Giroult, E.; Rushbrook, P.

    1999-01-01

    The waste produced in the course of health-care activities, from contaminated needles to radioactive isotopes, carries a greater potential for causing infection and injury than any other type of waste, and inadequate or inappropriate management is likely to have serious public health consequences and deleterious effects on the environment. This handbook - the result of extensive international consultation and collaboration - provides comprehensive guidance on safe, efficient, and environmentally sound methods for the handling and disposal of health-care wastes. The various categories of waste are clearly defined and the particular hazards that each poses are described. Considerable prominence is given to the careful planning that is essential for the success of waste management; workable means of minimizing waste production are outlined and the role of reuse and recycling of waste is discussed. Most of the text, however, is devoted to the collection, segregation, storage, transport, and disposal of wastes. Details of containers for each category of waste, labelling of waste packages, and storage conditions are provided, and the various technologies for treatment of waste and disposal of final residues are discussed at length. Advice is given on occupational safety for all personnel involved with waste handling, and a separate chapter is devoted to the closely related topic of hospital hygiene and infection control. The handbook pays particular attention to basic processes and technologies that are not only safe but also affordable, sustainable, and culturally appropriate. For health-care settings in which resources are severely limited there is a separate chapter on minimal programmes; this summarizes all the simplest and least costly techniques that can be employed for the safe management of health-care wastes. The guide is aimed at public health managers and policy-makers, hospital managers, environmental health professionals, and all administrators with an

  16. Development of CER-001: Preclinical Dose Selection Through to Phase I Clinical Findings.

    Science.gov (United States)

    Keyserling, Constance H; Barbaras, Ronald; Benghozi, Renee; Dasseux, Jean-Louis

    2017-05-01

    CER-001 comprises recombinant human apolipoprotein A-I complexed with phospholipids that mimics natural, nascent, pre-β high-density lipoprotein (HDL). We present animal model data showing dose-dependent increases in cholesterol efflux with CER-001 and its subsequent elimination by reverse lipid transport, together with inhibition of atherosclerotic plaque progression. We report the first phase I study results with CER-001 in humans, starting at 0.25 mg/kg, which is 1/80th of the safe dose (20 mg/kg) established in 4-week multiple-dose animal studies dosed every second day. Healthy volunteers, 18-55 years old with a low-density lipoprotein-cholesterol:HDL-cholesterol ratio greater than 3.0, received single intravenous escalating doses of CER-001 (0.25-45.0 mg/kg) and placebo in a double-blind randomised cross-over fashion. Subjects were followed up for 3 weeks post-dose. Assessments included adverse event monitoring, blood sampling, and clinical laboratory measurements. Thirty-two subjects were enrolled. All CER-001 doses (0.25-45 mg/kg) were safe and well tolerated, with an adverse event profile similar to placebo. Effects on clinical chemistry, haematology and coagulation parameters were comparable to placebo. No adverse effects of CER-001 on electrocardiograms were observed. No antibodies to apolipoprotein A-I were detected following single-dose administration of CER-001. Plasma apolipoprotein A-I levels increased in a dose-related manner and returned to baseline by 24 h post-dose for doses up to 10 mg/kg but remained in circulation for >72 h post-dose for doses >10 mg/kg. CER-001 caused elevations in plasma cholesterol and total and unesterified cholesterol in the HDL fraction. Mobilisation of unesterified cholesterol in the HDL fraction was seen with CER-001 at doses as low as 2 mg/kg. CER-001 is well tolerated when administered to humans as single doses up to 45 mg/kg and mobilises and eliminates cholesterol via reverse lipid transport.

  17. Development of the clinic of pulmonology and allergy.

    Science.gov (United States)

    Dokic, D

    2013-01-01

    University Pulmology and Allergy Clinic was founded in 1975 when the Depertment of Internal Medicine, directed by Prof. Dr. Dimitar Arsov, later member of the Macedonian Academy of Sciencies and Arts, was divided into eight separate and independent clinics. The first head of the Pulmonology and Allergy Clinic was Prof. Dr. Ljubomir Kotevski. He had a very difficult goal: to establish and further develop the newly formed clinic. The Clinic flourished and became one of the leading Clinics in the Clinical Centre during the directorship of Prof. dr. Dejan Dokic.. He completely rebuilt and refurbished the Clinic, which became a modern Clinic providing excellent working conditions for the employees and, most importantly, provided a first class service to the patients. During his mandate he obtained a grant from the Japanese Government worth $1,000,000 which was used to obtain a new, modern and sophisticated medical equipment. Since the establishment of the clinic, many national and international scientific projects were carried out and many scientific papers were published as well as many monographs, and chapters in scientific books. As a result of continuous education, of the total number of 24 doctors there are 16 subspecialists in respiratory medicine and 4 specialists in internal medicine. There are 9 professors in internal medicine at the University of Pulmonology and Allergy Clinic lecturing at the Medical Faculty in Skopje. The University Pulmonology and Allergy Clinic has an international reputation due to many contacts with famous European Institutions. All these international interrelations have resulted in honouring 3 professors: Prof. Dr. Gert Kunkel from Berlin, Germany, Prof. Dr. Robert Loddenkemper from Berlin, Germany and Prof. Dr. Peter Howard from Southampton, UK.

  18. Developing a "clinical presentation" curriculum at the University of Calgary.

    Science.gov (United States)

    Mandin, H; Harasym, P; Eagle, C; Watanabe, M

    1995-03-01

    Currently, medical curricula are structured according to disciplines, body systems, or clinical problems. Beginning in 1988, the faculty of the University of Calgary Faculty of Medicine (U of C) carefully evaluated the advantages and disadvantages of each of these models in seeking to revise their school's curriculum. However, all three models fell short of a curricular structure based on current knowledge and principles of adult learning, clinical problem solving, community demands, and curriculum management. By 1991, the U of C had formulated a strategic plan for a revised curriculum structure based on the way patients present to physicians, and implementation of this plan has begun. In creating the new curriculum, 120 clinical presentations (e.g., "loss of consciousness/syncope") were defined and each was assigned to an individual or small group of faculty for development based on faculty expertise and interest. Terminal objectives (i.e., "what to do") were defined for each presentation to describe the appropriate clinical behaviors of a graduating physician. Experts developed schemes that outlined how they differentiated one cause (i.e., disease category) from another. The underlying enabling objectives (i.e., knowledge, skills, and attitudes) for reaching the terminal objectives for each clinical presentation were assigned as departmental responsibilities. A new administrative structure evolved in which there is a partnership between a centralized multidisciplinary curriculum committee and the departments. This new competency-based, clinical presentation curriculum is expected to significantly enhance students' development of clinical problem-solving skills and affirms the premise that prudent, continuous updating is essential for improving the quality of medical education.

  19. A Pilot Project Demonstrating that Combat Medics Can Safely Administer Parenteral Medications in the Emergency Department.

    Science.gov (United States)

    Schauer, Steven G; Cunningham, Cord W; Fisher, Andrew D; DeLorenzo, Robert A

    2017-12-01

    Introduction Select units in the military have improved combat medic training by integrating their functions into routine clinical care activities with measurable improvements in battlefield care. This level of integration is currently limited to special operations units. It is unknown if regular Army units and combat medics can emulate these successes. The goal of this project was to determine whether US Army combat medics can be integrated into routine emergency department (ED) clinical care, specifically medication administration. Project Design This was a quality assurance project that monitored training of combat medics to administer parenteral medications and to ensure patient safety. Combat medics were provided training that included direct supervision during medication administration. Once proficiency was demonstrated, combat medics would prepare the medications under direct supervision, followed by indirect supervision during administration. As part of the quality assurance and safety processes, combat medics were required to document all medication administrations, supervising provider, and unexpected adverse events. Additional quality assurance follow-up occurred via complete chart review by the project lead. Data During the project period, the combat medics administered the following medications: ketamine (n=13), morphine (n=8), ketorolac (n=7), fentanyl (n=5), ondansetron (n=4), and other (n=6). No adverse events or patient safety events were reported by the combat medics or discovered during the quality assurance process. In this limited case series, combat medics safely administered parenteral medications under indirect provider supervision. Future research is needed to further develop this training model for both the military and civilian setting. Schauer SG , Cunningham C W, Fisher AD , DeLorenzo RA . A pilot project demonstrating that combat medics can safely administer parenteral medications in the emergency department. Prehosp Disaster Med. 2017;32(6):679-681.

  20. Impact Of The Ban On Uncovered SCDS Trade On the Interdependencies Between The CDS Market And Other Sectors Of Financial Markets. The Case Of Safe And Developed Versus Risky And Developing European Markets

    OpenAIRE

    Kliber, Agata

    2016-01-01

    The aim of the article is to verify the impact of the ban on uncovered sCDS trade in Europe on the interdependencies between the sCDS market and other sectors of financial markets. We analyse two European markets: the safe and developed Swedish market, and the risky and developing Hungarian one. The study covers the period from October 2008 to October 2013. We analyse changes in the interdependencies between the sCDS market and the bond market, as well as between the sCDS market and the stock...

  1. Designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain

    Directory of Open Access Journals (Sweden)

    Clark Michael E

    2010-04-01

    Full Text Available Abstract Background Opioid prescribing for chronic pain is common and controversial, but recommended clinical practices are followed inconsistently in many clinical settings. Strategies for increasing adherence to clinical practice guideline recommendations are needed to increase effectiveness and reduce negative consequences of opioid prescribing in chronic pain patients. Methods Here we describe the process and outcomes of a project to operationalize the 2003 VA/DOD Clinical Practice Guideline for Opioid Therapy for Chronic Non-Cancer Pain into a computerized decision support system (DSS to encourage good opioid prescribing practices during primary care visits. We based the DSS on the existing ATHENA-DSS. We used an iterative process of design, testing, and revision of the DSS by a diverse team including guideline authors, medical informatics experts, clinical content experts, and end-users to convert the written clinical practice guideline into a computable algorithm to generate patient-specific recommendations for care based upon existing information in the electronic medical record (EMR, and a set of clinical tools. Results The iterative revision process identified numerous and varied problems with the initially designed system despite diverse expert participation in the design process. The process of operationalizing the guideline identified areas in which the guideline was vague, left decisions to clinical judgment, or required clarification of detail to insure safe clinical implementation. The revisions led to workable solutions to problems, defined the limits of the DSS and its utility in clinical practice, improved integration into clinical workflow, and improved the clarity and accuracy of system recommendations and tools. Conclusions Use of this iterative process led to development of a multifunctional DSS that met the approval of the clinical practice guideline authors, content experts, and clinicians involved in testing. The

  2. Now, It's Your Turn: How You Can Take Medicine Safely

    Science.gov (United States)

    ... turn Javascript on. Feature: Taking Medicines Safely Now, It's Your Turn: How You Can Take Medicine Safely ... medicine. The pharmacist has filled the prescription. Now it's up to you to take the medicine safely. ...

  3. Organising a safe space for navigating social-ecological transformations to sustainability

    OpenAIRE

    Pereira, L.; Karpouzoglou, T.D.; Doshi, S.; Frantzeskaki, N.

    2015-01-01

    textabstractThe need for developing socially just living conditions for the world’s growing population whilst keeping human societies within a ‘safe operating space’ has become a modern imperative. This requires transformative changes in the dominant social norms, behaviours, governance and management regimes that guide human responses in areas such as urban ecology, public health, resource security (e.g., food, water, energy access), economic development and biodiversity conservation. Howeve...

  4. Development, Validation, and Implementation of a Clinic Nurse Staffing Guideline.

    Science.gov (United States)

    Deeken, Debra Jean; Wakefield, Douglas; Kite, Cora; Linebaugh, Jeanette; Mitchell, Blair; Parkinson, Deidre; Misra, Madhukar

    2017-10-01

    Ensuring that the level of nurse staffing used to care for patients is appropriate to the setting and service intensity is essential for high-quality and cost-effective care. This article describes the development, validation, and implementation of the clinic technical skills permission list developed specifically to guide nurse staffing decisions in physician clinics of an academic medical center. Results and lessons learned in using this staffing guideline are presented.

  5. Pseudo Control Hedging and its Application for Safe Flight Envelope Protection

    NARCIS (Netherlands)

    Lombaerts, T.J.J.; Looye, G.H.N.; Chu, Q.P.; Mulder, J.A.

    2010-01-01

    This paper describes how the previously developed concept of Pseudo Control Hedging (PCH) can be integrated in a Fault Tolerant Flight Controller (FTFC) as a safe flight envelope protection system of the first degree. This PCH algorithm adapts the reference model for the system output in case of

  6. Design of an integrated information management system for safe management of radioactive waste

    International Nuclear Information System (INIS)

    Son, Dong Chan; Hong, Suk Young; An, Kyoung Il

    2003-05-01

    An integrated data management system for the safe management of radioactive waste and spent fuel in Korea is developed to collect basic information, provide the framework for national regulation, and improve national competition and efficiency in the management of radioactive waste and spent fuel. This system can also provide public access to information such as a statistical graphs and integrated data from various waste generators to meet increased public needs and interests. Objectives can be summarized as: the five principles (independence, openness, clearance, efficiency and reliance) of safety regulation can be realized. Public understanding and reliance on the safety of spent fuel and radioactive waste management can be promoted by providing reliable information. Ensure an openness within the international nuclear community and efficiently support international agreements among contracting parties by operating safe and efficient management of spent fuel and radioactive waste (IAEA joint convention on the safety of spent fuel management and on the safety of radioactive waste management). The system can compensate for the imperfections in safe regulation of radioactive waste and spent fuel management related to waste generation, storage and disposal, and make it possible to holistic control. Re-organize the basic framework of KINS's intermediate and long term research organization and trends, regarding waste management policy is to integrate safe management and unit safe disposal

  7. Design of an integrated information management system for safe management of radioactive waste

    Energy Technology Data Exchange (ETDEWEB)

    Son, Dong Chan; Hong, Suk Young; An, Kyoung Il [Daesang Information Technology Co., Ltd., Seoul (Korea, Republic of)] (and others)

    2003-05-15

    An integrated data management system for the safe management of radioactive waste and spent fuel in Korea is developed to collect basic information, provide the framework for national regulation, and improve national competition and efficiency in the management of radioactive waste and spent fuel. This system can also provide public access to information such as a statistical graphs and integrated data from various waste generators to meet increased public needs and interests. Objectives can be summarized as: the five principles (independence, openness, clearance, efficiency and reliance) of safety regulation can be realized. Public understanding and reliance on the safety of spent fuel and radioactive waste management can be promoted by providing reliable information. Ensure an openness within the international nuclear community and efficiently support international agreements among contracting parties by operating safe and efficient management of spent fuel and radioactive waste (IAEA joint convention on the safety of spent fuel management and on the safety of radioactive waste management). The system can compensate for the imperfections in safe regulation of radioactive waste and spent fuel management related to waste generation, storage and disposal, and make it possible to holistic control. Re-organize the basic framework of KINS's intermediate and long term research organization and trends, regarding waste management policy is to integrate safe management and unit safe disposal.

  8. Training to Increase Safe Tray Carrying Among Cocktail Servers

    OpenAIRE

    Scherrer, Megan D; Wilder, David A

    2008-01-01

    We evaluated the effects of training on proper carrying techniques among 3 cocktail servers to increase safe tray carrying on the job and reduce participants' risk of developing musculoskeletal disorders. As participants delivered drinks to their tables, their finger, arm, and neck positions were observed and recorded. Each participant received individual safety training that focused on proper carrying positions and techniques after baseline data were collected. A multiple baseline design acr...

  9. Developing advanced clinical practice skills in gastrointestinal consequences of cancer treatment.

    Science.gov (United States)

    Gee, Caroline; Andreyev, Jervoise; Muls, Ann

    2018-03-08

    This article explores the transition from a clinical nurse specialist (CNS) towards developing advanced clinical practice skills within a gastrointestinal consequences of cancer clinic. It presents data on the first 50 patients assessed by the CNS from a prospective service evaluation, demonstrating how this informed the nurse's future learning. There is high demand for advanced clinical practice skills to address unmet health needs and improve the quality, efficiency, and sustainability of healthcare services. However, a literature review found no literature on developing advanced clinical practice skills in this setting. Emerging themes from the service evaluation focused on barriers and enablers, ongoing support, organisational commitment and working in a multidisciplinary team. Blended learning provided both structured and opportunistic learning, embedding both formal and tacit knowledge, as roles require increasing flexibility. Clinical supervision and reflective practice were key in maintaining professional and peer support.

  10. Application of radiation technology in vaccines development.

    Science.gov (United States)

    Seo, Ho Seong

    2015-07-01

    One of the earliest methods used in the manufacture of stable and safe vaccines is the use of chemical and physical treatments to produce inactivated forms of pathogens. Although these types of vaccines have been successful in eliciting specific humoral immune responses to pathogen-associated immunogens, there is a large demand for the development of fast, safe, and effective vaccine manufacturing strategies. Radiation sterilization has been used to develop a variety of vaccine types, because it can eradicate chemical contaminants and penetrate pathogens to destroy nucleic acids without damaging the pathogen surface antigens. Nevertheless, irradiated vaccines have not widely been used at an industrial level because of difficulties obtaining the necessary equipment. Recent successful clinical trials of irradiated vaccines against pathogens and tumors have led to a reevaluation of radiation technology as an alternative method to produce vaccines. In the present article, we review the challenges associated with creating irradiated vaccines and discuss potential strategies for developing vaccines using radiation technology.

  11. Clinical laboratory technologist professional development in Camagüey

    Directory of Open Access Journals (Sweden)

    Mercedes Caridad García González

    2015-05-01

    Full Text Available The paper describes the results of research aimed at assessing the current conditions related to clinical laboratory technologist professional development. A descriptive cross study covering the period between November 2013 and January 2014 is presented. Several techniques for identifying and hierarchically arranging professional developmental related problems were used to study a sample at the Faculty of Health Technology of the Medical University “Carlos Juan Finlay”. The study involved heads of teaching departments and methodologists of health care technology specialties; moreover a survey and a content test were given graduate clinical laboratory technicians. The authors reached at the conclusion that clinical laboratory technologist professional development is limited and usually underestimate the necessities and interests of these graduates. Likewise, a lack of systematization and integration of the biomedical basic sciences contents and the laboratory diagnosis is noticeable.

  12. The safe road transport system approach

    Directory of Open Access Journals (Sweden)

    Vollpracht Hans-Joachim

    2016-07-01

    Full Text Available More than 1,24 million people die each year on the worlds roads and between 20 to 50 million suffer from nonfatal injuries. The UN Road Safety Collaboration Meetings under the leadership of WHO developed the Programme for the Decade of Actions for road safety taking nations into the responsibility of improving their accident figures by the five pillars of a national Road Safety Policy, safer Roads, safer Vehicles, safer Road Users and Post Crash Care. It is this Safe System Approach that takes into consideration the land use, infrastructure and transport planning, road user’s abilities and limitations and the close cooperation of all governmental and none governmental stakeholders involved.

  13. Changing pattern of landslide risk in Europe - The SafeLand project

    Science.gov (United States)

    Nadim, F.; Kalsnes, B.

    2012-04-01

    The need to protect people and property with a changing pattern of landslide hazard and risk caused by climate change and changes in demography, and the reality for societies in Europe to live with the risk associated with natural hazards, were the motives for the project SafeLand: "Living with landslide risk in Europe: Assessment, effects of global change, and risk management strategies." SafeLand is a large, integrating research project under the European Commission's 7th Framework Programme (FP7). The project started on 1 May 2009 and will end on 30 April 2012. It involves 27 partners from 12 European countries, and has international collaborators and advisers from China, India, USA, Japan and Hong Kong. SafeLand also involves 25 End-Users from 11 countries. SafeLand is coordinated by the International Centre for Geohazards (ICG) at Norwegian Geotechnical Institute in Norway. Further information on the SafeLand project can be found at its web site http://safeland-fp7.eu/. Main results achieved in SafeLand include: - Various guidelines related to landslide triggering processes and run-out modelling. - Development and testing of several empirical methods for predicting the characteristics of threshold rainfall events for triggering of precipitation-induced landslides, and development of an empirical model for assessing the changes in landslide frequency (hazard) as a function of changes in the demography and population density. - Guideline for landslide susceptibility, hazard and risk assessment and zoning. - New methodologies for physical and societal vulnerability assessment. - Identification of landslide hazard and risk hotspots for Europe. The results show clearly where areas with the largest landslide risk are located in Europe and the objective approach allows a ranking of the countries by exposed area and population. - Different regional and local climate model simulations over selected regions of Europe at spatial resolutions of 10x10 km and 2.8x2.8 km

  14. Is nuclear power safe enough

    Energy Technology Data Exchange (ETDEWEB)

    Andresen, A F [Institutt for Atomenergi, Kjeller (Norway)

    1979-01-01

    The lecture formed a commentary on the report of the Norwegian Government's Commission on Nuclear power Safety which was published in October 1978. It was introductorily pointed out that 'safe' and 'safety' are not in themselves meaningful terms and that the probability of an occurrence is the real measure. The main items in the Commission's report have been core meltdown, releases during reprocessing, waste disposal, plutonium diversion and environmental impacts. The 21 members of the Commission were unanimous in 7 of the 8 chapters. In chapter 2, 'Summary and Conclusions', 3 members dissented from the majority opinion, that, subject to certain conditions, nuclear power was a safe and acceptable source of energy.

  15. A 'simple anterior fish excluder' (SAFE for mitigating penaeid-trawl bycatch.

    Directory of Open Access Journals (Sweden)

    Matthew J McHugh

    Full Text Available Various plastic strips and sheets (termed 'simple anterior fish excluders'-SAFEs were positioned across the openings of penaeid trawls in attempts at reducing the unwanted bycatches of small teleosts. Initially, three SAFEs (a single wire without, and with small and large plastic panels were compared against a control (no SAFE on paired beam trawls. All SAFEs maintained targeted Metapenaeus macleayi catches, while the largest plastic SAFE significantly reduced total bycatch by 51% and the numbers of Pomatomus saltatrix, Mugil cephalus and Herklotsichthys castelnaui by up to 58%. A redesigned SAFE ('continuous plastic' was subsequently tested (against a control on paired otter trawls, significantly reducing total bycatch by 28% and P. saltatrix and H. castelnaui by up to 42%. The continuous-plastic SAFE also significantly reduced M. macleayi catches by ~7%, but this was explained by ~5% less wing-end spread, and could be simply negated through otter-board refinement. Further work is required to refine the tested SAFEs, and to quantify species-specific escape mechanisms. Nevertheless, the SAFE concept might represent an effective approach for improving penaeid-trawl selectivity.

  16. The safe transport of radioactive materials

    CERN Document Server

    Gibson, R

    1966-01-01

    The Safe Transport of Radioactive Materials is a handbook that details the safety guidelines in transporting radioactive materials. The title covers the various regulations and policies, along with the safety measures and procedures of radioactive material transport. The text first details the 1963 version of the IAEA regulation for the safe transport of radioactive materials; the regulation covers the classification of radionuclides for transport purposes and the control of external radiation hazards during the transport of radioactive materials. The next chapter deals with concerns in the im

  17. Development of a Primary Care-Based Clinic to Support Adults With a History of Childhood Cancer: The Tactic Clinic.

    Science.gov (United States)

    Overholser, Linda S; Moss, Kerry M; Kilbourn, Kristin; Risendal, Betsy; Jones, Alison F; Greffe, Brian S; Garrington, Timothy; Leonardi-Warren, Kristin; Yamashita, Traci E; Kutner, Jean S

    2015-01-01

    Describe the development and evolution of a primary-care-based, multidisciplinary clinic to support the ongoing care of adult survivors of childhood cancer. A consultative clinic for adult survivors of childhood cancer has been developed that is located in an adult, academic internal medicine setting and is based on a long-term follow-up clinic model available at Children's Hospital Colorado. The clinic opened in July 2008. One hundred thirty-five patients have been seen as of April 2014. Referrals and clinic capacity have gradually increased over time, and a template has been developed in the electronic medical record to help facilitate completion of individualized care plan letters. A primary care-based, multidisciplinary consultative clinic for adults with a history of childhood cancer survivor is feasible and actively engages adult primary care resources to provide risk-based care for long-term pediatric cancer survivors. This model of care planning can help support adult survivors of pediatric cancer and their primary care providers in non-academic, community settings as well. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Combined SAFE/SNAP approach to safeguards evaluation

    International Nuclear Information System (INIS)

    Engi, D.; Chapman, L.D.; Grant, F.H.; Polito, J.

    1980-01-01

    Generally, the scope of a safeguards evaluation model can efficiently address one of two issues, (1) global safeguards effectiveness, or (2) vulnerability analysis for individual scenarios. The Safeguards Automated Facility Evaluation (SAFE) focuses on (1) while the Safeguards Network Analysis Procedure (SNAP) is directed at (2). SAFE addresses (1) in that it considers the entire facility, i.e., the composite system of hardware and human components, in one global analysis. SNAP addresses (2) by providing a safeguards modeling symbology sufficiently flexible to represent quite complex scenarios from the standpoint of hardware interfaces while also accounting for a rich variety of human decision making. A combined SAFE/SNAP approach to the problem of safeguards evaluation is described and illustrated through an example

  19. Against the odds: experiences of nurse leaders in Clinical Development Units (Nursing) in Australia.

    Science.gov (United States)

    Atsalos, Christine; O'Brien, Louise; Jackson, Debra

    2007-06-01

    This paper is a report of a longitudinal study to develop an understanding of the phenomena of Clinical Development Unit (Nursing) leadership by exploring the experiences of the nurse leaders of nine Australian units as they attempted to develop their existing wards or units into recognized centres of nursing excellence. The concept of Clinical Development Unit (Nursing) in Australia originated in the British Nursing Development Unit movement, which has been widely credited with introducing innovative approaches to developing nurses and nursing. A network of nine Clinical Development Units (Nursing) was set up in a suburban area health service in Australia. The aim was to develop existing wards or units into centres of excellence by disseminating a new vision for Australian nurses that was based on the pioneering work of the British Nursing Development Unit movement. Principles of Heideggerian hermeneutic phenomenology provided a framework for the study. Nine Clinical Development Unit (Nursing) leaders participated in qualitative interviews from 1998 to 2002. These interviews were transcribed into text and thematically analysed. Despite attempts to implement a variety of measures to nurture these Clinical Development Units (Nursing) until they had become well established, the new Clinical Development Unit (Nursing) leaders were unable to maintain the Clinical Development Unit (Nursing) vision with which they had been entrusted. This paper discusses their reactions to the problems they faced and the new understandings they developed of their Clinical Development Unit (Nursing) role over time. The findings illuminate the difficulties involved in maintaining the commitment of all levels of staff and management when attempting to introduce new nursing projects.

  20. Physician leadership development at Cleveland Clinic: a brief review.

    Science.gov (United States)

    Christensen, Terri; Stoller, James K

    2016-06-01

    We aim to describe the rationale for and spectrum of leadership development programs, highlighting experience at a large healthcare institution (Cleveland Clinic, Cleveland, Ohio, USA). Developing leaders is a universal priority to sustain organizational success. In health care, significant challenges of ensuring quality and access and making care affordable are widely shared internationally and demand effective physician leadership. Yet, leadership competencies differ from clinical and scientific competencies and features of selecting and training physicians-who have been called "heroic lone healers" -often conspire against physicians being effective leaders or followers. Thus, developing leadership competencies in physicians is critical.Leadership development programs have been signature features of successful organizations and various Australian organizations offer such training (e.g. The Australian Leadership Foundation and the University of South Australia), but relatively few health care organizations have adopted the practice of offering such training, both in Australia and elsewhere. As a United States example of one such integrated program, the Cleveland Clinic, a large, closed-staff physician-led group practice in Cleveland, Ohio has offered physician leadership training for over 15 years. This paper describes the rationale, structure, and some of the observed impacts associated with this program. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  1. LACK OF AWARENESS ABOUT SAFE BLOOD IN PAKISTANI POPULATION

    Directory of Open Access Journals (Sweden)

    Muhammad Usman

    2014-12-01

    Full Text Available Blood transfusion is a life saving procedure in various transfusion-dependent life threatening conditions and donation of safe blood is a prerequisite for achieving this goal. This study was designed to evaluate the awareness regarding “safe blood” in Pakistani population. This study was conducted at a large scale through a population survey. The test population was divided into two groups i.e. general population and students. The Performa was designed for a general and student population and included 20 questions related to awareness of safe blood. A total of 4900 individuals belonging to different ethnic groups were included in this population survey. Results of social survey were analyzed by using Usman and Moin awareness chart. Results of this study revealed profound unawareness about safe blood in Pakistani population. This study found lack of awareness about safe blood as a major factor that is playing a vital role in the propagation of blood borne diseases in Pakistan. To secure the recipients from blood borne complications through blood donation, it is necessary to create effective awareness about safe blood in Pakistani population.

  2. Model development for the dynamic analysis of the OSU inherently safe reactor. Part 1

    International Nuclear Information System (INIS)

    Aybar, H.S.

    1992-01-01

    Faculty and students in the Nuclear Engineering Program at the Ohio State University (OSU) have proposed a conceptual design for an inherently safe 340 MWe power reactor. The design is based on the state-of-the-art technology of LWRs and the High Temperature Gas- cooled Reactors (HTGRs). The OSU Inherently Safe Reactor (OSU-ISR) concept uses shorter than standard BWR fuel elements in the reactor core. All the fluid on the primary side is contained within a Prestressed Concrete Reactor Vessel (PCRV). This important feature significantly reduces the probability of a LOCA. A new feature of the OSU-ISR is an operator independent steam driven Emergency Core Cooling System (ECCS) housed within the PCRV. In accident conditions where the steam generators are incapacitated, steam from the core drives a jet injector, which takes water from the suppression pool and pumps it into the core cavity to maintain core coverability. The preliminary analysis of the concept was performed as a design project in the Nuclear Engineering Program at the OSU during the Spring of 1985, and published in ''Nuclear Technology.'' The use of a PCRV for ducting and containment and the replacement of forced recirculation with natural circulation on the primary side significantly improve the inherent safety of the plant. Currently, work is in progress for the refinement of the OSU-ISR concept, partially supported by a grant from the U.S. Department of Energy

  3. Self-Reflection of Video-Recorded High-Fidelity Simulations and Development of Clinical Judgment.

    Science.gov (United States)

    Bussard, Michelle E

    2016-09-01

    Nurse educators are increasingly using high-fidelity simulators to improve prelicensure nursing students' ability to develop clinical judgment. Traditionally, oral debriefing sessions have immediately followed the simulation scenarios as a method for students to connect theory to practice and therefore develop clinical judgment. Recently, video recording of the simulation scenarios is being incorporated. This qualitative, interpretive description study was conducted to identify whether self-reflection on video-recorded high-fidelity simulation (HFS) scenarios helped prelicensure nursing students to develop clinical judgment. Tanner's clinical judgment model was the framework for this study. Four themes emerged from this study: Confidence, Communication, Decision Making, and Change in Clinical Practice. This study indicated that self-reflection of video-recorded HFS scenarios is beneficial for prelicensure nursing students to develop clinical judgment. [J Nurs Educ. 2016;55(9):522-527.]. Copyright 2016, SLACK Incorporated.

  4. Electronic medical records in humanitarian emergencies - the development of an Ebola clinical information and patient management system.

    Science.gov (United States)

    Jobanputra, Kiran; Greig, Jane; Shankar, Ganesh; Perakslis, Eric; Kremer, Ronald; Achar, Jay; Gayton, Ivan

    2016-01-01

    By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. Data continued to also be recorded on paper charts, creating theoretically identical record "pairs" on paper and tablet. 83 record pairs for 33 patients with 22 data items (temperature and symptoms) per pair were analysed. The overall Kappa coefficient for agreement between sources was 0.62, but reduced to 0.59 when rare bleeding symptoms were excluded, indicating moderate to good agreement. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge

  5. The recent fall in postperinatal mortality in New Zealand and the Safe Sleep programme.

    Science.gov (United States)

    Mitchell, Edwin A; Cowan, Stephanie; Tipene-Leach, David

    2016-11-01

    Postneonatal mortality rates changed very little from 2000 until recently. There has been a decrease in mortality in New Zealand from 2009 to 2015. This study describes an infant Safe Sleep programme and postulates it is the cause for the recent decrease in deaths. The Safe Sleep programme involved as follows: a focus on preventing accidental suffocation, a 'blitz' approach to SUDI education, the targeted provision of portable infant Safe Sleep devices (ISSD) and the development of Safe Sleep policy across all district health boards (DHBs). Participation in the education 'blitz' by health professionals exceeded one in 23 live births, distribution of Safe Sleep leaflets exceeded two for every live birth, and over 16 500 ISSDs have been distributed to vulnerable infants. Postperinatal mortality fell 29% from 2009 to 2015 (2.8 to 2.0/1000 live births). The fall has been greatest for Māori and in regions with the most intensive programmes. The recent fall in postperinatal mortality has not happened by chance. It is likely that the components of end-stage prevention strategy, a focus on preventing accidental suffocation, the education 'blitz', the targeted supply of ISSDs and strengthened health policy, have all contributed to varying degrees. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  6. Review on research of suppression male fertility and male contraceptive drug development by natural products.

    Science.gov (United States)

    Bajaj, Vijay Kumar; Gupta, Radhey S

    2013-08-01

    Male contraceptive development in the present scenario is most viable aspect of research due to uncontrolled population growth in the world. In this respect investigators are busy to find out a safe male contraceptive drug. Researchers have started their finding for a suitable drug from natural sources because these are safe and easily acceptable for common man, most of natural sources are plants and their products. In this review 137 plants and their effects on reproduction and reproductive physiology are summarized. Some of them have intense effect on male reproductive system and do not produce any side effects. Reproductive toxicological studies are also important aspects of these kinds of researches, so it is important that drugs are safe and widely acceptable. An ideal male contraceptive can influence semen, testes, hormone level, accessory reproductive organs and general physiology of animals and produced some alterations. Many plants in this review are showing antifertility as well as antispermatogenic effects, so these may be used for further study for contraceptives development but it is important to find out the mechanism of reaction and further laboratory and clinical research on some plants are needed for final male contraceptive drug development. In conclusion this review will help for finding suitable plant products for male contraceptive clinical and laboratory studies.

  7. Telehealth Stroke Dysphagia Evaluation Is Safe and Effective.

    Science.gov (United States)

    Morrell, Kate; Hyers, Megan; Stuchiner, Tamela; Lucas, Lindsay; Schwartz, Karissa; Mako, Jenniffer; Spinelli, Kateri J; Yanase, Lisa

    2017-01-01

    Rapid evaluation of dysphagia poststroke significantly lowers rates of aspiration pneumonia. Logistical barriers often significantly delay in-person dysphagia evaluation by speech language pathologists (SLPs) in remote and rural hospitals. Clinical swallow evaluations delivered via telehealth have been validated in a number of clinical contexts, yet no one has specifically validated a teleswallow evaluation for in-hospital post-stroke dysphagia assessment. A team of 6 SLPs experienced in stroke care and a telestroke neurologist designed, implemented, and tested a teleswallow evaluation for acute stroke patients, in which 100 patients across 2 affiliated, urban certified stroke centers were sequentially evaluated by a bedside and telehealth SLP. Inter-rater reliability was analyzed using percent agreement, Cohen's kappa, Kendall's tau-b, and Wilcoxon matched-pairs signed rank tests. Logistic regression models accounting for age and gender were used to test the impact of stroke severity and stroke location on agreement. We found excellent agreement for both liquid (91% agreement; kappa = 0.808; Kendall's tau-b = 0.813, p Dysphagia evaluation by a remote SLP via telehealth is safe and effective following stroke. We plan to implement teleswallow across our multistate telestroke network as standard practice for poststroke dysphagia evaluation. © 2017 S. Karger AG, Basel.

  8. Development of a standardized and safe airborne antibacterial assay, and its evaluation on antibacterial biomimetic model surfaces.

    Directory of Open Access Journals (Sweden)

    Ali Al-Ahmad

    Full Text Available Bacterial infection of biomaterials is a major concern in medicine, and different kinds of antimicrobial biomaterial have been developed to deal with this problem. To test the antimicrobial performance of these biomaterials, the airborne bacterial assay is used, which involves the formation of biohazardous bacterial aerosols. We here describe a new experimental set-up which allows safe handling of such pathogenic aerosols, and standardizes critical parameters of this otherwise intractable and strongly user-dependent assay. With this new method, reproducible, thorough antimicrobial data (number of colony forming units and live-dead-stain was obtained. Poly(oxonorbornene-based Synthetic Mimics of Antimicrobial Peptides (SMAMPs were used as antimicrobial test samples. The assay was able to differentiate even between subtle sample differences, such as different sample thicknesses. With this new set-up, the airborne bacterial assay was thus established as a useful, reliable, and realistic experimental method to simulate the contamination of biomaterials with bacteria, for example in an intraoperative setting.

  9. Use of crowdsourcing for cancer clinical trial development.

    Science.gov (United States)

    Leiter, Amanda; Sablinski, Tomasz; Diefenbach, Michael; Foster, Marc; Greenberg, Alex; Holland, John; Oh, William K; Galsky, Matthew D

    2014-10-01

    Patient and physician awareness and acceptance of trials and patient ineligibility are major cancer clinical trial accrual barriers. Yet, trials are typically conceived and designed by small teams of researchers with limited patient input. We hypothesized that through crowdsourcing, the intellectual and creative capacity of a large number of researchers, clinicians, and patients could be harnessed to improve the clinical trial design process. In this study, we evaluated the feasibility and utility of using an internet-based crowdsourcing platform to inform the design of a clinical trial exploring an antidiabetic drug, metformin, in prostate cancer. Over a six-week period, crowd-sourced input was collected from 60 physicians/researchers and 42 patients/advocates leading to several major (eg, eligibility) and minor modifications to the clinical trial protocol as originally designed. Crowdsourcing clinical trial design is feasible, adds value to the protocol development process, and may ultimately improve the efficiency of trial conduct. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  10. Safe-haven CDS Premia

    DEFF Research Database (Denmark)

    Klingler, Sven; Lando, David

    We argue that Credit Default Swap (CDS) premia for safe-haven sovereigns, like Germany and the United States, are driven to a large extent by regulatory requirements under which derivatives dealing banks have an incentive to buy CDS to hedge counterparty credit risk of their counterparties. We...

  11. Effects of the Smartphone Application "Safe Patients" on Knowledge of Patient Safety Issues Among Surgical Patients.

    Science.gov (United States)

    Cho, Sumi; Lee, Eunjoo

    2017-12-01

    Recently, the patient's role in preventing adverse events has been emphasized. Patients who are more knowledgeable about safety issues are more likely to engage in safety initiatives. Therefore, nurses need to develop techniques and tools that increase patients' knowledge in preventing adverse events. For this reason, an educational smartphone application for patient safety called "Safe Patients" was developed through an iterative process involving a literature review, expert consultations, and pilot testing of the application. To determine the effect of "Safe Patients," it was implemented for patients in surgical units in a tertiary hospital in South Korea. The change in patients' knowledge about patient safety was measured using seven true/false questions developed in this study. A one-group pretest and posttest design was used, and a total of 123 of 190 possible participants were tested. The percentage of correct answers significantly increased from 64.5% to 75.8% (P effectively improve patients' knowledge of safety issues. This will ultimately empower patients to engage in safe practices and prevent adverse events related to surgery.

  12. Clinical imprinting: the impact of early clinical learning on career long professional development in nursing.

    Science.gov (United States)

    Andrew, Nicola

    2013-05-01

    The literature recognises a relationship between clinical experience and a successful undergraduate experience in nursing; however what constitutes an effective approach remains the subject of debate, particularly in relation to first year of learning. There is evidence from a biological standpoint that early experience impacts on the behavioural development of animals, described by Konrad Lorenz (1903-1989) as 'imprinting'. The concept of imprinting has resonance for nursing. In this article the importance of 'getting it right at the beginning' is explored and what, if anything, Lorenz's theory tells us about the impact of early clinical learning on subsequent professional development. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Nuclear hydrogen production and its safe handling

    International Nuclear Information System (INIS)

    Chung, Hongsuk; Paek, Seungwoo; Kim, Kwang-Rag; Ahn, Do-Hee; Lee, Minsoo; Chang, Jong Hwa

    2003-01-01

    An overview of the hydrogen related research presently undertaken at the Korea Atomic Energy Research Institute are presented. These encompass nuclear hydrogen production, hydrogen storage, and the safe handling of hydrogen, High temperature gas-cooled reactors can play a significant role, with respect to large-scale hydrogen production, if used as the provider of high temperature heat in fossil fuel conversion or thermochemical cycles. A variety of potential hydrogen production methods for high temperature gas-cooled reactors were analyzed. They are steam reforming of natural gas, thermochemical cycles, etc. The produced hydrogen should be stored safely. Titanium metal was tested primarily because its hydride has very low dissociation pressures at normal storage temperatures and a high capacity for hydrogen, it is easy to prepare and is non-reactive with air in the expected storage conditions. There could be a number of potential sources of hydrogen evolution risk in a nuclear hydrogen production facility. In order to reduce the deflagration detonation it is necessary to develop hydrogen control methods that are capable of dealing with the hydrogen release rate. A series of experiments were conducted to assess the catalytic recombination characteristics of hydrogen in an air stream using palladium catalysts. (author)

  14. Clinical assessment of early language development: a simplified short form of the Mandarin communicative development inventory.

    Science.gov (United States)

    Soli, Sigfrid D; Zheng, Yun; Meng, Zhaoli; Li, Gang

    2012-09-01

    The purpose of this study was to develop a practical mean for clinical evaluation of early pediatric language development by establishing developmental trajectories for receptive and expressive vocabulary growth in children between 6 and 32 months of age using a simple, time-efficient assessment tool. Simplified short form versions of the Words and Gestures and Words and Sentences vocabulary inventories in the Mandarin Communicative Development Inventory [1] were developed and used to assess early language development in developmentally normal children from 6 to 32 months of age during routine health checks. Developmental trajectories characterizing the rate of receptive and expressive vocabulary growth between 6 and 32 months of age are reported. These trajectories allow the equivalent age corresponding to a score to be determined after a brief structured interview with the child's parents that can be conducted in a busy clinical setting. The simplified short forms of the Mandarin Communicative Development Inventories can serve as a clinically useful tool to assess early child language development, providing a practical mean of objectively assessing early language development following early interventions to treat young children with hearing impairment as well as speech and language delays. Objective evidence of language development is essential for achievement of effective (re)habilitation outcomes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  15. Drug discovery and the impact of the safe harbor provision of the Hatch- Waxman Act.

    Science.gov (United States)

    Goodson, Susanne H

    2010-01-01

    Many facets of drug discovery involve the use of patented materials and methods, subjecting the researcher to potential liability from infringement of the underlying patents. Enacted in 1984, the Hatch-Waxman Act established a “safe harbor” for activities that would otherwise constitute infringement of a patented invention, if those activities were “solely for uses reasonably related to the development and submission of information under a Federal law which regulates the manufacture, use, or sale of drugs or veterinary biological products”. This article examines the major court decisions interpreting the scope of the safe harbor and their application to various activities in drug development.

  16. Swimming Safely (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    In the summertime, families will be flocking to pools for relaxation and relief from the heat. A few simple precautions can help ensure a safe day in the water. In this podcast, Michele Hlavsa discusses ways to stay safe at the pool.

  17. WHO safe surgery checklist: Barriers to universal acceptance

    Directory of Open Access Journals (Sweden)

    Divya Jain

    2018-01-01

    Full Text Available Development of the Safe Surgery Checklist is an initiative taken by the World Health Organization (WHO with an aim to reduce the complication rates during the surgical process. Despite gross reduction in the infection rate and morbidity following adoption of the checklist, many health-care providers are hesitant in implementing it in their everyday practice. In this article, we would like to highlight the hurdles in adoption of the WHO Surgical Checklist and measures that can be taken to overcome them.

  18. Clinical Trials

    Medline Plus

    Full Text Available ... Guidelines Funding Opportunities and Contacts Training and Career Development News and Events News and Events Home Email ... medicines or smaller medical devices. Their stage of development also can affect how safe a treatment is ...

  19. Factors to consider in the introduction of huddles on clinical wards: perceptions of staff on the SAFE programme.

    Science.gov (United States)

    Stapley, Emily; Sharples, Evelyn; Lachman, Peter; Lakhanpaul, Monica; Wolpert, Miranda; Deighton, Jessica

    2018-02-01

    To explore paediatric hospital staff members' perceptions of the emerging benefits and challenges of the huddle, a new safety improvement initiative, as well as the barriers and facilitators to its implementation. A qualitative study was conducted using semi-structured interviews to explore staff perspectives and experiences. Situation Awareness For Everyone (SAFE), a safety improvement programme, was implemented on a sample of National Health Service (NHS) paediatric wards from September 2014 to June 2016. Previously untested in England, the huddle was a central component of the programme. Semi-structured interviews were conducted with 76 staff members on four wards ~4 months after the start of the programme. A thematic analysis showed that staff perceived the huddle as helping to increase their awareness of important issues, improve communication, facilitate teamwork, and encourage a culture of increased efficiency, anticipation and planning on the ward. Challenges of the huddle included added pressure on staff time and workload, and the potential for junior nurses to be excluded from involvement, thus perhaps inadvertently reinforcing medical hierarchies. Staff also identified several barriers and facilitators to the huddle process, including the importance of senior nursing and medical staff leadership and managing staff time and capacity issues. The findings point towards the potential efficacy of the huddle as a way of improving hospital staff members' working environments and clinical practice, with important implications for other sites seeking to implement such safety improvement initiatives. © The Author(s) 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  20. Ergonomics: safe patient handling and mobility.

    Science.gov (United States)

    Hallmark, Beth; Mechan, Patricia; Shores, Lynne

    2015-03-01

    This article reviews and investigates the issues surrounding ergonomics, with a specific focus on safe patient handling and mobility. The health care worker of today faces many challenges, one of which is related to the safety of patients. Safe patient handling and mobility is on the forefront of the movement to improve patient safety. This article reviews the risks associated with patient handling and mobility, and informs the reader of current evidence-based practice relevant to this area of care. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. The clinical development process for a novel preventive vaccine: An overview

    Directory of Open Access Journals (Sweden)

    K Singh

    2016-01-01

    Full Text Available Each novel vaccine candidate needs to be evaluated for safety, immunogenicity, and protective efficacy in humans before it is licensed for use. After initial safety evaluation in healthy adults, each vaccine candidate follows a unique development path. This article on clinical development gives an overview on the development path based on the expectations of various guidelines issued by the World Health Organization (WHO, the European Medicines Agency (EMA, and the United States Food and Drug Administration (USFDA. The manuscript describes the objectives, study populations, study designs, study site, and outcome(s of each phase (Phase I-III of a clinical trial. Examples from the clinical development of a malaria vaccine candidate, a rotavirus vaccine, and two vaccines approved for human papillomavirus (HPV have also been discussed. The article also tabulates relevant guidelines, which can be referred to while drafting the development path of a novel vaccine candidate.

  2. Fail-safe computer-based plant protection systems

    International Nuclear Information System (INIS)

    Keats, A.B.

    1983-01-01

    A fail-safe mode of operation for computers used in nuclear reactor protection systems was first evolved in the UK for application to a sodium cooled fast reactor. The fail-safe properties of both the hardware and the software were achieved by permanently connecting test signals to some of the multiplexed inputs. This results in an unambiguous data pattern, each time the inputs are sequentially scanned by the multiplexer. The ''test inputs'' simulate transient excursions beyond defined safe limits. The alternating response of the trip algorithms to the ''out-of-limits'' test signals and the normal plant measurements is recognised by hardwired pattern recognition logic external to the computer system. For more general application to plant protection systems, a ''Test Signal Generator'' (TSG) is used to compute and generate test signals derived from prevailing operational conditions. The TSG, from its knowledge of the sensitivity of the trip algorithm to each of the input variables, generates a ''test disturbance'' which is superimposed upon each variable in turn, to simulate a transient excursion beyond the safe limits. The ''tripped'' status yielded by the trip algorithm when using data from a ''disturbed'' input forms part of a pattern determined by the order in which the disturbances are applied to the multiplexer inputs. The data pattern formed by the interleaved test disturbances is again recognised by logic external to the protection system's computers. This fail-safe mode of operation of computer-based protection systems provides a powerful defence against common-mode failure. It also reduces the importance of software verification in the licensing procedure. (author)

  3. Development of evidence-based clinical practice guidelines (CPGs: comparing approaches

    Directory of Open Access Journals (Sweden)

    Harris Claire

    2008-10-01

    Full Text Available Abstract Background While the potential of clinical practice guidelines (CPGs to support implementation of evidence has been demonstrated, it is not currently being achieved. CPGs are both poorly developed and ineffectively implemented. To improve clinical practice and health outcomes, both well-developed CPGs and effective methods of CPG implementation are needed. We sought to establish whether there is agreement on the fundamental characteristics of an evidence-based CPG development process and to explore whether the level of guidance provided in CPG development handbooks is sufficient for people using these handbooks to be able to apply it. Methods CPG development handbooks were identified through a broad search of published and grey literature. Documents published in English produced by national or international organisations purporting to support development of evidence-based CPGs were included. A list of 14 key elements of a CPG development process was developed. Two authors read each handbook. For each handbook a judgement was made as to how it addressed each element; assigned as: 'mentioned and clear guidance provided', 'mentioned but limited practical detail provided ', or 'not mentioned'. Results Six CPG development handbooks were included. These were produced by the Council of Europe, the National Health and Medical Research Council of Australia, the National Institute for Health and Clinical Excellence in the UK, the New Zealand Guidelines Group, the Scottish Intercollegiate Guideline Network, and the World Health Organization (WHO. There was strong concordance between the handbooks on the key elements of an evidence-based CPG development process. All six of the handbooks require and provide guidance on establishment of a multidisciplinary guideline development group, involvement of consumers, identification of clinical questions or problems, systematic searches for and appraisal of research evidence, a process for drafting

  4. An Integrated Data-Driven Strategy for Safe-by-Design Nanoparticles: The FP7 MODERN Project.

    Science.gov (United States)

    Brehm, Martin; Kafka, Alexander; Bamler, Markus; Kühne, Ralph; Schüürmann, Gerrit; Sikk, Lauri; Burk, Jaanus; Burk, Peeter; Tamm, Tarmo; Tämm, Kaido; Pokhrel, Suman; Mädler, Lutz; Kahru, Anne; Aruoja, Villem; Sihtmäe, Mariliis; Scott-Fordsmand, Janeck; Sorensen, Peter B; Escorihuela, Laura; Roca, Carlos P; Fernández, Alberto; Giralt, Francesc; Rallo, Robert

    2017-01-01

    The development and implementation of safe-by-design strategies is key for the safe development of future generations of nanotechnology enabled products. The safety testing of the huge variety of nanomaterials that can be synthetized is unfeasible due to time and cost constraints. Computational modeling facilitates the implementation of alternative testing strategies in a time and cost effective way. The development of predictive nanotoxicology models requires the use of high quality experimental data on the structure, physicochemical properties and bioactivity of nanomaterials. The FP7 Project MODERN has developed and evaluated the main components of a computational framework for the evaluation of the environmental and health impacts of nanoparticles. This chapter describes each of the elements of the framework including aspects related to data generation, management and integration; development of nanodescriptors; establishment of nanostructure-activity relationships; identification of nanoparticle categories; hazard ranking and risk assessment.

  5. 76 FR 19189 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2011-04-06

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative... through the Director of the Clinical Science Research and Development Service on the relevance and... notice under Public Law 92-463 (Federal Advisory Committee Act) that a meeting of the Clinical Science...

  6. 76 FR 65781 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2011-10-24

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative... Clinical Science Research and Development Service on the relevance and feasibility of proposed projects and... notice under Public Law 92-463 (Federal Advisory Committee Act) that a meeting of the Clinical Science...

  7. 75 FR 28686 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2010-05-21

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service; Cooperative... through the Director of the Clinical Science Research and Development Service on the relevance and... notice under Public Law 92-463 (Federal Advisory Committee Act) that a meeting of the Clinical Science...

  8. Phase II clinical development of new drugs

    CERN Document Server

    Ting, Naitee; Ho, Shuyen; Cappelleri, Joseph C

    2017-01-01

    This book focuses on how to appropriately plan and develop a Phase II program, and how to design Phase II clinical trials and analyze their data. It provides a comprehensive overview of the entire drug development process and highlights key questions that need to be addressed for the successful execution of Phase II, so as to increase its success in Phase III and for drug approval. Lastly it warns project team members of the common potential pitfalls and offers tips on how to avoid them.

  9. Developments in clinical trials: a Pharma Matters report.

    Science.gov (United States)

    Arjona, A; Nuskey, B; Rabasseda, X; Arias, E

    2014-08-01

    As the pharmaceutical industry strives to meet the ever-increasing complexity of drug development, new technology in clinical trials has become a beacon of hope. With big data comes the promise of accelerated patient recruitment, real-time monitoring of clinical trials, bioinformatics empowerment of quicker phase progression, and the overwhelming benefits of precision medicine for select trials. Risk-based monitoring stands to benefit as well. With a strengthening focus on centralized data by the FDA and industry's transformative initiative, TransCelerate, a new era in trial risk mitigation has begun. The traditional method of intensive on-site monitoring is becoming a thing of the past as statistical, real-time analysis of site and trial-wide data provides the means to monitor with greater efficiency and effectiveness from afar. However, when it comes to big data, there are challenges that lie ahead. Patient privacy, commercial investment protection, technology woes and data variability are all limitations to be met with considerable thought. At the Annual Meeting of the American Academy of Dermatology this year, clinical trials on psoriasis, atopic dermatitis and other skin diseases were discussed in detail. This review of clinical research reports on novel therapies for psoriasis and atopic dermatitis reveals the impact of these diseases and the drug candidates that have been successful in phase II and III studies. Data-focused highlights of novel dermatological trials, as well as real-life big data approaches and an insight on the new methodology of risk-based monitoring, are all discussed in this edition of Developments in Clinical Trials. Copyright 2014 Prous Science, S.A.U. or its licensors. All rights reserved.

  10. Safe handling of radiation sources

    International Nuclear Information System (INIS)

    Abd Nasir Ibrahim; Azali Muhammad; Ab Razak Hamzah; Abd Aziz Mohamed; Mohammad Pauzi Ismail

    2004-01-01

    This chapter discussed the subjects related to the safe handling of radiation sources: type of radiation sources, method of use: transport within premises, transport outside premises; Disposal of Gamma Sources

  11. Innovative approaches to clinical development and trial design

    Directory of Open Access Journals (Sweden)

    John J Orloff

    2011-01-01

    Full Text Available Pharmaceutical innovation is increasingly risky, costly and at times inefficient, which has led to a decline in industry productivity. Despite the increased investment in R&D by the industry, the number of new molecular entities achieving marketing authorization is not increasing. Novel approaches to clinical development and trial design could have a key role in overcoming some of these challenges by improving efficiency and reducing attrition rates. The effectiveness of clinical development can be improved by adopting a more integrated model that increases flexibility and maximizes the use of accumulated knowledge. Central to this model of drug development are novel tools, including modelling and simulation, Bayesian methodologies, and adaptive designs, such as seamless adaptive designs and sample-size re-estimation methods. Applications of these methodologies to early- and late-stage drug development are described with some specific examples, along with advantages, challenges, and barriers to implementation. Because they are so flexible, these new trial designs require significant statistical analyses, simulations and logistical considerations to verify their operating characteristics, and therefore tend to require more time for the planning and protocol development phase. Greater awareness of the distinct advantages of innovative designs by regulators and sponsors are crucial to increasing the adoption of these modern tools.

  12. Analysis of Methods of Determining the Safe Ship Trajectory

    Directory of Open Access Journals (Sweden)

    Jozef Lisowski

    2016-07-01

    Full Text Available The paper describes six methods of optimal and game theory and artificial neural network for synthesis of safe control in collision situations at sea. The application of optimal and game control algorithms to determine the own ship safe trajectory during the passing of other encountered ships in good and restricted visibility at sea is presented. The comparison of the safe ship control in collision situation: multi-step matrix non-cooperative and cooperative games, multi-stage positional non-cooperative and cooperative games have been introduced. The considerations have been illustrated with examples of computer simulation of the algorithms to determine safe of own ship trajectories in a navigational situation during passing of eight met ships.

  13. 78 FR 41198 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2013-07-09

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative... under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and.... The Committee advises the Chief Research and Development Officer through the Director of the Clinical...

  14. 75 FR 79446 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2010-12-20

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service; Cooperative... Officer through the Director of the Clinical Science Research and Development Service on the relevance and... notice under Public Law 92-463 (Federal Advisory Committee Act) that a meeting of the Clinical Science...

  15. 77 FR 72438 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2012-12-05

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative... under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and... through the Director of the Clinical Science Research and Development Service on the relevance and...

  16. 78 FR 53015 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2013-08-27

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative... under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and... Clinical Science Research and Development Service on the relevance and feasibility of proposed projects and...

  17. 76 FR 73781 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2011-11-29

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service; Cooperative... Officer through the Director of the Clinical Science Research and Development Service on the relevance and... notice under Public Law 92-463 (Federal Advisory Committee Act) that a meeting of the Clinical Science...

  18. Developing education tailored to clinical roles: genetics education for haemophilia nurses.

    Science.gov (United States)

    Burke, Sarah; Barker, Colin; Marshall, Dianne

    2012-01-01

    Genetics is an important component of the clinical work of haemophilia nurses, but little was known about the genetic education needs of haemophilia nurses. To develop, deliver and evaluate genetic education for haemophilia nurses, based on clinical roles. Perceived relevance of genetics to haemophilia nursing practice was explored using electronic voting (response rate 75%, 58/77). A follow-on questionnaire to a volunteer sample of participants explored educational preferences (response rate 41%, 17/41). Results informed development of a two-hour genetics workshop session, evaluated by questionnaire (response rate 67%, 47/70). Genetic competences were considered relevant to the clinical practice of haemophilia nurses, and learning needs were identified. Preference was expressed for education focused on practical skills. During the subsequent workshop, participant confidence ratings significantly increased in the four areas addressed. Planned changes to clinical care and training were reported. Within new areas of advanced nursing practice, learning needs can be addressed by: identifying relevant clinical activities and associated learning needs; creating a strategy and resources using preferred forms of delivery; implementing the strategy; and evaluating its effect. This will enable development of education that addresses the real needs of practising nurses, grounded in their daily clinical practice. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Development of β particle hemorrhoids applicator

    International Nuclear Information System (INIS)

    Cai Shanyu; Liu Yunsheng; Zhang Pinyuan; Teng Kezhi; Gu Zeliang; Li Zhi

    2012-01-01

    A brachytherapy instrument, called β particle hemorrhoid therapeutic instrument or β particle hemorrhoid applicator was developed. It is mainly composed of radiator, locator, lifter, shield sleeve and controller. It can be used to treat internal piles, external piles, combined piles, anal fissure, anal sinusitis, etc. Preliminary clinical tests indicate that the advantages of β particle intracavitary radiotherapy are safe, effective, convenient, painless and non-invasive for curing hemorrhoids comparing with other techniques. (authors)

  20. Data Safe Havens in health research and healthcare

    Science.gov (United States)

    Burton, Paul R.; Murtagh, Madeleine J.; Boyd, Andy; Williams, James B.; Dove, Edward S.; Wallace, Susan E.; Tassé, Anne-Marie; Little, Julian; Chisholm, Rex L.; Gaye, Amadou; Hveem, Kristian; Brookes, Anthony J.; Goodwin, Pat; Fistein, Jon; Bobrow, Martin; Knoppers, Bartha M.

    2015-01-01

    Motivation: The data that put the ‘evidence’ into ‘evidence-based medicine’ are central to developments in public health, primary and hospital care. A fundamental challenge is to site such data in repositories that can easily be accessed under appropriate technical and governance controls which are effectively audited and are viewed as trustworthy by diverse stakeholders. This demands socio-technical solutions that may easily become enmeshed in protracted debate and controversy as they encounter the norms, values, expectations and concerns of diverse stakeholders. In this context, the development of what are called ‘Data Safe Havens’ has been crucial. Unfortunately, the origins and evolution of the term have led to a range of different definitions being assumed by different groups. There is, however, an intuitively meaningful interpretation that is often assumed by those who have not previously encountered the term: a repository in which useful but potentially sensitive data may be kept securely under governance and informatics systems that are fit-for-purpose and appropriately tailored to the nature of the data being maintained, and may be accessed and utilized by legitimate users undertaking work and research contributing to biomedicine, health and/or to ongoing development of healthcare systems. Results: This review explores a fundamental question: ‘what are the specific criteria that ought reasonably to be met by a data repository if it is to be seen as consistent with this interpretation and viewed as worthy of being accorded the status of ‘Data Safe Haven’ by key stakeholders’? We propose 12 such criteria. Contact: paul.burton@bristol.ac.uk PMID:26112289