Designing a Free Academic Early Alert System

OpenAIRE

Adam C Welch; Adam Greever; Carmen Linne

2016-01-01

This manuscript describes the development and implementation of a cloud-based, academic early alert system using Google Sheets. It was written for a non-computer savvy person to be able to develop the early alert system. By creating a Master Sheet and using the syntax from the share function of Google Sheets, a unique sheet can be created for each advisor that limits information sharing of their specific advisees. By adding a Google Form to the sheet, advisor interventions can be captured tha...

77 FR 33661 - Review of the Emergency Alert System

Science.gov (United States)

2012-06-07

... Commission's Review of the Emergency Alert System, Fifth Report and Order (Order). This document is... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 11 [EB Docket No. 04-296; FCC 12-7] Review of the Emergency Alert System AGENCY: Federal Communications Commission. ACTION: Final rule; announcement of...

[Detection of Brucella with an automatic hemoculture system: Bact/Alert].

Science.gov (United States)

Casas, J; Partal, Y; Llosá, J; Leiva, J; Navarro, J M; de la Rosa, M

1994-12-01

The ability of in vitro and in vivo detection of Brucella spp. with the Bact/Alert system was studied. Three strains of Brucella melitensis and two of Brucella abortus were used. Different dilutions of the five strains were performed in trypticase soy broth (TSB), achieving concentrations of 1 cfu/ml, 5 cfu/ml, 10 cfu/ml and 100 cfu/ml. Ten ml of each dilution and strain were inoculated into 5 aerobic bottles Bact/Alert and 5 biphasic Hemóline bottles. Furthermore, over a 9 month period, 8,216 bottles of Bact/Alert bottles from hospitalized patients and from the emergency department were processed in the authors' laboratory. The mean detection time for Brucella growth was from 2 to 3 days with the Bact/Alert system, and 14 days in the biphasic bottles. Former bottles processed in the authors' laboratory, 11 aerobic bottles belonged to 5 patients in whom brucelosis was confirmed by bloodculture. The Bact/Alert system detected Brucella melitensis in only on bottle at 2.9 days of incubation. In 7 bottles Bact/Alert detected B. melitensis by a blind pass of these bottles at 10 to 20 days of incubation. These results suggest that the Bact/Alert system does not totally solve the diagnosis of brucellosis. Blind passes of the bloodcultures are required.

CISN ShakeAlert Earthquake Early Warning System Monitoring Tools

Science.gov (United States)

Henson, I. H.; Allen, R. M.; Neuhauser, D. S.

2015-12-01

CISN ShakeAlert is a prototype earthquake early warning system being developed and tested by the California Integrated Seismic Network. The system has recently been expanded to support redundant data processing and communications. It now runs on six machines at three locations with ten Apache ActiveMQ message brokers linking together 18 waveform processors, 12 event association processes and 4 Decision Module alert processes. The system ingests waveform data from about 500 stations and generates many thousands of triggers per day, from which a small portion produce earthquake alerts. We have developed interactive web browser system-monitoring tools that display near real time state-of-health and performance information. This includes station availability, trigger statistics, communication and alert latencies. Connections to regional earthquake catalogs provide a rapid assessment of the Decision Module hypocenter accuracy. Historical performance can be evaluated, including statistics for hypocenter and origin time accuracy and alert time latencies for different time periods, magnitude ranges and geographic regions. For the ElarmS event associator, individual earthquake processing histories can be examined, including details of the transmission and processing latencies associated with individual P-wave triggers. Individual station trigger and latency statistics are available. Detailed information about the ElarmS trigger association process for both alerted events and rejected events is also available. The Google Web Toolkit and Map API have been used to develop interactive web pages that link tabular and geographic information. Statistical analysis is provided by the R-Statistics System linked to a PostgreSQL database.

Lower alert rates by clustering of related drug interaction alerts

NARCIS (Netherlands)

Heringa, M.; Siderius, Hidde; Schreudering, A.; De Smet, Peter Agm; Bouvy, M.L.

OBJECTIVE: We aimed to investigate to what extent clustering of related drug interaction alerts (drug-drug and drug-disease interaction alerts) would decrease the alert rate in clinical decision support systems (CDSSs). METHODS: We conducted a retrospective analysis of drug interaction alerts

A deep-learning-based emergency alert system

Directory of Open Access Journals (Sweden)

Byungseok Kang

2016-06-01

Full Text Available Emergency alert systems serve as a critical link in the chain of crisis communication, and they are essential to minimize loss during emergencies. Acts of terrorism and violence, chemical spills, amber alerts, nuclear facility problems, weather-related emergencies, flu pandemics, and other emergencies all require those responsible such as government officials, building managers, and university administrators to be able to quickly and reliably distribute emergency information to the public. This paper presents our design of a deep-learning-based emergency warning system. The proposed system is considered suitable for application in existing infrastructure such as closed-circuit television and other monitoring devices. The experimental results show that in most cases, our system immediately detects emergencies such as car accidents and natural disasters.

47 CFR 80.1119 - Receipt and acknowledgement of distress alerts by coast stations and coast earth stations.

Science.gov (United States)

2010-10-01

... COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and Safety Communications...

PleurAlert: an augmented chest drainage system with electronic sensing, automated alerts and internet connectivity.

Science.gov (United States)

Leeson, Cory E; Weaver, Robert A; Bissell, Taylor; Hoyer, Rachel; McClain, Corinne; Nelson, Douglas A; Samosky, Joseph T

2012-01-01

We have enhanced a common medical device, the chest tube drainage container, with electronic sensing of fluid volume, automated detection of critical alarm conditions and the ability to automatically send alert text messages to a nurse's cell phone. The PleurAlert system provides a simple touch-screen interface and can graphically display chest tube output over time. Our design augments a device whose basic function dates back 50 years by adding technology to automate and optimize a monitoring process that can be time consuming and inconvenient for nurses. The system may also enhance detection of emergency conditions and speed response time.

Earthquake Early Warning ShakeAlert System: Testing and certification platform

Science.gov (United States)

Cochran, Elizabeth S.; Kohler, Monica D.; Given, Douglas; Guiwits, Stephen; Andrews, Jennifer; Meier, Men-Andrin; Ahmad, Mohammad; Henson, Ivan; Hartog, Renate; Smith, Deborah

2017-01-01

Earthquake early warning systems provide warnings to end users of incoming moderate to strong ground shaking from earthquakes. An earthquake early warning system, ShakeAlert, is providing alerts to beta end users in the western United States, specifically California, Oregon, and Washington. An essential aspect of the earthquake early warning system is the development of a framework to test modifications to code to ensure functionality and assess performance. In 2016, a Testing and Certification Platform (TCP) was included in the development of the Production Prototype version of ShakeAlert. The purpose of the TCP is to evaluate the robustness of candidate code that is proposed for deployment on ShakeAlert Production Prototype servers. TCP consists of two main components: a real‐time in situ test that replicates the real‐time production system and an offline playback system to replay test suites. The real‐time tests of system performance assess code optimization and stability. The offline tests comprise a stress test of candidate code to assess if the code is production ready. The test suite includes over 120 events including local, regional, and teleseismic historic earthquakes, recentering and calibration events, and other anomalous and potentially problematic signals. Two assessments of alert performance are conducted. First, point‐source assessments are undertaken to compare magnitude, epicentral location, and origin time with the Advanced National Seismic System Comprehensive Catalog, as well as to evaluate alert latency. Second, we describe assessment of the quality of ground‐motion predictions at end‐user sites by comparing predicted shaking intensities to ShakeMaps for historic events and implement a threshold‐based approach that assesses how often end users initiate the appropriate action, based on their ground‐shaking threshold. TCP has been developed to be a convenient streamlined procedure for objectively testing algorithms, and it has

The agile alert system for gamma-ray transients

Energy Technology Data Exchange (ETDEWEB)

Bulgarelli, A.; Trifoglio, M.; Gianotti, F.; Fioretti, V. [INAF/IASF-Bologna, Via Gobetti 101, I-40129 Bologna (Italy); Tavani, M.; Argan, A.; Trois, A.; Scalise, E. [INAF/IASF-Roma, Via del Fosso del Cavaliere 100, I-00133 Roma (Italy); Parmiggiani, N.; Beneventano, D. [University of Modena and Reggio Emilia, Dipartimento di Science e Metodi dell' Ingegneria (Italy); Chen, A. W. [INAF/IASF-Milano, Via E. Bassini 15, I-20133 Milano (Italy); Vercellone, S. [School of Physics, University of the Witwatersrand, Johannesburg Wits 2050 (South Africa); Pittori, C.; Verrecchia, F.; Lucarelli, F.; Santolamazza, P.; Fanari, G.; Giommi, P. [INAF/IASF-Palermo, Via U. La Malfa 153, I-90146 Palermo (Italy); Longo, F. [ASI-ASDC, Via G. Galilei, I-00044 Frascati (Roma) (Italy); Pellizzoni, A. [INFN Trieste, I-34127 Trieste (Italy); and others

2014-01-20

In recent years, a new generation of space missions has offered great opportunities for discovery in high-energy astrophysics. In this article we focus on the scientific operations of the Gamma-Ray Imaging Detector (GRID) on board the AGILE space mission. AGILE-GRID, sensitive in the energy range of 30 MeV-30 GeV, has detected many γ-ray transients of both galactic and extragalactic origin. This work presents the AGILE innovative approach to fast γ-ray transient detection, which is a challenging task and a crucial part of the AGILE scientific program. The goals are to describe (1) the AGILE Gamma-Ray Alert System, (2) a new algorithm for blind search identification of transients within a short processing time, (3) the AGILE procedure for γ-ray transient alert management, and (4) the likelihood of ratio tests that are necessary to evaluate the post-trial statistical significance of the results. Special algorithms and an optimized sequence of tasks are necessary to reach our goal. Data are automatically analyzed at every orbital downlink by an alert pipeline operating on different timescales. As proper flux thresholds are exceeded, alerts are automatically generated and sent as SMS messages to cellular telephones, via e-mail, and via push notifications from an application for smartphones and tablets. These alerts are crosschecked with the results of two pipelines, and a manual analysis is performed. Being a small scientific-class mission, AGILE is characterized by optimization of both scientific analysis and ground-segment resources. The system is capable of generating alerts within two to three hours of a data downlink, an unprecedented reaction time in γ-ray astrophysics.

The agile alert system for gamma-ray transients

International Nuclear Information System (INIS)

Bulgarelli, A.; Trifoglio, M.; Gianotti, F.; Fioretti, V.; Tavani, M.; Argan, A.; Trois, A.; Scalise, E.; Parmiggiani, N.; Beneventano, D.; Chen, A. W.; Vercellone, S.; Pittori, C.; Verrecchia, F.; Lucarelli, F.; Santolamazza, P.; Fanari, G.; Giommi, P.; Longo, F.; Pellizzoni, A.

2014-01-01

In recent years, a new generation of space missions has offered great opportunities for discovery in high-energy astrophysics. In this article we focus on the scientific operations of the Gamma-Ray Imaging Detector (GRID) on board the AGILE space mission. AGILE-GRID, sensitive in the energy range of 30 MeV-30 GeV, has detected many γ-ray transients of both galactic and extragalactic origin. This work presents the AGILE innovative approach to fast γ-ray transient detection, which is a challenging task and a crucial part of the AGILE scientific program. The goals are to describe (1) the AGILE Gamma-Ray Alert System, (2) a new algorithm for blind search identification of transients within a short processing time, (3) the AGILE procedure for γ-ray transient alert management, and (4) the likelihood of ratio tests that are necessary to evaluate the post-trial statistical significance of the results. Special algorithms and an optimized sequence of tasks are necessary to reach our goal. Data are automatically analyzed at every orbital downlink by an alert pipeline operating on different timescales. As proper flux thresholds are exceeded, alerts are automatically generated and sent as SMS messages to cellular telephones, via e-mail, and via push notifications from an application for smartphones and tablets. These alerts are crosschecked with the results of two pipelines, and a manual analysis is performed. Being a small scientific-class mission, AGILE is characterized by optimization of both scientific analysis and ground-segment resources. The system is capable of generating alerts within two to three hours of a data downlink, an unprecedented reaction time in γ-ray astrophysics.

The AGILE Alert System for Gamma-Ray Transients

Science.gov (United States)

Bulgarelli, A.; Trifoglio, M.; Gianotti, F.; Tavani, M.; Parmiggiani, N.; Fioretti, V.; Chen, A. W.; Vercellone, S.; Pittori, C.; Verrecchia, F.; Lucarelli, F.; Santolamazza, P.; Fanari, G.; Giommi, P.; Beneventano, D.; Argan, A.; Trois, A.; Scalise, E.; Longo, F.; Pellizzoni, A.; Pucella, G.; Colafrancesco, S.; Conforti, V.; Tempesta, P.; Cerone, M.; Sabatini, P.; Annoni, G.; Valentini, G.; Salotti, L.

2014-01-01

In recent years, a new generation of space missions has offered great opportunities for discovery in high-energy astrophysics. In this article we focus on the scientific operations of the Gamma-Ray Imaging Detector (GRID) on board the AGILE space mission. AGILE-GRID, sensitive in the energy range of 30 MeV-30 GeV, has detected many γ-ray transients of both galactic and extragalactic origin. This work presents the AGILE innovative approach to fast γ-ray transient detection, which is a challenging task and a crucial part of the AGILE scientific program. The goals are to describe (1) the AGILE Gamma-Ray Alert System, (2) a new algorithm for blind search identification of transients within a short processing time, (3) the AGILE procedure for γ-ray transient alert management, and (4) the likelihood of ratio tests that are necessary to evaluate the post-trial statistical significance of the results. Special algorithms and an optimized sequence of tasks are necessary to reach our goal. Data are automatically analyzed at every orbital downlink by an alert pipeline operating on different timescales. As proper flux thresholds are exceeded, alerts are automatically generated and sent as SMS messages to cellular telephones, via e-mail, and via push notifications from an application for smartphones and tablets. These alerts are crosschecked with the results of two pipelines, and a manual analysis is performed. Being a small scientific-class mission, AGILE is characterized by optimization of both scientific analysis and ground-segment resources. The system is capable of generating alerts within two to three hours of a data downlink, an unprecedented reaction time in γ-ray astrophysics.

Solar radiation alert system : final report.

Science.gov (United States)

2009-03-01

The Solar Radiation Alert (SRA) system continuously evaluates measurements of high-energy protons made by instruments on GOES satellites. If the measurements indicate a substantial elevation of effective dose rates at aircraft flight altitudes, the C...

Hanford Site Emergency Alerting System siren testing report

International Nuclear Information System (INIS)

Weidner, L.B.

1997-01-01

The purpose of the test was to determine the effective coverage of the proposed upgrades to the existing Hanford Site Emergency Alerting System (HSEAS). The upgrades are to enhance the existing HSEAS along the Columbia River from the Vernita Bridge to the White Bluffs Boat Launch as well as install a new alerting system in the 400 Area on the Hanford Site. Five siren sites along the Columbia River and two sites in the 400 Area were tested to determine the site locations that will provide the desired coverage

Rapid deployable global sensing hazard alert system

Science.gov (United States)

Cordaro, Joseph V; Tibrea, Steven L; Shull, Davis J; Coleman, Jerry T; Shuler, James M

2015-04-28

A rapid deployable global sensing hazard alert system and associated methods of operation are provided. An exemplary system includes a central command, a wireless backhaul network, and a remote monitoring unit. The remote monitoring unit can include a positioning system configured to determine a position of the remote monitoring unit based on one or more signals received from one or more satellites located in Low Earth Orbit. The wireless backhaul network can provide bidirectional communication capability independent of cellular telecommunication networks and the Internet. An exemplary method includes instructing at least one of a plurality of remote monitoring units to provide an alert based at least in part on a location of a hazard and a plurality of positions respectively associated with the plurality of remote monitoring units.

Feasibility of seismic alert systems in India

International Nuclear Information System (INIS)

Chauhan, P.K.S.; Pandey, Y.

2012-01-01

Natural disasters like flood, earthquakes and cyclones are very frequent in India since historical times. As far as the casualties are concerned, globally earthquakes are second in the list after the flood. The loss of property due to these earthquakes is huge and enormous. In the light of the present knowledge base, earthquake prediction is far from being a reality. An early earthquake warning has potential to save the precious human lives. In the present day scenario seismic instrumentation and telecommunication permits the implementation of seismic alert system (SAS) based on the real-time measurement of ground motions near the source. SAS is capable of providing a warning of several seconds before the arrival of destructive seismic waves caused by a large earthquake. SAS is successfully operational in many countries of the world. In a country, like India where earthquakes are taking heavy toll on the human lives and property, seismic alert system may prove to be very important step in natural hazard mitigation strategy. In this paper, an attempt has been made to compute the available alarm time before the destructive earthquake waves reaches to the cities like Delhi, Lucknow, Patna and Kolkata taking Himalaya as the source and feasibility of seismic alert system in Indian scenario. (author)

MyEEW: A Smartphone App for the ShakeAlert System

Science.gov (United States)

Strauss, J. A.; Allen, S.; Allen, R. M.; Hellweg, M.

2015-12-01

Earthquake Early Warning (EEW) is a system that can provide a few to tens of seconds warning prior to ground shaking at a user's location. The goal and purpose of such a system is to reduce, or minimize, the damage, costs, and casualties resulting from an earthquake. A demonstration earthquake early warning system (ShakeAlert) is undergoing testing in the United States by the UC Berkeley Seismological Laboratory, Caltech, ETH Zurich, University of Washington, the USGS, and beta users in California and the Pacific Northwest. The UC Berkeley Seismological Laboratory has created a smartphone app called MyEEW, which interfaces with the ShakeAlert system to deliver early warnings to individual users. Many critical facilities (transportation, police, and fire) have control rooms, which could run a centralized interface, but our ShakeAlert Beta Testers have also expressed their need for mobile options. This app augments the basic ShakeAlert Java desktop applet by allowing workers off-site (or merely out of hearing range) to be informed of coming hazards. MyEEW receives information from the ShakeAlert system to provide users with real-time information about shaking that is about to happen at their individual location. It includes a map, timer, and earthquake information similar to the Java desktop User Display. The app will also feature educational material to help users craft their own response and resiliency strategies. The app will be open to UC Berkeley Earthquake Research Affiliates members for testing in the near future.

Emergency Communications: The Emergency Alert System (EAS) and All-Hazard Warnings

National Research Council Canada - National Science Library

Moore, Linda K; Reese, Shawn

2005-01-01

... tested. Much has been accomplished in recent years but the current hodgepodge of warning and alert systems is inadequate for fully alerting the public about terrorist attacks or natural disasters...

Real time alert system: a disease management system leveraging health information exchange.

Science.gov (United States)

Anand, Vibha; Sheley, Meena E; Xu, Shawn; Downs, Stephen M

2012-01-01

Rates of preventive and disease management services can be improved by providing automated alerts and reminders to primary care providers (PCPs) using of health information technology (HIT) tools. Using Adaptive Turnaround Documents (ATAD), an existing Health Information Exchange (HIE) infrastructure and office fax machines, we developed a Real Time Alert (RTA) system. RTA is a computerized decision support system (CDSS) that is able to deliver alerts to PCPs statewide for recommended services around the time of the patient visit. RTA is also able to capture structured clinical data from providers using existing fax technology. In this study, we evaluate RTA's performance for alerting PCPs when their patients with asthma have an emergency room visit anywhere in the state. Our results show that RTA was successfully able to deliver "just in time" patient-relevant alerts to PCPs across the state. Furthermore, of those ATADs faxed back and automatically interpreted by the RTA system, 35% reported finding the provided information helpful. The PCPs who reported finding information helpful also reported making a phone call, sending a letter or seeing the patient for follow up care. We have successfully demonstrated the feasibility of electronically exchanging important patient related information with the PCPs statewide. This is despite a lack of a link with their electronic health records. We have shown that using our ATAD technology, a PCP can be notified quickly of an important event such as a patient's asthma related emergency room admission so further follow up can happen in near real time.

14 CFR 121.360 - Ground proximity warning-glide slope deviation alerting system.

Science.gov (United States)

2010-01-01

... deviation alerting system. 121.360 Section 121.360 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... Equipment Requirements § 121.360 Ground proximity warning-glide slope deviation alerting system. (a) No... system that meets the performance and environmental standards of TSO-C92 (available from the FAA, 800...

Wireless alerting system using vibration for vehicles dashboard

Science.gov (United States)

Raj, Sweta; Rai, Shweta; Magaramagara, Wilbert; Sivacoumar, R.

2017-11-01

This paper aims at improving the engine life of any vehicle through a continuous measurement and monitoring of vital engine operational parameters and providing an effective alerting to drivers for any abnormality. Vehicles currently are using audio and visible alerting signals through alarms and light as a warning to the driver but these are not effective in noisy environments and during daylight. Through the use of the sense of feeling a driver can be alerted effectively. The need to no other vehicle parameter needs to be aided through the mobile display (phone).Thus a system is designed and implements to measure engine temperature, RPM, Oil level and Coolant level using appropriate sensors and a wireless communication (Bluetooth) is established to actuate a portable vibration control device and to read the different vehicle sensor readings through an android application for display and diagnosis.

Alerts Analysis and Visualization in Network-based Intrusion Detection Systems

Energy Technology Data Exchange (ETDEWEB)

Yang, Dr. Li [University of Tennessee

2010-08-01

The alerts produced by network-based intrusion detection systems, e.g. Snort, can be difficult for network administrators to efficiently review and respond to due to the enormous number of alerts generated in a short time frame. This work describes how the visualization of raw IDS alert data assists network administrators in understanding the current state of a network and quickens the process of reviewing and responding to intrusion attempts. The project presented in this work consists of three primary components. The first component provides a visual mapping of the network topology that allows the end-user to easily browse clustered alerts. The second component is based on the flocking behavior of birds such that birds tend to follow other birds with similar behaviors. This component allows the end-user to see the clustering process and provides an efficient means for reviewing alert data. The third component discovers and visualizes patterns of multistage attacks by profiling the attacker s behaviors.

A mobile care system with alert mechanism.

Science.gov (United States)

Lee, Ren-Guey; Chen, Kuei-Chien; Hsiao, Chun-Chieh; Tseng, Chwan-Lu

2007-09-01

Hypertension and arrhythmia are chronic diseases, which can be effectively prevented and controlled only if the physiological parameters of the patient are constantly monitored, along with the full support of the health education and professional medical care. In this paper, a role-based intelligent mobile care system with alert mechanism in chronic care environment is proposed and implemented. The roles in our system include patients, physicians, nurses, and healthcare providers. Each of the roles represents a person that uses a mobile device such as a mobile phone to communicate with the server setup in the care center such that he or she can go around without restrictions. For commercial mobile phones with Bluetooth communication capability attached to chronic patients, we have developed physiological signal recognition algorithms that were implemented and built-in in the mobile phone without affecting its original communication functions. It is thus possible to integrate several front-end mobile care devices with Bluetooth communication capability to extract patients' various physiological parameters [such as blood pressure, pulse, saturation of haemoglobin (SpO2), and electrocardiogram (ECG)], to monitor multiple physiological signals without space limit, and to upload important or abnormal physiological information to healthcare center for storage and analysis or transmit the information to physicians and healthcare providers for further processing. Thus, the physiological signal extraction devices only have to deal with signal extraction and wireless transmission. Since they do not have to do signal processing, their form factor can be further reduced to reach the goal of microminiaturization and power saving. An alert management mechanism has been included in back-end healthcare center to initiate various strategies for automatic emergency alerts after receiving emergency messages or after automatically recognizing emergency messages. Within the time

Development of case-based medication alerting and recommender system: a new approach to prevention for medication error.

Science.gov (United States)

Miyo, Kengo; Nittami, Yuki S; Kitagawa, Yoichiro; Ohe, Kazuhiko

2007-01-01

The purpose of this study was to develop a new alerting and recommender system for preventing medication errors. In recent years, alerting systems have been widely implemented, but because these systems apply a same static threshold for all patients in all cases, they produce excessive alerts and subject physicians to "alert fatigue". We believe that the most commonly-written prescription for a patient's status is the safest one. From this standpoint, we developed a real-time case-based medication alerting and recommender system linked to a database of past prescriptions. When a physician issues his or her prescription, our system dynamically compares it with past ones for similar patients in the database. An analysis of the 10 most frequently-used drugs in the University of Tokyo Hospital revealed that our system reduced the number of false alerts compared to the traditional static alert method. Our system contributes to the creation of alerts that are appropriate for patients' clinical conditions and based on physicians' empirical discretion.

Reduction in alert fatigue in an assisted electronic prescribing system, through the Lean Six Sigma methodology.

Science.gov (United States)

Cuéllar Monreal, Mª Jesús; Reig Aguado, Jorge; Font Noguera, Isabel; Poveda Andrés, José Luis

2017-01-01

To reduce the alert fatigue in our Assisted Electronic Prescribing System (AEPS), through the Lean Six Sigma (LSS) methodology. An observational (transversal) and retrospective study, in a general hospital with 850 beds and AEPS. The LSS methodology was followed in order to evaluate the alert fatigue situation in the AEPS system, to implement improvements, and to assess outcomes. The alerts generated during two trimesters studied (before and after the intervention) were analyzed. In order to measure the qualitative indicators, the most frequent alert types were analyzed, as well as the molecules responsible for over 50% of each type of alert. The action by the prescriber was analyzed in a sample of 496 prescriptions that generated such alerts. For each type of alert and molecule, there was a prioritization of the improvements to be implemented according to the alert generated and its quality. A second survey evaluated the pharmacist action for the alerts most highly valued by physicians. The problem, the objective, the work team and the project schedule were defined. A survey was designed in order to understand the opinion of the client about the alert system in the program. Based on the surveys collected (n = 136), the critical characteristics and the quanti/qualitative indicators were defined. Sixty (60) fields in the alert system were modified, corresponding to 32 molecules, and this led to a 28% reduction in the total number of alerts. Regarding quality indicators, false po sitive results were reduced by 25% (p < 0.05), 100% of those alerts ignored with justification were sustained, and there were no significant differences in user adherence to the system. The project improvements and outcomes were reviewed by the work team. LSS methodology has demonstrated being a valid tool for the quantitative and qualitative improvement of the alert system in an Assisted Electronic Prescription Program, thus reducing alert fatigue. Copyright AULA MEDICA EDICIONES 2014

Earthquake early Warning ShakeAlert system: West coast wide production prototype

Science.gov (United States)

Kohler, Monica D.; Cochran, Elizabeth S.; Given, Douglas; Guiwits, Stephen; Neuhauser, Doug; Hensen, Ivan; Hartog, Renate; Bodin, Paul; Kress, Victor; Thompson, Stephen; Felizardo, Claude; Brody, Jeff; Bhadha, Rayo; Schwarz, Stan

2017-01-01

Earthquake early warning (EEW) is an application of seismological science that can give people, as well as mechanical and electrical systems, up to tens of seconds to take protective actions before peak earthquake shaking arrives at a location. Since 2006, the U.S. Geological Survey has been working in collaboration with several partners to develop EEW for the United States. The goal is to create and operate an EEW system, called ShakeAlert, for the highest risk areas of the United States, starting with the West Coast states of California, Oregon, and Washington. In early 2016, the Production Prototype v.1.0 was established for California; then, in early 2017, v.1.2 was established for the West Coast, with earthquake notifications being distributed to a group of beta users in California, Oregon, and Washington. The new ShakeAlert Production Prototype was an outgrowth from an earlier demonstration EEW system that began sending test notifications to selected users in California in January 2012. ShakeAlert leverages the considerable physical, technical, and organizational earthquake monitoring infrastructure of the Advanced National Seismic System, a nationwide federation of cooperating seismic networks. When fully implemented, the ShakeAlert system may reduce damage and injury caused by large earthquakes, improve the nation’s resilience, and speed recovery.

77 FR 41331 - Commercial Mobile Alert System

Science.gov (United States)

2012-07-13

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 10 [PS Docket No. 07-287; FCC 08-164] Commercial... with the Commission's Commercial Mobile Alert System (CMS), Second Report and Order (``CMAS Second..., for a period of three years, the information collection requirements relating to the Commercial Mobile...

A CCTV system with SMS alert (CMDSA): An implementation of pixel processing algorithm for motion detection

Science.gov (United States)

Rahman, Nurul Hidayah Ab; Abdullah, Nurul Azma; Hamid, Isredza Rahmi A.; Wen, Chuah Chai; Jelani, Mohamad Shafiqur Rahman Mohd

2017-10-01

Closed-Circuit TV (CCTV) system is one of the technologies in surveillance field to solve the problem of detection and monitoring by providing extra features such as email alert or motion detection. However, detecting and alerting the admin on CCTV system may complicate due to the complexity to integrate the main program with an external Application Programming Interface (API). In this study, pixel processing algorithm is applied due to its efficiency and SMS alert is added as an alternative solution for users who opted out email alert system or have no Internet connection. A CCTV system with SMS alert (CMDSA) was developed using evolutionary prototyping methodology. The system interface was implemented using Microsoft Visual Studio while the backend components, which are database and coding, were implemented on SQLite database and C# programming language, respectively. The main modules of CMDSA are motion detection, capturing and saving video, image processing and Short Message Service (SMS) alert functions. Subsequently, the system is able to reduce the processing time making the detection process become faster, reduce the space and memory used to run the program and alerting the system admin instantly.

Feature-based alert correlation in security systems using self organizing maps

Science.gov (United States)

Kumar, Munesh; Siddique, Shoaib; Noor, Humera

2009-04-01

The security of the networks has been an important concern for any organization. This is especially important for the defense sector as to get unauthorized access to the sensitive information of an organization has been the prime desire for cyber criminals. Many network security techniques like Firewall, VPN Concentrator etc. are deployed at the perimeter of network to deal with attack(s) that occur(s) from exterior of network. But any vulnerability that causes to penetrate the network's perimeter of defense, can exploit the entire network. To deal with such vulnerabilities a system has been evolved with the purpose of generating an alert for any malicious activity triggered against the network and its resources, termed as Intrusion Detection System (IDS). The traditional IDS have still some deficiencies like generating large number of alerts, containing both true and false one etc. By automatically classifying (correlating) various alerts, the high-level analysis of the security status of network can be identified and the job of network security administrator becomes much easier. In this paper we propose to utilize Self Organizing Maps (SOM); an Artificial Neural Network for correlating large amount of logged intrusion alerts based on generic features such as Source/Destination IP Addresses, Port No, Signature ID etc. The different ways in which alerts can be correlated by Artificial Intelligence techniques are also discussed. . We've shown that the strategy described in the paper improves the efficiency of IDS by better correlating the alerts, leading to reduced false positives and increased competence of network administrator.

Impact of e-alert systems on the care of patients with acute kidney injury.

Science.gov (United States)

Breighner, Crystal M; Kashani, Kianoush B

2017-09-01

With the recent advancement in electronic health record systems and meaningful use of information technology incentive programs (i.e., the American Recovery and Reinvestment Act, the Health Information Technology for Economic and Clinical Health Act, and the Centers for Medicare & Medicaid Services), interest in clinical decision support systems has risen. These systems have been used to examine a variety of different syndromes with variable reported effects. In recent years, electronic alerts (e-alerts) have been implemented at various institutions to decrease the morbidity associated with acute kidney injury (AKI). AKI is common, accounting for 1 in 7 hospital admissions, and is associated with increased length of hospital stay and mortality. AKI is often underrecognized, causing delayed intervention. The use of e-alerts may result in earlier recognition and intervention, as well as decreased morbidity and mortality. This must be balanced with the possibility of increased resource utilization that e-alerts may cause. Before widespread implementation, the ethical and legal consequences of not following e-alert recommendations must be established, and the optimal algorithm for AKI e-alert detection must be determined. Copyright © 2017 Elsevier Ltd. All rights reserved.

Discriminating between true-positive and false-positive clinical mastitis alerts from automatic milking systems

NARCIS (Netherlands)

Steeneveld, W.; Gaag, van der L.C.; Ouweltjes, W.; Mollenhorst, H.; Hogeveen, H.

2010-01-01

Automatic milking systems (AMS) generate alert lists reporting cows likely to have clinical mastitis (CM). Dutch farmers indicated that they use non-AMS cow information or the detailed alert information from the AMS to decide whether to check an alerted cow for CM. However, it is not yet known to

Microcontroller based driver alertness detection systems to detect drowsiness

Science.gov (United States)

Adenin, Hasibah; Zahari, Rahimi; Lim, Tiong Hoo

2018-04-01

The advancement of embedded system for detecting and preventing drowsiness in a vehicle is a major challenge for road traffic accident systems. To prevent drowsiness while driving, it is necessary to have an alert system that can detect a decline in driver concentration and send a signal to the driver. Studies have shown that traffc accidents usually occur when the driver is distracted while driving. In this paper, we have reviewed a number of detection systems to monitor the concentration of a car driver and propose a portable Driver Alertness Detection System (DADS) to determine the level of concentration of the driver based on pixelated coloration detection technique using facial recognition. A portable camera will be placed at the front visor to capture facial expression and the eye activities. We evaluate DADS using 26 participants and have achieved 100% detection rate with good lighting condition and a low detection rate at night.

Alert Exchange Process Protocol

Science.gov (United States)

Groen, Frank

2015-01-01

The National Aeronautics and Space Administration of the United States of America (NASA), and the European Space Agency (ESA), and the Japanese Aerospace Exploration Agency (JAXA), acknowledging that NASA, ESA and JAXA have a mutual interest in exchanging Alerts and Alert Status Lists to enhance the information base for each system participant while fortifying the general level of cooperation between the policy agreement subscribers, and each Party will exchange Alert listings on regular basis and detailed Alert information on a need to know basis to the extent permitted by law.

ToxAlerts: a Web server of structural alerts for toxic chemicals and compounds with potential adverse reactions.

Science.gov (United States)

Sushko, Iurii; Salmina, Elena; Potemkin, Vladimir A; Poda, Gennadiy; Tetko, Igor V

2012-08-27

The article presents a Web-based platform for collecting and storing toxicological structural alerts from literature and for virtual screening of chemical libraries to flag potentially toxic chemicals and compounds that can cause adverse side effects. An alert is uniquely identified by a SMARTS template, a toxicological endpoint, and a publication where the alert was described. Additionally, the system allows storing complementary information such as name, comments, and mechanism of action, as well as other data. Most importantly, the platform can be easily used for fast virtual screening of large chemical datasets, focused libraries, or newly designed compounds against the toxicological alerts, providing a detailed profile of the chemicals grouped by structural alerts and endpoints. Such a facility can be used for decision making regarding whether a compound should be tested experimentally, validated with available QSAR models, or eliminated from consideration altogether. The alert-based screening can also be helpful for an easier interpretation of more complex QSAR models. The system is publicly accessible and tightly integrated with the Online Chemical Modeling Environment (OCHEM, http://ochem.eu). The system is open and expandable: any registered OCHEM user can introduce new alerts, browse, edit alerts introduced by other users, and virtually screen his/her data sets against all or selected alerts. The user sets being passed through the structural alerts can be used at OCHEM for other typical tasks: exporting in a wide variety of formats, development of QSAR models, additional filtering by other criteria, etc. The database already contains almost 600 structural alerts for such endpoints as mutagenicity, carcinogenicity, skin sensitization, compounds that undergo metabolic activation, and compounds that form reactive metabolites and, thus, can cause adverse reactions. The ToxAlerts platform is accessible on the Web at http://ochem.eu/alerts, and it is constantly

IP telephony based danger alert communication system and its implementation

Science.gov (United States)

Rezac, Filip; Safarik, Jakub; Voznak, Miroslav; Tomala, Karel; Partila, Pavol

2013-05-01

This article discusses a danger alert system created as a part of the research project at Department of Telecommunications of Technical University of Ostrava. The aim of the system is to distribute pre-recorded voice messages in order to alert the called party in danger. This article describes individual technologies, which the application uses for its operation as well as issues relating to hardware requirements and transfer line bandwidth load. The article also describes new algorithms, which had to be developed in order to ensure the reliability of the system. Our intent is focused on disaster management, the message, which should be delivered within specified time span, is typed in the application and text-to-speech module ensures its transformation to a speech format, after that a particular scenario or warned area is selected and a target group is automatically unloaded. For this purpose, we have defined XML format for delivery of phone numbers which are located in the target area and these numbers are obtained from mobile BTS's (Base transmission stations). The benefit of such communication compared to others, is the fact, that it uses a phone call and, therefore, it is possible to get feedback who accepted the message and to improve efficiency of alert system. Finally, the list of unanswered calls is exported and these users can be informed via SMS.

Alert-derivative bimodal space power and propulsion systems

International Nuclear Information System (INIS)

Houts, M.G.; Ranken, W.A.; Buksa, J.J.

1994-01-01

Safe, reliable, low-mass bimodal space power and propulsion systems could have numerous civilian and military applications. This paper discusses potential bimodal systems that could be derived from the ALERT space fission power supply concept. These bimodal concepts have the potential for providing 5 to 10 kW of electrical power and a total impulse of 100 MN-s at an average specific impulse of 770 s. System mass is on the order of 1000 kg

A review of human factors principles for the design and implementation of medication safety alerts in clinical information systems.

Science.gov (United States)

Phansalkar, Shobha; Edworthy, Judy; Hellier, Elizabeth; Seger, Diane L; Schedlbauer, Angela; Avery, Anthony J; Bates, David W

2010-01-01

The objective of this review is to describe the implementation of human factors principles for the design of alerts in clinical information systems. First, we conduct a review of alarm systems to identify human factors principles that are employed in the design and implementation of alerts. Second, we review the medical informatics literature to provide examples of the implementation of human factors principles in current clinical information systems using alerts to provide medication decision support. Last, we suggest actionable recommendations for delivering effective clinical decision support using alerts. A review of studies from the medical informatics literature suggests that many basic human factors principles are not followed, possibly contributing to the lack of acceptance of alerts in clinical information systems. We evaluate the limitations of current alerting philosophies and provide recommendations for improving acceptance of alerts by incorporating human factors principles in their design.

AN AUTOMATED NETWORK SECURITYCHECKING AND ALERT SYSTEM: A NEW FRAMEWORK

Directory of Open Access Journals (Sweden)

Vivek Kumar Yadav

2013-09-01

Full Text Available Network security checking is a vital process to assess and to identify weaknesses in network for management of security. Insecure entry points of a network provide attackers an easy target to access and compromise. Open ports of network components such as firewalls, gateways and end systems are analogues to open gates of a building through which any one can get into. Network scanning is performed to identify insecure entry points in the network components. To find out vulnerabilities on these points vulnerability assessment is performed. So security checking consists of both activities- network scanning as well as vulnerability assessment. A single tool used for the security checking may not give reliable results. This paper presents a framework for assessing the security of a network using multiple Network Scanning and Vulnerability Assessment tools. The proposed framework is an extension of the framework given by Jun Yoon and Wontae Sim [1] which performs vulnerability scanning only. The framework presented here adds network scanning, alerting and reporting system to their framework. Network scanning and vulnerability tools together complement each other and make it amenable for centralized control and management. The reporting system of framework sends an email to the network administrator which contains detailed report (as attachment of security checking process. Alerting system sends a SMS message as an alert to the network administrator in case of severe threats found in the network. Initial results of the framework are encouraging and further work is in progress.

Technical implementation plan for the ShakeAlert production system: an Earthquake Early Warning system for the West Coast of the United States

Science.gov (United States)

Given, Douglas D.; Cochran, Elizabeth S.; Heaton, Thomas; Hauksson, Egill; Allen, Richard; Hellweg, Peggy; Vidale, John; Bodin, Paul

2014-01-01

Earthquake Early Warning (EEW) systems can provide as much as tens of seconds of warning to people and automated systems before strong shaking arrives. The United States Geological Survey (USGS) and its partners are developing such an EEW system, called ShakeAlert, for the West Coast of the United States. This document describes the technical implementation of that system, which leverages existing stations and infrastructure of the Advanced National Seismic System (ANSS) regional networks to achieve this new capability. While significant progress has been made in developing the ShakeAlert early warning system, improved robustness of each component of the system and additional testing and certification are needed for the system to be reliable enough to issue public alerts. Major components of the system include dense networks of ground motion sensors, telecommunications from those sensors to central processing systems, algorithms for event detection and alert creation, and distribution systems to alert users. Capital investment costs for a West Coast EEW system are projected to be $38.3M, with additional annual maintenance and operations totaling $16.1M—in addition to current ANSS expenditures for earthquake monitoring. An EEW system is complementary to, but does not replace, other strategies to mitigate earthquake losses. The system has limitations: false and missed alerts are possible, and the area very near to an earthquake epicenter may receive little or no warning. However, such an EEW system would save lives, reduce injuries and damage, and improve community resilience by reducing longer-term economic losses for both public and private entities.

Radar-based alert system to operate a sewerage network: relevance and operational effectiveness after several years of use.

Science.gov (United States)

Faure, D; Payrastre, O; Auchet, P

2005-01-01

Since January 2000, the sewerage network of a very urbanised catchment area in the Greater Nancy Urban Community has been operated according to the alarms generated in real time by a storm alert system using weather radar data. This alert system is based on an automatic identification of intense rain cells in the radar images. This paper presents the characteristics of this alert system and synthesises the main results of two complementary studies realised in 2002 in order to estimate the relevance and the operational effectiveness of the alert system. The first study consisted in an off-line analysis of almost 50,000 intense rain cells detected in four years of historical radar data. The second study was an analysis of the experience feedback after two years of operational use of this alert system. The results of these studies are discussed in function of the initial operational objectives.

A Health System-wide Moral Distress Consultation Service: Development and Evaluation.

Science.gov (United States)

Hamric, Ann B; Epstein, Elizabeth G

2017-06-01

Although moral distress is now a well-recognized phenomenon among all of the healthcare professions, few evidence-based strategies have been published to address it. In morally distressing situations, the "presenting problem" may be a particular patient situation, but most often signals a deeper unit- or system-centered issue. This article describes one institution's ongoing effort to address moral distress in its providers. We discuss the development and evaluation of the Moral Distress Consultation Service, an interprofessional, unit/system-oriented approach to addressing and ameliorating moral distress.

Impact-based earthquake alerts with the U.S. Geological Survey's PAGER system: what's next?

Science.gov (United States)

Wald, D.J.; Jaiswal, K.S.; Marano, K.D.; Garcia, D.; So, E.; Hearne, M.

2012-01-01

In September 2010, the USGS began publicly releasing earthquake alerts for significant earthquakes around the globe based on estimates of potential casualties and economic losses with its Prompt Assessment of Global Earthquakes for Response (PAGER) system. These estimates significantly enhanced the utility of the USGS PAGER system which had been, since 2006, providing estimated population exposures to specific shaking intensities. Quantifying earthquake impacts and communicating estimated losses (and their uncertainties) to the public, the media, humanitarian, and response communities required a new protocol—necessitating the development of an Earthquake Impact Scale—described herein and now deployed with the PAGER system. After two years of PAGER-based impact alerting, we now review operations, hazard calculations, loss models, alerting protocols, and our success rate for recent (2010-2011) events. This review prompts analyses of the strengths, limitations, opportunities, and pressures, allowing clearer definition of future research and development priorities for the PAGER system.

Comparison of warfarin therapy clinical outcomes following implementation of an automated mobile phone-based critical laboratory value text alert system.

Science.gov (United States)

Lin, Shu-Wen; Kang, Wen-Yi; Lin, Dong-Tsamn; Lee, James; Wu, Fe-Lin; Chen, Chuen-Liang; Tseng, Yufeng J

2014-01-01

Computerized alert and reminder systems have been widely accepted and applied to various patient care settings, with increasing numbers of clinical laboratories communicating critical laboratory test values to professionals via either manual notification or automated alerting systems/computerized reminders. Warfarin, an oral anticoagulant, exhibits narrow therapeutic range between treatment response and adverse events. It requires close monitoring of prothrombin time (PT)/international normalized ratio (INR) to ensure patient safety. This study was aimed to evaluate clinical outcomes of patients on warfarin therapy following implementation of a Personal Handy-phone System-based (PHS) alert system capable of generating and delivering text messages to communicate critical PT/INR laboratory results to practitioners' mobile phones in a large tertiary teaching hospital. A retrospective analysis was performed comparing patient clinical outcomes and physician prescribing behavior following conversion from a manual laboratory result alert system to an automated system. Clinical outcomes and practitioner responses to both alert systems were compared. Complications to warfarin therapy, warfarin utilization, and PT/INR results were evaluated for both systems, as well as clinician time to read alert messages, time to warfarin therapy modification, and monitoring frequency. No significant differences were detected in major hemorrhage and thromboembolism, warfarin prescribing patterns, PT/INR results, warfarin therapy modification, or monitoring frequency following implementation of the PHS text alert system. In both study periods, approximately 80% of critical results led to warfarin discontinuation or dose reduction. Senior physicians' follow-up response time to critical results was significantly decreased in the PHS alert study period (46.3% responded within 1 day) compared to the manual notification study period (24.7%; P = 0.015). No difference in follow-up response time

ATLANTIDES: An Architecture for Alert Verification in Network Intrusion Detection Systems

NARCIS (Netherlands)

Bolzoni, D.; Crispo, Bruno; Etalle, Sandro

2007-01-01

We present an architecture designed for alert verification (i.e., to reduce false positives) in network intrusion-detection systems. Our technique is based on a systematic (and automatic) anomaly-based analysis of the system output, which provides useful context information regarding the network

Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project

DEFF Research Database (Denmark)

Boriani, Elena; Esposito, Roberto; Frazzoli, Chiara

2017-01-01

of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST) aimed at monitoring the quality, health, and traceability of the chain of the bovine milk......], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety), human, and ecosystem health (1). In fact, the European food safety framework calls for science-based support to the primary producers......’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account...

Aircraft Alerting Systems Standardization Study. Phase IV. Accident Implications on Systems Design.

Science.gov (United States)

1982-06-01

computing and processing to assimilate and process status informa- 5 tion using...provided with capabilities in computing and processing , sensing, interfacing, and controlling and displaying. 17 o Computing and Processing - Algorithms...alerting system to perform a flight status monitor function would require additional sensinq, computing and processing , interfacing, and controlling

Mobile Traffic Alert and Tourist Route Guidance System Design Using Geospatial Data

Science.gov (United States)

Bhattacharya, D.; Painho, M.; Mishra, S.; Gupta, A.

2017-09-01

The present study describes an integrated system for traffic data collection and alert warning. Geographical information based decision making related to traffic destinations and routes is proposed through the design. The system includes a geospatial database having profile relating to a user of a mobile device. The processing and understanding of scanned maps, other digital data input leads to route guidance. The system includes a server configured to receive traffic information relating to a route and location information relating to the mobile device. Server is configured to send a traffic alert to the mobile device when the traffic information and the location information indicate that the mobile device is traveling toward traffic congestion. Proposed system has geospatial and mobile data sets pertaining to Bangalore city in India. It is envisaged to be helpful for touristic purposes as a route guidance and alert relaying information system to tourists for proximity to sites worth seeing in a city they have entered into. The system is modular in architecture and the novelty lies in integration of different modules carrying different technologies for a complete traffic information system. Generic information processing and delivery system has been tested to be functional and speedy under test geospatial domains. In a restricted prototype model with geo-referenced route data required information has been delivered correctly over sustained trials to designated cell numbers, with average time frame of 27.5 seconds, maximum 50 and minimum 5 seconds. Traffic geo-data set trials testing is underway.

Evaluation of Visual Alerts in the Maritime Domain

National Research Council Canada - National Science Library

Roberts, Shelley; Foster-Hunt, Tara

2008-01-01

.... As the auditory modality is overloaded in the current alerting system, one method of potentially reducing perceptual overload is to replace auditory alerts with alerts presented in the visual domain...

A process-based model for the definition of hydrological alert systems in landslide risk mitigation

Directory of Open Access Journals (Sweden)

M. Floris

2012-11-01

Full Text Available The definition of hydrological alert systems for rainfall-induced landslides is strongly related to a deep knowledge of the geological and geomorphological features of the territory. Climatic conditions, spatial and temporal evolution of the phenomena and characterization of landslide triggering, together with propagation mechanisms, are the key elements to be considered. Critical steps for the development of the systems consist of the identification of the hydrological variable related to landslide triggering and of the minimum rainfall threshold for landslide occurrence.

In this paper we report the results from a process-based model to define a hydrological alert system for the Val di Maso Landslide, located in the northeastern Italian Alps and included in the Vicenza Province (Veneto region, NE Italy. The instability occurred in November 2010, due to an exceptional rainfall event that hit the Vicenza Province and the entire NE Italy. Up to 500 mm in 3-day cumulated rainfall generated large flood conditions and triggered hundreds of landslides. During the flood, the Soil Protection Division of the Vicenza Province received more than 500 warnings of instability phenomena. The complexity of the event and the high level of risk to infrastructure and private buildings are the main reasons for deepening the specific phenomenon occurred at Val di Maso.

Empirical and physically-based models have been used to identify the minimum rainfall threshold for the occurrence of instability phenomena in the crown area of Val di Maso landslide, where a retrogressive evolution by multiple rotational slides is expected. Empirical models helped in the identification and in the evaluation of recurrence of critical rainfall events, while physically-based modelling was essential to verify the effects on the slope stability of determined rainfall depths. Empirical relationships between rainfall and landslide consist of the calculation of rainfall

Alert system for students with visual disabilities at the UTM

Directory of Open Access Journals (Sweden)

Marely del Rosario Cruz Felipe

2018-01-01

Full Text Available In the transfer of students with visual disabilities at the Technical University of Manabí (UTM accidents have been reported when going through some ramps and other obstacles, especially on rainy days. This article belongs to an investigation into the realization of an alert system for students with visual disabilities. The objective of the implementation of this system is to guide students with visual disabilities on different obstacles that exist in their transfer through the university. To carry out the implementation of this system, the alert systems and the technologies that are currently used as a result of a recording studio in the national and international scope were analyzed, the tools and technologies used in the developed solution are described. (Definition, technologies for the change of people, software, programming languages, etc. that allowed an efficient implementation in a short time of the proposed system by means of RFID (Radio Frequency Identification technology. The above is reflected in the positive orientation for the transfer of 32 students with visual disabilities through the university and by those who have contributed to improving their quality of life.

MOBILE TRAFFIC ALERT AND TOURIST ROUTE GUIDANCE SYSTEM DESIGN USING GEOSPATIAL DATA

Directory of Open Access Journals (Sweden)

D. Bhattacharya

2017-09-01

Full Text Available The present study describes an integrated system for traffic data collection and alert warning. Geographical information based decision making related to traffic destinations and routes is proposed through the design. The system includes a geospatial database having profile relating to a user of a mobile device. The processing and understanding of scanned maps, other digital data input leads to route guidance. The system includes a server configured to receive traffic information relating to a route and location information relating to the mobile device. Server is configured to send a traffic alert to the mobile device when the traffic information and the location information indicate that the mobile device is traveling toward traffic congestion. Proposed system has geospatial and mobile data sets pertaining to Bangalore city in India. It is envisaged to be helpful for touristic purposes as a route guidance and alert relaying information system to tourists for proximity to sites worth seeing in a city they have entered into. The system is modular in architecture and the novelty lies in integration of different modules carrying different technologies for a complete traffic information system. Generic information processing and delivery system has been tested to be functional and speedy under test geospatial domains. In a restricted prototype model with geo-referenced route data required information has been delivered correctly over sustained trials to designated cell numbers, with average time frame of 27.5 seconds, maximum 50 and minimum 5 seconds. Traffic geo-data set trials testing is underway.

Strengthening Laboratory Capacity for Early Warning Alert and Response System (EWARS) in Indonesia

OpenAIRE

Kandel, Nirmal; Hapsari, Ratna Budi; Riana, Dyah Armi; Setiawaty, Vivi; Larasati, Wita; Wulandari, Endang; Purwanto, Edy

2017-01-01

Background: Establishment of Early Warning Alert and Response System (EWARS) in Indonesia was initiated since 2009 in few selected provinces and government was planning to roll out in other provinces. Before initiating this roll out the assessment of performance of EWARS in 2012 was conducted. The aim of the assessment is to strengthen laboratory for supporting to EWARS for alerts testing. Methods: Laboratory capacity mapping tool and laboratory algorithm for twenty two priority diseases of ...

CERN alerter-RSS based system for information broadcast to all CERN offices

International Nuclear Information System (INIS)

Otto, R

2008-01-01

Nearly every large organization uses a tool to broadcast messages and information across the internal campus (messages like alerts announcing interruption in services or just information about upcoming events). These tools typically allow administrators (operators) to send 'targeted' messages which are sent only to specific groups of users or computers, e/g only those located in a specified building or connected to a particular computing service. CERN has a long history of such tools: CERNVMS's SPM q uotMESSAGE command, Zephyr [2] and the most recent the NICE Alerter based on the NNTP protocol. The NICE Alerter used on all Windows-based computers had to be phased out as a consequence of phasing out NNTP at CERN. The new solution to broadcast information messages on the CERN campus continues to provide the service based on cross-platform technologies, hence minimizing custom developments and relying on commercial software as much as possible. The new system, called CERN Alerter, is based on RSS (Really Simple Syndication) [9] for the transport protocol and uses Microsoft SharePoint as the backend for database and posting interface. The windows-based client relies on Internet Explorer 7.0 with custom code to trigger the window pop-ups and the notifications for new events. Linux and Mac OS X clients could also rely on any RSS readers to subscribe to targeted notifications. The paper covers the architecture and implementation aspects of the new system

A review of human factors principles for the design and implementation of medication safety alerts in clinical information systems

OpenAIRE

Phansalkar, Shobha; Edworthy, Judy; Hellier, Elizabeth; Seger, Diane L; Schedlbauer, Angela; Avery, Anthony J; Bates, David W

2010-01-01

The objective of this review is to describe the implementation of human factors principles for the design of alerts in clinical information systems. First, we conduct a review of alarm systems to identify human factors principles that are employed in the design and implementation of alerts. Second, we review the medical informatics literature to provide examples of the implementation of human factors principles in current clinical information systems using alerts to provide medication decisio...

Evaluation of health alerts from an early illness warning system in independent living.

Science.gov (United States)

Rantz, Marilyn J; Scott, Susan D; Miller, Steven J; Skubic, Marjorie; Phillips, Lorraine; Alexander, Greg; Koopman, Richelle J; Musterman, Katy; Back, Jessica

2013-06-01

Passive sensor networks were deployed in independent living apartments to monitor older adults in their home environments to detect signs of impending illness and alert clinicians so they can intervene and prevent or delay significant changes in health or functional status. A retrospective qualitative deductive content analysis was undertaken to refine health alerts to improve clinical relevance to clinicians as they use alerts in their normal workflow of routine care delivery to older adults. Clinicians completed written free-text boxes to describe actions taken (or not) as a result of each alert; they also rated the clinical significance (relevance) of each health alert on a scale of 1 to 5. Two samples of the clinician's written responses to the health alerts were analyzed after alert algorithms had been adjusted based on results of a pilot study using health alerts to enhance clinical decision-making. In the first sample, a total of 663 comments were generated by seven clinicians in response to 385 unique alerts; there are more comments than alerts because more than one clinician rated the same alert. The second sample had a total of 142 comments produced by three clinicians in response to 88 distinct alerts. The overall clinical relevance of the alerts, as judged by the content of the qualitative comments by clinicians for each alert, improved from 33.3% of the alerts in the first sample classified as clinically relevant to 43.2% in the second. The goal is to produce clinically relevant alerts that clinicians find useful in daily practice. The evaluation methods used are described to assist others as they consider building and iteratively refining health alerts to enhance clinical decision making.

47 CFR 80.1117 - Procedure for receipt and acknowledgement of distress alerts.

Science.gov (United States)

2010-10-01

..._locations.html. The ITU-R Recommendation can be purchased from the International Telecommunication Union... identification of the station sending the distress message, spoken three times; (3) The words THIS IS (or DE... station acknowledging receipt, spoken three times; (5) The word RECEIVED (or RRR spoken as ROMEO ROMEO...

Collaborative knowledge acquisition for the design of context-aware alert systems.

Science.gov (United States)

Joffe, Erel; Havakuk, Ofer; Herskovic, Jorge R; Patel, Vimla L; Bernstam, Elmer Victor

2012-01-01

To present a framework for combining implicit knowledge acquisition from multiple experts with machine learning and to evaluate this framework in the context of anemia alerts. Five internal medicine residents reviewed 18 anemia alerts, while 'talking aloud'. They identified features that were reviewed by two or more physicians to determine appropriate alert level, etiology and treatment recommendation. Based on these features, data were extracted from 100 randomly-selected anemia cases for a training set and an additional 82 cases for a test set. Two staff internists assigned an alert level, etiology and treatment recommendation before and after reviewing the entire electronic medical record. The training set of 118 cases (100 plus 18) and the test set of 82 cases were explored using RIDOR and JRip algorithms. The feature set was sufficient to assess 93% of anemia cases (intraclass correlation for alert level before and after review of the records by internists 1 and 2 were 0.92 and 0.95, respectively). High-precision classifiers were constructed to identify low-level alerts (precision p=0.87, recall R=0.4), iron deficiency (p=1.0, R=0.73), and anemia associated with kidney disease (p=0.87, R=0.77). It was possible to identify low-level alerts and several conditions commonly associated with chronic anemia. This approach may reduce the number of clinically unimportant alerts. The study was limited to anemia alerts. Furthermore, clinicians were aware of the study hypotheses potentially biasing their evaluation. Implicit knowledge acquisition, collaborative filtering and machine learning were combined automatically to induce clinically meaningful and precise decision rules.

The national web-based outbreak rapid alert system in Norway: eight years of experience, 2006-2013.

Science.gov (United States)

Guzman-Herrador, B; Vold, L; Berg, T; Berglund, T M; Heier, B; Kapperud, G; Lange, H; Nygård, K

2016-01-01

In 2005, the Norwegian Institute of Public Health established a web-based outbreak rapid alert system called Vesuv. The system is used for mandatory outbreak alerts from municipal medical officers, healthcare institutions, and food safety authorities. As of 2013, 1426 outbreaks have been reported, involving 32913 cases. More than half of the outbreaks occurred in healthcare institutions (759 outbreaks, 53·2%). A total of 474 (33·2%) outbreaks were associated with food or drinking water. The web-based rapid alert system has proved to be a helpful tool by enhancing reporting and enabling rapid and efficient information sharing between different authorities at both the local and national levels. It is also an important tool for event-based reporting, as required by the International Health Regulations (IHR) 2005. Collecting information from all the outbreak alerts and reports in a national database is also useful for analysing trends, such as occurrence of certain microorganisms, places or sources of infection, or route of transmission. This can facilitate the identification of specific areas where more general preventive measures are needed.

Alerts Visualization and Clustering in Network-based Intrusion Detection

Energy Technology Data Exchange (ETDEWEB)

Yang, Dr. Li [University of Tennessee; Gasior, Wade C [ORNL; Dasireddy, Swetha [University of Tennessee

2010-04-01

Today's Intrusion detection systems when deployed on a busy network overload the network with huge number of alerts. This behavior of producing too much raw information makes it less effective. We propose a system which takes both raw data and Snort alerts to visualize and analyze possible intrusions in a network. Then we present with two models for the visualization of clustered alerts. Our first model gives the network administrator with the logical topology of the network and detailed information of each node that involves its associated alerts and connections. In the second model, flocking model, presents the network administrator with the visual representation of IDS data in which each alert is represented in different color and the alerts with maximum similarity move together. This gives network administrator with the idea of detecting various of intrusions through visualizing the alert patterns.

Physicians' Perceptions on the usefulness of contextual information for prioritizing and presenting alerts in computerized physician order entry systems

NARCIS (Netherlands)

Jung, Martin; Riedmann, Daniel; Hackl, Werner O.; Hoerbst, Alexander; Jaspers, Monique W.; Ferret, Laurie; Lawton, Kitta; Ammenwerth, Elske

2012-01-01

Background: One possible approach towards avoiding alert overload and alert fatigue in Computerized Physician Order Entry (CPOE) systems is to tailor their drug safety alerts to the context of the clinical situation. Our objective was to identify the perceptions of physicians on the usefulness of

An IDS Alerts Aggregation Algorithm Based on Rough Set Theory

Science.gov (United States)

Zhang, Ru; Guo, Tao; Liu, Jianyi

2018-03-01

Within a system in which has been deployed several IDS, a great number of alerts can be triggered by a single security event, making real alerts harder to be found. To deal with redundant alerts, we propose a scheme based on rough set theory. In combination with basic concepts in rough set theory, the importance of attributes in alerts was calculated firstly. With the result of attributes importance, we could compute the similarity of two alerts, which will be compared with a pre-defined threshold to determine whether these two alerts can be aggregated or not. Also, time interval should be taken into consideration. Allowed time interval for different types of alerts is computed individually, since different types of alerts may have different time gap between two alerts. In the end of this paper, we apply proposed scheme on DAPRA98 dataset and the results of experiment show that our scheme can efficiently reduce the redundancy of alerts so that administrators of security system could avoid wasting time on useless alerts.

[Health alert management and emerging risk].

Science.gov (United States)

Pillonel, J

2010-12-01

Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

The Low-Level Wind Shear Alert System (LLWSAS)

Science.gov (United States)

1980-05-01

ALERT SYSTEM (LLWSAS). (May R.. a.-ol - 8..’P" Imng Organization Report No, 9, Perfo~ring Or~ni-otlon Ro-r. -andAddress 10. Work Unit No. (TRAIS) Federal...rather than electronic approach. The 2-minute average adheres to recommended International Civil Aviation Organization (ICAO) standards (referernce 14...speed of 140 knots. **Cold front. 80 ’ # 90 0 STRONG CASES: COFF , 1975 80 9STRONG CASES: UNPU1BLISHED 70 60 A STRONG CASES: COFF , et al., 1978 50 \\ 50 -0

Geo-targeted Weather Alerts Coming to Millions of Mobile Devices

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Gerber, M.

2011-12-01

The Personal Localized Alert Network (PLAN), aka Commercial Mobile Alert System (CMAS), is readying for roll out and will be broadcasting emergency public alerts to millions of cell phones by the middle of 2012. Learn how the National Weather Serivce (NWS) is supplying PLAN with geo-referenced weather alert information in the industry standard Common Alerting Protocol (CAP) format and how you can access this same information for integration with mobile devices, other consumer electronics, and decision support systems. Information will also be provided on the NWS' new collaborative venue that encourages wide participation in the evolution and use of NWS CAP alerts in a variety of applications.

Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting

Directory of Open Access Journals (Sweden)

Andrew M. Harrison

2017-03-01

Full Text Available Background Electronic Health Record (EHR-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. Objective To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system. Study Design In one arm of this simulation study, real alerts for patients in the medical ICU were delivered to critical care clinicians through the EHR. In the other arm, simulated alerts were delivered through text paging. The primary outcome was time to alert acknowledgement. The secondary outcomes were a structured, mixed quantitative/qualitative survey and informal group interview. Results The alert acknowledgement rate from the severe sepsis alert system was 3% (N = 148 and 51% (N = 156 from simulated severe sepsis alerts through traditional text paging. Time to alert acknowledgement from the severe sepsis alert system was median 274 min (N = 5 and median 2 min (N = 80 from text paging. The response rate from the EHR-based alert system was insufficient to compare primary measures. However, secondary measures revealed important barriers. Conclusion Alert fatigue, interruption, human error, and information overload are barriers to alert and simulation studies in the ICU setting.

Spirituality and distress in palliative care consultation.

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Hills, Judith; Paice, Judith A; Cameron, Jacqueline R; Shott, Susan

2005-08-01

One's spirituality or religious beliefs and practices may have a profound impact on how the individual copes with the suffering that so often accompanies advanced disease. Several previous studies suggest that negative religious coping can significantly affect health outcomes. The primary aim of this study was to explore the relationship between spirituality, religious coping, and symptoms of distress among a group of inpatients referred to the palliative care consult service. Pilot study. The study was conducted in a large academic medical center with a comprehensive Palliative Care and Home Hospice Program. (1) National Comprehensive Cancer Network Distress Management Assessment Tool; (2) Pargament Brief Religious Coping Scale (Brief RCOPE); (3) Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp); (4) Puchalski's FICA; and (5) Profile of Mood States-Short Form (POMS-SF). The 31 subjects surveyed experienced moderate distress (5.8 +/- 2.7), major physical and psychosocial symptom burden, along with reduced function and significant caregiving needs. The majority (87.2%) perceived themselves to be at least somewhat spiritual, with 77.4% admitting to being at least somewhat religious. Negative religious coping (i.e., statements regarding punishment or abandonment by God) was positively associated with distress, confusion, depression, and negatively associated with physical and emotional well-being, as well as quality of life. Palliative care clinicians should be alert to symptoms of spiritual distress and intervene accordingly. Future research is needed to identify optimal techniques to address negative religious coping.

V-Alert: Description and Validation of a Vulnerable Road User Alert System in the Framework of a Smart City.

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Hernandez-Jayo, Unai; De-la-Iglesia, Idoia; Perez, Jagoba

2015-07-29

V-Alert is a cooperative application to be deployed in the frame of Smart Cities with the aim of reducing the probability of accidents involving Vulnerable Road Users (VRU) and vehicles. The architecture of V-Alert combines short- and long-range communication technologies in order to provide more time to the drivers and VRU to take the appropriate maneuver and avoid a possible collision. The information generated by mobile sensors (vehicles and cyclists) is sent over this heterogeneous communication architecture and processed in a central server, the Drivers Cloud, which is in charge of generating the messages that are shown on the drivers' and cyclists' Human Machine Interface (HMI). First of all, V-Alert has been tested in a simulated scenario to check the communications architecture in a complex scenario and, once it was validated, all the elements of V-Alert have been moved to a real scenario to check the application reliability. All the results are shown along the length of this paper.

A systematic review of the effectiveness of interruptive medication prescribing alerts in hospital CPOE systems to change prescriber behavior and improve patient safety.

Science.gov (United States)

Page, N; Baysari, M T; Westbrook, J I

2017-09-01

To assess the evidence of the effectiveness of different categories of interruptive medication prescribing alerts to change prescriber behavior and/or improve patient outcomes in hospital computerized provider order entry (CPOE) systems. PubMed, Embase, CINAHL and the Cochrane Library were searched for relevant articles published between January 2000 and February 2016. Studies were included if they compared the outcomes of automatic, interruptive medication prescribing alert/s to a control/comparison group to determine alert effectiveness. Twenty-three studies describing 32 alerts classified into 11 alert categories were identified. The most common alert categories studied were drug-condition interaction (n=6), drug-drug interaction alerts (n=6) and corollary order alerts (n=6). All 23 papers investigated the effect of the intervention alert on at least one outcome measure of prescriber behavior. Just over half of the studies (53%, n=17) reported a statistically significant beneficial effect from the intervention alert; 34% (n=11) reported no statistically significant effect, and 6% (n=2) reported a significant detrimental effect. Two studies also evaluated the effect of alerts on patient outcome measures; neither finding that patient outcomes significantly improved following alert implementation (6%, n=2). The greatest volume of evidence relates to three alert categories: drug-condition, drug-drug and corollary order alerts. Of these, drug-condition alerts had the greatest number of studies reporting positive effects (five out of six studies). Only two of six studies of drug-drug interaction and one of six of corollary alerts reported positive benefits. The current evidence-base does not show a clear indication that particular categories of alerts are more effective than others. While the majority of alert categories were shown to improve outcomes in some studies, there were also many cases where outcomes did not improve. This lack of evidence hinders decisions

Lay persons alerted by mobile application system initiate earlier cardio-pulmonary resuscitation: A comparison with SMS-based system notification.

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Caputo, Maria Luce; Muschietti, Sandro; Burkart, Roman; Benvenuti, Claudio; Conte, Giulio; Regoli, François; Mauri, Romano; Klersy, Catherine; Moccetti, Tiziano; Auricchio, Angelo

2017-05-01

We compared the time to initiation of cardiopulmonary resuscitation (CPR) by lay responders and/or first responders alerted either via Short Message Service (SMS) or by using a mobile application-based alert system (APP). The Ticino Registry of Cardiac Arrest collects all data about out-of-hospital cardiac arrests (OHCAs) occurring in the Canton of Ticino. At the time of a bystander's call, the EMS dispatcher sends one ambulance and alerts the first-responders network made up of police officers or fire brigade equipped with an automatic external defibrillator, the so called "traditional" first responders, and - if the scene was considered safe - lay responders as well. We evaluated the time from call to arrival of traditional first responders and/or lay responders when alerted either via SMS or the new developed mobile APP. Over the study period 593 OHCAs have occurred. Notification to the first responders network was sent via SMS in 198 cases and via mobile APP in 134 cases. Median time to first responder/lay responder arrival on scene was significantly reduced by the APP-based system (3.5 [2.8-5.2]) compared to the SMS-based system (5.6 [4.2-8.5] min, p 0.0001). The proportion of lay responders arriving first on the scene significantly increased (70% vs. 15%, play responder determined a higher survival rate. The mobile APP system is highly efficient in the recruitment of first responders, significantly reducing the time to the initiation of CPR thus increasing survival rates. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Perceptual evaluation of visual alerts in surveillance videos

Science.gov (United States)

Rogowitz, Bernice E.; Topkara, Mercan; Pfeiffer, William; Hampapur, Arun

2015-03-01

Visual alerts are commonly used in video monitoring and surveillance systems to mark events, presumably making them more salient to human observers. Surprisingly, the effectiveness of computer-generated alerts in improving human performance has not been widely studied. To address this gap, we have developed a tool for simulating different alert parameters in a realistic visual monitoring situation, and have measured human detection performance under conditions that emulated different set-points in a surveillance algorithm. In the High-Sensitivity condition, the simulated alerts identified 100% of the events with many false alarms. In the Lower-Sensitivity condition, the simulated alerts correctly identified 70% of the targets, with fewer false alarms. In the control condition, no simulated alerts were provided. To explore the effects of learning, subjects performed these tasks in three sessions, on separate days, in a counterbalanced, within subject design. We explore these results within the context of cognitive models of human attention and learning. We found that human observers were more likely to respond to events when marked by a visual alert. Learning played a major role in the two alert conditions. In the first session, observers generated almost twice as many False Alarms as in the No-Alert condition, as the observers responded pre-attentively to the computer-generated false alarms. However, this rate dropped equally dramatically in later sessions, as observers learned to discount the false cues. Highest observer Precision, Hits/(Hits + False Alarms), was achieved in the High Sensitivity condition, but only after training. The successful evaluation of surveillance systems depends on understanding human attention and performance.

Implementation of a simple electronic transfusion alert system decreases inappropriate ordering of packed red blood cells and plasma in a multi-hospital health care system.

Science.gov (United States)

Smith, Matthew; Triulzi, Darrell J; Yazer, Mark H; Rollins-Raval, Marian A; Waters, Jonathan H; Raval, Jay S

2014-12-01

Prescriber adherence to institutional blood component ordering guidelines can be low. The goal of this study was to decrease red blood cell (RBC) and plasma orders that did not meet institutional transfusion guidelines by using data within the laboratory information system to trigger alerts in the computerized order entry (CPOE) system at the time of order entry. At 10 hospitals within a regional health care system, discernment rules were created for RBC and plasma orders utilizing transfusion triggers of hemoglobin 1.6, respectively, with subsequent alert generation that appears within the CPOE system when a prescriber attempts to order RBCs or plasma on a patient whose antecedent laboratory values do not suggest that a transfusion is indicated. Orders and subsequent alerts were tracked for RBCs and plasma over evaluation periods of 15 and 10 months, respectively, along with the hospital credentials of the ordering health care providers (physician or nurse). Alerts triggered which were heeded remained steady and averaged 11.3% for RBCs and 19.6% for plasma over the evaluation periods. Overall, nurses and physicians canceled statistically identical percentages of alerted RBC (10.9% vs. 11.5%; p = 0.78) and plasma (21.3% vs. 18.7%; p = 0.22) orders. Implementing a simple evidence-based transfusion alert system at the time of order entry decreased non-evidence based transfusion orders by both nurse and physician providers. Copyright © 2014 Elsevier Ltd. All rights reserved.

FULCRUM - A dam safety management and alert system

Energy Technology Data Exchange (ETDEWEB)

Butt, Cameron; Greenaway, Graham [Knight Piesold Ltd., Vancouver, (Canada)

2010-07-01

Efficient management of instrumentation, monitoring and inspection data are the keys to safe performance and dam structure stability. This paper presented a data management system, FULCRUM, developed for dam safety management. FULCRUM is a secure web-based data management system which simplifies the process of data collection, processing and analysis of the information. The system was designed to organize and coordinate dam safety management requirements. Geotechnical instrumentation such as piezometers or inclinometers and operating data can be added to the database. Data from routine surveillance and engineering inspection can also be incorporated into the database. The system provides users with immediate access to historical and recent data. The integration of a GIS system allows for rapid assessment of the project site. Customisable alerting protocols can be set to identify and respond quickly to significant changes in operating conditions and potential impacts on dam safety.

Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project

Directory of Open Access Journals (Sweden)

Elena Boriani

2017-07-01

Full Text Available Health intervention systems are complex and subject to multiple variables in different phases of implementation. This constitutes a concrete challenge for the application of translational science in real life. Complex systems as health-oriented interventions call for interdisciplinary approaches with carefully defined system boundaries. Exploring individual components of such systems from different viewpoints gives a wide overview and helps to understand the elements and the relationships that drive actions and consequences within the system. In this study, we present an application and assessment of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST aimed at monitoring the quality, health, and traceability of the chain of the bovine milk], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety, human, and ecosystem health (1. In fact, the European food safety framework calls for science-based support to the primary producers’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account the main actors, interactions, and relationships of stakeholders to depict a simplified skeleton of the system. The framework can provide elements to highlight how and where to improve the project development when project evaluations are required.

Optimizing the response to surveillance alerts in automated surveillance systems.

Science.gov (United States)

Izadi, Masoumeh; Buckeridge, David L

2011-02-28

Although much research effort has been directed toward refining algorithms for disease outbreak alerting, considerably less attention has been given to the response to alerts generated from statistical detection algorithms. Given the inherent inaccuracy in alerting, it is imperative to develop methods that help public health personnel identify optimal policies in response to alerts. This study evaluates the application of dynamic decision making models to the problem of responding to outbreak detection methods, using anthrax surveillance as an example. Adaptive optimization through approximate dynamic programming is used to generate a policy for decision making following outbreak detection. We investigate the degree to which the model can tolerate noise theoretically, in order to keep near optimal behavior. We also evaluate the policy from our model empirically and compare it with current approaches in routine public health practice for investigating alerts. Timeliness of outbreak confirmation and total costs associated with the decisions made are used as performance measures. Using our approach, on average, 80 per cent of outbreaks were confirmed prior to the fifth day of post-attack with considerably less cost compared to response strategies currently in use. Experimental results are also provided to illustrate the robustness of the adaptive optimization approach and to show the realization of the derived error bounds in practice. Copyright © 2011 John Wiley & Sons, Ltd.

Simulation and Proposed Handover Alert Algorithm for Mobile Communication System

Directory of Open Access Journals (Sweden)

Muzhir Shaban Al-Ani

2009-10-01

Full Text Available this paper deals with the simulation and presentation of a novel approach to design and implementation of algorithm to realize hand over process for a mobile communication system during mobile network. This algorithm performs the ability of the system to extract important information features about the received signal. When the strength of the received signal is dropped below a certain threshold value then an alert process is activated to achieve the continuity of the transmission due to a ready scan which is existed on time.

Provider and pharmacist responses to warfarin drug–drug interaction alerts: a study of healthcare downstream of CPOE alerts

Science.gov (United States)

Boro, Maureen S; Korman, Nancy E; Davoren, J Ben

2011-01-01

Objective To categorize the appropriateness of provider and pharmacist responses to warfarin critical drug–drug interaction (cDDI) alerts, assess responses and actions to the cDDI, and determine the occurrence of warfarin adverse drug events (ADE) after alerts. Design An 18-month, retrospective study of acute care admissions at a single Veterans Affairs medical center using computerized provider order entry (CPOE). Measurements Patients included had at least one warfarin cDDI alert. Chart reviews included baseline laboratory values and demographics, provider actions, patient outcomes, and associated factors, including other interacting medications and number of simultaneously processed alerts. Results 137 admissions were included (133 unique patients). Amiodarone, vitamin E in a multivitamin, sulfamethoxazole, and levothyroxine accounted for 75% of warfarin cDDI. Provider responses were clinically appropriate in 19.7% of admissions and pharmacist responses were appropriate in 9.5% of admissions. There were 50 ADE (36.6% of admissions) with warfarin; 80% were rated as having no or mild clinical effect. An increased number of non-critical alerts at the time of the reference cDDI alert was the only variable associated with an inappropriate provider response (p=0.01). Limitations This study was limited by being a retrospective review and the possibility of confounding variables, such as other interacting medications. Conclusion The large number of CPOE alerts may lead to inappropriate responses by providers and pharmacists. The high rate of ADE suggests a need for improved medication management systems for patients on warfarin. This study highlights the possibility of alert fatigue contributing to the high prevalence of inappropriate alert over-ride text responses. PMID:22037888

The effect of phasic auditory alerting on visual perception.

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Petersen, Anders; Petersen, Annemarie Hilkjær; Bundesen, Claus; Vangkilde, Signe; Habekost, Thomas

2017-08-01

Phasic alertness refers to a short-lived change in the preparatory state of the cognitive system following an alerting signal. In the present study, we examined the effect of phasic auditory alerting on distinct perceptual processes, unconfounded by motor components. We combined an alerting/no-alerting design with a pure accuracy-based single-letter recognition task. Computational modeling based on Bundesen's Theory of Visual Attention was used to examine the effect of phasic alertness on visual processing speed and threshold of conscious perception. Results show that phasic auditory alertness affects visual perception by increasing the visual processing speed and lowering the threshold of conscious perception (Experiment 1). By manipulating the intensity of the alerting cue, we further observed a positive relationship between alerting intensity and processing speed, which was not seen for the threshold of conscious perception (Experiment 2). This was replicated in a third experiment, in which pupil size was measured as a physiological marker of alertness. Results revealed that the increase in processing speed was accompanied by an increase in pupil size, substantiating the link between alertness and processing speed (Experiment 3). The implications of these results are discussed in relation to a newly developed mathematical model of the relationship between levels of alertness and the speed with which humans process visual information. Copyright © 2017 Elsevier B.V. All rights reserved.

Improving the health forecasting alert system for cold weather and heat-waves in England: a case-study approach using temperature-mortality relationships

Science.gov (United States)

Masato, Giacomo; Cavany, Sean; Charlton-Perez, Andrew; Dacre, Helen; Bone, Angie; Carmicheal, Katie; Murray, Virginia; Danker, Rutger; Neal, Rob; Sarran, Christophe

2015-04-01

The health forecasting alert system for cold weather and heatwaves currently in use in the Cold Weather and Heatwave plans for England is based on 5 alert levels, with levels 2 and 3 dependent on a forecast or actual single temperature action trigger. Epidemiological evidence indicates that for both heat and cold, the impact on human health is gradual, with worsening impact for more extreme temperatures. The 60% risk of heat and cold forecasts used by the alerts is a rather crude probabilistic measure, which could be substantially improved thanks to the state-of-the-art forecast techniques. In this study a prototype of a new health forecasting alert system is developed, which is aligned to the approach used in the Met Office's (MO) National Severe Weather Warning Service (NSWWS). This is in order to improve information available to responders in the health and social care system by linking temperatures more directly to risks of mortality, and developing a system more coherent with other weather alerts. The prototype is compared to the current system in the Cold Weather and Heatwave plans via a case-study approach to verify its potential advantages and shortcomings. The prototype health forecasting alert system introduces an "impact vs likelihood matrix" for the health impacts of hot and cold temperatures which is similar to those used operationally for other weather hazards as part of the NSWWS. The impact axis of this matrix is based on existing epidemiological evidence, which shows an increasing relative risk of death at extremes of outdoor temperature beyond a threshold which can be identified epidemiologically. The likelihood axis is based on a probability measure associated with the temperature forecast. The new method is tested for two case studies (one during summer 2013, one during winter 2013), and compared to the performance of the current alert system. The prototype shows some clear improvements over the current alert system. It allows for a much greater

Implications of resolved hypoxemia on the utility of desaturation alerts sent from an anesthesia decision support system to supervising anesthesiologists.

Science.gov (United States)

Epstein, Richard H; Dexter, Franklin

2012-10-01

Hypoxemia (oxygen saturation operating room settings. Alarm management functionality can be added to decision support systems (DSS) to send text alerts about vital signs outside specified thresholds, using data in anesthesia information management systems. We considered enhancing our DSS to send hypoxemia alerts to the text pagers of supervising anesthesiologists. As part of a voluntary application for an investigative device exemption from our IRB to implement such functionality, we evaluated the maximum potential utility of such an alert system. Pulse oximetry values (Spo(2)) were extracted from our anesthesia information management systems for all cases performed in our main operating rooms and ambulatory surgical center between September 1, 2011, and February 4, 2012 (n = 16,870). Hypoxemic episodes (Spo(2) operating room. These results suggest that the principal research focus should be on developing more sophisticated alerts and processes within rooms for the anesthesia care provider to initiate treatment promptly, to interpret or correct artifacts, and to make it easier to call for assistance via a rapid communication system.

Project ALERT: Forging New Partnerships to Improve Earth System Science Education for Pre-Service and In-Service Teachers

Science.gov (United States)

Metzger, E. P.; Ambos, E. L.; Ng, E. W.; Skiles, J.; Simila, G.; Garfield, N.

2002-05-01

Project ALERT (Augmented Learning Environment and Renewable Teaching) was founded in 1998, with funding from NASA and the California State University (CSU), to improve earth system science education for pre-service teachers. Project ALERT has formed linkages between ten campuses of the CSU, which prepares about 60 percent of California's teachers, and two NASA centers, Ames Research Center and the Jet Propulsion Laboratory. ALERT has also fostered alliances between earth science and science education faculty. The combined expertise of Project ALERT's diverse partners has led to a wide array of activities and products, including: 1) incorporation in university classrooms of NASA-developed imagery, data, and educational resources; 2) creation and/or enhancement of several courses that bring earth systems science to pre-service teachers; 3) fellowships for CSU faculty to participate in collaborative research and education projects at the NASA Centers; 4) development of teaching modules on such varied topics as volcanoes, landslides, and paleoclimate; and 5) a central web site that highlights resources for teaching introductory Earth system science. An outgrowth of Project ALERT is the increased interest on the part of CSU earth scientists in education issues. This has catalyzed their participation in other projects, including NASA's Project NOVA, Earth System Science Education Alliance, and Sun-Earth Connection Education Forum, the Digital Library for Earth System Science Education, and the California Science Project. Project ALERT has also expanded to provide professional development opportunities for in-service teachers, as exemplified by its support of the Bay Area Earth Science Institute (BAESI) at San Jose State University. Each year, BAESI offers 10-15 full-day workshops that supply teachers and teachers-to-be with a blend of science concepts and classroom activities, free instructional materials, and the opportunity to earn inexpensive university credit. These

A new method for determining a sector alert

Science.gov (United States)

2008-09-29

The Traffic Flow Management System (TFMS) currently declares an alert for any 15-minute interval in which the predicted demand exceeds the Monitor/Alert Parameter (MAP) for any airport, sector, or fix. For a sector, TFMS predicts the demand for each ...

Electronic Immunization Alerts and Spillover Effects on Other Preventive Care.

Science.gov (United States)

Kim, Julia M; Rivera, Maria; Persing, Nichole; Bundy, David G; Psoter, Kevin J; Ghazarian, Sharon R; Miller, Marlene R; Solomon, Barry S

2017-08-01

The impact of electronic health record (EHR) immunization clinical alert systems on the delivery of other preventive services remains unknown. We assessed for spillover effects of an EHR immunization alert on delivery of 6 other preventive services, in children 18 to 30 months of age needing immunizations. We conducted a secondary data analysis, with additional primary data collection, of a randomized, historically controlled trial to improve immunization rates with EHR alerts, in an urban, primary care clinic. No significant differences were found in screening for anemia, lead, development, nutrition, and injury prevention counseling in children prompting EHR immunization alerts (n = 129), compared with controls (n = 135). Significant increases in oral health screening in patients prompting EHR alerts (odds ratio = 4.8, 95% CI = 1.8-13.0) were likely due to practice changes over time. An EHR clinical alert system targeting immunizations did not have a spillover effect on the delivery of other preventive services.

Alerts in mobile healthcare applications: requirements and pilot study.

Science.gov (United States)

Kafeza, Eleanna; Chiu, Dickson K W; Cheung, S C; Kafeza, Marina

2004-06-01

Recent advances in mobile technologies have greatly extended traditional communication technologies to mobile devices. At the same time, healthcare environments are by nature "mobile" where doctors and nurses do not have fixed workspaces. Irregular and exceptional events are generated in daily hospital routines, such as operations rescheduling, laboratory/examination results, and adverse drug events. These events may create requests that should be delivered to the appropriate person at the appropriate time. Those requests that are classified as urgent are referred to as alerts. Efficient routing and monitoring of alerts are keys to quality and cost-effective healthcare services. Presently, these are generally handled in an ad hoc manner. In this paper, we propose the use of a healthcare alert management system to handle these alert messages systematically. We develop a model for specifying alerts that are associated with medical tasks and a set of parameters for their routing. We design an alert monitor that matches medical staff and their mobile devices to receive alerts, based on the requirements of these alerts. We also propose a mechanism to handle and reroute, if necessary, an alert message when it has not been acknowledged within a specific deadline.

Stimulated reporting: the impact of US food and drug administration-issued alerts on the adverse event reporting system (FAERS).

Science.gov (United States)

Hoffman, Keith B; Demakas, Andrea R; Dimbil, Mo; Tatonetti, Nicholas P; Erdman, Colin B

2014-11-01

The US Food and Drug Administration (FDA) uses the Adverse Event Reporting System (FAERS) to support post-marketing safety surveillance programs. Currently, almost one million case reports are submitted to FAERS each year, making it a vast repository of drug safety information. Sometimes cited as a limitation of FAERS, however, is the assumption that "stimulated reporting" of adverse events (AEs) occurs in response to warnings, alerts, and label changes that are issued by the FDA. To determine the extent of "stimulated reporting" in the modern-day FAERS database. One hundred drugs approved by the FDA between 2001 and 2010 were included in this analysis. FDA alerts were obtained by a comprehensive search of the FDA's MedWatch and main websites. Publicly available FAERS data were used to assess the "primary suspect" AE reporting pattern for up to four quarters before, and after, the issuance of an FDA alert. A few drugs did demonstrate "stimulated reporting" trends. A majority of the drugs, however, showed little evidence for significant reporting changes associated with the issuance of alerts. When we compared the percentage changes in reporting after an FDA alert with those after a sham "control alert", the overall reporting trends appeared to be quite similar. Of 100 drugs analyzed for short-term reporting trends, 21 real alerts and 25 sham alerts demonstrated an increase (greater than or equal to 1 %) in reporting. The long-term analysis of 91 drugs showed that 24 real alerts and 28 sham alerts demonstrated a greater than or equal to 1 % increase. Our results suggest that most of modern day FAERS reporting is not significantly affected by the issuance of FDA alerts.

Generalized Philosophy of Alerting with Applications for Parallel Approach Collision Prevention

Science.gov (United States)

Winder, Lee F.; Kuchar, James K.

2000-01-01

The goal of the research was to develop formal guidelines for the design of hazard avoidance systems. An alerting system is automation designed to reduce the likelihood of undesirable outcomes that are due to rare failures in a human-controlled system. It accomplishes this by monitoring the system, and issuing warning messages to the human operators when thought necessary to head off a problem. On examination of existing and recently proposed logics for alerting it appears that few commonly accepted principles guide the design process. Different logics intended to address the same hazards may take disparate forms and emphasize different aspects of performance, because each reflects the intuitive priorities of a different designer. Because performance must be satisfactory to all users of an alerting system (implying a universal meaning of acceptable performance) and not just one designer, a proposed logic often undergoes significant piecemeal modification before gamma general acceptance. This report is an initial attempt to clarify the common performance goals by which an alerting system is ultimately judged. A better understanding of these goals will hopefully allow designers to reach the final logic in a quicker, more direct and repeatable manner. As a case study, this report compares three alerting logics for collision prevention during independent approaches to parallel runways, and outlines a fourth alternative incorporating elements of the first three, but satisfying stated requirements. Three existing logics for parallel approach alerting are described. Each follows from different intuitive principles. The logics are presented as examples of three "philosophies" of alerting system design.

Impact of an electronic alert notification system embedded in radiologists' workflow on closed-loop communication of critical results: a time series analysis.

Science.gov (United States)

Lacson, Ronilda; O'Connor, Stacy D; Sahni, V Anik; Roy, Christopher; Dalal, Anuj; Desai, Sonali; Khorasani, Ramin

2016-07-01

Optimal critical test result communication is a Joint Commission national patient safety goal and requires documentation of closed-loop communication among care providers in the medical record. Electronic alert notification systems can facilitate an auditable process for creating alerts for transmission and acknowledgement of critical test results. We evaluated the impact of a patient safety initiative with an alert notification system on reducing critical results lacking documented communication, and assessed potential overuse of the alerting system for communicating results. We implemented an alert notification system-Alert Notification of Critical Results (ANCR)-in January 2010. We reviewed radiology reports finalised in 2009-2014 which lacked documented communication between the radiologist and another care provider, and assessed the impact of ANCR on the proportion of such reports with critical findings, using trend analysis over 10 semiannual time periods. To evaluate potential overuse of ANCR, we assessed the proportion of reports with non-critical results among provider-communicated reports. The proportion of reports with critical results among reports without documented communication decreased significantly over 4 years (2009-2014) from 0.19 to 0.05 (pcommunicated reports with non-critical results remained unchanged over time before and after ANCR implementation (0.20 to 0.15, p=0.45, Cochran-Armitage trend test). A patient safety initiative with an alert notification system reduced the proportion of critical results among reports lacking documented communication between care providers. We observed no change in documented communication of non-critical results, suggesting the system did not promote overuse. Future studies are needed to evaluate whether such systems prevent subsequent patient harm. 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/

Effects of an alert system on implantable cardioverter defibrillator-related anxiety

DEFF Research Database (Denmark)

Duru, Firat; Dorian, Paul; Favale, Stefano

2010-01-01

failing to receive needed therapy for the same reason. New devices include programmable vibrating patient notifiers (PN), which, by warning patients of a possible device dysfunction, might lower device-related anxiety. PAtient NOtifier feature for Reduction of Anxiety: a Multicentre ICD study (PANORAMIC......) is a multicentre, randomized, clinical trial designed to examine the effects of the awareness of an active vibrating alert system on device-related anxiety....

Real-time Seismic Alert System of NIED

Science.gov (United States)

Horiuchi, S.; Fujinawa, Y.; Negishi, H.; Matsumoto, T.; Fujiwara, H.; Kunugi, T.; Hayashi, Y.

2001-12-01

An extensive seismic network has been constructed nationwide composed of hi-sensitivity seismographic network, broadband seismographic network and strong motion seismographic network. All these data from some 3,000 sites belonging to NIED, JMA and universities are to be accumulated and distributed through NIED to any scientists and engineering through INTERNET under the coordination of the National Seismic Research Committee of MEXT. As a practical application of those data we are now developing a real-time seismic alert information system for the purpose of providing short-term warning of imminent strong grounds motions from major earthquakes from several seconds to a few days. The contents of information are seismic focal parameters (several seconds), seismic fault plane solutions (some 10 seconds), after-shock activities (several minutes-a few days ). The fundamental fault parameters are used to build specific information at sites for particular users for use of triggering automated and /or half-automated responses. The most important application is an immediate estimate of expected shaking distribution and damages in a district using synthetic database and site effects for local governments to initial proper measures of hazard mitigation. Another application is estimation of arrival time and shaking strength at any individual site for human lives to be safeguarded. The system could also start an automatic electrical isolation and protection of computer systems, protection of hazardous chronic systems, transportation systems and so on. The information are corrected successively as seismic ground motion are received at a larger number of sites in time with the result that more accurate and more sophisticated earthquake information is transmitted to any user. Besides the rapid determination of seismic parameters, one of essential items in this alert system is the data transmission means. The data transmission is chosen to assure negligibly small delay of data

Physicians' Perceptions on the usefulness of contextual information for prioritizing and presenting alerts in computerized physician order entry systems

Directory of Open Access Journals (Sweden)

Jung Martin

2012-10-01

Full Text Available Abstract Background One possible approach towards avoiding alert overload and alert fatigue in Computerized Physician Order Entry (CPOE systems is to tailor their drug safety alerts to the context of the clinical situation. Our objective was to identify the perceptions of physicians on the usefulness of clinical context information for prioritizing and presenting drug safety alerts. Methods We performed a questionnaire survey, inquiring CPOE-using physicians from four hospitals in four European countries to estimate the usefulness of 20 possible context factors. Results The 223 participants identified the ‘severity of the effect’ and the ‘clinical status of the patient’ as the most useful context factors. Further important factors are the ‘complexity of the case’ and the ‘risk factors of the patient’. Conclusions Our findings confirm the results of a prior, comparable survey inquiring CPOE researchers. Further research should focus on implementing these context factors in CPOE systems and on subsequently evaluating their impact.

Idioms of Distress.

Science.gov (United States)

Desai, Geetha; Chaturvedi, Santosh K

2017-08-01

The presentations of psychosocial distress and cultural conflicts are often bodily symptoms, especially in traditional societies and village backgrounds. These might not meet the criteria of the current psychiatric diagnostic systems. Sociocultural milieu contributes to the unique presentations of the stress in the form of idioms of distress. The latter are alternative modes of expressing distress and indicate manifestations of distress in relation to personal and cultural meaning. Health professionals often consider these as hysterical, functional or having functional overlays, and abnormal illness behaviors. Management of idioms of distress would need cultural competence and sensitivity. This article highlights the common idioms of distress in India with specific focus on bodily symptoms.

Volcanic Alert System (VAS) developed during the (2011-2013) El Hierro (Canary Islands) volcanic process

Science.gov (United States)

Ortiz, Ramon; Berrocoso, Manuel; Marrero, Jose Manuel; Fernandez-Ros, Alberto; Prates, Gonçalo; De la Cruz-Reyna, Servando; Garcia, Alicia

2014-05-01

In volcanic areas with long repose periods (as El Hierro), recently installed monitoring networks offer no instrumental record of past eruptions nor experience in handling a volcanic crisis. Both conditions, uncertainty and inexperience, contribute to make the communication of hazard more difficult. In fact, in the initial phases of the unrest at El Hierro, the perception of volcanic risk was somewhat distorted, as even relatively low volcanic hazards caused a high political impact. The need of a Volcanic Alert System became then evident. In general, the Volcanic Alert System is comprised of the monitoring network, the software tools for the analysis of the observables, the management of the Volcanic Activity Level, and the assessment of the threat. The Volcanic Alert System presented here places special emphasis on phenomena associated to moderate eruptions, as well as on volcano-tectonic earthquakes and landslides, which in some cases, as in El Hierro, may be more destructive than an eruption itself. As part of the Volcanic Alert System, we introduce here the Volcanic Activity Level which continuously applies a routine analysis of monitoring data (particularly seismic and deformation data) to detect data trend changes or monitoring network failures. The data trend changes are quantified according to the Failure Forecast Method (FFM). When data changes and/or malfunctions are detected, by an automated watchdog, warnings are automatically issued to the Monitoring Scientific Team. Changes in the data patterns are then translated by the Monitoring Scientific Team into a simple Volcanic Activity Level, that is easy to use and understand by the scientists and technicians in charge for the technical management of the unrest. The main feature of the Volcanic Activity Level is its objectivity, as it does not depend on expert opinions, which are left to the Scientific Committee, and its capabilities for early detection of precursors. As a consequence of the El Hierro

Emergency distress call system for automobiles in Lagos state, Nigeria

African Journals Online (AJOL)

Emergency distress call system for automobiles in Lagos state, Nigeria. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... and communications technology capabilities to transportation and the medical care system in order to save lives, ...

Self-Alert Training: Volitional Modulation of Autonomic Arousal Improves Sustained Attention

Science.gov (United States)

O'Connell, Redmond G.; Bellgrove, Mark A.; Dockree, Paul M.; Lau, Adam; Fitzgerald, Michael; Robertson, Ian H.

2008-01-01

The present study examines a new alertness training strategy (Self-Alert Training, SAT) designed to explore the relationship between the top-down control processes governing arousal and sustained attention. In order to maximally target frontal control systems SAT combines a previously validated behavioural self-alerting technique [Robertson, I.…

An Investigation of an RFID-based Patient-tracking and Mobile Alert System

Directory of Open Access Journals (Sweden)

C.L. Yeung

2011-02-01

Full Text Available In the modern era, patient health is no longer the only concern for hospitals. Hospitals have to bear the responsibility of the patient safety and the patient comfort. However, due to the overcrowded and understaffed clinical areas with complex workflow patterns, there are different forms of medical care errors arisen in the healthcare system. According to recent statistic from World Health Organization, ten of milions of patient around the world are injured or dead every yearas a result of incorrect medical care. Rroughly 10% patients admitted to hospital in developed countries suffered some forms of medical care errors or medical adverse events. It is about 1.4 million of world population.In order to enhance the patient safety and patient comfort in the current medical service system, an RFID‐based Patient Tracking and Mobile Alert System integrated with information communications technology was designed and developed. Apart from identifying different patient’s whereabouts, instant alerts are generated through mobile devices so as to enhance patients’ safety and comfort. With a view of investigating the feasibility of RFID and mobile technology in the healthcare environment, a pilot study was conducted in Mindset Club in the Castle Peak Hospital in Hong Kong.

Gaia Science Alerts: Early Validation Phase Data from Gaia

Science.gov (United States)

Walton, Nicholas; Hodgkin, Simon; van Leeuwen, Floor

2015-08-01

The ESA Gaia satellite launched Dec 2013, and after successful completion of its in orbit commissioning in July 2014, begun routine operations, with the aim to accurately measure the astrometric and astrophysical properties of more than a billion stars in our Milky Way.As a significant by product of its observational scanning law, where each point on the sky is observed multiple times (~80 revisits on average) over the nominal 5 year mission, Gaia has significant utility in detecting new transients, both flux (e.g. Supernovae, Flare stars) and positional (e.g. Asteroids).We will present the current status of the Gaia Photometric Science Alerts (PSA) system that has been developed within the Gaia DPAC. The PSA pipeline provides a quick look analysis of the daily data stream from Gaia, and identifies new photometric alerts, from analysis of the object photometric and the low resolution spectro-photometric data. Via a set of filters, those identified as astrophysical in nature, are published to the community. The information provided currently includes positional and flux information.The Gaia Alerts working group has organised a significant early stage followup campaign, providing access to a wide variety of followup facilities. These have been used to provide classification spectra of the Gaia alert candidates, with the early phase data confirming that the alerts issued are indeed largely astrophysical transients, with only a small contamination rate.The presentation will address the early phase issues that have been addressed in localising and classifying alerts in the early phase of Gaia observations (for instance, how lack of early knowledge of the sky as seen by Gaia was mitigated by reference to external image data), and how the alert rate published by the PSA will ramp up towards the end of 2015, with the availability of more Gaia sky data.Information concerning the Gaia alerts system can be found at http://gaia.ac.uk/selected-gaia-science-alerts

75 FR 26269 - Draft Programmatic Environmental Assessment for the Integrated Public Alert and Warning Program's...

Science.gov (United States)

2010-05-11

... system to alert and warn the American people in situations of war, terrorist attack, natural disaster, or... Order 13407, Public Alert and Warning System, by providing robust and survivable power generation, fuel... of interoperable public alert and warning systems, to identify technologies and standards that...

A Bowen Family Systems Model of Generalized Anxiety Disorder and Romantic Relationship Distress.

Science.gov (United States)

Priest, Jacob B

2015-07-01

Many individuals with generalized anxiety disorder (GAD) do not respond well to currently available treatments. Moreover, treatments are less effective when GAD is accompanied by romantic relationship distress. In order to develop effective treatments for GAD and relationship distress, it is necessary to conduct theory-based research to identify links common to both GAD and romantic relationship distress. Drawing on Bowen's family systems theory, the roles of family abuse/violence and differentiation in GAD and romantic relationship distress were examined using existing data from the National Comorbidity Survey Replication (n = 2,312; 2005). As predicted, family abuse/violence was directly linked to both GAD and romantic relationship distress. Differentiation mediated the relationship between family abuse/violence and GAD, and partially mediated the relationship between family abuse/violence and romantic relationship distress. Findings suggest that current and past relationship processes may help maintain chronic anxiety and that Bowen's theory may be a useful framework for developing couple therapy treatment of GAD and romantic relationship distress. © 2013 American Association for Marriage and Family Therapy.

Implementation Of CAN Based Intelligent Driver Alert System

Directory of Open Access Journals (Sweden)

Yin Mar Win Kyaw Myo Maung Maung

2015-08-01

Full Text Available This system is an attempt to analyze Intelligent Driver Alert System Using CAN Protocol. CAN Controller Area Network offer an efficient communication protocol among sensors actuators controllers and other nodes in real-time applications and is known for its simplicity reliability and high performance. It has given an effective way by which can increase the car and driver safety. This system presents the development and implementation of a digital driving system for a semi-autonomous vehicle to improve the driver-vehicle interface using microcontroller based data acquisition system that uses ADC to bring all control data from analog to digital format. In this system the signal information like temperature LM35 sensor if the temperature increase above the 60 o C and ultrasonic sensor is adapted to measure the distance between the object and vehicle if obstacle is detected within 75cm from the vehicle the controller gives buzzer to the driver speed measure using RPM sensor if revolution increase up to 1200 per minute controller act and to avoid the maximum revolution and to check the fuel level continuously and display in the percentage if fuel level below 20 percent the controller also gives buzzer to the driver and distance fuel level and temperature continuously display on the LCD.

Multicenter Clinical Evaluation of BacT/Alert Virtuo Blood Culture System.

Science.gov (United States)

Jacobs, Michael R; Mazzulli, Tony; Hazen, Kevin C; Good, Caryn E; Abdelhamed, Ayman M; Lo, Pauline; Shum, Bianche; Roman, Katharine P; Robinson, Danielle C

2017-08-01

BacT/Alert Virtuo is an advanced, automated blood culture system incorporating improved automation and an enhanced detection algorithm to shorten time to detection. A multicenter study of the investigational Virtuo system (bioMérieux, Inc., Durham, NC) compared to BacT/Alert 3D (BTA3D) for detection of bacteremia/fungemia in four bottle types, SA and FA Plus (aerobic) and SN and FN Plus (anaerobic), was performed in a clinical setting with patient samples in a matched system design clinical trial. Blood was added to paired aerobic or anaerobic bottles, with the volume in each bottle in each pair required to be ≤10 ml and with the volumes required to be within 30% of each other. Of 5,709 bottle sets (52.5% aerobic pairs and 47.5% anaerobic pairs), 430 (7.5%) were positive for bacterial or fungal growth, with 342 (6.0%) clinically significant and 83 (1.5%) contaminated. A total of 3,539 sets (62.0%) were volume compliant, with 203 sets (5.7%) clinically significant. The positivity rates for volume-compliant bottle pairs determined by the two systems were comparable, with 68.7% of clinically significant isolates detected by both instruments, 15.7% by Virtuo only, and 15.7% by BTA3D only. Virtuo detected microbial growth nearly 2 h sooner overall than BTA3D (mean, 15.9 h versus 17.7 h). Shorter time to detection by Virtuo was related to organism group, with the time to detection being significantly shorter for enteric Gram-negative bacilli and enterococci (means, 3.6 h and 2.3 h shorter, respectively). This large clinical study demonstrated that the Virtuo blood culture system produced results comparable to those seen with the long-established BTA3D system, with significantly shorter time to detection. Copyright © 2017 Jacobs et al.

Use of Circadian Lighting System to improve night shift alertness and performance of NRC Headquarters Operations Officers

International Nuclear Information System (INIS)

Baker, T.L.; Morisseau, D.; Murphy, N.M.

1995-01-01

The Nuclear Regulatory Commission's (NRC) Headquarters Operations Officers (HOOs) receive and respond to events reported in the nuclear industry on a 24-hour basis. The HOOs have reported reduced alertness on the night shift, leading to a potential deterioration in their on-shift cognitive performance during the early morning hours. For some HOOs, maladaptation to the night shift was also reported to be the principal cause of: (a) reduced alertness during the commute to and from work, (b) poor sleep quality, and (c) personal lifestyle problems. ShiftWork Systems, Inc. (SWS) designed and installed a Circadian Lighting System (CLS) at both the Bethesda and Rockville HOO stations with the goal of facilitating the HOOs physiological adjustment to their night shift schedules. The data indicate the following findings: less subjective fatigue on night shifts; improved night shift alertness and mental performance; higher HOO confidence in their ability to assess event reports; longer, deeper and more restorative day sleep after night duty shifts; swifter adaptation to night work; and a safer commute, particularly for those with extensive drives

Use of Circadian Lighting System to improve night shift alertness and performance of NRC Headquarters Operations Officers

Energy Technology Data Exchange (ETDEWEB)

Baker, T.L.; Morisseau, D.; Murphy, N.M. [ShiftWork Systems, Cambridge, MA (United States)] [and others

1995-04-01

The Nuclear Regulatory Commission`s (NRC) Headquarters Operations Officers (HOOs) receive and respond to events reported in the nuclear industry on a 24-hour basis. The HOOs have reported reduced alertness on the night shift, leading to a potential deterioration in their on-shift cognitive performance during the early morning hours. For some HOOs, maladaptation to the night shift was also reported to be the principal cause of: (a) reduced alertness during the commute to and from work, (b) poor sleep quality, and (c) personal lifestyle problems. ShiftWork Systems, Inc. (SWS) designed and installed a Circadian Lighting System (CLS) at both the Bethesda and Rockville HOO stations with the goal of facilitating the HOOs physiological adjustment to their night shift schedules. The data indicate the following findings: less subjective fatigue on night shifts; improved night shift alertness and mental performance; higher HOO confidence in their ability to assess event reports; longer, deeper and more restorative day sleep after night duty shifts; swifter adaptation to night work; and a safer commute, particularly for those with extensive drives.

Radiation Alert Immediate Disclosure, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — Invocon's Radiation Alert Immediate Disclosure (RAID) system is a miniature, low-power, real-time, active radiation badge. It is designed for monitoring personnel,...

Commonly used stimulants: Sleep problems, dependence and psychological distress.

Science.gov (United States)

Ogeil, Rowan P; Phillips, James G

2015-08-01

Caffeine and nicotine are commonly used stimulants that enhance alertness and mood. Discontinuation of both stimulants is associated with withdrawal symptoms including sleep and mood disturbances, which may differ in males and females. The present study examines changes in sleep quality, daytime sleepiness and psychological distress associated with use and dependence on caffeine and nicotine. An online survey comprising validated tools to assess sleep quality, excessive daytime sleepiness and psychological distress was completed by 166 participants (74 males, 96 females) with a mean age of 28 years. Participants completed the study in their own time, and were not offered any inducements to participate. Sleep quality was poorer in those dependent upon caffeine or nicotine, and there were also significant interaction effects with gender whereby females reported poorer sleep despite males reporting higher use of both stimulants. Caffeine dependence was associated with poorer sleep quality, increased daytime dysfunction, and increased levels of night time disturbance, while nicotine dependence was associated with poorer sleep quality and increased use of sleep medication and sleep disturbances. There were strong links between poor sleep and diminished affect, with psychological distress found to co-occur in the context of disturbed sleep. Stimulants are widely used to promote vigilance and mood; however, dependence on commonly used drugs including caffeine and nicotine is associated with decrements in sleep quality and increased psychological distress, which may be compounded in female dependent users. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A new CERN Alerter mechanism

CERN Multimedia

2007-01-01

A new version of the CERN Alerter used for sending urgent messages was installed in July on all centrally managed NICE computers. This latest version is based on RSS (Really Simple Syndication) and all alerts are now displayed in an Internet Explorer window (see the picture). You can print the window by right-clicking on the alert background and selecting the Print option from the menu. If the message is not urgent, then the alert will only appear as a "balloon" window the following morning or at next logon. Non-Windows computers can also subscribe to this service by using their browser as an RSS reader (Really Simple Syndication). All recent web browsers can act as RSS readers, including Firefox and Safari. Simply subscribe to the following RSS feed: http://cern.ch/cernalerts/alerts.aspx to see all messages sent by the central services. More information on the CERN Alerter is available at: https://cern.ch/winservices/Help/?kbid=060810. Documentation on reading RSS feeds fr...

A new CERN Alerter mechanism

CERN Multimedia

2007-01-01

A new version of the CERN Alerter used for sending urgent messages was installed in July on all centrally managed NICE computers. This latest version is based on RSS (Really Simple Syndication) and all alerts are now displayed in an Internet Explorer window (see picture). You can print the window by right-clicking on the alert background and selecting the Print option from the menu. If the message is not urgent, the alert will only appear as a "balloon" window the following morning or at next log-on. Non-Windows computers can also subscribe to this service by using their browser as an RSS reader. All recent web browsers can act as RSS readers, including Firefox and Safari. Simply subscribe to the following RSS feed: http://cern.ch/cernalerts/alerts.aspx to see all messages sent by the central services. More information on the CERN Alerter is available at: https://cern.ch/winservices/Help/?kbid=060810. Documentation on reading RSS fee...

A clinical data warehouse-based process for refining medication orders alerts.

Science.gov (United States)

Boussadi, Abdelali; Caruba, Thibaut; Zapletal, Eric; Sabatier, Brigitte; Durieux, Pierre; Degoulet, Patrice

2012-01-01

The objective of this case report is to evaluate the use of a clinical data warehouse coupled with a clinical information system to test and refine alerts for medication orders control before they were fully implemented. A clinical decision rule refinement process was used to assess alerts. The criteria assessed were the frequencies of alerts for initial prescriptions of 10 medications whose dosage levels depend on renal function thresholds. In the first iteration of the process, the frequency of the 'exceeds maximum daily dose' alerts was 7.10% (617/8692), while that of the 'under dose' alerts was 3.14% (273/8692). Indicators were presented to the experts. During the different iterations of the process, 45 (16.07%) decision rules were removed, 105 (37.5%) were changed and 136 new rules were introduced. Extensive retrospective analysis of physicians' medication orders stored in a clinical data warehouse facilitates alert optimization toward the goal of maximizing the safety of the patient and minimizing overridden alerts.

75 FR 67201 - Flightcrew Alerting

Science.gov (United States)

2010-11-02

... two different senses for warning and caution alerts. Identifying an alert and determining corrective... pilots to the urgency that should be associated with the meaning of these colors, which could increase... consistent and standardized color usage is desirable to ensure the pilot understands the urgency of an alert...

Sensor Alerting Capability

Science.gov (United States)

Henriksson, Jakob; Bermudez, Luis; Satapathy, Goutam

2013-04-01

There is a large amount of sensor data generated today by various sensors, from in-situ buoys to mobile underwater gliders. Providing sensor data to the users through standardized services, language and data model is the promise of OGC's Sensor Web Enablement (SWE) initiative. As the amount of data grows it is becoming difficult for data providers, planners and managers to ensure reliability of data and services and to monitor critical data changes. Intelligent Automation Inc. (IAI) is developing a net-centric alerting capability to address these issues. The capability is built on Sensor Observation Services (SOSs), which is used to collect and monitor sensor data. The alerts can be configured at the service level and at the sensor data level. For example it can alert for irregular data delivery events or a geo-temporal statistic of sensor data crossing a preset threshold. The capability provides multiple delivery mechanisms and protocols, including traditional techniques such as email and RSS. With this capability decision makers can monitor their assets and data streams, correct failures or be alerted about a coming phenomena.

Provider risk factors for medication administration error alerts: analyses of a large-scale closed-loop medication administration system using RFID and barcode.

Science.gov (United States)

Hwang, Yeonsoo; Yoon, Dukyong; Ahn, Eun Kyoung; Hwang, Hee; Park, Rae Woong

2016-12-01

To determine the risk factors and rate of medication administration error (MAE) alerts by analyzing large-scale medication administration data and related error logs automatically recorded in a closed-loop medication administration system using radio-frequency identification and barcodes. The subject hospital adopted a closed-loop medication administration system. All medication administrations in the general wards were automatically recorded in real-time using radio-frequency identification, barcodes, and hand-held point-of-care devices. MAE alert logs recorded during a full 1 year of 2012. We evaluated risk factors for MAE alerts including administration time, order type, medication route, the number of medication doses administered, and factors associated with nurse practices by logistic regression analysis. A total of 2 874 539 medication dose records from 30 232 patients (882.6 patient-years) were included in 2012. We identified 35 082 MAE alerts (1.22% of total medication doses). The MAE alerts were significantly related to administration at non-standard time [odds ratio (OR) 1.559, 95% confidence interval (CI) 1.515-1.604], emergency order (OR 1.527, 95%CI 1.464-1.594), and the number of medication doses administered (OR 0.993, 95%CI 0.992-0.993). Medication route, nurse's employment duration, and working schedule were also significantly related. The MAE alert rate was 1.22% over the 1-year observation period in the hospital examined in this study. The MAE alerts were significantly related to administration time, order type, medication route, the number of medication doses administered, nurse's employment duration, and working schedule. The real-time closed-loop medication administration system contributed to improving patient safety by preventing potential MAEs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Building a Communication, Education, an Outreach Program for the ShakeAlert National Earthquake Early Warning Program - Recommendations for Public Alerts Via Cell Phones

Science.gov (United States)

DeGroot, R. M.; Long, K.; Strauss, J. A.

2017-12-01

The United States Geological Survey (USGS) and its partners are developing the ShakeAlert Earthquake Early Warning System for the West Coast of the United States. To be an integral part of successful implementation, ShakeAlert engagement programs and materials must integrate with and leverage broader earthquake risk programs. New methods and products for dissemination must be multidisciplinary, cost effective, and consistent with existing hazards education and communication efforts. The ShakeAlert Joint Committee for Communication, Education, and Outreach (JCCEO), is identifying, developing, and cultivating partnerships with ShakeAlert stakeholders including Federal, State, academic partners, private companies, policy makers, and local organizations. Efforts include developing materials, methods for delivery, and reaching stakeholders with information on ShakeAlert, earthquake preparedness, and emergency protective actions. It is essential to develop standards to ensure information communicated via the alerts is consistent across the public and private sector and achieving a common understanding of what actions users take when they receive a ShakeAlert warning. In February 2017, the JCCEO convened the Warning Message Focus Group (WMFG) to provide findings and recommendations to the Alliance for Telecommunications Industry Solutions on the use of earthquake early warning message content standards for public alerts via cell phones. The WMFG represents communications, education, and outreach stakeholders from various sectors including ShakeAlert regional coordinators, industry, emergency managers, and subject matter experts from the social sciences. The group knowledge was combined with an in-depth literature review to ensure that all groups who could receive the message would be taken into account. The USGS and the participating states and agencies acknowledge that the implementation of ShakeAlert is a collective effort requiring the participation of hundreds of

Contributors to Frequent Telehealth Alerts Including False Alerts for Patients with Heart Failure: A Mixed Methods Exploration

Science.gov (United States)

Radhakrishna, K.; Bowles, K.; Zettek-Sumner, A.

2013-01-01

Summary Background Telehealth data overload through high alert generation is a significant barrier to sustained adoption of telehealth for managing HF patients. Objective To explore the factors contributing to frequent telehealth alerts including false alerts for Medicare heart failure (HF) patients admitted to a home health agency. Materials and Methods A mixed methods design that combined quantitative correlation analysis of patient characteristic data with number of telehealth alerts and qualitative analysis of telehealth and visiting nurses’ notes on follow-up actions to patients’ telehealth alerts was employed. All the quantitative and qualitative data was collected through retrospective review of electronic records of the home heath agency. Results Subjects in the study had a mean age of 83 (SD = 7.6); 56% were female. Patient co-morbidities (ppatient characteristics along with establishing patient-centered telehealth outcome goals may allow meaningful generation of telehealth alerts. Reducing avoidable telehealth alerts could vastly improve the efficiency and sustainability of telehealth programs for HF management. PMID:24454576

Randomized Trial of Intelligent Sensor System for Early Illness Alerts in Senior Housing.

Science.gov (United States)

Rantz, Marilyn; Phillips, Lorraine J; Galambos, Colleen; Lane, Kari; Alexander, Gregory L; Despins, Laurel; Koopman, Richelle J; Skubic, Marjorie; Hicks, Lanis; Miller, Steven; Craver, Andy; Harris, Bradford H; Deroche, Chelsea B

2017-10-01

Measure the clinical effectiveness and cost effectiveness of using sensor data from an environmentally embedded sensor system for early illness recognition. This sensor system has demonstrated in pilot studies to detect changes in function and in chronic diseases or acute illnesses on average 10 days to 2 weeks before usual assessment methods or self-reports of illness. Prospective intervention study in 13 assisted living (AL) communities of 171 residents randomly assigned to intervention (n=86) or comparison group (n=85) receiving usual care. Intervention participants lived with the sensor system an average of one year. Continuous data collected 24 hours/7 days a week from motion sensors to measure overall activity, an under mattress bed sensor to capture respiration, pulse, and restlessness as people sleep, and a gait sensor that continuously measures gait speed, stride length and time, and automatically assess for increasing fall risk as the person walks around the apartment. Continuously running computer algorithms are applied to the sensor data and send health alerts to staff when there are changes in sensor data patterns. The randomized comparison group functionally declined more rapidly than the intervention group. Walking speed and several measures from GaitRite, velocity, step length left and right, stride length left and right, and the fall risk measure of functional ambulation profile (FAP) all had clinically significant changes. The walking speed increase (worse) and velocity decline (worse) of 0.073 m/s for comparison group exceeded 0.05 m/s, a value considered to be a minimum clinically important difference. No differences were measured in health care costs. These findings demonstrate that sensor data with health alerts and fall alerts sent to AL nursing staff can be an effective strategy to detect and intervene in early signs of illness or functional decline. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published

Enhanced 911/global position system wizard: a telemedicine application for the prevention of severe hypoglycemia--monitor, alert, and locate.

Science.gov (United States)

Dassau, Eyal; Jovanovic, Lois; Doyle, Francis J; Zisser, Howard C

2009-11-01

Intensive insulin therapy has an inherent risk of hypoglycemia that can lead to loss of consciousness, cardiac arrhythmia, seizure, and death ("dead-in-bed syndrome"). This risk of hypoglycemia is a major concern for patients, families, and physicians. The need for an automated system that can alert in the event of severe hypoglycemia is evident. In engineering systems, where there is a risk of malfunction of the primary control system, alert and safety mechanisms are implemented in layers of protection. This concept has been adopted in the proposed system that integrates a hypoglycemia prediction algorithm with a global position system (GPS) locator and short message service such that the current glucose value with the rate of change (ROC) and the location of the subject can be communicated to a predefined list. Furthermore, if the system is linked to the insulin pump, it can suspend the pump or decrease the basal insulin infusion rate to prevent the pending event. The system was evaluated on clinical datasets of glucose tracings from the DexCom Seven system. Glucose tracings were analyzed for hypoglycemia events and then a text message was broadcast to a predefined list of people who were notified with the glucose value, ROC, GPS coordinates, and a Google map of the location. In addition to providing a safety layer to a future artificial pancreas, this system also can be easily implemented in current continuous glucose monitors to help provide information and alerts to people with diabetes.

Influencing Anesthesia Provider Behavior Using Anesthesia Information Management System Data for Near Real-Time Alerts and Post Hoc Reports.

Science.gov (United States)

Epstein, Richard H; Dexter, Franklin; Patel, Neil

2015-09-01

In this review article, we address issues related to using data from anesthesia information management systems (AIMS) to deliver near real-time alerts via AIMS workstation popups and/or alphanumeric pagers and post hoc reports via e-mail. We focus on reports and alerts for influencing the behavior of anesthesia providers (i.e., anesthesiologists, anesthesia residents, and nurse anesthetists). Multiple studies have shown that anesthesia clinical decision support (CDS) improves adherence to protocols and increases financial performance through facilitation of billing, regulatory, and compliance documentation; however, improved clinical outcomes have not been demonstrated. We inform developers and users of feedback systems about the multitude of concerns to consider during development and implementation of CDS to increase its effectiveness and to mitigate its potentially disruptive aspects. We discuss the timing and modalities used to deliver messages, implications of outlier-only versus individualized feedback, the need to consider possible unintended consequences of such feedback, regulations, sustainability, and portability among systems. We discuss statistical issues related to the appropriate evaluation of CDS efficacy. We provide a systematic review of the published literature (indexed in PubMed) of anesthesia CDS and offer 2 case studies of CDS interventions using AIMS data from our own institution illustrating the salient points. Because of the considerable expense and complexity of maintaining near real-time CDS systems, as compared with providing individual reports via e-mail after the fact, we suggest that if the same goal can be accomplished via delayed reporting versus immediate feedback, the former approach is preferable. Nevertheless, some processes require near real-time alerts to produce the desired improvement. Post hoc e-mail reporting from enterprise-wide electronic health record systems is straightforward and can be accomplished using system

Time-to-detection of bacteria and yeast with the BACTEC FX versus BacT/Alert Virtuo blood culture systems.

Science.gov (United States)

Somily, Ali Mohammed; Habib, Hanan Ahmed; Torchyan, Armen Albert; Sayyed, Samina B; Absar, Muhammed; Al-Aqeel, Rima; Binkhamis, A Khalifa

2018-01-01

Bloodstream infections are associated with high rates of morbidity and mortality. Rapid detection of bloodstream infections is important in achieving better patient outcomes. Compare the time-to-detection (TTD) of the new BacT/Alert Virtuo and the BACTEC FX automated blood culture systems. Prospective simulated comparison of two instruments using seeded samples. Medical microbiology laboratory. Blood culture bottles were seeded in triplicate with each of the standard ATCC strains of aerobes, anaerobes and yeast. TTD was calculated as the length of time from the beginning of culture incubation to the detection of bacterial growth. TTD for the various tested organisms on the two microbial detection systems. The 99 bottles of seeded blood cultures incubated in each of the blood culture systems included 21 anaerobic, 39 aerobic and 39 pediatric bottles. The BacT/Alert Virtuo system exhibited significantly shorter TTD for 72.7 % of the tested organisms compared to BACTEC FX system with a median difference in mean TTD of 2.1 hours (interquartile range: 1.5-3.5 hours). The BACTEC FX system was faster in 15.2% (5/33) of microorganisms, with a median difference in mean TTD of 25.9 hours (IQR: 9.1-29.2 hours). TTD was significantly shorter for most of the microorganisms tested on the new BacT/Alert Virtuo system compared to the BACTEC FX system. Use of simulated cultures to assess TTD may not precisely represent clinical blood cultures. None.

Evaluation of a National Call Center and a Local Alerts System for Detection of New Cases of Ebola Virus Disease - Guinea, 2014-2015.

Science.gov (United States)

Lee, Christopher T; Bulterys, Marc; Martel, Lise D; Dahl, Benjamin A

2016-03-11

The epidemic of Ebola virus disease (Ebola) in West Africa began in Guinea in late 2013 (1), and on August 8, 2014, the World Health Organization (WHO) declared the epidemic a Public Health Emergency of International Concern (2). Guinea was declared Ebola-free on December 29, 2015, and is under a 90 day period of enhanced surveillance, following 3,351 confirmed and 453 probable cases of Ebola and 2,536 deaths (3). Passive surveillance for Ebola in Guinea has been conducted principally through the use of a telephone alert system. Community members and health facilities report deaths and suspected Ebola cases to local alert numbers operated by prefecture health departments or to a national toll-free call center. The national call center additionally functions as a source of public health information by responding to questions from the public about Ebola. To evaluate the sensitivity of the two systems and compare the sensitivity of the national call center with the local alerts system, the CDC country team performed probabilistic record linkage of the combined prefecture alerts database, as well as the national call center database, with the national viral hemorrhagic fever (VHF) database; the VHF database contains records of all known confirmed Ebola cases. Among 17,309 alert calls analyzed from the national call center, 71 were linked to 1,838 confirmed Ebola cases in the VHF database, yielding a sensitivity of 3.9%. The sensitivity of the national call center was highest in the capital city of Conakry (11.4%) and lower in other prefectures. In comparison, the local alerts system had a sensitivity of 51.1%. Local public health infrastructure plays an important role in surveillance in an epidemic setting.

Simplify the interpretation of alert lists for clinical mastitis in automatic

NARCIS (Netherlands)

Steeneveld, W.; Gaag, van der M.A.; Barkema, H.W.; Hogeveen, H.

2010-01-01

Based on sensor measurements, an automatic milking system (AMS) generates mastitis alert lists indicating cows which are likely to have clinical mastitis (CM). Because of the general assumption of equal probabilities of developing CM for all cows, all alerts on the list have the same success rate.

Sounding the Alert: Designing an Effective Voice for Earthquake Early Warning

Science.gov (United States)

Burkett, E. R.; Given, D. D.

2015-12-01

The USGS is working with partners to develop the ShakeAlert Earthquake Early Warning (EEW) system (http://pubs.usgs.gov/fs/2014/3083/) to protect life and property along the U.S. West Coast, where the highest national seismic hazard is concentrated. EEW sends an alert that shaking from an earthquake is on its way (in seconds to tens of seconds) to allow recipients or automated systems to take appropriate actions at their location to protect themselves and/or sensitive equipment. ShakeAlert is transitioning toward a production prototype phase in which test users might begin testing applications of the technology. While a subset of uses will be automated (e.g., opening fire house doors), other applications will alert individuals by radio or cellphone notifications and require behavioral decisions to protect themselves (e.g., "Drop, Cover, Hold On"). The project needs to select and move forward with a consistent alert sound to be widely and quickly recognized as an earthquake alert. In this study we combine EEW science and capabilities with an understanding of human behavior from the social and psychological sciences to provide insight toward the design of effective sounds to help best motivate proper action by alert recipients. We present a review of existing research and literature, compiled as considerations and recommendations for alert sound characteristics optimized for EEW. We do not yet address wording of an audible message about the earthquake (e.g., intensity and timing until arrival of shaking or possible actions), although it will be a future component to accompany the sound. We consider pitch(es), loudness, rhythm, tempo, duration, and harmony. Important behavioral responses to sound to take into account include that people respond to discordant sounds with anxiety, can be calmed by harmony and softness, and are innately alerted by loud and abrupt sounds, although levels high enough to be auditory stressors can negatively impact human judgment.

ECG Holter monitor with alert system and mobile application

Science.gov (United States)

Teron, Abigail C.; Rivera, Pedro A.; Goenaga, Miguel A.

2016-05-01

This paper proposes a new approach on the Holter monitor by creating a portable Electrocardiogram (ECG) Holter monitor that will alert the user by detecting abnormal heart beats using a digital signal processing software. The alarm will be triggered when the patient experiences arrhythmias such as bradycardia and tachycardia. The equipment is simple, comfortable and small in size that fit in the hand. It can be used at any time and any moment by placing three leads to the person's chest which is connected to an electronic circuit. The ECG data will be transmitted via Bluetooth to the memory of a selected mobile phone using an application that will store the collected data for up to 24 hrs. The arrhythmia is identified by comparing the reference signals with the user's signal. The diagnostic results demonstrate that the ECG Holter monitor alerts the user when an arrhythmia is detected thru the Holter monitor and mobile application.

Dynamic malware containment under an epidemic model with alert

Science.gov (United States)

Zhang, Tianrui; Yang, Lu-Xing; Yang, Xiaofan; Wu, Yingbo; Tang, Yuan Yan

2017-03-01

Alerting at the early stage of malware invasion turns out to be an important complement to malware detection and elimination. This paper addresses the issue of how to dynamically contain the prevalence of malware at a lower cost, provided alerting is feasible. A controlled epidemic model with alert is established, and an optimal control problem based on the epidemic model is formulated. The optimality system for the optimal control problem is derived. The structure of an optimal control for the proposed optimal control problem is characterized under some conditions. Numerical examples show that the cost-efficiency of an optimal control strategy can be enhanced by adjusting the upper and lower bounds on admissible controls.

Unintended consequences of reducing QT-alert overload in a computerized physician order entry system

NARCIS (Netherlands)

I.H. van der Sijs (Heleen); R. Kowlesar (Ravi); J.E.C.M. Aarts (Jos); M. Berg (Marc); A.G. Vulto (Arnold); T. van Gelder (Teun)

2009-01-01

textabstractPurpose: After complaints of too many low-specificity drug-drug interaction (DDI) alerts on QT prolongation, the rules for QT alerting in the Dutch national drug database were restricted in 2007 to obviously QT-prolonging drugs. The aim of this virtual study was to investigate whether

The Design and Implementation of a Prototype Web-Portal for the Integrated Mobile Alerting System (IMAS)

National Research Council Canada - National Science Library

Le, Phong D; Hsu, Michael

2006-01-01

.... It demonstrates that a web-portal written in PHP script supported by a relational database is a good configuration for IMAS. Additionally, a proof of concept system that converts messages into disseminated mobile alerts is presented. This thesis marks the founding steps in developing the IMAS.

The results of the Seismic Alert System of Mexico SASMEX, during the earthquakes of 7 and 19 of September 2017

Science.gov (United States)

Espinosa Aranda, J. M., Sr.; Cuellar Martinez, A.

2017-12-01

The Seismic Alert System of Mexico, SASMEX began in 1991, is integrated by the seismic alert system of Mexico City and the seismic alert system of Oaxaca. SASMEX has 97 seismic sensors which are distributed in the seismic regions of the Pacific coast and the South of the Trans-Mexican Volcanic Belt of states of Jalisco, Colima, Michoacán, Guerrero, Oaxaca and Puebla. The alert dissemination covers the cities of: Acapulco, Chilpancingo, Morelia, Puebla, Oaxaca, Toluca and Mexico City, reaching the earthquake warnings to more than 25 millions of people. SASMEX has detected correctly more than 5600 earthquakes and warned 156. Mexico City has different alert dissemination systems like several Radio and Tv commercial broadcasters, dedicated radio receivers, EAS-SAME-SARMEX radio receivers and more tha 6700 public loud speakers. The other cities have only some of those systems. The Mw 8.2 Chiapas earthquake on September 7, despite the epicentral distance far of the first seismic detections (more than 180 km) and the low amplitudes of the P waves, the earthquake warning time gave more than 90 seconds to Mexico City before the arrivals of S waves with minor damages to the city in contrast with high damages in towns in the coast. This earthquake offered an opportunity to show the developments and lacks to reduce the risk, such as the need to increase the seismic detection coverage and the earthquake warning dissemination in towns with high seismic vulnerability. The Mw 7.1 Morelos earthquake on September 19 caused thousands of damages and hundreds of deaths and injuries in Mexico City, this earthquake is the second with the most damages after the Mw 8.1 Michoacán earthquake of September 19 on 1985. The earthquake early warning gave 11 seconds after the arrivals of S waves, however the activation occurred few seconds after the P waves arrives to Mexico City, and due to the seismic focus was near to the city, the P waves were felt for the people. The Accelerographic Network

A novel strategy for evaluating the effects of an electronic test ordering alert message: Optimizing cardiac marker use.

Science.gov (United States)

Baron, Jason M; Lewandrowski, Kent B; Kamis, Irina K; Singh, Balaji; Belkziz, Sidi M; Dighe, Anand S

2012-01-01

Laboratory ordering functions within computerized provider order entry (CPOE) systems typically support the display of electronic alert messages to improve test utilization or implement new ordering policies. However, alert strategies have been shown to vary considerably in their success and the characteristics contributing to an alert's success are poorly understood. Improved methodologies are needed to evaluate alerts and their mechanisms of action. Clinicians order inpatient and emergency department laboratory tests using our institutional CPOE system. We analyzed user interaction data captured by our CPOE system to evaluate how clinicians responded to an alert. We evaluated an alert designed to implement an institutional policy restricting the indications for ordering creatine kinase-MB (CKMB). Within 2 months of alert implementation, CKMB-associated searches declined by 79% with a corresponding decline in CKMB orders. Furthermore, while prior to alert implementation, clinicians searching for CKMB ultimately ordered this test 99% of the time, following implementation, only 60% of CKMB searches ultimately led to CKMB test orders. This difference presumably represents clinicians who reconsidered the need for CKMB in response to the alert, demonstrating the alert's just-in-time advisory capability. In addition, as clinicians repeatedly viewed the alert, there was a "dose-dependant" decrease in the fraction of searches without orders. This presumably reflects the alerting strategy's long-term educational component, as clinicians aware of the new policy will not search for CKMB when not indicated. Our analytic approach provides insight into the mechanism of a CPOE alert and demonstrates that alerts may act through a combination of just-in-time advice and longer term education. Use of this approach when implementing alerts may prove useful to improve the success of a given alerting strategy.

Communication of Unexpected and Significant Findings on Chest Radiographs With an Automated PACS Alert System.

LENUS (Irish Health Repository)

Hayes, Sara A

2014-08-01

An integral part of realizing the enormous potential of imaging in patient care is close communication between radiologists and referring physicians. One key element of this process is the communication of unexpected significant findings. The authors examined the performance of a PACS-based alert system in the appropriate communication of reports containing unexpected significant findings to referring physicians.

Automated health alerts from Kinect-based in-home gait measurements.

Science.gov (United States)

Stone, Erik E; Skubic, Marjorie; Back, Jessica

2014-01-01

A method for automatically generating alerts to clinicians in response to changes in in-home gait parameters is investigated. Kinect-based gait measurement systems were installed in apartments in a senior living facility. The systems continuously monitored the walking speed, stride time, and stride length of apartment residents. A framework for modeling uncertainty in the residents' gait parameter estimates, which is critical for robust change detection, is developed; along with an algorithm for detecting changes that may be clinically relevant. Three retrospective case studies, of individuals who had their gait monitored for periods ranging from 12 to 29 months, are presented to illustrate use of the alert method. Evidence suggests that clinicians could be alerted to health changes at an early stage, while they are still small and interventions may be most successful. Additional potential uses are also discussed.

Fibromyalgia: When Distress Becomes (Unsympathetic Pain

Directory of Open Access Journals (Sweden)

Manuel Martinez-Lavin

2012-01-01

Full Text Available Fibromyalgia is a painful stress-related disorder. A key issue in fibromyalgia research is to investigate how distress could be converted into pain. The sympathetic nervous system is the main element of the stress response system. In animal models, physical trauma, infection, or distressing noise can induce abnormal connections between the sympathetic nervous system and the nociceptive system. Dorsal root ganglia sodium channels facilitate this type of sympathetic pain. Similar mechanisms may operate in fibromyalgia. Signs of sympathetic hyperactivity have been described in this condition. Genetic factors and/or distressful lifestyle may lead to this state of sympathetic hyperactivity. Trauma and infection are recognized fibromyalgia triggers. Women who suffer from fibromyalgia have catecholamine-evoked pain. Sympathetic dysfunction may also explain nonpain-related fibromyalgia symptoms. In conclusion, in fibromyalgia, distress could be converted into pain through forced hyperactivity of the sympathetic component of the stress response system.

Population-based Post-crisis Psychological Distress: An Example From the SARS Outbreak in Taiwan

Science.gov (United States)

Peng, Eugene Yu-Chang; Lee, Ming-Been; Tsai, Shang-Ta; Yang, Chih-Chien; Morisky, Donald Edward; Tsai, Liang-Ting; Weng, Ya-Ling; Lyu, Shu-Yu

2011-01-01

Background/Purpose As a result of the severe acute respiratory syndrome (SARS) pandemic, the World Health Organization placed Taiwan on the travel alert list from May 21 to July 5, 2003. The aim of this study was to explore the post-crisis psychological distress among residents in Taiwan after the SARS epidemic. Methods The target population consisted of a nationwide representative sample of residents aged ≥ 18 years. Data were collected using computer assisted telephone interview systems by stratified random sampling according to geographic area. The survey (n = 1278) was conducted in November 2003, about 4 months after resolution of the SARS crisis in Taiwan. The maximum deviation of sampling error at the 95% confidence level was ± 2.74%. Psychological distress was measured by a question related to subject’s changes in perception of life, plus the five-item Brief Symptom Rating Scale. Multivariate logistic regression was used to examine the correlation of psychological distress. Results About 9.2% of the participants reported that their perceptions of life became more pessimistic following the SARS crisis. The prevalence of psychiatric morbidity was 11.7%. Major predictors of higher levels of pessimism after the SARS epidemic included demographic factors, perception of SARS and pre-paredness, knowing people or having personal experiences of SARS-related discrimination, and individual worries and psychiatric morbidity. The correlates of symptomatic cases, as indicated by the five-item Brief Symptom Rating Scale, included age ≥ 50 years, senior high school graduate, and worries about recurrence of SARS. Conclusion Psychological distress was significantly correlated with demographic factors and perception regarding the SARS epidemic. It is suggested that marketing of mental health education should be segmented according to age and education level, which should enhance crisis communication for newly emerging infectious diseases among community populations

Central nervous system involvement in the autonomic responses to psychological distress

NARCIS (Netherlands)

de Morree, H.M.; Szabó, B.M.; Rutten, G.J.; Kop, W.J.

2013-01-01

Psychological distress can trigger acute coronary syndromes and sudden cardiac death in vulnerable patients. The primary pathophysiological mechanism that plays a role in stress-induced cardiac events involves the autonomic nervous system, particularly disproportional sympathetic activation and

Reduced Effectiveness of Interruptive Drug-Drug Interaction Alerts after Conversion to a Commercial Electronic Health Record.

Science.gov (United States)

Wright, Adam; Aaron, Skye; Seger, Diane L; Samal, Lipika; Schiff, Gordon D; Bates, David W

2018-05-15

Drug-drug interaction (DDI) alerts in electronic health records (EHRs) can help prevent adverse drug events, but such alerts are frequently overridden, raising concerns about their clinical usefulness and contribution to alert fatigue. To study the effect of conversion to a commercial EHR on DDI alert and acceptance rates. Two before-and-after studies. 3277 clinicians who received a DDI alert in the outpatient setting. Introduction of a new, commercial EHR and subsequent adjustment of DDI alerting criteria. Alert burden and proportion of alerts accepted. Overall interruptive DDI alert burden increased by a factor of 6 from the legacy EHR to the commercial EHR. The acceptance rate for the most severe alerts fell from 100 to 8.4%, and from 29.3 to 7.5% for medium severity alerts (P fell by 50.5%, and acceptance of Tier 1 alerts rose from 9.1 to 12.7% (P < 0.01). Changing from a highly tailored DDI alerting system to a more general one as part of an EHR conversion decreased acceptance of DDI alerts and increased alert burden on users. The decrease in acceptance rates cannot be fully explained by differences in the clinical knowledge base, nor can it be fully explained by alert fatigue associated with increased alert burden. Instead, workflow factors probably predominate, including timing of alerts in the prescribing process, lack of differentiation of more and less severe alerts, and features of how users interact with alerts.

A novel strategy for evaluating the effects of an electronic test ordering alert message: Optimizing cardiac marker use

Directory of Open Access Journals (Sweden)

Jason M Baron

2012-01-01

Full Text Available Background: Laboratory ordering functions within computerized provider order entry (CPOE systems typically support the display of electronic alert messages to improve test utilization or implement new ordering policies. However, alert strategies have been shown to vary considerably in their success and the characteristics contributing to an alert′s success are poorly understood. Improved methodologies are needed to evaluate alerts and their mechanisms of action. Materials and Methods: Clinicians order inpatient and emergency department laboratory tests using our institutional CPOE system. We analyzed user interaction data captured by our CPOE system to evaluate how clinicians responded to an alert. We evaluated an alert designed to implement an institutional policy restricting the indications for ordering creatine kinase-MB (CKMB. Results: Within 2 months of alert implementation, CKMB-associated searches declined by 79% with a corresponding decline in CKMB orders. Furthermore, while prior to alert implementation, clinicians searching for CKMB ultimately ordered this test 99% of the time, following implementation, only 60% of CKMB searches ultimately led to CKMB test orders. This difference presumably represents clinicians who reconsidered the need for CKMB in response to the alert, demonstrating the alert′s just-in-time advisory capability. In addition, as clinicians repeatedly viewed the alert, there was a "dose-dependant" decrease in the fraction of searches without orders. This presumably reflects the alerting strategy′s long-term educational component, as clinicians aware of the new policy will not search for CKMB when not indicated. Conclusions: Our analytic approach provides insight into the mechanism of a CPOE alert and demonstrates that alerts may act through a combination of just-in-time advice and longer term education. Use of this approach when implementing alerts may prove useful to improve the success of a given alerting

Regulatory alerts for dietary supplements in Canada and the United States, 2005-13.

Science.gov (United States)

Abe, Andrew M; Hein, Darren J; Gregory, Philip J

2015-06-01

Dietary supplement regulatory alerts published by the Food and Drug Administration (FDA) and Health Canada were evaluated and characterized. FDA MedWatch and Health Canada websites were reviewed to identify regulatory alerts regarding dietary supplements from January 1, 2005, through December 31, 2013. Alerts were analyzed to identify product characteristics that may be predictive of product quality issues and potential patient harm. A total of 1560 dietary supplement-related regulatory alerts were identified. Of those, 1287 (83%) were identified through Health Canada, and 273 (18%) were identified through FDA MedWatch. The country of origin of dietary supplements associated with regulatory alerts was not provided in most regulatory alerts; however, when their origin was provided, the United States was the most common. Dietary supplements intended for sexual enhancement were the subject of 33% of all regulatory alerts identified. Products purchased online were the most likely to be associated with a regulatory alert. Dietary supplements intended for sexual enhancement, weight loss, and bodybuilding or athletic performance appeared to pose the greatest risk for patient harm due to product contamination with a pharmaceutical such as a phosphodiesterase-5 inhibitor or sibutramine. Analysis of Canadian and U.S. regulatory alerts concerning dietary supplements revealed that more than 80% of the composite alerts were issued by Health Canada. The most common intended uses of supplements for which alerts were issued were sexual enhancement, weight loss, and bodybuilding or athletic performance. The most common reason for alerts was the presence of a pharmaceutical contaminant. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Navigating moral distress using the moral distress map.

Science.gov (United States)

Dudzinski, Denise Marie

2016-05-01

The plethora of literature on moral distress has substantiated and refined the concept, provided data about clinicians' (especially nurses') experiences, and offered advice for coping. Fewer scholars have explored what makes moral distress moral If we acknowledge that patient care can be distressing in the best of ethical circumstances, then differentiating distress and moral distress may refine the array of actions that are likely to ameliorate it. This article builds upon scholarship exploring the normative and conceptual dimensions of moral distress and introduces a new tool to map moral distress from emotional source to corrective actions. The Moral Distress Map has proven useful in clinical teaching and ethics-related debriefings. 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/

Standardisation of the USGS Volcano Alert Level System (VALS): analysis and ramifications

Science.gov (United States)

Fearnley, C. J.; McGuire, W. J.; Davies, G.; Twigg, J.

2012-11-01

The standardisation of volcano early warning systems (VEWS) and volcano alert level systems (VALS) is becoming increasingly common at both the national and international level, most notably following UN endorsement of the development of globally comprehensive early warning systems. Yet, the impact on its effectiveness, of standardising an early warning system (EWS), in particular for volcanic hazards, remains largely unknown and little studied. This paper examines this and related issues through evaluation of the emergence and implementation, in 2006, of a standardised United States Geological Survey (USGS) VALS. Under this upper-management directive, all locally developed alert level systems or practices at individual volcano observatories were replaced with a common standard. Research conducted at five USGS-managed volcano observatories in Alaska, Cascades, Hawaii, Long Valley and Yellowstone explores the benefits and limitations this standardisation has brought to each observatory. The study concludes (1) that the process of standardisation was predominantly triggered and shaped by social, political, and economic factors, rather than in response to scientific needs specific to each volcanic region; and (2) that standardisation is difficult to implement for three main reasons: first, the diversity and uncertain nature of volcanic hazards at different temporal and spatial scales require specific VEWS to be developed to address this and to accommodate associated stakeholder needs. Second, the plural social contexts within which each VALS is embedded present challenges in relation to its applicability and responsiveness to local knowledge and context. Third, the contingencies of local institutional dynamics may hamper the ability of a standardised VALS to effectively communicate a warning. Notwithstanding these caveats, the concept of VALS standardisation clearly has continuing support. As a consequence, rather than advocating further commonality of a standardised

RSS based CERN Alerter. Information broadcast to all CERN offices.

CERN Multimedia

Otto, R

2007-01-01

Nearly every large organization uses a tool to broadcast messages and information across the internal campus (messages like alerts announcing interruption in services or just information about upcoming events). These tools typically allow administrators (operators) to send "targeted" messages which are sent only to specific groups of users or computers, e/g only those located in a specified building or connected to a particular computing service. CERN has a long history of such tools: CERNVMS€™s SPM_quotMESSAGE command, Zephyr and the most recent the NICE Alerter based on the NNTP protocol. The NICE Alerter used on all Windows-based computers had to be phased out as a consequence of phasing out NNTP at CERN. The new solution to broadcast information messages on the CERN campus continues to provide the service based on cross-platform technologies, hence minimizing custom developments and relying on commercial software as much as possible. The new system, called CERN Alerter, is based on RSS (Really Simpl...

Implementation of 'early alert system' area detector at patient from entrance in afterloading brachytherapy

International Nuclear Information System (INIS)

Videla Valdebenito, R.

2001-01-01

A system of area monitors to detect the involuntary exit of the radiation sources used in low dose rate deferred brachytherapy treatment is being implemented in all facilities in Chile. The first implementation of this system, named 'Early Alert', was 5 years ago as a complement to the administrative procedures and verification measures by the medical physics carried out through visual verifications and by means of portable radiation detectors. This detector of the system should be located preferentially at the exit of the treatment room at a height not smaller than two meters. This has resulted in an increase of facilities safety in this practice. (author) [es

Wireless Sensor Node for Autonomous Monitoring and Alerts in Remote Environments

Science.gov (United States)

Monacos, Steve P. (Inventor); Panangadan, Anand V. (Inventor)

2015-01-01

A method, apparatus, system, and computer program products provides personal alert and tracking capabilities using one or more nodes. Each node includes radio transceiver chips operating at different frequency ranges, a power amplifier, sensors, a display, and embedded software. The chips enable the node to operate as either a mobile sensor node or a relay base station node while providing a long distance relay link between nodes. The power amplifier enables a line-of-sight communication between the one or more nodes. The sensors provide a GPS signal, temperature, and accelerometer information (used to trigger an alert condition). The embedded software captures and processes the sensor information, provides a multi-hop packet routing protocol to relay the sensor information to and receive alert information from a command center, and to display the alert information on the display.

Understanding the context of network traffic alerts

NARCIS (Netherlands)

Cappers, B.C.M.; van Wijk, J.J.; Best, D.M.; Staheli, D.; Prigent, N.; Engle, S.; Harrison, L.

2016-01-01

For the protection of critical infrastructures against complex virus attacks, automated network traffic analysis and deep packet inspection are unavoidable. However, even with the use of network intrusion detection systems, the number of alerts is still too large to analyze manually. In addition,

Optimization of drug-drug interaction alert rules in a pediatric hospital's electronic health record system using a visual analytics dashboard.

Science.gov (United States)

Simpao, Allan F; Ahumada, Luis M; Desai, Bimal R; Bonafide, Christopher P; Gálvez, Jorge A; Rehman, Mohamed A; Jawad, Abbas F; Palma, Krisha L; Shelov, Eric D

2015-03-01

To develop and evaluate an electronic dashboard of hospital-wide electronic health record medication alerts for an alert fatigue reduction quality improvement project. We used visual analytics software to develop the dashboard. We collaborated with the hospital-wide Clinical Decision Support committee to perform three interventions successively deactivating clinically irrelevant drug-drug interaction (DDI) alert rules. We analyzed the impact of the interventions on care providers' and pharmacists' alert and override rates using an interrupted time series framework with piecewise regression. We evaluated 2 391 880 medication alerts between January 31, 2011 and January 26, 2014. For pharmacists, the median alert rate prior to the first DDI deactivation was 58.74 alerts/100 orders (IQR 54.98-60.48) and 25.11 alerts/100 orders (IQR 23.45-26.57) following the three interventions (pdashboard facilitated safe rapid-cycle reductions in alert burden that were temporally associated with lower pharmacist override rates in a subgroup of DDIs not directly affected by the interventions; meanwhile, the pharmacists' frequency of selecting the 'cancel' option increased. We hypothesize that reducing the alert burden enabled pharmacists to devote more attention to clinically relevant alerts. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Early alert system for oscillations detection applied to the Central of Laguna Verde

International Nuclear Information System (INIS)

Calleros M, G.; Zapata Y, M.; Avila N, A.; Herrera H, S. F.

2011-11-01

The code Early Alert System developed by Engineering of the Reactor of the nuclear power plant of Laguna Verde is presented, showing its reliability like preventive and corrective instrument to external interferences to the reactor core, due to equipment malfunction associated to the typical systems of a nuclear power plant, as those that control the reactor pressure, those that feed water to the reactor, those that control the valves of the main turbine. With this purpose, real cases of application of the System are shown where the results are compared with the independent evaluations carried out by the supplier, observing compatibility in both results. The benefits of the logarithm are discussed in the nuclear industry as soon as in non nuclear ambits. (Author)

Speech Auditory Alerts Promote Memory for Alerted Events in a Video-Simulated Self-Driving Car Ride.

Science.gov (United States)

Nees, Michael A; Helbein, Benji; Porter, Anna

2016-05-01

Auditory displays could be essential to helping drivers maintain situation awareness in autonomous vehicles, but to date, few or no studies have examined the effectiveness of different types of auditory displays for this application scenario. Recent advances in the development of autonomous vehicles (i.e., self-driving cars) have suggested that widespread automation of driving may be tenable in the near future. Drivers may be required to monitor the status of automation programs and vehicle conditions as they engage in secondary leisure or work tasks (entertainment, communication, etc.) in autonomous vehicles. An experiment compared memory for alerted events-a component of Level 1 situation awareness-using speech alerts, auditory icons, and a visual control condition during a video-simulated self-driving car ride with a visual secondary task. The alerts gave information about the vehicle's operating status and the driving scenario. Speech alerts resulted in better memory for alerted events. Both auditory display types resulted in less perceived effort devoted toward the study tasks but also greater perceived annoyance with the alerts. Speech auditory displays promoted Level 1 situation awareness during a simulation of a ride in a self-driving vehicle under routine conditions, but annoyance remains a concern with auditory displays. Speech auditory displays showed promise as a means of increasing Level 1 situation awareness of routine scenarios during an autonomous vehicle ride with an unrelated secondary task. © 2016, Human Factors and Ergonomics Society.

Alertness function of thalamus in conflict adaptation.

Science.gov (United States)

Wang, Xiangpeng; Zhao, Xiaoyue; Xue, Gui; Chen, Antao

2016-05-15

Conflict adaptation reflects the ability to improve current conflict resolution based on previously experienced conflict, which is crucial for our goal-directed behaviors. In recent years, the roles of alertness are attracting increasing attention when discussing the generation of conflict adaptation. However, due to the difficulty of manipulating alertness, very limited progress has been made in this line. Inspired by that color may affect alertness, we manipulated background color of experimental task and found that conflict adaptation significantly presented in gray and red backgrounds but did not in blue background. Furthermore, behavioral and functional magnetic resonance imaging results revealed that the modulation of color on conflict adaptation was implemented through changing alertness level. In particular, blue background eliminated conflict adaptation by damping the alertness regulating function of thalamus and the functional connectivity between thalamus and inferior frontal gyrus (IFG). In contrast, in gray and red backgrounds where alertness levels are typically high, the thalamus and the right IFG functioned normally and conflict adaptations were significant. Therefore, the alertness function of thalamus is determinant to conflict adaptation, and thalamus and right IFG are crucial nodes of the neural circuit subserving this ability. Present findings provide new insights into the neural mechanisms of conflict adaptation. Copyright © 2016 Elsevier Inc. All rights reserved.

The DOPA decarboxylase (DDC) gene is associated with alerting attention.

Science.gov (United States)

Zhu, Bi; Chen, Chuansheng; Moyzis, Robert K; Dong, Qi; Chen, Chunhui; He, Qinghua; Li, Jin; Li, Jun; Lei, Xuemei; Lin, Chongde

2013-06-03

DOPA decarboxylase (DDC) is involved in the synthesis of dopamine, norepinephrine and serotonin. It has been suggested that genes involved in the dopamine, norepinephrine, and cholinergic systems play an essential role in the efficiency of human attention networks. Attention refers to the cognitive process of obtaining and maintaining the alert state, orienting to sensory events, and regulating the conflicts of thoughts and behavior. The present study tested seven single nucleotide polymorphisms (SNPs) within the DDC gene for association with attention, which was assessed by the Attention Network Test to detect three networks of attention, including alerting, orienting, and executive attention, in a healthy Han Chinese sample (N=451). Association analysis for individual SNPs indicated that four of the seven SNPs (rs3887825, rs7786398, rs10499695, and rs6969081) were significantly associated with alerting attention. Haplotype-based association analysis revealed that alerting was associated with the haplotype G-A-T for SNPs rs7786398-rs10499695-rs6969081. These associations remained significant after correcting for multiple testing by max(T) permutation. No association was found for orienting and executive attention. This study provides the first evidence for the involvement of the DDC gene in alerting attention. A better understanding of the genetic basis of distinct attention networks would allow us to develop more effective diagnosis, treatment, and prevention of deficient or underdeveloped alerting attention as well as its related prevalent neuropsychiatric disorders. Copyright © 2012 Elsevier Inc. All rights reserved.

Non-visual effects of light on melatonin, alertness and cognitive performance: can blue-enriched light keep us alert?

Directory of Open Access Journals (Sweden)

Sarah Laxhmi Chellappa

Full Text Available BACKGROUND: Light exposure can cascade numerous effects on the human circadian process via the non-imaging forming system, whose spectral relevance is highest in the short-wavelength range. Here we investigated if commercially available compact fluorescent lamps with different colour temperatures can impact on alertness and cognitive performance. METHODS: Sixteen healthy young men were studied in a balanced cross-over design with light exposure of 3 different light settings (compact fluorescent lamps with light of 40 lux at 6500K and at 2500K and incandescent lamps of 40 lux at 3000K during 2 h in the evening. RESULTS: Exposure to light at 6500K induced greater melatonin suppression, together with enhanced subjective alertness, well-being and visual comfort. With respect to cognitive performance, light at 6500K led to significantly faster reaction times in tasks associated with sustained attention (Psychomotor Vigilance and GO/NOGO Task, but not in tasks associated with executive function (Paced Visual Serial Addition Task. This cognitive improvement was strongly related with attenuated salivary melatonin levels, particularly for the light condition at 6500K. CONCLUSIONS: Our findings suggest that the sensitivity of the human alerting and cognitive response to polychromatic light at levels as low as 40 lux, is blue-shifted relative to the three-cone visual photopic system. Thus, the selection of commercially available compact fluorescent lights with different colour temperatures significantly impacts on circadian physiology and cognitive performance at home and in the workplace.

Improving Radiology Workflow with Automated Examination Tracking and Alerts.

Science.gov (United States)

Pianykh, Oleg S; Jaworsky, Christina; Shore, M T; Rosenthal, Daniel I

2017-07-01

The modern radiology workflow is a production line where imaging examinations pass in sequence through many steps. In busy clinical environments, even a minor delay in any step can propagate through the system and significantly lengthen the examination process. This is particularly true for the tasks delegated to the human operators, who may be distracted or stressed. We have developed an application to track examinations through a critical part of the workflow, from the image-acquisition scanners to the PACS archive. Our application identifies outliers and actively alerts radiology managers about the need to resolve these problems as soon as they happen. In this study, we investigate how this real-time tracking and alerting affected the speed of examination delivery to the radiologist. We demonstrate that active alerting produced a 3-fold reduction of examination-to-PACS delays. Additionally, we discover an overall improvement in examination-to-PACS delivery, evidence that the tracking and alerts instill a culture where timely processing is essential. By providing supervisors with information about exactly where delays emerge in their workflow and alerting the correct staff to take action, applications like ours create more robust radiology workflow with predictable, timely outcomes. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

SC-228 Inclusion of DAA Warning Alert for TCAS Interoperability

Science.gov (United States)

Fern, Lisa

2016-01-01

This white paper summarizes NASA research results that have informed Special Committee 228 (SC-228) discussions and decisions regarding the inclusion of a warning-level alert within the detect and avoid (DAA) alerting structure for unmanned aircraft systems (UAS). For UAS, the removal of the pilot from onboard the aircraft has eliminated the ability of the ground-based pilot in command (PIC) to use out-the-window visual information to make judgments about a potential threat of a loss of well clear with another aircraft. As a result, the DAA traffic display will be the primary source of information that the PIC can use to execute the three primary well clear functions: 1) detect a potential loss of well clear, 2) determine a resolution maneuver, and 3) upload that maneuver to the aircraft via the ground control station (GCS). In addition, pilots are required to coordinate with air traffic control (ATC) prior to maneuvering off of their approved flight plan. In determining an appropriate resolution maneuver to avoid a loss of well clear, the PIC must decide both when and how to maneuver, and both the timeliness and the accuracy (i.e., correctness) of the maneuver are critical to reducing the likelihood and/or severity of a loss of well clear. Alerting information is one of three critical components of the DAA display, along with traffic information elements (e.g., relative heading, speed and altitude) and maneuver guidance. Alerting information and maneuver guidance, in particular, have been found to have a significant impact, both statistically and practically, on pilots' ability to avoid and minimize the severity of losses of well clear While all three display components are key to pilots performing the traffic avoidance task of remaining well clear, in general, alerting information provides crucial information about when a resolution maneuver is required while maneuver guidance assists the pilot in determining how best to maneuver. A fundamental task of the DAA

A Non-Intrusive Alert System for Maritime Anomalies: Literature Review and the Development and Assessment of Interface Design Concepts (Systeme d’Alerte non Intrusive en cas d’Anomalies Maritimes: Examen de la Documentation et Elaboration/Evaluation de Concepts d’Interface)

Science.gov (United States)

2009-03-01

visualisation , en l’occurrence un système d’alerte, qui aiderait les opérateurs du TSM à mieux connaître et comprendre les anomalies maritimes indiquées...and would much rather have an audio alert. Assessment While this paper recognises the need for the operator to configure appropriate alert...displayed on the screen). The intrusiveness filter would also allow leaders to turn off audio alerts, which could be especially important if there is a

A Logic Architecture for 360 ADAS-Alerts for Hazards Detection Based in Driver Actions

Directory of Open Access Journals (Sweden)

Izquierdo-Reyes Javier

2017-01-01

Full Text Available In this work is presented a novel approach for passive safety in vehicles by Advanced Driver Assistance Systems (ADAS alert emission in 360° around driver to notify about hazards nearby the vehicle depending on the actions taken by driver per the context. This proposal would create a more robust system compared to current passive ADAS systems since the feedback to driver is in the same direction that hazard is detected (Punctual Sound Source Alert, compared with most assistance systems that emits sounds from the monitor or from the dashboard provoking distractions when emits alerts unnecessarily. The increase of security by this method will allow the driver to be aware of their surroundings even in a very quiet cabin or in a noisy environment. Also, it would detect the steering wheel angle, speed of movement and the activation of turning lights among other alerts, which would allow us to define a critical action during driving; apart from using sensors and cameras aimed at the driver to detect patterns of movement during these critical actions and have a prediction of a possible turn or manoeuvre when driving, refer to Figure 1. It will be necessary a reconfiguration of the alert in frequency, time of action depending upon the level of risk to prevent an accident or to reduce the consequences in an imminent accident.

Design and Implementation of Distress Prevention System using a Beacon

Directory of Open Access Journals (Sweden)

Lee Imsu

2016-01-01

Full Text Available It was proven that human accidents due to mountain climbing occupy large proportion of recently occurred man-made disasters. This paper designed and implemented an application that tells users about a variety of accidents that frequently occur in mountain and shows dynamic information about mountain climbing. It designed ‘distress prevention system using beacon’. When using beacon, it can dynamically express information without using GPS. It has advantage of supporting BLE and has little Smartphone battery consumption. The application was developed based on Android as a prototype. We expect that the application developed in this paper can contribute to the protection of precious lives by helping quick rescue in case of emergency such as distress. Manager of mountain can control data regarding the mountain climbing accident where the related functions are provided through view and user authority setup in DBMS.

Alert Workplace From Healthcare Workers' Perspective: Behavioral and Environmental Strategies to Improve Vigilance and Alertness in Healthcare Settings.

Science.gov (United States)

Sagah Zadeh, Rana; Shepley, Mardelle; Sadatsafavi, Hessam; Owora, Arthur Hamie; Krieger, Ana C

2018-04-01

This study aims to identify the behavioral and environmental strategies that healthcare workers view as helpful for managing sleepiness, improving alertness, and therefore optimizing workplace safety. Reduced alertness is a common issue in healthcare work environments and is associated with impaired cognitive performance and decision-making ability as well as increased errors and injuries. We surveyed 136 healthcare professionals at a primary care clinic, an acute care hospital, and a mental health clinic. Nonstructured, semistructured, and structured questionnaires were used to elicit relevant information which was analyzed using qualitative content analysis and logistic regression models, respectively. In order by frequency of endorsement: dietary intervention; physical mobility; cognitive, sensory, or social stimulation; personal lifestyle strategies; and rest/nap opportunities were reported as behavioral strategies used to address workplace alertness. Compared to other environmental features, daylight and thermal comfort were perceived to be more important to addressing workplace alertness ( p based guidelines is needed to address sleepiness and alertness to improve workplace safety in healthcare facilities.

IP Telephony Based Danger Alert Communication System and Its Implementation

Directory of Open Access Journals (Sweden)

Filip Rezac

2012-01-01

Full Text Available The paper deals with development of a web application allowing to deliver pre-recorded voice messages by using SIP generator. The developed application is a part of complex system, which has been evolved in Dpt. of Telecommunications, Technical University of Ostrava for last three years. Our intent is focused on disaster management, the message, which should be delivered within specified time span, is typed in the application and text-to-speech module ensures its transormation to a speech format, after that a particular scenario or warned area is selected and a target group is automatically unloaded. For this purpose, we have defined XML format for delivery of phone numbers which are located in the target area and these numbers are obtained from mobile BTS's (Base transmission stations. The advantage of this aproach lies in controlled delivery and finally the list of unanswered calls is exported and these users are informed via SMS. In the paper, the core of the danger alert system is described including algorithms of the voice message delivery.

Moral distress in end-of-life care in the intensive care unit.

Science.gov (United States)

St Ledger, Una; Begley, Ann; Reid, Joanne; Prior, Lindsay; McAuley, Danny; Blackwood, Bronagh

2013-08-01

To explore moral distress in relatives doctors and nurses, in end-of-life care decision-making, in the adult intensive care unit. Many deaths in intensive care involve decisions about withholding and withdrawing therapy, potentially triggering moral distress. Moral distress occurs when individuals feel constrained from acting in accordance with moral choice, or act against moral judgement, generating painful, unresolved emotions, and problems that continue long after an event. Prior research has focused mainly on nurses; less is known about doctors' experiences and occurrence and impact on relatives is unknown. A narrative inquiry case study approach, funded by a Northern Ireland Health and Social Care Doctorate Fellowship Award (April 2011). In-depth digitally recorded interviews will be conducted with relatives, doctors, and nurses involved in end-of-life cases comprising: (1) withdrawal of therapy, including circulatory death organ donation; (2) non-escalation of therapy; and (3) brain stem death with a request for organ donation. Relatives will be offered the opportunity to share their experiences on 'Healthtalkonline' by copyrighting audio-visual interviews to the Health Experiences Research Group, Oxford University. Research Ethics Committee approval was obtained (April 2012). This is the first time that moral distress is explored, in a case approach, among relatives, doctors, and nurses intimately involved in end-of-life decisions in intensive care. Dissemination of findings will make a large contribution to international knowledge and understanding in this area and alert healthcare professionals and relatives to an otherwise under-recognized, but potentially detrimental, experience. Findings will inform education, practice, and policy. © 2012 Blackwell Publishing Ltd.

Development of satellite position location system for aircraft and boat distress beacons

Science.gov (United States)

Kahle, D. R.

1982-01-01

An international satellite system for the detection and location of distress beacons carried on aircraft and vessels is in its technical checkout phase. User demonstration and evaluation (D&E) will start in early 1983 and continue for two years. The D&E phase and a subsequent transition period will form the basis for improved search and rescue operations for the 1980's and beyond. The system, called COSPAS/SARSAT, has international participation involving the U.S., Canada, and France as SARSAT members and joint participation with the Soviet Union's COSPAS Project. Norway and the U.K. have recently joined as investigators. Average position location error of the satellite aided processing is expected to be from 10-20KM for the existing 121.5/243 MHz distress beacons and from 2-5KM for experimental beacons transmitting in the 406 MHz band.

Uncertainty, Alert and Distress: The Precarious Position of NGO Search and Rescue Operations in the Central Mediterranean

OpenAIRE

Smith, Adam

2017-01-01

The international framework for maritime search and rescue relies on state actors establishing regions of responsibility supported by private shipmasters acting in compliance with traditional duties to rescue persons in distress at sea. Despite revisions to the framework’s foundational treaty, questions persist about the extent of state responsibilities and the interaction between those responsibilities and international human rights law. Over the past three years, non-governmenta...

Finite-Fault and Other New Capabilities of CISN ShakeAlert

Science.gov (United States)

Boese, M.; Felizardo, C.; Heaton, T. H.; Hudnut, K. W.; Hauksson, E.

2013-12-01

Over the past 6 years, scientists at Caltech, UC Berkeley, the Univ. of Southern California, the Univ. of Washington, the US Geological Survey, and ETH Zurich (Switzerland) have developed the 'ShakeAlert' earthquake early warning demonstration system for California and the Pacific Northwest. We have now started to transform this system into a stable end-to-end production system that will be integrated into the daily routine operations of the CISN and PNSN networks. To quickly determine the earthquake magnitude and location, ShakeAlert currently processes and interprets real-time data-streams from several hundred seismic stations within the California Integrated Seismic Network (CISN) and the Pacific Northwest Seismic Network (PNSN). Based on these parameters, the 'UserDisplay' software predicts and displays the arrival and intensity of shaking at a given user site. Real-time ShakeAlert feeds are currently being shared with around 160 individuals, companies, and emergency response organizations to gather feedback about the system performance, to educate potential users about EEW, and to identify needs and applications of EEW in a future operational warning system. To improve the performance during large earthquakes (M>6.5), we have started to develop, implement, and test a number of new algorithms for the ShakeAlert system: the 'FinDer' (Finite Fault Rupture Detector) algorithm provides real-time estimates of locations and extents of finite-fault ruptures from high-frequency seismic data. The 'GPSlip' algorithm estimates the fault slip along these ruptures using high-rate real-time GPS data. And, third, a new type of ground-motion prediction models derived from over 415,000 rupture simulations along active faults in southern California improves MMI intensity predictions for large earthquakes with consideration of finite-fault, rupture directivity, and basin response effects. FinDer and GPSlip are currently being real-time and offline tested in a separate internal

Bar Code Medication Administration Technology: Characterization of High-Alert Medication Triggers and Clinician Workarounds.

Science.gov (United States)

Miller, Daniel F; Fortier, Christopher R; Garrison, Kelli L

2011-02-01

Bar code medication administration (BCMA) technology is gaining acceptance for its ability to prevent medication administration errors. However, studies suggest that improper use of BCMA technology can yield unsatisfactory error prevention and introduction of new potential medication errors. To evaluate the incidence of high-alert medication BCMA triggers and alert types and discuss the type of nursing and pharmacy workarounds occurring with the use of BCMA technology and the electronic medication administration record (eMAR). Medication scanning and override reports from January 1, 2008, through November 30, 2008, for all adult medical/surgical units were retrospectively evaluated for high-alert medication system triggers, alert types, and override reason documentation. An observational study of nursing workarounds on an adult medicine step-down unit was performed and an analysis of potential pharmacy workarounds affecting BCMA and the eMAR was also conducted. Seventeen percent of scanned medications triggered an error alert of which 55% were for high-alert medications. Insulin aspart, NPH insulin, hydromorphone, potassium chloride, and morphine were the top 5 high-alert medications that generated alert messages. Clinician override reasons for alerts were documented in only 23% of administrations. Observational studies assessing for nursing workarounds revealed a median of 3 clinician workarounds per administration. Specific nursing workarounds included a failure to scan medications/patient armband and scanning the bar code once the dosage has been removed from the unit-dose packaging. Analysis of pharmacy order entry process workarounds revealed the potential for missed doses, duplicate doses, and doses being scheduled at the wrong time. BCMA has the potential to prevent high-alert medication errors by alerting clinicians through alert messages. Nursing and pharmacy workarounds can limit the recognition of optimal safety outcomes and therefore workflow processes

Emotional security in the family system and psychological distress in female survivors of child sexual abuse.

Science.gov (United States)

Cantón-Cortés, David; Cantón, José; Cortés, María Rosario

2016-01-01

The Emotional Security Theory (EST) was originally developed to investigate the association between high levels of interparental conflict and child maladaptative outcome. The objective of the present study was to analyze the effects of emotional security in the family system on psychological distress among a sample of young female adult survivors of child sexual abuse (CSA). The role of emotional security was investigated through the interactive effects of a number of factors including the type of abuse, the continuity of abuse, the relationship with the perpetrator and the existence of disclosure for the abuse. Participants were 167 female survivors of CSA. Information about the abuse was obtained from a self-reported questionnaire. Emotional security was assessed with the Security in the Family System (SIFS) Scale, and the Symptom Checklist-90-Revised (SCL-90-R) was used to assess psychological distress. In the total sample, insecurity (preoccupation and disengagement) was correlated with high psychological distress scores, whereas no relationship was found between security and psychological distress. The relationship between emotional insecurity and psychological distress was stronger in cases of continued abuse and non-disclosure, while the relationship between emotional security and distress was stronger in cases of extrafamilial abuse and especially isolated or several incidents and when a disclosure had been made. No interactive effect was found between any of the three emotional variables and the type of abuse committed. The results of the current study suggest that characteristics of CSA such as relationship with the perpetrator and, especially, continuity of abuse and whether or not disclosure had been made, can affect the impact of emotional security on psychological distress of CSA survivors. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of BacT/Alert 3D Liquid Culture System for Recovery of Mycobacteria from Clinical Specimens Using Sodium Dodecyl (Lauryl) Sulfate-NaOH Decontamination

Science.gov (United States)

Carricajo, A.; Fonsale, N.; Vautrin, A. C.; Aubert, G.

2001-01-01

A total of 52 mycobacterial isolates were recovered from 1,197 clinical specimens decontaminated by a sodium dodecyl (lauryl) sulfate (SDS)-NaOH protocol. Of these, 94% were recovered with the BacT/Alert 3D system (Organon Teknika, Durham, N.C.) and 79% were recovered on Löwenstein-Jensen (LJ) medium. Mean times to detection of organisms of the Mycobacterium tuberculosis complex (n = 47) were 22.8 days with LJ medium and 16.2 days with the system. The BacT/Alert 3D system is a rapid and efficient detection system which can be used with an SDS-NaOH decontamination procedure. PMID:11574623

Disease spreading with epidemic alert on small-world networks

International Nuclear Information System (INIS)

Han, Xiao-Pu

2007-01-01

Base on two-dimension small-world networks, a susceptible-infected model with epidemic alert is proposed in this Letter. In this model, if some parts of the network are alarmed as dangerous, a fraction of edges between the alarmed parts and others will be removed, and two cases of alerting rules that the degree and frequency of contacts kept unchanged are considered respectively. The numerical simulations show that the spreading velocity is reduced by the accurate and timely epidemic alert, and the more accurate and timely, the stronger the deceleration effect. This model indicates that to broadcast epidemic alert timely is helpful and necessary in the control of epidemic spreading, and in agreement with the general view of epidemic alert. This work is helpful to understand the effects of epidemic alert on disease spreading

Investigating Empathy-Like Responding to Conspecifics' Distress in Pet Dogs.

Directory of Open Access Journals (Sweden)

Mylene Quervel-Chaumette

Full Text Available Empathy covers a wide range of phenomena varying according to the degree of cognitive complexity involved; ranging from emotional contagion, defined as the sharing of others' emotional states, to sympathetic concern requiring animals to have an appraisal of the others' situation and showing concern-like behaviors. While most studies have investigated how animals reacted in response to conspecifics' distress, dogs so far have mainly been targeted to examine cross-species empathic responses. To investigate whether dogs would respond with empathy-like behavior also to conspecifics, we adopted a playback method using conspecifics' vocalizations (whines recorded during a distressful event as well as control sounds. Our subjects were first exposed to a playback phase where they were subjected either to a control sound, a familiar whine (from their familiar partner or a stranger whine stimulus (from a stranger dog, and then a reunion phase where the familiar partner entered the room. When exposed to whines, dogs showed a higher behavioral alertness and exhibited more stress-related behaviors compared to when exposed to acoustically similar control sounds. Moreover, they demonstrated more comfort-offering behaviors toward their familiar partners following whine playbacks than after control stimuli. Furthermore, when looking at the first session, this comfort offering was biased towards the familiar partner when subjects were previously exposed to the familiar compared to the stranger whines. Finally, familiar whine stimuli tended to maintain higher cortisol levels while stranger whines did not. To our knowledge, these results are the first to suggest that dogs can experience and demonstrate "empathic-like" responses to conspecifics' distress-calls.

Alerts and Advisories

Science.gov (United States)

... in Select Bottles of Muscle Strength and Nighttime Recovery Product Because of Undeclared Milk Allergen on The Label ( FDA 04/06/18 ) Independent Nutrition, Inc Issues Allergy Alert On Undeclared Milk in ...

DDBS DB Alert

Data.gov (United States)

Social Security Administration — Data store used by the database area for monitoring of database objects. It is used to generate alerts that the DBAs investigate to determine if any action needs to...

ATR-Hanford site emergency alerting system - 400 Area (F1-F2) and 600 Area (S6-S10)

International Nuclear Information System (INIS)

Whattam, J.W.

1998-01-01

This document provides the results of the acceptance test procedure performed under document number: HNF-2501, Rev 0. This Acceptance Test Procedure has been prepared to demonstrate the Hanford Site Emergency Alerting System functions as required by Specification WHC-S0454, Rev. 1 and project criteria

Comparison of 'time to detection' values between BacT/ALERT VIRTUO and BacT/ALERT 3D instruments for clinical blood culture samples.

Science.gov (United States)

Congestrì, Francesco; Pedna, Maria Federica; Fantini, Michela; Samuelli, Michela; Schiavone, Pasqua; Torri, Arianna; Bertini, Stefania; Sambri, Vittorio

2017-09-01

The early detection of bacteraemia and fungemia is of paramount importance to guide antimicrobial therapy in septic patients. In this study the 'time to detection' (TTD) value for the new blood culture system BacT/ALERT VIRTUO (VIRTUO) was evaluated in 1462 positive clinical bottles and compared with the TTD for 1601 positive clinical bottles incubated in the BacT/ALERT 3D system (BTA-3D). The most representative microorganisms isolated from bottles incubated in both blood culture systems were divided into eight categories (in order of frequency): coagulase-negative staphylococci (CoNS), Escherichia coli, Enterobacteriaceae (other than E. coli), Staphylococcus aureus, Enterococcus spp, viridans group streptococci, Pseudomonas aeruginosa, and Candida spp. The comparison of TTD values for the two blood culture systems strongly indicated that growth of the first five groups listed above was detected earlier with VIRTUO than with BTA-3D (p culture system can reduce the TTD for more than 75% of isolated microorganisms. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Fibromyalgia: When Distress Becomes (Un)sympathetic Pain

OpenAIRE

Martinez-Lavin, Manuel

2012-01-01

Fibromyalgia is a painful stress-related disorder. A key issue in fibromyalgia research is to investigate how distress could be converted into pain. The sympathetic nervous system is the main element of the stress response system. In animal models, physical trauma, infection, or distressing noise can induce abnormal connections between the sympathetic nervous system and the nociceptive system. Dorsal root ganglia sodium channels facilitate this type of sympathetic pain. Similar mechanisms may...

Primary Care Providers' Opening of Time-Sensitive Alerts Sent to Commercial Electronic Health Record InBaskets.

Science.gov (United States)

Cutrona, Sarah L; Fouayzi, Hassan; Burns, Laura; Sadasivam, Rajani S; Mazor, Kathleen M; Gurwitz, Jerry H; Garber, Lawrence; Sundaresan, Devi; Houston, Thomas K; Field, Terry S

2017-11-01

Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. We analyzed data for 799 automated alerts. Alerts highlighted actionable medication concerns for older patients post-hospital discharge (2010-2011). These were study-generated alerts sent 3 days post-discharge to InBaskets for 75 PCPs across a multisite healthcare system, and represent a subset of all urgent InBasket notifications. Using EHR access and audit logs to track alert opening, we performed bivariate and multivariate analyses calculating associations between patient characteristics, provider characteristics, contextual factors at the time of alert delivery (number of InBasket notifications, weekday), and alert opening within 24 h. At the time of alert delivery, the PCPs had a median of 69 InBasket notifications and had received a median of 379.8 notifications (IQR 295.0, 492.0) over the prior 7 days. Of the 799 alerts, 47.1% were opened within 24 h. Patients with longer hospital stays (>4 days) were marginally more likely to have alerts opened (OR 1.48 [95% CI 1.00-2.19]). Alerts delivered to PCPs whose InBaskets had a higher number of notifications at the time of alert delivery were significantly less likely to be opened within 24 h (top quartile >157 notifications: OR 0.34 [95% CI 0.18-0.61]; reference bottom quartile ≤42). Alerts delivered on Saturdays were also less likely to be opened within 24 h (OR 0.18 [CI 0.08-0.39]). The number of total InBasket notifications and weekend delivery may impact the opening of time-sensitive EHR alerts. Further study is needed to support safe and effective approaches to care team management of InBasket notifications.

FACT. Flare alerts from blazar monitoring

Energy Technology Data Exchange (ETDEWEB)

Dorner, Daniela [Universitaet Wuerzburg (Germany); Bretz, Thomas [RWTH Aachen (Germany); Collaboration: FACT-Collaboration

2015-07-01

One of the major goals of the First G-APD Cherenkov Telescope is the longterm monitoring of bright TeV blazars. For more than three years, FACT has observed the blazars Mrk 421 and Mrk 501 and a few other sources on a regular basis. To understand these highly variable objects, simultaneous data at different wavelengths are very useful. FACT is not only taking part in multi-wavelength campaigns, but also sending alerts to other instruments in case of enhanced flux, to study flares within the multi-wavelength frame. To send fast alerts, an automatic quick look analysis was set up on site. Once the data are written on disk, they are automatically processed, and the analysis results are published on a website where other observers can monitor the activity of the source in the very high energy band. In addition, alerts are sent in case the flux is higher than a certain predefined value. In 2014, more than five alerts have been sent. Results from three years of monitoring are presented.

Heavy Metals in Notifications of Rapid Alert System for Food and Feed

Science.gov (United States)

Pigłowski, Marcin

2018-01-01

Heavy metals represent the fourth most often notified hazard category in the Rapid Alert System for Food and Feed (RASFF) from 1980–2016. The goal of the study was to examine the similarities in notifications of particular heavy metals within the RASFF year, product category, notifying country, country of origin, notification basis, notification type, distribution status, risk decision, and action taken, taking into account the particular product type, such as food, food contact material, and feed. The data originated from the RASFF database. Cluster analysis on pivot tables was applied using joining and two-way joining methods. Most notifications concerned food, in which the highest number were related to mercury, cadmium, chromium, lead, arsenic, and nickel. Notifications were mainly related to fish and food contact materials, in addition to fruits and vegetables, seafood, and dietetic food. The number of notifications decreased in 2015 and 2016. The majority of products were notified by Italy, Spain, Germany, and France. The notified products originated mainly from China and Spain. The notification was usually based on official controls on the market, as well as border controls. The notification types were mainly information, alert, and border rejections. Products were not frequently distributed due to distribution restriction to the notifying country or the possibility of distribution to the market. A risk decision was not usually made. The taken actions included re-dispatch of products, withdrawal from the market, or destruction. The data on heavy metals from the RASFF database can help European and national authorities in shaping public health. PMID:29461471

Heavy Metals in Notifications of Rapid Alert System for Food and Feed

Directory of Open Access Journals (Sweden)

Marcin Pigłowski

2018-02-01

Full Text Available Heavy metals represent the fourth most often notified hazard category in the Rapid Alert System for Food and Feed (RASFF from 1980–2016. The goal of the study was to examine the similarities in notifications of particular heavy metals within the RASFF year, product category, notifying country, country of origin, notification basis, notification type, distribution status, risk decision, and action taken, taking into account the particular product type, such as food, food contact material, and feed. The data originated from the RASFF database. Cluster analysis on pivot tables was applied using joining and two-way joining methods. Most notifications concerned food, in which the highest number were related to mercury, cadmium, chromium, lead, arsenic, and nickel. Notifications were mainly related to fish and food contact materials, in addition to fruits and vegetables, seafood, and dietetic food. The number of notifications decreased in 2015 and 2016. The majority of products were notified by Italy, Spain, Germany, and France. The notified products originated mainly from China and Spain. The notification was usually based on official controls on the market, as well as border controls. The notification types were mainly information, alert, and border rejections. Products were not frequently distributed due to distribution restriction to the notifying country or the possibility of distribution to the market. A risk decision was not usually made. The taken actions included re-dispatch of products, withdrawal from the market, or destruction. The data on heavy metals from the RASFF database can help European and national authorities in shaping public health.

The effect of phasic auditory alerting on visual perception

DEFF Research Database (Denmark)

Petersen, Anders; Petersen, Annemarie Hilkjær; Bundesen, Claus

2017-01-01

/no-alerting design with a pure accuracy-based single-letter recognition task. Computational modeling based on Bundesen’s Theory of Visual Attention was used to examine the effect of phasic alertness on visual processing speed and threshold of conscious perception. Results show that phasic auditory alertness affects...

Impact of electronic-alerting of acute kidney injury: workgroup statements from the 15(th) ADQI Consensus Conference.

Science.gov (United States)

Hoste, Eric A J; Kashani, Kianoush; Gibney, Noel; Wilson, F Perry; Ronco, Claudio; Goldstein, Stuart L; Kellum, John A; Bagshaw, Sean M

2016-01-01

Among hospitalized patients, acute kidney injury is common and associated with significant morbidity and risk for mortality. The use of electronic health records (EHR) for prediction and detection of this important clinical syndrome has grown in the past decade. The steering committee of the 15(th) Acute Dialysis Quality Initiative (ADQI) conference dedicated a workgroup with the task of identifying elements that may impact the course of events following Acute Kidney Injury (AKI) e-alert. Following an extensive, non-systematic literature search, we used a modified Delphi process to reach consensus regarding several aspects of the utilization of AKI e-alerts. Topics discussed in this workgroup included progress in evidence base practices, the characteristics of an optimal e-alert, the measures of efficacy and effectiveness, and finally what responses would be considered best practices following AKI e-alerts. Authors concluded that the current evidence for e-alert system efficacy, although growing, remains insufficient. Technology and human-related factors were found to be crucial elements of any future investigation or implementation of such tools. The group also concluded that implementation of such systems should not be done without a vigorous plan to evaluate the efficacy and effectiveness of e-alerts. Efficacy and effectiveness of e-alerts should be measured by context-specific process and patient outcomes. Finally, the group made several suggestions regarding the clinical decision support that should be considered following successful e-alert implementation. This paper reflects the findings of a non-systematic review and expert opinion. We recommend implementation of the findings of this workgroup report for use of AKI e-alerts.

A Novel Design for Drug-Drug Interaction Alerts Improves Prescribing Efficiency.

Science.gov (United States)

Russ, Alissa L; Chen, Siying; Melton, Brittany L; Johnson, Elizabette G; Spina, Jeffrey R; Weiner, Michael; Zillich, Alan J

2015-09-01

Drug-drug interactions (DDIs) are common in clinical care and pose serious risks for patients. Electronic health records display DDI alerts that can influence prescribers, but the interface design of DDI alerts has largely been unstudied. In this study, the objective was to apply human factors engineering principles to alert design. It was hypothesized that redesigned DDI alerts would significantly improve prescribers' efficiency and reduce prescribing errors. In a counterbalanced, crossover study with prescribers, two DDI alert designs were evaluated. Department of Veterans Affairs (VA) prescribers were video recorded as they completed fictitious patient scenarios, which included DDI alerts of varying severity. Efficiency was measured from time-stamped recordings. Prescribing errors were evaluated against predefined criteria. Efficiency and prescribing errors were analyzed with the Wilcoxon signed-rank test. Other usability data were collected on the adequacy of alert content, prescribers' use of the DDI monograph, and alert navigation. Twenty prescribers completed patient scenarios for both designs. Prescribers resolved redesigned alerts in about half the time (redesign: 52 seconds versus original design: 97 seconds; p<.001). Prescribing errors were not significantly different between the two designs. Usability results indicate that DDI alerts might be enhanced by facilitating easier access to laboratory data and dosing information and by allowing prescribers to cancel either interacting medication directly from the alert. Results also suggest that neither design provided adequate information for decision making via the primary interface. Applying human factors principles to DDI alerts improved overall efficiency. Aspects of DDI alert design that could be further enhanced prior to implementation were also identified.

Study on the possibility of assessment of alertness using subsidiary behaviors

International Nuclear Information System (INIS)

Hirose, Ayako; Nagasaka, Akihiko

2003-01-01

The aim of this study is to explore the possibility of assessment of alertness using subsidiary behaviors. Using the previous experimental data, 8 subjects' subsidiary behaviors, which appeared during 3 monotonous VDU tasks, were picked up by 3 experimenters. These behaviors were classified into 13 categories according to their similarity. As a physiological index, electroencephalogram (EEG), which was known as the most sensitive index for measuring alertness, was measured. To investigate whether the number of these behaviors could be utilized for assessment of alertness, the following studies were carried out: 1) the relationships among the task performance, categorized behaviors and EEG were analyzed to make sure whether alertness had an impact on the task performance and the behaviors, 2) using the task performance, the level of alertness was classified tentatively, then the behaviors that were changed by the classified level of alertness were specified, 3) to testify the possibility of assessment of alertness, discriminant analysis was conducted using the behaviors which were specified above, and 4) quantification analysis III and cross correlation analysis were carried out to explore if the behaviors could estimate a decline in alertness before the performance deteriorated. As the results of the above 4 points, the followings were suggested: 1) some subsidiary behaviors were influenced by alertness, to say nothing of performance, 2) regardless of individual differences, there were some behaviors that were changed by the level of alertness which was tentatively classified in this study, 3) the level of alertness at the point could assess using some behaviors, such as 'rub, pinch, and scratch', 'ease the stiffness', 'postural adjustments', 'movement of eye's and mouth', 'action of low alertness', and 4) some behaviors indicated the premonitory sign of a decline in alertness, the other increased when a decline in alertness had been observed. Also, depends on

Structure alerts for carcinogenicity, and the Salmonella assay system: a novel insight through the chemical relational databases technology.

Science.gov (United States)

Benigni, Romualdo; Bossa, Cecilia

2008-01-01

In the past decades, chemical carcinogenicity has been the object of mechanistic studies that have been translated into valuable experimental (e.g., the Salmonella assays system) and theoretical (e.g., compilations of structure alerts for chemical carcinogenicity) models. These findings remain the basis of the science and regulation of mutagens and carcinogens. Recent advances in the organization and treatment of large databases consisting of both biological and chemical information nowadays allows for a much easier and more refined view of data. This paper reviews recent analyses on the predictive performance of various lists of structure alerts, including a new compilation of alerts that combines previous work in an optimized form for computer implementation. The revised compilation is part of the Toxtree 1.50 software (freely available from the European Chemicals Bureau website). The use of structural alerts for the chemical biological profiling of a large database of Salmonella mutagenicity results is also reported. Together with being a repository of the science on the chemical biological interactions at the basis of chemical carcinogenicity, the SAs have a crucial role in practical applications for risk assessment, for: (a) description of sets of chemicals; (b) preliminary hazard characterization; (c) formation of categories for e.g., regulatory purposes; (d) generation of subsets of congeneric chemicals to be analyzed subsequently with QSAR methods; (e) priority setting. An important aspect of SAs as predictive toxicity tools is that they derive directly from mechanistic knowledge. The crucial role of mechanistic knowledge in the process of applying (Q)SAR considerations to risk assessment should be strongly emphasized. Mechanistic knowledge provides a ground for interaction and dialogue between model developers, toxicologists and regulators, and permits the integration of the (Q)SAR results into a wider regulatory framework, where different types of

The relations between de-alerting nuclear force and nuclear strategy

International Nuclear Information System (INIS)

Li Zhimin

2001-01-01

De-alerting nuclear force is a hot-point issue in recent years. The relations between de-alerting and strategy (including nuclear force, target doctrine and use principle et al.), stability, advanced conventional force and NMD of the United States are analyzed, the impact of de-alerting on Chinese nuclear force were discussed and the proposal of de-alerting by stages is presented

Technical features of a low-cost earthquake alert system

International Nuclear Information System (INIS)

Harben, P.

1991-01-01

The concept and features of an Earthquake Alert System (EAS) involving a distributed network of strong motion sensors is discussed. The EAS analyzes real-time data telemetered to a central facility and issues an areawide warning of a large earthquake in advance of the spreading elastic wave energy. A low-cost solution to high-cost estimates for installation and maintenance of a dedicated EAS is presented that makes use of existing microseismic stations. Using the San Francisco Bay area as an example, we show that existing US Geological Survey microseismic monitoring stations are of sufficient density to form the elements of a prototype EAS. By installing strong motion instrumentation and a specially developed switching device, strong ground motion can be telemetered in real-time to the central microseismic station on the existing communication channels. When a large earthquake occurs, a dedicated real-time central processing unit at the central microseismic station digitizes and analyzes the incoming data and issues a warning containing location and magnitude estimations. A 50-station EAS of this type in the San Francisco Bay area should cost under $70,000 to install and less than $5,000 annually to maintain

Taking up national safety alerts to improve patient safety in hospitals: The perspective of healthcare quality and risk managers.

Science.gov (United States)

Pfeiffer, Yvonne; Schwappach, David

2016-01-01

National safety alert systems publish relevant information to improve patient safety in hospitals. However, the information has to be transformed into local action to have an effect on patient safety. We studied three research questions: How do Swiss healthcare quality and risk managers (qm/rm(1)) see their own role in learning from safety alerts issued by the Swiss national voluntary reporting and analysis system? What are their attitudes towards and evaluations of the alerts, and which types of improvement actions were fostered by the safety alerts? A survey was developed and applied to Swiss healthcare risk and quality managers, with a response rate of 39 % (n=116). Descriptive statistics are presented. The qm/rm disseminate and communicate with a broad variety of professional groups about the alerts. While most respondents felt that they should know the alerts and their contents, only a part of them felt responsible for driving organizational change based on the recommendations. However, most respondents used safety alerts to back up their own patient safety goals. The alerts were evaluated positively on various dimensions such as usefulness and were considered as standards of good practice by the majority of the respondents. A range of organizational responses was applied, with disseminating information being the most common. An active role is related to using safety alerts for backing up own patient safety goals. To support an active role of qm/rm in their hospital's learning from safety alerts, appropriate organizational structures should be developed. Furthermore, they could be given special information or training to act as an information hub on the issues discussed in the alerts. Copyright © 2016. Published by Elsevier GmbH.

Alert: An Adaptive Low-Latency Event-Driven MAC Protocol for Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

Vinod Namboodiri

2011-01-01

Full Text Available Collection of rare but delay-critical messages from a group of sensor nodes is a key process in many wireless sensor network applications. This is particularly important for security-related applications like intrusion detection and fire alarm systems. An event sensed by multiple sensor nodes in the network can trigger many messages to be sent simultaneously. We present Alert, a MAC protocol for collecting event-triggered urgent messages from a group of sensor nodes with minimum latency and without requiring any cooperation or prescheduling among the senders or between senders and receiver during protocol execution. Alert is designed to handle multiple simultaneous messages from different nodes efficiently and reliably, minimizing the overall delay to collect all messages along with the delay to get the first message. Moreover, the ability of the network to handle a large number of simultaneous messages does not come at the cost of excessive delays when only a few messages need to be handled. We analyze Alert and evaluate its feasibility and performance with an implementation on commodity hardware. We further compare Alert with existing approaches through simulations and show the performance improvement possible through Alert.

Applying the Toyota Production System: using a patient safety alert system to reduce error.

Science.gov (United States)

Furman, Cathie; Caplan, Robert

2007-07-01

In 2002, Virginia Mason Medical Center (VMMC) adapted the Toyota Production System, also known as lean manufacturing. To translate the techniques of zero defects and stopping the line into health care, the Patient Safety Alert (PSA) system requires any employee who encounters a situation that is likely to harm a patient to make an immediate report and to cease any activity that could cause further harm (stopping the line). IMPLEMENTING THE PSA SYSTEM--STOPPING THE LINE: If any VMMC employee's practice or conduct is deemed capable of causing harm to a patient, a PSA can cause that person to be stopped from working until the problem is resolved. A policy statement, senior executive commitment, dedicated resources, a 24-hour hotline, and communication were all key features of implementation. As of December 2006, 6,112 PSA reports were received: 20% from managers, 8% from physicians, 44% from nurses, and 23% from nonclinical support personnel, for example. The number of reports received per month increased from an average of 3 in 2002 to 285 in 2006. Most reports were processed within 24 hours and were resolved within 2 to 3 weeks. Implementing the PSA system has drastically increased the number of safety concerns that are resolved at VMMC, while drastically reducing the time it takes to resolve them. Transparent discussion and feedback have helped promote staff acceptance and participation.

Les lanceurs d’alerte

OpenAIRE

Foegle, Jean-Philippe

2014-01-01

Le lanceur ou « donneur » d'alerte, ou, en langue anglaise, whistleblower est défini par l'assemblée parlementaire du conseil de l'Europe (Résolution 1729 (2010), §1) comme « toute personne soucieuse qui tire la sonnette d’alarme afin de faire cesser des agissements pouvant représenter un risque pour autrui ». Le présent mémoire vise, en menant une étude comparée France-Etats-Unis du droit encadrant le phénomène du « lancement d'alerte », à cerner les éléments principaux de la notion. Le prem...

MedWatch Safety Alerts for Human Medical Products

Data.gov (United States)

U.S. Department of Health & Human Services — MedWatch alerts provide timely new safety information on human drugs, medical devices, vaccines and other biologics, dietary supplements, and cosmetics. The alerts...

AMDIS Case Conference: Intrusive Medication Safety Alerts.

Science.gov (United States)

Graham, J; Levick, D; Schreiber, R

2010-01-01

Clinical decision support that provides enhanced patient safety at the point of care frequently encounters significant pushback from clinicians who find the process intrusive or time-consuming. We present a hypothetical medical center's dilemma about its allergy alerting system and discuss similar problems faced by real hospitals. We then share some lessons learned and best practices for institutions who wish to implement these tools themselves.

AMDIS Case Conference: Intrusive Medication Safety Alerts

OpenAIRE

Graham, J.; Levick, D.; Schreiber, R.

2010-01-01

Clinical decision support that provides enhanced patient safety at the point of care frequently encounters significant pushback from clinicians who find the process intrusive or time-consuming. We present a hypothetical medical center’s dilemma about its allergy alerting system and discuss similar problems faced by real hospitals. We then share some lessons learned and best practices for institutions who wish to implement these tools themselves.

Wet snow hazard for power lines: a forecast and alert system applied in Italy

Directory of Open Access Journals (Sweden)

P. Bonelli

2011-09-01

Full Text Available Wet snow icing accretion on power lines is a real problem in Italy, causing failures on high and medium voltage power supplies during the cold season. The phenomenon is a process in which many large and local scale variables contribute in a complex way and not completely understood. A numerical weather forecast can be used to select areas where wet snow accretion has an high probability of occurring, but a specific accretion model must also be used to estimate the load of an ice sleeve and its hazard. All the information must be carefully selected and shown to the electric grid operator in order to warn him promptly.

The authors describe a prototype of forecast and alert system, WOLF (Wet snow Overload aLert and Forecast, developed and applied in Italy. The prototype elaborates the output of a numerical weather prediction model, as temperature, precipitation, wind intensity and direction, to determine the areas of potential risk for the power lines. Then an accretion model computes the ice sleeves' load for different conductor diameters. The highest values are selected and displayed on a WEB-GIS application principally devoted to the electric operator, but also to more expert users. Some experimental field campaigns have been conducted to better parameterize the accretion model. Comparisons between real accidents and forecasted icing conditions are presented and discussed.

Wet snow hazard for power lines: a forecast and alert system applied in Italy

Science.gov (United States)

Bonelli, P.; Lacavalla, M.; Marcacci, P.; Mariani, G.; Stella, G.

2011-09-01

Wet snow icing accretion on power lines is a real problem in Italy, causing failures on high and medium voltage power supplies during the cold season. The phenomenon is a process in which many large and local scale variables contribute in a complex way and not completely understood. A numerical weather forecast can be used to select areas where wet snow accretion has an high probability of occurring, but a specific accretion model must also be used to estimate the load of an ice sleeve and its hazard. All the information must be carefully selected and shown to the electric grid operator in order to warn him promptly. The authors describe a prototype of forecast and alert system, WOLF (Wet snow Overload aLert and Forecast), developed and applied in Italy. The prototype elaborates the output of a numerical weather prediction model, as temperature, precipitation, wind intensity and direction, to determine the areas of potential risk for the power lines. Then an accretion model computes the ice sleeves' load for different conductor diameters. The highest values are selected and displayed on a WEB-GIS application principally devoted to the electric operator, but also to more expert users. Some experimental field campaigns have been conducted to better parameterize the accretion model. Comparisons between real accidents and forecasted icing conditions are presented and discussed.

The effect of automated alerts on provider ordering behavior in an outpatient setting.

Directory of Open Access Journals (Sweden)

2005-09-01

Full Text Available BACKGROUND: Computerized order entry systems have the potential to prevent medication errors and decrease adverse drug events with the use of clinical-decision support systems presenting alerts to providers. Despite the large volume of medications prescribed in the outpatient setting, few studies have assessed the impact of automated alerts on medication errors related to drug-laboratory interactions in an outpatient primary-care setting. METHODS AND FINDINGS: A primary-care clinic in an integrated safety net institution was the setting for the study. In collaboration with commercial information technology vendors, rules were developed to address a set of drug-laboratory interactions. All patients seen in the clinic during the study period were eligible for the intervention. As providers ordered medications on a computer, an alert was displayed if a relevant drug-laboratory interaction existed. Comparisons were made between baseline and postintervention time periods. Provider ordering behavior was monitored focusing on the number of medication orders not completed and the number of rule-associated laboratory test orders initiated after alert display. Adverse drug events were assessed by doing a random sample of chart reviews using the Naranjo scoring scale. The rule processed 16,291 times during the study period on all possible medication orders: 7,017 during the pre-intervention period and 9,274 during the postintervention period. During the postintervention period, an alert was displayed for 11.8% (1,093 out of 9,274 of the times the rule processed, with 5.6% for only "missing laboratory values," 6.0% for only "abnormal laboratory values," and 0.2% for both types of alerts. Focusing on 18 high-volume and high-risk medications revealed a significant increase in the percentage of time the provider stopped the ordering process and did not complete the medication order when an alert for an abnormal rule-associated laboratory result was displayed

Association between patient unconscious or not alert conditions and cardiac arrest or high-acuity outcomes within the Medical Priority Dispatch System "Falls" protocol.

Science.gov (United States)

Clawson, Jeff; Olola, Christopher; Scott, Greg; Schultz, Bryon; Pertgen, Richard; Robinson, Don; Bagwell, Barry; Patterson, Brett

2010-01-01

Falls are one of the most common types of complaints received by 9-1-1 emergency medical dispatch centers. They can be accidental or may be caused by underlying medical problems. Though "not alert" falls patients with severe outcomes mostly are "hot" transported to the hospital, some of these cases may be due to other acute medical events (cardiac, respiratory, circulatory, or neurological), which may not always be apparent to the emergency medical dispatcher (EMD) during call processing. The objective of this study was to characterize the risk of cardiac arrest and "hot-transport" outcomes in patients with "not alert" condition, within the Medical Priority Dispatch System (MPDS®) Falls protocol descriptors. This retrospective study used 129 months of de-identified, aggregate, dispatch datasets from three US emergency communication centers. The communication centers used the Medical Priority Dispatch System version 11.3-OMEGA type (released in 2006) to interrogate Emergency Medical System callers, select dispatch codes assigned to various response configurations, and provide pre-arrival instructions. The distribution of cases and percentages of cardiac arrest and hot-transport outcomes, categorized by MPDS® code, was profiled. Assessment of the association between MPDS® Delta-level 3 (D-3) "not alert" condition and cardiac arrest and hot-transport outcomes then followed. Overall, patients within the D-3 and D-2 "long fall" conditions had the highest proportions (compared to the other determinants in the "falls" protocol) of cardiac arrest and hot-transport outcomes, respectively. "Not alert" condition was associated significantly with cardiac arrest and hot-transport outcomes (pdeterminant within the MPDS® "fall" protocol was associated significantly with severe outcomes for short falls (falls. As reported to 9-1-1, the complaint of a "fall" may include the presence of underlying conditions that go beyond the obvious traumatic injuries caused by the fall itself.

A Service-Oriented Healthcare Message Alerting Architecture in an Asia Medical Center: A Case Study

Directory of Open Access Journals (Sweden)

Jin-Shin Lai

2009-06-01

Full Text Available This paper illustrates how our development team has used some information technologies to let physicians obtain an instant abnormal laboratory result report for critical patient care services. We have implementeda healthcare message alerting system (HMAS on a healthcare short message service (HSMS engine and the distributed healthcare-oriented service environment (DiHOSE in the National Taiwan University Hospital (NTUH. The HSMS engine has a general interface for all applications which could easily send any kind of alerting messages. Fundamentally, the DiHOSE uses HL7 standard formats to process the information exchange behaviors and can be flexibly extended for reasonable user requirements. The disease surveillance subsystem is an integral part of NTUH new hospital information system which is based on DiHOSE and the disease surveillance subsystem would send alerting messages through the HSMS engine. The latest cell phone message alerting subsystem, a case study, in NTUH proved that the DiHOSE could integrate the user required functions without much work. We concluded that both HSMS and DiHOSE can generalize and extend application demands efficiently.

Need of a disaster alert system for India through a network of real-time monitoring of sea-level and other meteorological events

Digital Repository Service at National Institute of Oceanography (India)

Joseph, A.; Desai, R.G.P.

Need of a disaster alert system (DAS) capable of online transmission of real-time integrated sea-level and surface meteorological data is discussed. In addition to INSAT platform transmit terminal, VHF, etc., the ubiquitous cellular phone network...

Project "Hypertension Alert."

Science.gov (United States)

Sailors, Emma Lou

1983-01-01

"Hypertension Alert," a 1979-80 blood pressure screening-awareness project of the Yonkers, New York Public Schools, is described. Data is analyzed in tables for ethnic composition, and range of blood pressure readings for the high school, junior high school, and elementary school students tested. (Author/JMK)

Medical alert bracelet (image)

Science.gov (United States)

People with diabetes should always wear a medical alert bracelet or necklace that emergency medical workers will be able to find. Medical identification products can help ensure proper treatment in an ...

Impact of real-time electronic alerting of acute kidney injury on therapeutic intervention and progression of RIFLE class.

Science.gov (United States)

Colpaert, Kirsten; Hoste, Eric A; Steurbaut, Kristof; Benoit, Dominique; Van Hoecke, Sofie; De Turck, Filip; Decruyenaere, Johan

2012-04-01

To evaluate whether a real-time electronic alert system or "AKI sniffer," which is based on the RIFLE classification criteria (Risk, Injury and Failure), would have an impact on therapeutic interventions and acute kidney injury progression. Prospective intervention study. Surgical and medical intensive care unit in a tertiary care hospital. A total of 951 patients having in total 1,079 admission episodes were admitted during the study period (prealert control group: 227, alert group: 616, and postalert control group: 236). Three study phases were compared: A 1.5-month prealert control phase in which physicians were blinded for the acute kidney injury sniffer and a 3-month intervention phase with real-time alerting of worsening RIFLE class through the Digital Enhanced Cordless Technology telephone system followed by a second 1.5-month postalert control phase. A total of 2593 acute kidney injury alerts were recorded with a balanced distribution over all study phases. Most acute kidney injury alerts were RIFLE class risk (59.8%) followed by RIFLE class injury (34.1%) and failure (6.1%). A higher percentage of patients in the alert group received therapeutic intervention within 60 mins after the acute kidney injury alert (28.7% in alert group vs. 7.9% and 10.4% in the pre- and postalert control groups, respectively, p μ .001). In the alert group, more patients received fluid therapy (23.0% vs. 4.9% and 9.2%, p μ .01), diuretics (4.2% vs. 2.6% and 0.8%, p μ .001), or vasopressors (3.9% vs. 1.1% and 0.8%, p μ .001). Furthermore, these patients had a shorter time to intervention (p μ .001). A higher proportion of patients in the alert group showed return to a baseline kidney function within 8 hrs after an acute kidney injury alert "from normal to risk" compared with patients in the control group (p = .048). The real-time alerting of every worsening RIFLE class by the acute kidney injury sniffer increased the number and timeliness of early therapeutic interventions

Patient Blood Pressure and Pulse Rate Monitoring With an Alert ...

African Journals Online (AJOL)

2012-12-01

Dec 1, 2012 ... an Alert System Using the Omron 790it Blood Pressure. Monitor ... detailed medical information on the vital signs of patients and will save many lives that may be lost. Keywords: Omron .... at rest, in beats per minute (BPM):.

Alerting, Orienting or Executive Attention Networks: Differential Patters of Pupil Dilations

Directory of Open Access Journals (Sweden)

Ronny eGeva

2013-10-01

Full Text Available Attention capacities, alerting responses, orienting to sensory stimulation, and executive monitoring of performance are considered independent yet interrelated systems. These operations play integral roles in regulating the behavior of diverse species along the evolutionary ladder. Each of the primary attention constructs—alerting, orienting, and executive monitoring— involves salient autonomic correlates as evidenced by changes in reactive pupil dilation (PD, heart rate, and skin conductance. Recent technological advances that use remote high-resolution recording may allow the discernment of temporo-spatial attributes of autonomic responses that characterize the alerting, orienting, and executive monitoring networks during free viewing, irrespective of voluntary performance. This may deepen the understanding of the roles of autonomic regulation in these mental operations and may deepen our understanding of behavioral changes in verbal as well as in non-verbal species.The aim of this study was to explore differences between psychosensory pupil dilation responses in alerting, orienting, and executive conflict monitoring tasks to generate estimates of concurrent locus coeruleus (LC noradrenergic input trajectories in healthy human adults using the attention networks test (ANT. The analysis revealed a construct-specific pattern of pupil responses: alerting is characterized by an early component (Pa, its acceleration enables covert orienting, and executive control is evidenced by a prominent late component (Pe. Pupil dilation characteristics seem to be task-sensitive, allowing exploration of mental operations irrespective of conscious voluntary responses. These data may facilitate development of studies designed to assess mental operations in diverse species using autonomic responses.

The Nature and Variability of Automated Practice Alerts Derived from Electronic Health Records in a U.S. Nationwide Critical Care Research Network.

Science.gov (United States)

Benthin, Cody; Pannu, Sonal; Khan, Akram; Gong, Michelle

2016-10-01

The nature, variability, and extent of early warning clinical practice alerts derived from automated query of electronic health records (e-alerts) currently used in acute care settings for clinical care or research is unknown. To describe e-alerts in current use in acute care settings at medical centers participating in a nationwide critical care research network. We surveyed investigators at 38 institutions involved in the National Institutes of Health-funded Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL) for quantitative and qualitative analysis. Thirty sites completed the survey (79% response rate). All sites used electronic health record systems. Epic Systems was used at 56% of sites; the others used alternate commercially available vendors or homegrown systems. Respondents at 57% of sites represented in this survey used e-alerts. All but 1 of these 17 sites used an e-alert for early detection of sepsis-related syndromes, and 35% used an e-alert for pneumonia. E-alerts were triggered by abnormal laboratory values (37%), vital signs (37%), or radiology reports (15%) and were used about equally for clinical decision support and research. Only 59% of sites with e-alerts have evaluated them either for accuracy or for validity. A majority of the research network sites participating in this survey use e-alerts for early notification of potential threats to hospitalized patients; however, there was significant variability in the nature of e-alerts between institutions. Use of one common electronic health record vendor at more than half of the participating sites suggests that it may be possible to standardize e-alerts across multiple sites in research networks, particularly among sites using the same medical record platform.

Revealing the functional neuroanatomy of intrinsic alertness using fMRI: methodological peculiarities.

Science.gov (United States)

Clemens, Benjamin; Zvyagintsev, Mikhail; Sack, Alexander T; Sack, Alexander; Heinecke, Armin; Willmes, Klaus; Sturm, Walter

2011-01-01

Clinical observations and neuroimaging data revealed a right-hemisphere fronto-parietal-thalamic-brainstem network for intrinsic alertness, and additional left fronto-parietal activity during phasic alertness. The primary objective of this fMRI study was to map the functional neuroanatomy of intrinsic alertness as precisely as possible in healthy participants, using a novel assessment paradigm already employed in clinical settings. Both the paradigm and the experimental design were optimized to specifically assess intrinsic alertness, while at the same time controlling for sensory-motor processing. The present results suggest that the processing of intrinsic alertness is accompanied by increased activity within the brainstem, thalamus, anterior cingulate gyrus, right insula, and right parietal cortex. Additionally, we found increased activation in the left hemisphere around the middle frontal gyrus (BA 9), the insula, the supplementary motor area, and the cerebellum. Our results further suggest that rather minute aspects of the experimental design may induce aspects of phasic alertness, which in turn might lead to additional brain activation in left-frontal areas not normally involved in intrinsic alertness. Accordingly, left BA 9 activation may be related to co-activation of the phasic alertness network due to the switch between rest and task conditions functioning as an external warning cue triggering the phasic alertness network. Furthermore, activation of the intrinsic alertness network during fixation blocks due to enhanced expectancy shortly before the switch to the task block might, when subtracted from the task block, lead to diminished activation in the typical right hemisphere intrinsic alertness network. Thus, we cautiously suggest that--as a methodological artifact--left frontal activations might show up due to phasic alertness involvement and intrinsic alertness activations might be weakened due to contrasting with fixation blocks, when assessing the

Acute alerting effects of light: A systematic literature review.

Science.gov (United States)

Souman, Jan L; Tinga, Angelica M; Te Pas, Susan F; van Ee, Raymond; Vlaskamp, Björn N S

2018-01-30

Periodic, well timed exposure to light is important for our health and wellbeing. Light, in particular in the blue part of the spectrum, is thought to affect alertness both indirectly, by modifying circadian rhythms, and directly, giving rise to acute effects. We performed a systematic review of empirical studies on direct, acute effects of light on alertness to evaluate the reliability of these effects. In total, we identified 68 studies in which either light intensity, spectral distribution, or both were manipulated, and evaluated the effects on behavioral measures of alertness, either subjectively or measured in reaction time performance tasks. The results show that increasing the intensity of polychromatic white light has been found to increase subjective ratings of alertness in a majority of studies, though a substantial proportion of studies failed to find significant effects, possibly due to small sample sizes or high baseline light intensities. The effect of the color temperature of white light on subjective alertness is less clear. Some studies found increased alertness with higher color temperatures, but other studies reported no detrimental effects of filtering out the short wavelengths from the spectrum. Similarly, studies that used monochromatic light exposure showed no systematic pattern for the effects of blue light compared to longer wavelengths. Far fewer studies investigated the effects of light intensity or spectrum on alertness as measured with reaction time tasks and of those, very few reported significant effects. In general, the small sample sizes used in studies on acute alerting effects of light make it difficult to draw definitive conclusions and better powered studies are needed, especially studies that allow for the construction of dose-response curves. Copyright © 2017 Elsevier B.V. All rights reserved.

Cooperative Monitoring Center Occasional Paper/9: De-Alerting Strategic Ballistic Missiles

Energy Technology Data Exchange (ETDEWEB)

Connell, Leonard W.; Edenburn, Michael W.; Fraley, Stanley K.; Trost, Lawrence C.

1999-03-01

This paper presents a framework for evaluating the technical merits of strategic ballistic missile de-alerting measures, and it uses the framework to evaluate a variety of possible measures for silo-based, land-mobile, and submarine-based missiles. De-alerting measures are defined for the purpose of this paper as reversible actions taken to increase the time or effort required to launch a strategic ballistic missile. The paper does not assess the desirability of pursuing a de-alerting program. Such an assessment is highly context dependent. The paper postulates that if de-alerting is desirable and is used as an arms control mechanism, de-alerting measures should satisfy specific cirteria relating to force security, practicality, effectiveness, significant delay, and verifiability. Silo-launched missiles lend themselves most readily to de-alerting verification, because communications necessary for monitoring do not increase the vulnerabilty of the weapons by a significant amount. Land-mobile missile de-alerting measures would be more challenging to verify, because monitoring measures that disclose the launcher's location would potentially increase their vulnerability. Submarine-launched missile de-alerting measures would be extremely challlenging if not impossible to monitor without increasing the submarine's vulnerability.

Space Environment Automated Alerts and Anomaly Analysis Assistant (SEA^5) for NASA

Data.gov (United States)

National Aeronautics and Space Administration — We propose to develop a comprehensive analysis and dissemination system (Space Environment Automated Alerts  & Anomaly Analysis Assistant: SEA5) that will...

Machine-learning-based Brokers for Real-time Classification of the LSST Alert Stream

Science.gov (United States)

Narayan, Gautham; Zaidi, Tayeb; Soraisam, Monika D.; Wang, Zhe; Lochner, Michelle; Matheson, Thomas; Saha, Abhijit; Yang, Shuo; Zhao, Zhenge; Kececioglu, John; Scheidegger, Carlos; Snodgrass, Richard T.; Axelrod, Tim; Jenness, Tim; Maier, Robert S.; Ridgway, Stephen T.; Seaman, Robert L.; Evans, Eric Michael; Singh, Navdeep; Taylor, Clark; Toeniskoetter, Jackson; Welch, Eric; Zhu, Songzhe; The ANTARES Collaboration

2018-05-01

The unprecedented volume and rate of transient events that will be discovered by the Large Synoptic Survey Telescope (LSST) demand that the astronomical community update its follow-up paradigm. Alert-brokers—automated software system to sift through, characterize, annotate, and prioritize events for follow-up—will be critical tools for managing alert streams in the LSST era. The Arizona-NOAO Temporal Analysis and Response to Events System (ANTARES) is one such broker. In this work, we develop a machine learning pipeline to characterize and classify variable and transient sources only using the available multiband optical photometry. We describe three illustrative stages of the pipeline, serving the three goals of early, intermediate, and retrospective classification of alerts. The first takes the form of variable versus transient categorization, the second a multiclass typing of the combined variable and transient data set, and the third a purity-driven subtyping of a transient class. Although several similar algorithms have proven themselves in simulations, we validate their performance on real observations for the first time. We quantitatively evaluate our pipeline on sparse, unevenly sampled, heteroskedastic data from various existing observational campaigns, and demonstrate very competitive classification performance. We describe our progress toward adapting the pipeline developed in this work into a real-time broker working on live alert streams from time-domain surveys.

Alertness modulates conflict adaptation and feature integration in an opposite way.

Directory of Open Access Journals (Sweden)

Peiduo Liu

Full Text Available Previous studies show that the congruency sequence effect can result from both the conflict adaptation effect (CAE and feature integration effect which can be observed as the repetition priming effect (RPE and feature overlap effect (FOE depending on different experimental conditions. Evidence from neuroimaging studies suggests that a close correlation exists between the neural mechanisms of alertness-related modulations and the congruency sequence effect. However, little is known about whether and how alertness mediates the congruency sequence effect. In Experiment 1, the Attentional Networks Test (ANT and a modified flanker task were used to evaluate whether the alertness of the attentional functions had a correlation with the CAE and RPE. In Experimental 2, the ANT and another modified flanker task were used to investigate whether alertness of the attentional functions correlate with the CAE and FOE. In Experiment 1, through the correlative analysis, we found a significant positive correlation between alertness and the CAE, and a negative correlation between the alertness and the RPE. Moreover, a significant negative correlation existed between CAE and RPE. In Experiment 2, we found a marginally significant negative correlation between the CAE and the RPE, but the correlation between alertness and FOE, CAE and FOE was not significant. These results suggest that alertness can modulate conflict adaptation and feature integration in an opposite way. Participants at the high alerting level group may tend to use the top-down cognitive processing strategy, whereas participants at the low alerting level group tend to use the bottom-up processing strategy.

Alertness Modulates Conflict Adaptation and Feature Integration in an Opposite Way

Science.gov (United States)

Chen, Jia; Huang, Xiting; Chen, Antao

2013-01-01

Previous studies show that the congruency sequence effect can result from both the conflict adaptation effect (CAE) and feature integration effect which can be observed as the repetition priming effect (RPE) and feature overlap effect (FOE) depending on different experimental conditions. Evidence from neuroimaging studies suggests that a close correlation exists between the neural mechanisms of alertness-related modulations and the congruency sequence effect. However, little is known about whether and how alertness mediates the congruency sequence effect. In Experiment 1, the Attentional Networks Test (ANT) and a modified flanker task were used to evaluate whether the alertness of the attentional functions had a correlation with the CAE and RPE. In Experimental 2, the ANT and another modified flanker task were used to investigate whether alertness of the attentional functions correlate with the CAE and FOE. In Experiment 1, through the correlative analysis, we found a significant positive correlation between alertness and the CAE, and a negative correlation between the alertness and the RPE. Moreover, a significant negative correlation existed between CAE and RPE. In Experiment 2, we found a marginally significant negative correlation between the CAE and the RPE, but the correlation between alertness and FOE, CAE and FOE was not significant. These results suggest that alertness can modulate conflict adaptation and feature integration in an opposite way. Participants at the high alerting level group may tend to use the top-down cognitive processing strategy, whereas participants at the low alerting level group tend to use the bottom-up processing strategy. PMID:24250824

Distress screening using distress thermometer in head and neck cancer patients undergoing radiotherapy and evaluation of causal factors predicting occurrence of distress

Directory of Open Access Journals (Sweden)

Shirley Lewis

2013-01-01

Full Text Available Introduction: Distress is commonly seen in head and neck cancer patients undergoing radiotherapy. Causal factors of distress are multifactorial; which encompasses physical, psychological, spiritual, and existential factors with complex interrelationship among the factors. Materials and Methods: Thirty patients undergoing head and neck radiotherapy were included in the study. Patients were screened for pain scores, distress scores, physical and psychological symptoms, and spiritual and emotional distress. Results: Significant increasing trend seen for pain score, distress score, and total number of symptoms during 2 nd week, 4 th week, and on completion of radiotherapy treatment (all P′s < 0.001 compared to pretreatment. Those who had chemotherapy (CT along with radiation had significantly greater pain score (t = 5.54, P = 0.03 and distress score (t = 3.9, P = 0.05 at 2 weeks into radiotherapy compared to those who did not receive CT. There was significantly higher grade of skin toxicity in those with spiritual distress (Somers′ d = 0.36, P = 0.02 and higher grade of mucositis in those with existential distress (d = 0.34, P = 0.02 at 4 weeks into radiotherapy. Conclusion: Positive correlation between distress score and pain score and occurrence of physical symptoms. Increasing trend seen for pain score, distress score, and total number of symptoms during 2 nd week, 4 th week, and completion of radiotherapy treatment compared to pretreatment. Increase in distress score in those with existential and spiritual distress.

Space Debris Alert System for Aviation

Science.gov (United States)

Sgobba, Tommaso

2013-09-01

Despite increasing efforts to accurately predict space debris re-entry, the exact time and location of re-entry is still very uncertain. Partially, this is due to a skipping effect uncontrolled spacecraft may experience as they enter the atmosphere at a shallow angle. Such effect difficult to model depends on atmospheric variations of density. When the bouncing off ends and atmospheric re-entry starts, the trajectory and the overall location of surviving fragments can be precisely predicted but the time to impact with ground, or to reach the airspace, becomes very short.Different is the case of a functional space system performing controlled re-entry. Suitable forecasts methods are available to clear air and maritime traffic from hazard areas (so-called traffic segregation).In US, following the Space Shuttle Columbia accident in 2003, a re-entry hazard areas location forecast system was putted in place for the specific case of major malfunction of a Reusable Launch Vehicles (RLV) at re-entry. The Shuttle Hazard Area to Aircraft Calculator (SHAAC) is a system based on ground equipment and software analyses and prediction tools, which require trained personnel and close coordination between the organization responsible for RLV operation (NASA for Shuttle) and the Federal Aviation Administration. The system very much relies on the operator's capability to determine that a major malfunction has occurred.This paper presents a US pending patent by the European Space Agency, which consists of a "smart fragment" using a GPS localizer together with pre- computed debris footprint area and direct broadcasting of such hazard areas.The risk for aviation from falling debris is very remote but catastrophic. Suspending flight over vast swath of airspace for every re-entering spacecraft or rocket upper stage, which is a weekly occurrence, would be extremely costly and disruptive.The Re-entry Direct Broadcasting Alert System (R- DBAS) is an original merging and evolution of the Re

Assigning a volcano alert level: negotiating uncertainty, risk, and complexity in decision-making processes

OpenAIRE

Carina J Fearnley

2013-01-01

A volcano alert level system (VALS) is used to communicate warning information from scientists to civil authorities managing volcanic hazards. This paper provides the first evaluation of how the decision-making process behind the assignation of an alert level, using forecasts of volcanic behaviour, operates in practice . Using interviews conducted from 2007 to 2009 at five USGS-managed (US Geological Survey) volcano observatories (Alaska, Cascades, Hawaii, Long Valley, and Yellowstone), two k...

Standard practice for design and use of safety alert system for hazardous work locations in the coatings and lining industry

International Nuclear Information System (INIS)

Anon.

1984-01-01

This practice covers a safety alert system for hazardous work locations and materials for the coatings and lining application industry. This practice is designed for multi-employer work sites. Limitations--This practice does not identify specific hazardous materials or work locations but provides a means for rating each. This standard may involve hazardous materials, operations, and equipment

Operator alertness and performance on 8-hour and 12-hour work shifts

International Nuclear Information System (INIS)

Baker, T.L.; Campbell, S.S.; Dawson, D.; Moore-Ede, M.

1989-01-01

Recently, much attention has been paid to the alertness and performance problems of rotational shiftworkers in the nuclear power industry. Growing awareness of higher rates of human errors and accidents on night shifts and reports of operations personnel falling asleep on the job have contributed to the heightened interest in this subject. The industry is now considering the effects of different shift rotation systems, including evaluation of the most recent of industry trends in shift scheduling-schedules that include 12 hour work shifts. Surveys show that within the past 5 years about 20% of commercially operational nuclear power plants have instituted schedules that use only 12 hour shifts, or schedules using a combination of 8-hour and 12-hour shifts. Many more plants routinely use 12-hour work shifts during plant outages and refueling operations. In response to this growing trend, the NRC has funded research which is a first attempt to compare alertness, operator performance, and sleep-wake patterns in subjects working simulated 8-hour and 12-hour shifts at the Human Alertness Research Center (HARC), located at the Institute of Circadian Physiology in Boston, MA. This paper will describe in greater detail the design of the study, measurement techniques for alertness and sleep, work routine, work task performance measures, and cognitive performance test protocols. It will review the role of circadian factors in human alertness and performance, and discuss previous research findings in this area. It will discuss other variables that are known to influence human alertness in the workplace, such as caffeine, alcohol, and working environment. The physiological basis for shift worker sleep problems will be explained in the context of the ongoing research project at HARC. Finally, the paper presents previous research on shift work and fatigue which may be relevant to a comparison of 8-hour and 12-hour shifts

Alertness management in two-person long-haul flight operations

Science.gov (United States)

Rosekind, M. R.; Gander, P. H.

1992-01-01

Long-haul flight operations involve cumulative sleep loss, circadian disruption, and extended and irregular duty schedules. These factors reduce pilot alertness and performance on the flightdeck. Conceptually and operationally, alertness management in flight operations can be divided into preventive strategies and operational countermeasures. Preventive strategies are utilized prior to a duty period to mitigate or reduce the effects of sleep loss, circadian disruption and fatigue during subsequent flight operations. Operational countermeasures are used during operations as acute techniques for maintaining performance and alertness. Results from previous NASA Ames field studies document the sleep loss and circadian disruption in three-person long-haul flying and illustrate the application of preventive strategies and operational countermeasures. One strategy that can be used in both a preventive and operational manner is strategic napping. The application and effectiveness of strategic napping in long-haul operations will be discussed. Finally, long-haul flying in two-person highly automated aircraft capable of extended range operations will create new challenges to maintaining pilot alertness and performance. Alertness management issues in this flight environment will be explored.

Education and Training Module in Alertness Management

Science.gov (United States)

Mallis, M. M.; Brandt, S. L.; Oyung, R. L.; Reduta, D. D.; Rosekind, M. R.

2006-01-01

The education and training module (ETM) in alertness management has now been integrated as part of the training regimen of the Pilot Proficiency Awards Program ("WINGS") of the Federal Aviation Administration. Originated and now maintained current by the Fatigue Countermeasures Group at NASA Ames Research Center, the ETM in Alertness Management is designed to give pilots the benefit of the best and most recent research on the basics of sleep physiology, the causes of fatigue, and strategies for managing alertness during flight operations. The WINGS program is an incentive program that encourages pilots at all licensing levels to participate in recurrent training, upon completion of which distinctive lapel or tie pins (wings) and certificates of completion are awarded. In addition to flight training, all WINGS applicants must attend at least one FAA-sponsored safety seminar, FAA-sanctioned safety seminar, or industry recurrent training program. The Fatigue Countermeasures Group provides an FAA-approved industry recurrent training program through an on-line General Aviation (GA) WINGS ETM in alertness management to satisfy this requirement. Since 1993, the Fatigue Countermeasures Group has translated fatigue and alertness information to operational environments by conducting two-day ETM workshops oriented primarily toward air-carrier operations subject to Part 121 of the Federal Aviation Regulations pertaining to such operations. On the basis of the information presented in the two-day ETM workshops, an ETM was created for GA pilots and was transferred to a Web-based version. To comply with the requirements of the WINGS Program, the original Web-based version has been modified to include hypertext markup language (HTML) content that makes information easily accessible, in-depth testing of alertness-management knowledge, new interactive features, and increased informational resources for GA pilots. Upon successful completion of this training module, a participant

Distributed Pedestrian Detection Alerts Based on Data Fusion with Accurate Localization

Directory of Open Access Journals (Sweden)

Arturo de la Escalera

2013-09-01

Full Text Available Among Advanced Driver Assistance Systems (ADAS pedestrian detection is a common issue due to the vulnerability of pedestrians in the event of accidents. In the present work, a novel approach for pedestrian detection based on data fusion is presented. Data fusion helps to overcome the limitations inherent to each detection system (computer vision and laser scanner and provides accurate and trustable tracking of any pedestrian movement. The application is complemented by an efficient communication protocol, able to alert vehicles in the surroundings by a fast and reliable communication. The combination of a powerful location, based on a GPS with inertial measurement, and accurate obstacle localization based on data fusion has allowed locating the detected pedestrians with high accuracy. Tests proved the viability of the detection system and the efficiency of the communication, even at long distances. By the use of the alert communication, dangerous situations such as occlusions or misdetections can be avoided.

Distributed pedestrian detection alerts based on data fusion with accurate localization.

Science.gov (United States)

García, Fernando; Jiménez, Felipe; Anaya, José Javier; Armingol, José María; Naranjo, José Eugenio; de la Escalera, Arturo

2013-09-04

Among Advanced Driver Assistance Systems (ADAS) pedestrian detection is a common issue due to the vulnerability of pedestrians in the event of accidents. In the present work, a novel approach for pedestrian detection based on data fusion is presented. Data fusion helps to overcome the limitations inherent to each detection system (computer vision and laser scanner) and provides accurate and trustable tracking of any pedestrian movement. The application is complemented by an efficient communication protocol, able to alert vehicles in the surroundings by a fast and reliable communication. The combination of a powerful location, based on a GPS with inertial measurement, and accurate obstacle localization based on data fusion has allowed locating the detected pedestrians with high accuracy. Tests proved the viability of the detection system and the efficiency of the communication, even at long distances. By the use of the alert communication, dangerous situations such as occlusions or misdetections can be avoided.

EEG quantification of alertness: methods for early identification of individuals most susceptible to sleep deprivation

Science.gov (United States)

Berka, Chris; Levendowski, Daniel J.; Westbrook, Philip; Davis, Gene; Lumicao, Michelle N.; Olmstead, Richard E.; Popovic, Miodrag; Zivkovic, Vladimir T.; Ramsey, Caitlin K.

2005-05-01

Electroencephalographic (EEG) and neurocognitive measures were simultaneously acquired to quantify alertness from 24 participants during 44-hours of sleep deprivation. Performance on a three-choice vigilance task (3C-VT), paired-associate learning/memory task (PAL) and modified Maintenance of Wakefulness Test (MWT), and sleep technician-observed drowsiness (eye-closures, head-nods, EEG slowing) were quantified. The B-Alert system automatically classifies each second of EEG on an alertness/drowsiness continuum. B-Alert classifications were significantly correlated with technician-observations, visually scored EEG and performance measures. B-Alert classifications during 3C-VT, and technician observations and performance during the 3C-VT and PAL evidenced progressively increasing drowsiness as a result of sleep deprivation with a stabilizing effect observed at the batteries occurring between 0600 and 1100 suggesting a possible circadian effect similar to those reported in previous sleep deprivation studies. Participants were given an opportunity to take a 40-minute nap approximately 24-hours into the sleep deprivation portion of the study (i.e., 7 PM on Saturday). The nap was followed by a transient period of increased alertness. Approximately 8 hours after the nap, behavioral and physiological measures of drowsiness returned to levels prior to the nap. Cluster analysis was used to stratify individuals into three groups based on their level of impairment as a result of sleep deprivation. The combination of B-Alert and neuro-behavioral measures may identify individuals whose performance is most susceptible to sleep deprivation. These objective measures could be applied in an operational setting to provide a "biobehavioral assay" to determine vulnerability to sleep deprivation.

The use of electronic alerts in primary care computer systems to identify the excessive prescription of short-acting beta2-agonists for people with asthma: a systematic review.

Science.gov (United States)

McKibben, Shauna; De Simoni, Anna; Bush, Andy; Thomas, Mike; Griffiths, Chris

2018-04-16

Computers are increasingly used to improve prescribing decisions in the management of long-term conditions however the effects on asthma prescribing remain unclear. We aimed to synthesise the evidence for the use of computerised alerts that identify excessive prescribing of short-acting beta 2 -agonists (SABAs) to improve asthma management for people with asthma. MEDLINE, CINAHL, Embase, Cochrane and Scopus databases (1990-2016) were searched for randomised controlled trials using electronic alerts to identify excessive prescribing of SABAs for people with asthma in primary care. Inclusion eligibility, quality appraisal (Cochrane risk of bias tool) and data extraction were performed by two independent reviewers. Findings were synthesised narratively. A total of 2035 articles were screened and four trials were eligible. Three studies had low risk of bias: one reported a positive effect on our primary outcome of interest, excessive SABA prescribing; another reported positive effects on the ratio of inhaled corticosteroid (ICS)-SABA prescribing, and asthma control; a third reported no effect on outcomes of interest. One study at high risk of bias reported a reduction in exacerbations and primary care consultations. There is some evidence that electronic alerts reduce excessive prescribing of SABAs, when delivered as part of a multicomponent intervention in an integrated health care system. However due to the variation in health care systems, intervention design and outcomes measured, further research is required to establish optimal design of alerting and intervening systems.

Control-room operator alertness and performance in nuclear power plants

International Nuclear Information System (INIS)

Baker, T.l.; Campbell, S.C.; Linder, K.D.; Moore-Ede, M.C

1990-02-01

All industries requiring round-the-clock operation must deal with the potential problem of impaired alertness, especially among those who work night shifts. In the nuclear power industry, maintaining optimal alertness and performance of control room operators at all times of day is critical. Many of the toot causes of reduced alertness are straightforward and can be easily remedied with tangible solutions; this manual both discusses the reasons for the problem and suggests solutions. The manual surveys factors that influence operator alertness and performance, including shift schedules, caffeine and alcohol use, diet and family lifestyle factors, the control room enviornment, staffing and overtime practices, and work task design. Specific recommendations are made in each of these areas. The project team, consisting of experts on managing round-the-clock operations and scientists who study human alertness and performance, prepared this manual using the latest scientific research and direct input from shift supervisors and operators via interviews, on-site observation, and questionnaires distributed to every nuclear power station. The material contained within is relevant to shiftwork managers, shift supervisors, and operators, each of whom plays a vital role in maintaining optimal alertness and performance on the job. 90 refs., 35 figs

Efficacy of a low-cost bubble CPAP system in treatment of respiratory distress in a neonatal ward in Malawi.

Directory of Open Access Journals (Sweden)

Kondwani Kawaza

Full Text Available Respiratory failure is a leading cause of neonatal mortality in the developing world. Bubble continuous positive airway pressure (bCPAP is a safe, effective intervention for infants with respiratory distress and is widely used in developed countries. Because of its high cost, bCPAP is not widely utilized in low-resource settings. We evaluated the performance of a new bCPAP system to treat severe respiratory distress in a low resource setting, comparing it to nasal oxygen therapy, the current standard of care.We conducted a non-randomized convenience sample study to test the efficacy of a low-cost bCPAP system treating newborns with severe respiratory distress in the neonatal ward of Queen Elizabeth Central Hospital, in Blantyre, Malawi. Neonates weighing >1,000 g and presenting with severe respiratory distress who fulfilled inclusion criteria received nasal bCPAP if a device was available; if not, they received standard care. Clinical assessments were made during treatment and outcomes compared for the two groups.87 neonates (62 bCPAP, 25 controls were recruited. Survival rate for neonates receiving bCPAP was 71.0% (44/62 compared with 44.0% (11/25 for controls. 65.5% (19/29 of very low birth weight neonates receiving bCPAP survived to discharge compared to 15.4% (1/13 of controls. 64.6% (31/48 of neonates with respiratory distress syndrome (RDS receiving bCPAP survived to discharge, compared to 23.5% (4/17 of controls. 61.5% (16/26 of neonates with sepsis receiving bCPAP survived to discharge, while none of the seven neonates with sepsis in the control group survived.Use of a low-cost bCPAP system to treat neonatal respiratory distress resulted in 27% absolute improvement in survival. The beneficial effect was greater for neonates with very low birth weight, RDS, or sepsis. Implementing appropriate bCPAP devices could reduce neonatal mortality in developing countries.

Efficacy of a low-cost bubble CPAP system in treatment of respiratory distress in a neonatal ward in Malawi.

Science.gov (United States)

Kawaza, Kondwani; Machen, Heather E; Brown, Jocelyn; Mwanza, Zondiwe; Iniguez, Suzanne; Gest, Al; Smith, E O'Brian; Oden, Maria; Richards-Kortum, Rebecca R; Molyneux, Elizabeth

2014-01-01

Respiratory failure is a leading cause of neonatal mortality in the developing world. Bubble continuous positive airway pressure (bCPAP) is a safe, effective intervention for infants with respiratory distress and is widely used in developed countries. Because of its high cost, bCPAP is not widely utilized in low-resource settings. We evaluated the performance of a new bCPAP system to treat severe respiratory distress in a low resource setting, comparing it to nasal oxygen therapy, the current standard of care. We conducted a non-randomized convenience sample study to test the efficacy of a low-cost bCPAP system treating newborns with severe respiratory distress in the neonatal ward of Queen Elizabeth Central Hospital, in Blantyre, Malawi. Neonates weighing >1,000 g and presenting with severe respiratory distress who fulfilled inclusion criteria received nasal bCPAP if a device was available; if not, they received standard care. Clinical assessments were made during treatment and outcomes compared for the two groups. 87 neonates (62 bCPAP, 25 controls) were recruited. Survival rate for neonates receiving bCPAP was 71.0% (44/62) compared with 44.0% (11/25) for controls. 65.5% (19/29) of very low birth weight neonates receiving bCPAP survived to discharge compared to 15.4% (1/13) of controls. 64.6% (31/48) of neonates with respiratory distress syndrome (RDS) receiving bCPAP survived to discharge, compared to 23.5% (4/17) of controls. 61.5% (16/26) of neonates with sepsis receiving bCPAP survived to discharge, while none of the seven neonates with sepsis in the control group survived. Use of a low-cost bCPAP system to treat neonatal respiratory distress resulted in 27% absolute improvement in survival. The beneficial effect was greater for neonates with very low birth weight, RDS, or sepsis. Implementing appropriate bCPAP devices could reduce neonatal mortality in developing countries.

Entrepreneurial alertness: Study of the Influence of Individual Characteristics and Entrepreneurship

Directory of Open Access Journals (Sweden)

Hilka Pelizza Vier Machado

2016-01-01

Full Text Available ABSTRACT This research tried to understand which statistical variables associated to the individual and the company influence the entrepreneurial alertness. The sample was constituted by 180 entrepreneurs. The entrepreneurial alertness was measured in agreement with the model of Tang, Kacmar and Busenitz (2012. Descriptive statistical tests and normality exam were developed; as well as checked the validity and reliability of the scale through Confirmatory Factor Analysis (CFA. In order to identify the factors that influenced the alertness we developed multiple linear regression and the ANOVA test to determine possible differences among groups (gender, education. The results showed the negative influence of the educational level and the size of enterprises on alertness level; as well as the negative relationship between age and entrepreneurial experience, furthermore, shows that alert level is not determined by gender difference. One of the main implications of this research is to present factors that can potentiate the effects of the entrepreneurial alertness, enlarging the possibilities of identification of opportunities for individuals.

Distressed Relationships : Lessons from the Norwegian Banking Crisis

NARCIS (Netherlands)

Ongena, S.; Smith, D.C.; Michalsen, D.

2000-01-01

This paper measures the economy-wide impact of bank distress on the loss of relationship benefits. We use the near-collapse of the Norwegian banking system during the period 1988 to 1991 to measure the impact of bank distress announcements on the stock prices of firms maintaining a relationship with

Neonatal respiratory distress syndrome

Science.gov (United States)

Hyaline membrane disease (HMD); Infant respiratory distress syndrome; Respiratory distress syndrome in infants; RDS - infants ... improves slowly after that. Some infants with severe respiratory distress syndrome will die. This most often occurs ...

Correlating intrusion detection alerts on bot malware infections using neural network

DEFF Research Database (Denmark)

Kidmose, Egon; Stevanovic, Matija; Pedersen, Jens Myrup

2016-01-01

Millions of computers are infected with bot malware, form botnets and enable botmaster to perform malicious and criminal activities. Intrusion Detection Systems are deployed to detect infections, but they raise many correlated alerts for each infection, requiring a large manual investigation effort...

Development and psychometric testing of a new tool for detecting moral distress: the Moral Distress Thermometer.

Science.gov (United States)

Wocial, Lucia D; Weaver, Michael T

2013-01-01

To report the development and psychometric testing of the Moral Distress Thermometer. The Moral Distress Thermometer is a new screening tool to measure moral distress in nurses who practise in the hospital setting. Moral distress occurs when one knows the ethically correct thing to do, but is prevented from acting on that perceived obligation. It is a well documented phenomenon with negative consequences that may be experienced by nurses. Creating an instrument to effectively and efficiently measure moral distress in a timely way has been identified as a priority for nursing. This study used a cross-sectional survey design. Data collection for this research occurred in 2009. Participants simultaneously completed either the adult or pediatric version of the Moral Distress Scale version 2009 and the Moral Distress Thermometer. A total of 529 participants from various clinical areas completed both tools. Coefficients alpha were adequate for both Adult (0·90) and Pediatric (0·92) Moral Distress Scale 2009 scales. Statistically significant Pearson correlations were found for the Moral Distress Thermometer with Adult Moral Distress Scale 2009 and Pediatric Moral Distress Scale 2009 and higher Moral Distress Thermometer, Adult Moral Distress Scale 2009 and Pediatric Moral Distress Scale 2009 means for participants who had left or who considered leaving a position because of moral distress. These findings provide support for the validity of the Moral Distress Thermometer. © 2012 Blackwell Publishing Ltd.

47 CFR 80.1109 - Distress, urgency, and safety communications.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Distress, urgency, and safety communications. 80.1109 Section 80.1109 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS...

Optical flow and driver's kinematics analysis for state of alert sensing.

Science.gov (United States)

Jiménez-Pinto, Javier; Torres-Torriti, Miguel

2013-03-28

Road accident statistics from different countries show that a significant number of accidents occur due to driver's fatigue and lack of awareness to traffic conditions. In particular, about 60% of the accidents in which long haul truck and bus drivers are involved are attributed to drowsiness and fatigue. It is thus fundamental to improve non-invasive systems for sensing a driver's state of alert. One of the main challenges to correctly resolve the state of alert is measuring the percentage of eyelid closure over time (PERCLOS), despite the driver's head and body movements. In this paper, we propose a technique that involves optical flow and driver's kinematics analysis to improve the robustness of the driver's alert state measurement under pose changes using a single camera with near-infrared illumination. The proposed approach infers and keeps track of the driver's pose in 3D space in order to ensure that eyes can be located correctly, even after periods of partial occlusion, for example, when the driver stares away from the camera. Our experiments show the effectiveness of the approach with a correct eyes detection rate of 99.41%, on average. The results obtained with the proposed approach in an experiment involving fifteen persons under different levels of sleep deprivation also confirm the discriminability of the fatigue levels. In addition to the measurement of fatigue and drowsiness, the pose tracking capability of the proposed approach has potential applications in distraction assessment and alerting of machine operators.

Human-computer interaction for alert warning and attention allocation systems of the multimodal watchstation

Science.gov (United States)

Obermayer, Richard W.; Nugent, William A.

2000-11-01

The SPAWAR Systems Center San Diego is currently developing an advanced Multi-Modal Watchstation (MMWS); design concepts and software from this effort are intended for transition to future United States Navy surface combatants. The MMWS features multiple flat panel displays and several modes of user interaction, including voice input and output, natural language recognition, 3D audio, stylus and gestural inputs. In 1999, an extensive literature review was conducted on basic and applied research concerned with alerting and warning systems. After summarizing that literature, a human computer interaction (HCI) designer's guide was prepared to support the design of an attention allocation subsystem (AAS) for the MMWS. The resultant HCI guidelines are being applied in the design of a fully interactive AAS prototype. An overview of key findings from the literature review, a proposed design methodology with illustrative examples, and an assessment of progress made in implementing the HCI designers guide are presented.

Detecting acute distress and risk of future psychological morbidity in critically ill patients: validation of the intensive care psychological assessment tool.

Science.gov (United States)

Wade, Dorothy M; Hankins, Matthew; Smyth, Deborah A; Rhone, Elijah E; Mythen, Michael G; Howell, David C J; Weinman, John A

2014-09-24

The psychological impact of critical illness on a patient can be severe, and frequently results in acute distress as well as psychological morbidity after leaving hospital. A UK guideline states that patients should be assessed in critical care units, both for acute distress and risk of future psychological morbidity; but no suitable method for carrying out this assessment exists. The Intensive care psychological assessment tool (IPAT) was developed as a simple, quick screening tool to be used routinely to detect acute distress, and the risk of future psychological morbidity, in critical care units. A validation study of IPAT was conducted in the critical care unit of a London hospital. Once un-sedated, orientated and alert, critical care patients were assessed with the IPAT and validated tools for distress, to determine the IPAT's concurrent validity. Fifty six patients took IPAT again to establish test-retest reliability. Finally, patients completed posttraumatic stress disorder (PTSD), depression and anxiety questionnaires at three months, to determine predictive validity of the IPAT. One hundred and sixty six patients completed the IPAT, and 106 completed follow-up questionnaires at 3 months. Scale analysis showed IPAT was a reliable 10-item measure of critical care-related psychological distress. Test-retest reliability was good (r =0.8). There was good concurrent validity with measures of anxiety and depression (r =0.7, P psychological morbidity was good (r =0.4, P psychological morbidity (AUC =0.7). The IPAT was found to have good reliability and validity. Sensitivity and specificity analysis suggest the IPAT could provide a way of allowing staff to assess psychological distress among critical care patients after further replication and validation. Further work is also needed to determine its utility in predicting future psychological morbidity.

Dignity and Distress towards the End of Life across Four Non-Cancer Populations

Science.gov (United States)

Chochinov, Harvey Max

2016-01-01

Objective The purpose of this study was to identify four non-cancer populations that might benefit from a palliative approach; and describe and compare the prevalence and patterns of dignity related distress across these diverse clinical populations. Design A prospective, multi-site approach was used. Setting Outpatient clinics, inpatient facilities or personal care homes, located in Winnipeg, Manitoba and Edmonton, Alberta, Canada. Participants Patients with advanced Amyotrophic Lateral Sclerosis (ALS), Chronic Obstructive Pulmonary Disease (COPD), End Stage Renal Disease (ESRD); and the institutionalized alert frail elderly. Main Outcome Measure In addition to standardized measures of physical, psychological and spiritual aspects of patient experience, the Patient Dignity Inventory (PDI). Results Between February 2009 and December 2012, 404 participants were recruited (ALS, 101; COPD, 100; ESRD, 101; and frail elderly, 102). Depending on group designation, 35% to 58% died within one year of taking part in the study. While moderate to severe loss of sense of dignity did not differ significantly across the four study populations (4–11%), the number of PDI items reported as problematic was significantly different i.e. ALS 6.2 (5.2), COPD 5.6 (5.9), frail elderly 3.0 (4.4) and ESRD 2.3 (3.9) [p < .0001]. Each of the study populations also revealed unique and distinct patterns of physical, psychological and existential distress. Conclusion People with ALS, COPD, ESRD and the frail elderly face unique challenges as they move towards the end of life. Knowing the intricacies of distress and how they differ across these groups broadens our understanding of end-of-life experience within non-cancer populations and how best to meet their palliative care needs. PMID:26808530

Verbal collision avoidance messages during simulated driving: perceived urgency, alerting effectiveness and annoyance.

Science.gov (United States)

Baldwin, Carryl L

2011-04-01

Matching the perceived urgency of an alert with the relative hazard level of the situation is critical for effective alarm response. Two experiments describe the impact of acoustic and semantic parameters on ratings of perceived urgency, annoyance and alerting effectiveness and on alarm response speed. Within a simulated driving context, participants rated and responded to collision avoidance system (CAS) messages spoken by a female or male voice (experiments 1 and 2, respectively). Results indicated greater perceived urgency and faster alarm response times as intensity increased from -2 dB signal to noise (S/N) ratio to +10 dB S/N, although annoyance ratings increased as well. CAS semantic content interacted with alarm intensity, indicating that at lower intensity levels participants paid more attention to the semantic content. Results indicate that both acoustic and semantic parameters independently and interactively impact CAS alert perceptions in divided attention conditions and this work can inform auditory alarm design for effective hazard matching. Matching the perceived urgency of an alert with the relative hazard level of the situation is critical for effective alarm response. Here, both acoustic and semantic parameters independently and interactively impacted CAS alert perceptions in divided attention conditions. This work can inform auditory alarm design for effective hazard matching. STATEMENT OF RELEVANCE: Results indicate that both acoustic parameters and semantic content can be used to design collision warnings with a range of urgency levels. Further, these results indicate that verbal warnings tailored to a specific hazard situation may improve hazard-matching capabilities without substantial trade-offs in perceived annoyance.

Monitoring alert and drowsy states by modeling EEG source nonstationarity

Science.gov (United States)

Hsu, Sheng-Hsiou; Jung, Tzyy-Ping

2017-10-01

Objective. As a human brain performs various cognitive functions within ever-changing environments, states of the brain characterized by recorded brain activities such as electroencephalogram (EEG) are inevitably nonstationary. The challenges of analyzing the nonstationary EEG signals include finding neurocognitive sources that underlie different brain states and using EEG data to quantitatively assess the state changes. Approach. This study hypothesizes that brain activities under different states, e.g. levels of alertness, can be modeled as distinct compositions of statistically independent sources using independent component analysis (ICA). This study presents a framework to quantitatively assess the EEG source nonstationarity and estimate levels of alertness. The framework was tested against EEG data collected from 10 subjects performing a sustained-attention task in a driving simulator. Main results. Empirical results illustrate that EEG signals under alert versus drowsy states, indexed by reaction speeds to driving challenges, can be characterized by distinct ICA models. By quantifying the goodness-of-fit of each ICA model to the EEG data using the model deviation index (MDI), we found that MDIs were significantly correlated with the reaction speeds (r  =  -0.390 with alertness models and r  =  0.449 with drowsiness models) and the opposite correlations indicated that the two models accounted for sources in the alert and drowsy states, respectively. Based on the observed source nonstationarity, this study also proposes an online framework using a subject-specific ICA model trained with an initial (alert) state to track the level of alertness. For classification of alert against drowsy states, the proposed online framework achieved an averaged area-under-curve of 0.745 and compared favorably with a classic power-based approach. Significance. This ICA-based framework provides a new way to study changes of brain states and can be applied to

Exploring health promotion practitioners' experiences of moral distress in Canada and Australia.

Science.gov (United States)

Sunderland, Naomi; Harris, Paul; Johnstone, Kylie; Del Fabbro, Letitia; Kendall, Elizabeth

2015-03-01

This article introduces moral distress - the experience of painful feelings due to institutional constraints on personal moral action - as a significant issue for the international health promotion workforce. Our exploratory study of practitioners' experiences of health promotion in Australia and Canada during 2009-2010 indicated that practitioners who work in upstream policy- and systems-level health promotion are affected by experiences of moral distress. Health promotion practitioners at all levels of the health promotion continuum also described themselves as being engaged in a minority practice within a larger dominant system that does not always value health promotion. We argue that health promotion practitioners are vulnerable to moral distress due to the values-driven and political nature of the practice, the emphasis on systems change and the inherent complexity and diversity of the practice. This vulnerability to moral distress poses significant challenges to both workers and organisations and the communities they seek to benefit. We propose that further research should be undertaken to fully identify the causes and symptoms of moral distress in health promotion. Extensive existing research on moral distress in nursing provides ample resources to conduct such research. © The Author(s) 2014.

Time to Detection with BacT/Alert FA Plus Compared to BacT/Alert FA Blood Culture Media.

Science.gov (United States)

Nutman, A; Fisher Even-Tsur, S; Shapiro, G; Braun, T; Schwartz, D; Carmeli, Y

2016-09-01

Rapid identification of the causative pathogen in patients with bacteremia allows adjustment of antibiotic therapy and improves patient outcomes. We compared in vitro and real-life time to detection (TTD) of two blood culture media, BacT/Alert FA (FA) and BacT/Alert FA Plus (FA Plus), for the nine most common species of bacterial pathogens recovered from blood samples. Experimental data from simulated cultures was compared with microbiology records of TTD for both culture media with growth of the species of interest in clinical blood cultures. In the experimental conditions, median TTD was 3.8 hours (23.9 %) shorter using FA Plus media. The magnitude of reduction differed between species. Similarly, in real life data, FA Plus had shorter TTD than FA media; however, the difference between culture media was smaller, and median TTD was only 1 hour (8.5 %) less. We found shorter TTD with BacT/Alert FA Plus culture media, both experimentally and in real-life conditions and unrelated to antibiotic neutralization, highlighting the importance of appropriate blood culture media selection.

Alerting or Somnogenic Light: Pick Your Color

Science.gov (United States)

Bourgin, Patrice; Hubbard, Jeffrey

2016-01-01

In mammals, light exerts pervasive effects on physiology and behavior in two ways: indirectly through clock synchronization and the phase adjustment of circadian rhythms, and directly through the promotion of alertness and sleep, respectively, in diurnal and nocturnal species. A recent report by Pilorz and colleagues describes an even more complex role for the acute effects of light. In mice, blue light acutely causes behavioral arousal, whereas green wavelengths promote sleep. These opposing effects are mediated by melanopsin-based phototransduction through different neural pathways. These findings reconcile nocturnal and diurnal species through a common alerting response to blue light. One can hypothesize that the opposite responses to natural polychromatic light in night- or day-active animals may reflect higher sensitivity of nocturnal species to green, and diurnals to blue wavelengths, resulting in hypnogenic and alerting effects, respectively. Additional questions remain to be clarified. How do different light wavelengths affect other behaviors such as mood and cognition? How do those results apply to humans? How does light pose either a risk or benefit, depending on whether one needs to be asleep or alert? Indeed, in addition to timing, luminance levels, and light exposure duration, these findings stress the need to understand how best to adapt the color spectrum of light to our needs and to take this into account for the design of daily lighting concepts—a key challenge for today’s society, especially with the emergence of LED light technology. PMID:27525420

Alerting or Somnogenic Light: Pick Your Color.

Directory of Open Access Journals (Sweden)

Patrice Bourgin

2016-08-01

Full Text Available In mammals, light exerts pervasive effects on physiology and behavior in two ways: indirectly through clock synchronization and the phase adjustment of circadian rhythms, and directly through the promotion of alertness and sleep, respectively, in diurnal and nocturnal species. A recent report by Pilorz and colleagues describes an even more complex role for the acute effects of light. In mice, blue light acutely causes behavioral arousal, whereas green wavelengths promote sleep. These opposing effects are mediated by melanopsin-based phototransduction through different neural pathways. These findings reconcile nocturnal and diurnal species through a common alerting response to blue light. One can hypothesize that the opposite responses to natural polychromatic light in night- or day-active animals may reflect higher sensitivity of nocturnal species to green, and diurnals to blue wavelengths, resulting in hypnogenic and alerting effects, respectively. Additional questions remain to be clarified. How do different light wavelengths affect other behaviors such as mood and cognition? How do those results apply to humans? How does light pose either a risk or benefit, depending on whether one needs to be asleep or alert? Indeed, in addition to timing, luminance levels, and light exposure duration, these findings stress the need to understand how best to adapt the color spectrum of light to our needs and to take this into account for the design of daily lighting concepts-a key challenge for today's society, especially with the emergence of LED light technology.

Bioremediation of petroleum contaminated soil at CFS Alert - Laboratory scale respirometry experiment

International Nuclear Information System (INIS)

Haidar, S.; Bennett, J.; Jarrett, P.; Biggar, K.

1998-01-01

The feasibility of 'biopiling' was tested at Canadian Forces Station 'Alert', located in the high Arctic where the feasibility of bioremediation is yet to be proven. Laboratory respirometer experiments were conducted at 11 degrees C that examined the behaviour of indigenous microorganisms. Experiments were also carried out at one contaminated site. Various soil properties were analyzed, as well as total petroleum hydrocarbons. Results showed that the respirometer system functioned properly in monitoring the behaviour of microorganisms, that indigenous microorganisms were active at 11 degrees C, and that they functioned at a constant rate of oxygen consumption. These results suggest that biopiling may be feasible under the conditions existing at CFS 'Alert'. 12 refs., 5 tabs., 8 figs

Advantages and Disadvantages of Educational Email Alerts for Family Physicians: Viewpoint

Science.gov (United States)

Badran, Hani; Grad, Roland

2015-01-01

Background Electronic knowledge resources constitute an important channel for accredited Continuing Medical Education (CME) activities. However, email usage for educational purposes is controversial. On the one hand, family physicians become aware of new information, confirm what they already know, and obtain reassurance by reading educational email alerts. Email alerts can also encourage physicians to search Web-based resources. On the other hand, technical difficulties and privacy issues are common obstacles. Objective The purpose of this discussion paper, informed by a literature review and a small qualitative study, was to understand family physicians’ knowledge, attitudes, and behavior in regard to email in general and educational emails in particular, and to explore the advantages and disadvantages of educational email alerts. In addition, we documented participants’ suggestions to improve email alert services for CME. Methods We conducted a qualitative descriptive study using the “Knowledge, Attitude, Behavior” model. We conducted semi-structured face-to-face interviews with 15 family physicians. We analyzed the collected data using inductive-deductive thematic qualitative data analysis. Results All 15 participants scanned and prioritized their email, and 13 of them checked their email daily. Participants mentioned (1) advantages of educational email alerts such as saving time, convenience and valid information, and (2) disadvantages such as an overwhelming number of emails and irrelevance. They offered suggestions to improve educational email. Conclusions The advantages of email alerts seem to compensate for their disadvantages. Suggestions proposed by family physicians can help to improve educational email alerts. PMID:25803184

Advantages and disadvantages of educational email alerts for family physicians: viewpoint.

Science.gov (United States)

Badran, Hani; Pluye, Pierre; Grad, Roland

2015-02-27

Electronic knowledge resources constitute an important channel for accredited Continuing Medical Education (CME) activities. However, email usage for educational purposes is controversial. On the one hand, family physicians become aware of new information, confirm what they already know, and obtain reassurance by reading educational email alerts. Email alerts can also encourage physicians to search Web-based resources. On the other hand, technical difficulties and privacy issues are common obstacles. The purpose of this discussion paper, informed by a literature review and a small qualitative study, was to understand family physicians' knowledge, attitudes, and behavior in regard to email in general and educational emails in particular, and to explore the advantages and disadvantages of educational email alerts. In addition, we documented participants' suggestions to improve email alert services for CME. We conducted a qualitative descriptive study using the "Knowledge, Attitude, Behavior" model. We conducted semi-structured face-to-face interviews with 15 family physicians. We analyzed the collected data using inductive-deductive thematic qualitative data analysis. All 15 participants scanned and prioritized their email, and 13 of them checked their email daily. Participants mentioned (1) advantages of educational email alerts such as saving time, convenience and valid information, and (2) disadvantages such as an overwhelming number of emails and irrelevance. They offered suggestions to improve educational email. The advantages of email alerts seem to compensate for their disadvantages. Suggestions proposed by family physicians can help to improve educational email alerts.

Perceived discrimination, psychological distress, and current smoking status: results from the Behavioral Risk Factor Surveillance System Reactions to Race module, 2004-2008.

Science.gov (United States)

Purnell, Jason Q; Peppone, Luke J; Alcaraz, Kassandra; McQueen, Amy; Guido, Joseph J; Carroll, Jennifer K; Shacham, Enbal; Morrow, Gary R

2012-05-01

We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of mediation examining associations between perceived discrimination in health care and workplace settings, psychological distress, and current smoking status. Regardless of race/ethnicity, perceived discrimination was associated with increased odds of current smoking. Psychological distress was also a significant mediator of the discrimination-smoking association. Our results indicate that individuals who report discriminatory treatment in multiple domains may be more likely to smoke, in part, because of the psychological distress associated with such treatment.

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...

Design and implementation of the UFFO burst alert and trigger telescope

DEFF Research Database (Denmark)

Kim, J.E.; Ahmad, S.; Barrillon, P.

2012-01-01

The Ultra Fast Flash Observatory pathfinder (UFFO-p) is a telescope system designed for the detection of the prompt optical/UV photons from Gamma-Ray Bursts (GRBs), and it will be launched onboard the Lomonosov spacecraft in 2012. The UFFO-p consists of two instruments: the UFFO Burst Alert and T...

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...

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...

What Is Respiratory Distress Syndrome?

Science.gov (United States)

... Home / Respiratory Distress Syndrome Respiratory Distress Syndrome Also known as What Is Respiratory ... This condition is called apnea (AP-ne-ah). Respiratory Distress Syndrome Complications Depending on the severity of ...

A prospective study of the feasibility and acceptability of a Web-based, electronic patient-reported outcome system in assessing patient recovery after major gynecologic cancer surgery.

Science.gov (United States)

Andikyan, Vaagn; Rezk, Youssef; Einstein, M Heather; Gualtiere, Gina; Leitao, Mario M; Sonoda, Yukio; Abu-Rustum, Nadeem R; Barakat, Richard R; Basch, Ethan M; Chi, Dennis S

2012-11-01

The purposes of this study are to evaluate the feasibility of capturing patient-reported outcomes (PROs) electronically and to identify the most common distressing symptoms in women recovering from major gynecologic cancer surgery. This was a prospective, single-arm pilot study. Eligible participants included those scheduled for a laparotomy for presumed or known gynecologic malignancy. Patients completed a Web-based "STAR" (Symptom Tracking and Reporting for Patients) questionnaire once preoperatively and weekly during the 6-week postoperative period. The questionnaire consisted of the patient adaptation of the NCI CTCAE 3.0 and EORTC QLQ-C30 3.0. When a patient submitted a response that was concerning, an automated email alert was sent to the clinician. The patient's assessment of STAR's usefulness was measured via an exit survey. Forty-nine patients completed the study. The procedures included the following: hysterectomy±staging (67%), resection of tumor (22%), salpingo-oophorectomy (6%), and other (4%). Most patients (82%) completed at least 4 sessions in STAR. The CTC generated 43 alerts. These alerts resulted in 25 telephone contacts with patients, 2 ER referrals, one new appointment, and one pharmaceutical prescription. The 3 most common patient-reported symptoms generating an alert were as follows: poor performance status (19%), nausea (18%), and fatigue (17%). Most patients found STAR useful (80%) and would recommend it to others (85%). Application of a Web-based, electronic STAR system is feasible in the postoperative period, highly accepted by patients, and warrants further study. Poor performance status, nausea, and fatigue were the most common distressing patient-reported symptoms. Copyright © 2012 Elsevier Inc. All rights reserved.

Moral distress in emergency nurses.

Science.gov (United States)

Fernandez-Parsons, Robin; Rodriguez, Lori; Goyal, Deepika

2013-11-01

For nurses, moral distress leads to burnout, attrition, compassion fatigue, and patient avoidance. Using a quantitative, cross-sectional, and descriptive design, we assessed the frequency, intensity, and type of moral distress in 51 emergency nurses in 1 community hospital using a 21-item, self-report, Likert-type questionnaire. Results showed a total mean moral distress level of 3.18, indicative of overall low moral distress. Situations with the highest levels of moral distress were related to the competency of health care providers and following family wishes to continue life support, also known as futile care. Moral distress was the reason given by 6.6% of registered nurses for leaving a previous position, 20% said that they had considered leaving a position but did not, and 13.3% stated that they are currently considering leaving their position because of moral distress. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Nurse middle manager ethical dilemmas and moral distress.

Science.gov (United States)

Ganz, Freda D; Wagner, Nurit; Toren, Orly

2015-02-01

Nurse managers are placed in a unique position within the healthcare system where they greatly impact upon the nursing work environment. Ethical dilemmas and moral distress have been reported for staff nurses but not for nurse middle managers. To describe ethical dilemmas and moral distress among nurse middle managers arising from situations of ethical conflict. The Ethical Dilemmas in Nursing-Middle Manager Questionnaire and a personal characteristics questionnaire were administered to a convenience sample of middle managers from four hospitals in Israel. Middle managers report low to moderate levels of frequency and intensity of ethical dilemmas and moral distress. Highest scores were for administrative dilemmas. Middle managers experience lower levels of ethical dilemmas and moral distress than staff nurses, which are irrespective of their personal characteristics. Interventions should be developed, studied, and then incorporated into institutional frameworks in order to improve this situation. © The Author(s) 2014.

GEOSPATIAL ANALYSIS OF ROAD DISTRESSES AND THE RELATIONSHIP WITH THE SLOPE FACTOR

Directory of Open Access Journals (Sweden)

NOR A. M. NASIR

2016-05-01

Full Text Available A road is a medium that a person uses to move from one destination to another. A good road can provide comfort and safety to users, however, poor maintenance of a road might cause danger to them. Therefore, a road maintenance management system needs to be carried out to ensure the effectiveness as well as the efficiency of road maintenance itself. In this era, there are so many systems created in order to help data storage and analysis. One of the systems is the Geographic Information System (GIS. Other than getting the location of distresses, GIS also can help to classify the severity level of distresses and to correlate the distresses occurring in Universiti Kebangsaan Malaysia (UKM with the slope gradient. Road distress data was collected using GPS applications supported by Supersurv 3 software. The study shows that the GIS method helps to produce a good spatial database. The road gradient factor is related to the level of road damage.

IR panoramic alerting sensor concepts and applications

Science.gov (United States)

de Jong, Arie N.; Schwering, Piet B. W.

2003-09-01

During the last decade, protection of military and civilian operational platforms against weapons like guns, grenades, missiles, Unmanned Combat Aerial (and surface) Vehicles (UCAV's) and mines, has been an issue of increased importance due to the improved kill-probability of these threats. The standard countermeasure package of armour, guns, decoys, jammers, camouflage nets and smokes is inadequate when not accompanied by a suitable sensor package, primarily consisting of an alerting device, triggering consecutive steps in the countermeasure-chain. In this process of alert four different detection techniques are considered: pre-alert, giving the directions of possible attack, detection of an action of attack, identification of the threat and finally the precise localization (3-D). The design of the alerting device is greatly depending on the platform, on which it will be used, the associated and affordable cost and the nature of the threat. A number of sensor packages, considered, developed and evaluated at TNO-FEL is presented for simple, medium size and large and expensive platforms. In recent years the requirements for these sensors have become more and more strigent due to the growing number of scenarios. The attack can practically be from any direction, implying the need for a large Field of Regard (FOR), the attack range can vary considerably and the type of threat can be very diverse, implying great flexibility and dynamic range and rapid response of the sensor. Especially the localization at short ranges is a challenging issue. Various configurations including advantages and drawbacks are discussed.

Augmented real-time navigation with critical structure proximity alerts for endoscopic skull base surgery.

Science.gov (United States)

Dixon, Benjamin J; Daly, Michael J; Chan, Harley; Vescan, Allan; Witterick, Ian J; Irish, Jonathan C

2014-04-01

Image-guided surgery (IGS) systems are frequently utilized during cranial base surgery to aid in orientation and facilitate targeted surgery. We wished to assess the performance of our recently developed localized intraoperative virtual endoscopy (LIVE)-IGS prototype in a preclinical setting prior to deployment in the operating room. This system combines real-time ablative instrument tracking, critical structure proximity alerts, three-dimensional virtual endoscopic views, and intraoperative cone-beam computed tomographic image updates. Randomized-controlled trial plus qualitative analysis. Skull base procedures were performed on 14 cadaver specimens by seven fellowship-trained skull base surgeons. Each subject performed two endoscopic transclival approaches; one with LIVE-IGS and one using a conventional IGS system in random order. National Aeronautics and Space Administration Task Load Index (NASA-TLX) scores were documented for each dissection, and a semistructured interview was recorded for qualitative assessment. The NASA-TLX scores for mental demand, effort, and frustration were significantly reduced with the LIVE-IGS system in comparison to conventional navigation (P < .05). The system interface was judged to be intuitive and most useful when there was a combination of high spatial demand, reduced or absent surface landmarks, and proximity to critical structures. The development of auditory icons for proximity alerts during the trial better informed the surgeon while limiting distraction. The LIVE-IGS system provided accurate, intuitive, and dynamic feedback to the operating surgeon. Further refinements to proximity alerts and visualization settings will enhance orientation while limiting distraction. The system is currently being deployed in a prospective clinical trial in skull base surgery. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Best practices: an electronic drug alert program to improve safety in an accountable care environment.

Science.gov (United States)

Griesbach, Sara; Lustig, Adam; Malsin, Luanne; Carley, Blake; Westrich, Kimberly D; Dubois, Robert W

2015-04-01

The accountable care organization (ACO), one of the most promising and talked about new models of care, focuses on improving communication and care transitions by tying potential shared savings to specific clinical and financial benchmarks. An important factor in meeting these benchmarks is an ACO's ability to manage medications in an environment where medical and pharmacy care has been integrated. The program described in this article highlights the critical components of Marshfield Clinic's Drug Safety Alert Program (DSAP), which focuses on prioritizing and communicating safety issues related to medications with the goal of reducing potential adverse drug events. Once the medication safety concern is identified, it is reviewed to evaluate whether an alert warrants sending prescribers a communication that identifies individual patients or a general communication to all physicians describing the safety concern. Instead of basing its decisions regarding clinician notification about drug alerts on subjective criteria, the Marshfield Clinic's DSAP uses an internally developed scoring system. The scoring system includes criteria developed from previous drug alerts, such as level of evidence, size of population affected, severity of adverse event identified or targeted, litigation risk, available alternatives, and potential for duration of medication use. Each of the 6 criteria is assigned a weight and is scored based upon the content and severity of the alert received.  In its first 12 months, the program targeted 6 medication safety concerns involving the following medications: topiramate, glyburide, simvastatin, citalopram, pioglitazone, and lovastatin. Baseline and follow-up prescribing data were gathered on the targeted medications. Follow-up review of prescribing data demonstrated that the DSAP provided quality up-to-date safety information that led to changes in drug therapy and to decreases in potential adverse drug events. In aggregate, nearly 10,000 total

An Unobtrusive Fall Detection and Alerting System Based on Kalman Filter and Bayes Network Classifier.

Science.gov (United States)

He, Jian; Bai, Shuang; Wang, Xiaoyi

2017-06-16

Falls are one of the main health risks among the elderly. A fall detection system based on inertial sensors can automatically detect fall event and alert a caregiver for immediate assistance, so as to reduce injuries causing by falls. Nevertheless, most inertial sensor-based fall detection technologies have focused on the accuracy of detection while neglecting quantization noise caused by inertial sensor. In this paper, an activity model based on tri-axial acceleration and gyroscope is proposed, and the difference between activities of daily living (ADLs) and falls is analyzed. Meanwhile, a Kalman filter is proposed to preprocess the raw data so as to reduce noise. A sliding window and Bayes network classifier are introduced to develop a wearable fall detection system, which is composed of a wearable motion sensor and a smart phone. The experiment shows that the proposed system distinguishes simulated falls from ADLs with a high accuracy of 95.67%, while sensitivity and specificity are 99.0% and 95.0%, respectively. Furthermore, the smart phone can issue an alarm to caregivers so as to provide timely and accurate help for the elderly, as soon as the system detects a fall.

Acute respiratory distress syndrome: epidemiology and management approaches

Directory of Open Access Journals (Sweden)

Walkey AJ

2012-07-01

Full Text Available Allan J Walkey,1 Ross Summer,1 Vu Ho,1 Philip Alkana21The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA; 2Asthma Research Center, Brigham and Women's Hospital, Boston, MA, USAAbstract: Acute lung injury and the more severe acute respiratory distress syndrome represent a spectrum of lung disease characterized by the sudden onset of inflammatory pulmonary edema secondary to myriad local or systemic insults. The present article provides a review of current evidence in the epidemiology and treatment of acute lung injury and acute respiratory distress syndrome, with a focus on significant knowledge gaps that may be addressed through epidemiologic methods.Keywords: acute lung injury, acute respiratory distress syndrome, review, epidemiology

Perceived Discrimination, Psychological Distress, and Current Smoking Status: Results From the Behavioral Risk Factor Surveillance System Reactions to Race Module, 2004–2008

Science.gov (United States)

Peppone, Luke J.; Alcaraz, Kassandra; McQueen, Amy; Guido, Joseph J.; Carroll, Jennifer K.; Shacham, Enbal; Morrow, Gary R.

2012-01-01

Objectives. We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample. Methods. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of mediation examining associations between perceived discrimination in health care and workplace settings, psychological distress, and current smoking status. Results. Regardless of race/ethnicity, perceived discrimination was associated with increased odds of current smoking. Psychological distress was also a significant mediator of the discrimination–smoking association. Conclusions. Our results indicate that individuals who report discriminatory treatment in multiple domains may be more likely to smoke, in part, because of the psychological distress associated with such treatment. PMID:22420821

Ordered LOGIT Model approach for the determination of financial distress.

Science.gov (United States)

Kinay, B

2010-01-01

Nowadays, as a result of the global competition encountered, numerous companies come up against financial distresses. To predict and take proactive approaches for those problems is quite important. Thus, the prediction of crisis and financial distress is essential in terms of revealing the financial condition of companies. In this study, financial ratios relating to 156 industrial firms that are quoted in the Istanbul Stock Exchange are used and probabilities of financial distress are predicted by means of an ordered logit regression model. By means of Altman's Z Score, the dependent variable is composed by scaling the level of risk. Thus, a model that can compose an early warning system and predict financial distress is proposed.

Generating Artificial Snort Alerts and Implementing SELK: The Snort-Elasticsearch-Logstash-Kibana Stack

Science.gov (United States)

2017-09-01

classification system with 38 classifications for alerts. These include things such as “trojan- activity”, “shellcode-detect”, “denial-of-service...Abbreviations, and Acronyms ARL US Army Research Laboratory CIDR classless inter-domain routing IP Internet Protocol NIDS network intrusion

Relationship between alertness, performance, and body temperature in humans

Science.gov (United States)

Wright, Kenneth P Jr; Hull, Joseph T.; Czeisler, Charles A.

2002-01-01

Body temperature has been reported to influence human performance. Performance is reported to be better when body temperature is high/near its circadian peak and worse when body temperature is low/near its circadian minimum. We assessed whether this relationship between performance and body temperature reflects the regulation of both the internal biological timekeeping system and/or the influence of body temperature on performance independent of circadian phase. Fourteen subjects participated in a forced desynchrony protocol allowing assessment of the relationship between body temperature and performance while controlling for circadian phase and hours awake. Most neurobehavioral measures varied as a function of internal biological time and duration of wakefulness. A number of performance measures were better when body temperature was elevated, including working memory, subjective alertness, visual attention, and the slowest 10% of reaction times. These findings demonstrate that an increased body temperature, associated with and independent of internal biological time, is correlated with improved performance and alertness. These results support the hypothesis that body temperature modulates neurobehavioral function in humans.

Optical Flow and Driver’s Kinematics Analysis for State of Alert Sensing

Directory of Open Access Journals (Sweden)

Miguel Torres-Torriti

2013-03-01

Full Text Available Road accident statistics from different countries show that a significant number of accidents occur due to driver’s fatigue and lack of awareness to traffic conditions. In particular, about 60% of the accidents in which long haul truck and bus drivers are involved are attributed to drowsiness and fatigue. It is thus fundamental to improve non-invasive systems for sensing a driver’s state of alert. One of the main challenges to correctly resolve the state of alert is measuring the percentage of eyelid closure over time (PERCLOS, despite the driver’s head and body movements. In this paper, we propose a technique that involves optical flow and driver’s kinematics analysis to improve the robustness of the driver’s alert state measurement under pose changes using a single camera with near-infrared illumination. The proposed approach infers and keeps track of the driver’s pose in 3D space in order to ensure that eyes can be located correctly, even after periods of partial occlusion, for example, when the driver stares away from the camera. Our experiments show the effectiveness of the approach with a correct eyes detection rate of 99.41%, on average. The results obtained with the proposed approach in an experiment involving fifteen persons under different levels of sleep deprivation also confirm the discriminability of the fatigue levels. In addition to the measurement of fatigue and drowsiness, the pose tracking capability of the proposed approach has potential applications in distraction assessment and alerting of machine operators.

Assessment of work intensification by managers and psychological distressed and non-distressed employees: a multilevel comparison.

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Bamberger, Simon Grandjean; Larsen, Anelia; Vinding, Anker Lund; Nielsen, Peter; Fonager, Kirsten; Nielsen, René Nesgaard; Ryom, Pia; Omland, Øyvind

2015-01-01

Work intensification is a popular management strategy to increase productivity, but at the possible expense of employee mental stress. This study examines associations between ratings of work intensification and psychological distress, and the level of agreement between compared employee-rated and manager-rated work intensification. Multi-source survey data were collected from 3,064 employees and 573 company managers from the private sector in 2010. Multilevel regression models were used to compare different work intensification ratings across psychological distress strata. Distressed employees rated higher degree of total work intensification compared to non-distressed employees, and on three out of five sub ratings there were an increased prevalence of work intensification in the case group. In general, there was poor agreement between employee and company work intensification rating. Neither manager-rated work intensification nor employee/manager discrepancy in work intensification ratings was associated with psychological distress. Distressed employees had a higher total score of employee/manager agreed work intensification, and a higher prevalence of increased demands of labour productivity. This study demonstrates higher ratings of employee/manager agreed work intensification in distressed employees compared to non-distressed employees, challenging previous findings of reporting bias in distressed employees' assessment of work environment.

Psychological distress among homeless adults.

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Gelberg, L; Linn, L S

1989-05-01

Recent studies have reported a high prevalence of mental illness among the homeless. As part of a community-based survey of 529 homeless adults, we developed and tested a model to increase our understanding of the factors related to their psychological distress. Using a previously validated and reliable scale of perceived psychological distress, we found that homeless adults were more likely to report psychological distress than the general population (80% vs. 49%). Distress levels were not associated with most demographic or homeless characteristics or general appearance. However, distress was related to unemployment, greater cigarette and alcohol use, worse physical health, fewer social supports, and perceived barriers to obtaining needed medical care. Since mental, physical, and social health are strongly related among homeless adults, alleviating distress among them may be most effectively done by implementing a broad-based health services package coupled with employment programs provided in an accessible service delivery setting.

Effects of chewing gum and time-on-task on alertness and attention.

Science.gov (United States)

Allen, A P; Smith, A P

2012-07-01

Chewing gum has been shown to reliably increase subjective alertness whereas the effects on attention are more variable. It has been suggested that chewing gum only enhances attention when the person has been performing a task for some time. The current research aimed to investigate if time-on-task trends enhancing effects of chewing gum could be observed in alertness and attention during and following chewing. Study 1 used tests of reported mood, including reported mood, and tests of attention (categoric search, focussed attention, simple reaction time, and vigilance). These tasks were performed shortly after the start of chewing. Study 2 examined effects of previous and current chewing on reported alertness and the attention tests. Study 1 showed that chewing gum increased reported alertness and hedonic tone and improved performance on the categoric search task. Chewing gum maintained reported alertness across sessions in study 2. In the first experimental session of study 2 gum improved categoric search performance, and during the second session gum broadened focus of attention and quickened vigilance reaction time. This effect on vigilance reaction time was moderated by time-on-task, with an initial negative effect being replaced by a positive effect. The results confirm the robust effect of chewing gum on reported alertness and show that changes in the effects of chewing gum on attention require further investigation. Future research may also determine underlying mechanisms for an alerting effect.

'Moral distress'--time to abandon a flawed nursing construct?

Science.gov (United States)

Johnstone, Megan-Jane; Hutchinson, Alison

2015-02-01

Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains. © The Author(s) 2013.

Who is Distressed Applying the Diabetes Related Distress Scale in a Diabetes Clinic

Science.gov (United States)

2017-06-09

59 MDW /SGVU SUBJECT: Professional Presentation Approval 7APR 2017 1. Your paper, entitled Who is Distressed? Applying the Diabetes -Related Distress...Scale in A Diabetes Clinic presented at/published to American Diabetes Association 2017 Meeting, San Francisco, CA (National Conference), 9-16 June...as a publication/presentation, a new 59 MOW Form 3039 must be submitted for review and approval.) Using the Diabetes -Related Distress Scale in

Infant Responsiveness, Alertness, Hemoglobin and Growth in Rural Sidama, Ethiopia

Science.gov (United States)

Aubuchon-Endsley, Nicki L.; Grant, Stephanie L.; Thomas, David G.; Kennedy, Tay S.; Berhanu, Getenesh; Stoecker, Barbara J.; Hubbs-Tait, Laura; Hambidge, K. Michael

2011-01-01

Several recent studies have supported relations between infant behavior (alertness and responsiveness) and nutrition (e.g. Dempsey 2008, Wachs et al 2005) in addition to investigating infant behavior within the context of changes in iron status over time (e.g. Black et al. 2004, Murray-Kolb & Beard 2009). Existing research is typically limited to investigation of the effects of a single vitamin or mineral and no studies have been found that examined the influence that early alertness and responsiveness have on growth in early infancy, despite the fact that relations between behavior and nutritional status may be bidirectional (Hulthén 2003). The current study used a sample of Ethiopian infants and investigated anthropometrics, hemoglobin, the frequency of alertness, and the frequency of responsiveness at 6 and 9 months of age. Six-month weight-for-age predicted 9-month frequency of alertness, while 6-month hemoglobin predicted 9-month frequency of responsiveness. Compared to responsive infants, non-responsive infants at 6 months remained more non-responsive at 9 months, though weight-for-age for both groups converged at 9 months. Results support relations between nutrition and behavior (alertness and responsiveness) and provide evidence of a potentially useful tool (the Laboratory Temperament Assessment Battery [Lab-TAB]) that was adapted to evaluate these relations in Ethiopia. PMID:22233352

Satellites for Distress Alerting and Locating

Science.gov (United States)

1976-10-01

cipally from the techniques and frequencies internationally adopted for public correspondence (e.g., business and personal communications).- As a... Unicorn stations (30 percent of uncontrolled landing fields have li- cerised Unicom stations). Such monitoring could be performed with inexpensiver...departure f. Military aircraft (Note: most carry ELT’s). All other general aviation aircraft whether for business , pleasure, or charter are required

Idioms of distress: alternatives in the expression of psychosocial distress: a case study from South India.

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Nichter, M

1981-12-01

This paper focuses attention on alternative modes of expressing distress and the need to analyze particular manifestations of distress in relation to personal and cultural meaning complexes as well as the availability and social implications of coexisting idioms of expression. To illustrate this point the case of South Kanarese Havik Brahmin women is presented. These women are described as having a weak social support network and limited opportunities to ventilate feelings and seek counsel outside the household. Alternative means of expressing psychosocial distress resorted to by Havik women are discussed in relation to associated Brahminic values, norms and stereotypes. Somatization is focused upon as an important idiom through which distress is communicated. Idioms of distress more peripheral to the personal or cultural behavioral repertoire of Havik women are considered as adaptive responses in circumstances where other modes of expression fail to communicate distress adequately or provide appropriate coping strategies. The importance of an 'idioms of distress' approach to psychiatric evaluation is noted.

Alertness Management In Flight Operations: A NASA Education and Training Module

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Rosekind, Mark R.; Lebacqz, Victor J.; Gander, Philippa H.; Co, Elizabeth L.; Weldon, Keri J.; Smith, Roy M.; Miller, Donna L.; Gregory, Kevin B.; Statler, Irving C. (Technical Monitor)

1994-01-01

Since 1980, the NASA Ames Fatigue Countermeasures Program has been conducting research on sleep, circadian rhythms, and fatigue in a variety of flight operations 1. An original goal of the program was to return the scientific and operational knowledge to the aviation industry. To meet this goal, the NASA Ames Fatigue Countermeasures Program has created an Education and Training Module entitled, "Strategies for Alertness Management in Flight Operations." The Module was designed to meet three objectives: 1) explain the current state of knowledge about the physiological mechanisms underlying fatigue, 2) demonstrate how this knowledge can be applied to improve flight crew sleep, performance, and alertness, and 3) offer countermeasure recommendations. The Module is composed of two components: 1) a 60-minute live presentation provided by a knowledgeable individual and 2) a NASA/FAA Technical Memorandum (TM) that contains the presentation materials and appendices with complementary information. The TM is provided to all individuals attending the live presentation. The Module content is divided into three parts: 1) basic information on sleep, sleepiness, circadian rhythms, fatigue, and how flight operations affect these physiological factors, 2) common misconceptions about sleep, sleepiness, and fatigue, and 3) alertness management strategies. The Module is intended for pilots, management personnel, schedulers, flight attendants, and the many other individuals involved in the aviation system.

CEI-PEA Alert, Summer 2006

Science.gov (United States)

Center for Educational Innovation - Public Education Association, 2006

2006-01-01

The "CEI-PEA Alert" is an advocacy newsletter that deals with topics of interest to all concerned with the New York City public schools. This issue includes: (1) Practical Skills & High Academic Standards: Career Technical Education; (2) Parents: Help Your Children Gain "Soft Skills" for the Workforce; (3) Culinary Arts…

Conflict resolution and alert zone estimation in air traffic management

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Kuo, Vincent Hao-Hung

The current air traffic control (ATC) system provides separations among all aircraft through pre-defined routes and flight procedures, and active controller participation. In particular, en route separations are achieved by choices of different flight routes, different flight levels, and speed control. During the final descent approach over an extended terminal area, aircraft separations are achieved by speed changes, altitude changes, and path stretching. Recently, a concept of free flight has been proposed for future air traffic management. In the proposed free flight environment, aircraft operators can change flight paths in real time, in order to achieve the best efficiency for the aircraft. Air traffic controllers are only supposed to intervene when situation warrants, to resolve potential conflicts among aircraft. In both cases, there is a region around each aircraft called alert zone. As soon as another aircraft touches the alert zone of own aircraft, either the own aircraft or both aircraft must initiate avoidance maneuvers to resolve a potential conflict. This thesis develops a systematic approach based on nonlinear optimal control theories to estimate alert zones in two aircraft conflict scenarios. Specifically, point-mass aircraft models are used to describe aircraft motions. Separate uses of heading, speed, and altitude control are first examined, and then the synergetic use of two control authorities are studied. Both cooperative maneuvers (in which both aircraft act) and non-cooperative maneuvers (in which the own aircraft acts alone) are considered. Optimal control problems are formulated to minimize the initial relative separation between the two aircraft for all possible initial conditions, subject to the requirement that inter-aircraft separation at any time satisfies the separation requirement. These nonlinear optimal control problems are solved numerically using a collation approach and the NPSOL software line for nonlinear programming. In

Core drug-drug interaction alerts for inclusion in pediatric electronic health records with computerized prescriber order entry.

Science.gov (United States)

Harper, Marvin B; Longhurst, Christopher A; McGuire, Troy L; Tarrago, Rod; Desai, Bimal R; Patterson, Al

2014-03-01

The study aims to develop a core set of pediatric drug-drug interaction (DDI) pairs for which electronic alerts should be presented to prescribers during the ordering process. A clinical decision support working group composed of Children's Hospital Association (CHA) members was developed. CHA Pharmacists and Chief Medical Information Officers participated. Consensus was reached on a core set of 19 DDI pairs that should be presented to pediatric prescribers during the order process. We have provided a core list of 19 high value drug pairs for electronic drug-drug interaction alerts to be recommended for inclusion as high value alerts in prescriber order entry software used with a pediatric patient population. We believe this list represents the most important pediatric drug interactions for practical implementation within computerized prescriber order entry systems.

Acute respiratory distress syndrome

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... page: //medlineplus.gov/ency/article/000103.htm Acute respiratory distress syndrome To use the sharing features on this page, please enable JavaScript. Acute respiratory distress syndrome (ARDS) is a life-threatening lung ...

Effectiveness of National Weather Service heat alerts in preventing mortality in 20 US cities.

Science.gov (United States)

Weinberger, Kate R; Zanobetti, Antonella; Schwartz, Joel; Wellenius, Gregory A

2018-04-09

Extreme heat is a well-documented public health threat. The US National Weather Service (NWS) issues heat advisories and warnings (collectively, "heat alerts") in advance of forecast extreme heat events. The effectiveness of these alerts in preventing deaths remains largely unknown. To quantify the change in mortality rates associated with heat alerts in 20 US cities between 2001 and 2006. Because NWS heat alerts are issued based on forecast weather and these forecasts are imperfect, in any given location there exists a set of days of similar observed heat index in which heat alerts have been issued for some days but not others. We used a case-crossover design and conditional logistic regression to compare mortality rates on days with versus without heat alerts among such eligible days, adjusting for maximum daily heat index and temporal factors. We combined city-specific estimates into a summary measure using standard random-effects meta-analytic techniques. Overall, NWS heat alerts were not associated with lower mortality rates (percent change in rate: -0.5% [95% CI: -2.8, 1.9]). In Philadelphia, heat alerts were associated with a 4.4% (95% CI: -8.3, -0.3) lower mortality rate or an estimated 45.1 (95% empirical CI: 3.1, 84.1) deaths averted per year if this association is assumed to be causal. No statistically significant beneficial association was observed in other individual cities. Our results suggest that between 2001 and 2006, NWS heat alerts were not associated with lower mortality in most cities studied, potentially missing a valuable opportunity to avert a substantial number of heat-related deaths. These results highlight the need to better link alerts to effective communication and intervention strategies to reduce heat-related mortality. Copyright © 2018 Elsevier Ltd. All rights reserved.

Reducing Unnecessary and Duplicate Ordering for Ovum and Parasite Examinations and Clostridium difficile PCR in Immunocompromised Patients by Using an Alert at the Time of Request in the Order Management System.

Science.gov (United States)

Otto, Caitlin C; Shuptar, Susan L; Milord, Philippe; Essick, Connor J; Nevrekar, Reshma; Granovsky, Svetlana L; Seo, Susan K; Babady, N Esther; Martin, Steven C; Tang, Yi-Wei; Pessin, Melissa S

2015-08-01

We implemented hospital information system (HIS) alerts to deter unnecessary test orders for ovum and parasite (O&P) exams and Clostridium difficile PCR. The HIS alerts decreased noncompliant O&P orders (orders after >72 h of hospitalization) from 49.8% to 30.9%, an overall decrease of 19%, and reduced noncompliant C. difficile PCR orders (orders <7 days after a previous positive result) from 30.6% to 19.2%, an overall decrease of 31.9%. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Moral Distress, Workplace Health, and Intrinsic Harm.

Science.gov (United States)

Weber, Elijah

2016-05-01

Moral distress is now being recognized as a frequent experience for many health care providers, and there's good evidence that it has a negative impact on the health care work environment. However, contemporary discussions of moral distress have several problems. First, they tend to rely on inadequate characterizations of moral distress. As a result, subsequent investigations regarding the frequency and consequences of moral distress often proceed without a clear understanding of the phenomenon being discussed, and thereby risk substantially misrepresenting the nature, frequency, and possible consequences of moral distress. These discussions also minimize the intrinsically harmful aspects of moral distress. This is a serious omission. Moral distress doesn't just have a negative impact on the health care work environment; it also directly harms the one who experiences it. In this paper, I claim that these problems can be addressed by first clarifying our understanding of moral distress, and then identifying what makes moral distress intrinsically harmful. I begin by identifying three common mistakes that characterizations of moral distress tend to make, and explaining why these mistakes are problematic. Next, I offer an account of moral distress that avoids these mistakes. Then, I defend the claim that moral distress is intrinsically harmful to the subject who experiences it. I conclude by explaining how acknowledging this aspect of moral distress should reshape our discussions about how best to deal with this phenomenon. © 2015 John Wiley & Sons Ltd.

Volcanic alert system (VAS) developed during the 2011-2014 El Hierro (Canary Islands) volcanic process

Science.gov (United States)

García, Alicia; Berrocoso, Manuel; Marrero, José M.; Fernández-Ros, Alberto; Prates, Gonçalo; De la Cruz-Reyna, Servando; Ortiz, Ramón

2014-06-01

The 2011 volcanic unrest at El Hierro Island illustrated the need for a Volcanic Alert System (VAS) specifically designed for the management of volcanic crises developing after long repose periods. The VAS comprises the monitoring network, the software tools for analysis of the monitoring parameters, the Volcanic Activity Level (VAL) management, and the assessment of hazard. The VAS presented here focuses on phenomena related to moderate eruptions, and on potentially destructive volcano-tectonic earthquakes and landslides. We introduce a set of new data analysis tools, aimed to detect data trend changes, as well as spurious signals related to instrumental failure. When data-trend changes and/or malfunctions are detected, a watchdog is triggered, issuing a watch-out warning (WOW) to the Monitoring Scientific Team (MST). The changes in data patterns are then translated by the MST into a VAL that is easy to use and understand by scientists, technicians, and decision-makers. Although the VAS was designed specifically for the unrest episodes at El Hierro, the methodologies may prove useful at other volcanic systems.

Crew Factors in Flight Operations XV: Alertness Management in General Aviation Education Module

Science.gov (United States)

Rosekind, Mark R.; Co, Elizabeth L.; Neri, David F.; Oyung, Raymond L.; Mallis, Melissa M.; Cannon, Mary M. (Technical Monitor)

2002-01-01

Regional operations encompass a broad range of pilots and equipment. This module is intended to help all those involved in regional aviation, including pilots, schedulers, dispatchers, maintenance technicians, policy makers, and others, to understand the physiological factors underlying fatigue, how flight operations affect fatigue, and what can be done to counteract fatigue and maximize alertness and performance in their operations. The overall purpose of this module is to promote aviation safety, performance, and productivity. It is intended to meet three specific objectives: (1) to explain the current state of knowledge about the physiological mechanisms underlying fatigue; (2) to demonstrate how this knowledge can be applied to improving flight crew sleep, performance, and alertness; and (3) to offer strategies for alertness management. Aviation Safety Reporting System (ASRS) and National Transportation Safety Board (NISH) reports are used throughout this module to demonstrate that fatigue is a safety issue in the regional operations community. The appendices at the end of this module include the ASRS reports used for the examples contained in this publication, brief introductions to sleep disorders and relaxation techniques, summaries of relevant NASA publications, and a list of general readings on sleep, sleep disorders, and circadian rhythms.

Towards cross-lingual alerting for bursty epidemic events.

Science.gov (United States)

Collier, Nigel

2011-10-06

Online news reports are increasingly becoming a source for event-based early warning systems that detect natural disasters. Harnessing the massive volume of information available from multilingual newswire presents as many challanges as opportunities due to the patterns of reporting complex spatio-temporal events. In this article we study the problem of utilising correlated event reports across languages. We track the evolution of 16 disease outbreaks using 5 temporal aberration detection algorithms on text-mined events classified according to disease and outbreak country. Using ProMED reports as a silver standard, comparative analysis of news data for 13 languages over a 129 day trial period showed improved sensitivity, F1 and timeliness across most models using cross-lingual events. We report a detailed case study analysis for Cholera in Angola 2010 which highlights the challenges faced in correlating news events with the silver standard. The results show that automated health surveillance using multilingual text mining has the potential to turn low value news into high value alerts if informed choices are used to govern the selection of models and data sources. An implementation of the C2 alerting algorithm using multilingual news is available at the BioCaster portal http://born.nii.ac.jp/?page=globalroundup.

Towards cross-lingual alerting for bursty epidemic events

Directory of Open Access Journals (Sweden)

Collier Nigel

2011-10-01

Full Text Available Abstract Background Online news reports are increasingly becoming a source for event-based early warning systems that detect natural disasters. Harnessing the massive volume of information available from multilingual newswire presents as many challanges as opportunities due to the patterns of reporting complex spatio-temporal events. Results In this article we study the problem of utilising correlated event reports across languages. We track the evolution of 16 disease outbreaks using 5 temporal aberration detection algorithms on text-mined events classified according to disease and outbreak country. Using ProMED reports as a silver standard, comparative analysis of news data for 13 languages over a 129 day trial period showed improved sensitivity, F1 and timeliness across most models using cross-lingual events. We report a detailed case study analysis for Cholera in Angola 2010 which highlights the challenges faced in correlating news events with the silver standard. Conclusions The results show that automated health surveillance using multilingual text mining has the potential to turn low value news into high value alerts if informed choices are used to govern the selection of models and data sources. An implementation of the C2 alerting algorithm using multilingual news is available at the BioCaster portal http://born.nii.ac.jp/?page=globalroundup.

Girls in Distress in Israel.

Science.gov (United States)

Steiner, Yosepha

The typical girl in distress in Israel comes from a Jewish family of oriental origin. Her distress is partially due to the strains of immigrating to Israel from, in most cases, North Africa. Authority models in distressed girls' families feature either the role of the father as the commanding familial authority figure; the mother as the dominant…

Distinguishing Between Spiritual Distress, General Distress, Spiritual Well-Being, and Spiritual Pain Among Cancer Patients During Oncology Treatment.

Science.gov (United States)

Schultz, Michael; Meged-Book, Tehilah; Mashiach, Tanya; Bar-Sela, Gil

2017-07-01

Spiritual distress is present in approximately 25% of oncology patients. We examined the extent to which this measure is identical to a variety of other measures, such as spiritual well-being, spiritual injury, spiritual pain, and general distress. Structured interview of oncology outpatients over 12 months, approached nonselectively. The presence or absence of spiritual distress was compared against spiritual pain and two spiritual well-being tools: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12-Item Scale (FACIT-Sp-12) and the Spiritual Injury Scale (SIS). We also examined whether a general distress visual analogue scale sufficed to identify spiritual distress. Other questions concerned demographic and clinical data. Of 416 patients approached, 202 completed the interview, of whom 23% reported spiritual distress. All measures showed significant correlation (receiver operating characteristic, area under the curve: SIS 0.79; distress thermometer [DT] 0.68; FACIT-Sp-12 0.67), yet none were identical with spiritual distress (sensitivity/specificity: SIS 64%/79%; spiritual pain 72%/76%; DT 41%/76%; FACIT-Sp-12 57%/72%). Of the FACIT-Sp-12 subscales, only peace correlated with spiritual distress. A significant predictor of spiritual distress was patients' self-evaluation of grave clinical condition (odds ratio 3.3; 95% CI 1.1-9.5). Multivariable analysis of individual measure items suggests an alternative three-parameter model for spiritual distress: not feeling peaceful, feeling unable to accept that this is happening, and perceived severity of one's illness. The DT is not sufficient to identify spiritual distress. The peace subscale of FACIT-Sp-12 is a better match than the measure as a whole. The SIS is the best match for spiritual distress, although an imperfect one. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

The Common Alerting Protocol (CAP) and Emergency Data Exchange Language (EDXL) - Application in Early Warning Systems for Natural Hazard

Science.gov (United States)

Lendholt, Matthias; Hammitzsch, Martin; Wächter, Joachim

2010-05-01

The Common Alerting Protocol (CAP) [1] is an XML-based data format for exchanging public warnings and emergencies between alerting technologies. In conjunction with the Emergency Data Exchange Language (EDXL) Distribution Element (-DE) [2] these data formats can be used for warning message dissemination in early warning systems for natural hazards. Application took place in the DEWS (Distance Early Warning System) [3] project where CAP serves as central message format containing both human readable warnings and structured data for automatic processing by message receivers. In particular the spatial reference capabilities are of paramount importance both in CAP and EDXL. Affected areas are addressable via geo codes like HASC (Hierarchical Administrative Subdivision Codes) [4] or UN/LOCODE [5] but also with arbitrary polygons that can be directly generated out of GML [6]. For each affected area standardized criticality values (urgency, severity and certainty) have to be set but also application specific key-value-pairs like estimated time of arrival or maximum inundation height can be specified. This enables - together with multilingualism, message aggregation and message conversion for different dissemination channels - the generation of user-specific tailored warning messages. [1] CAP, http://www.oasis-emergency.org/cap [2] EDXL-DE, http://docs.oasis-open.org/emergency/edxl-de/v1.0/EDXL-DE_Spec_v1.0.pdf [3] DEWS, http://www.dews-online.org [4] HASC, "Administrative Subdivisions of Countries: A Comprehensive World Reference, 1900 Through 1998" ISBN 0-7864-0729-8 [5] UN/LOCODE, http://www.unece.org/cefact/codesfortrade/codes_index.htm [6] GML, http://www.opengeospatial.org/standards/gml

Behavioral and Brain Measures of Phasic Alerting Effects on Visual Attention.

Science.gov (United States)

Wiegand, Iris; Petersen, Anders; Finke, Kathrin; Bundesen, Claus; Lansner, Jon; Habekost, Thomas

2017-01-01

In the present study, we investigated effects of phasic alerting on visual attention in a partial report task, in which half of the displays were preceded by an auditory warning cue. Based on the computational Theory of Visual Attention (TVA), we estimated parameters of spatial and non-spatial aspects of visual attention and measured event-related lateralizations (ERLs) over visual processing areas. We found that the TVA parameter sensory effectiveness a , which is thought to reflect visual processing capacity, significantly increased with phasic alerting. By contrast, the distribution of visual processing resources according to task relevance and spatial position, as quantified in parameters top-down control α and spatial bias w index , was not modulated by phasic alerting. On the electrophysiological level, the latencies of ERLs in response to the task displays were reduced following the warning cue. These results suggest that phasic alerting facilitates visual processing in a general, unselective manner and that this effect originates in early stages of visual information processing.

The Early Awareness and Alert System in Sweden: History and Current Status

Directory of Open Access Journals (Sweden)

Irene Eriksson

2017-10-01

Full Text Available Introduction: Over the past decades, early awareness and alert (EAA activities and systems have gained importance and become a key early health technology assessment (HTA tool. While a pioneer in HTA, Sweden had no national level EAA activities until 2010. We describe the evolution and current status of the Swedish EAA System.Methods: This was a historical analysis based on the knowledge and experience of the authors supplemented by a targeted review of published and gray literature as well as documents relating to EAA activities in Sweden. Key milestones and a description of the current state of the Swedish EAA System is presented.Results: Initiatives to establish a system for the identification and assessment of emerging health technologies in Sweden date back to the 1980s. In the 1990s, the Swedish Agency for HTA and Assessment of Social Services (SBU supported the development of EuroScan as one of its founder members. In the mid-2000s, an independent regional initiative, driven by the Stockholm County Drug and Therapeutics Committee, resulted in the establishment of a regional horizon scanning function. By 2009, this work had expanded to a collaboration between the four biggest counties in Sweden. The following year it was further expanded to the national level and since then the Swedish EAA System has been carrying out identification, filtration and prioritization of new medicines, early assessment of the prioritized medicines, and dissemination of information. In 2015, the EAA System was incorporated into the Swedish national process for managed introduction and follow-up of new medicines. Outputs from the EAA System are now used to select new medicines for inclusion in this process.Conclusions: The Swedish EAA System started as a regional initiative and rapidly grew to become a national level activity. An important feature of the system today is its complete integration into the national process for managed introduction and follow-up of

47 CFR 80.314 - Distress communications.

Science.gov (United States)

2010-10-01

... radiotelephone distress call consists of: (1) The distress signal MAYDAY spoken three times; (2) The words THIS IS; (3) The call sign (or name, if no call sign assigned) of the mobile station in distress, spoken...

Automaticity of phasic alertness: Evidence for a three-component model of visual cueing.

Science.gov (United States)

Lin, Zhicheng; Lu, Zhong-Lin

2016-10-01

The automaticity of phasic alertness is investigated using the attention network test. Results show that the cueing effect from the alerting cue-double cue-is strongly enhanced by the task relevance of visual cues, as determined by the informativeness of the orienting cue-single cue-that is being mixed (80 % vs. 50 % valid in predicting where the target will appear). Counterintuitively, the cueing effect from the alerting cue can be negatively affected by its visibility, such that masking the cue from awareness can reveal a cueing effect that is otherwise absent when the cue is visible. Evidently, then, top-down influences-in the form of contextual relevance and cue awareness-can have opposite influences on the cueing effect from the alerting cue. These findings lead us to the view that a visual cue can engage three components of attention-orienting, alerting, and inhibition-to determine the behavioral cueing effect. We propose that phasic alertness, particularly in the form of specific response readiness, is regulated by both internal, top-down expectation and external, bottom-up stimulus properties. In contrast to some existing views, we advance the perspective that phasic alertness is strongly tied to temporal orienting, attentional capture, and spatial orienting. Finally, we discuss how translating attention research to clinical applications would benefit from an improved ability to measure attention. To this end, controlling the degree of intraindividual variability in the attentional components and improving the precision of the measurement tools may prove vital.

Thermal Energy for Space Cooling--Federal Technology Alert

Energy Technology Data Exchange (ETDEWEB)

Brown, Daryl R.

2000-12-31

Cool storage technology can be used to significantly reduce energy costs by allowing energy-intensive, electrically driven cooling equipment to be predominantly operated during off peak hours when electricity rates are lower. This Federal Technology Alert, which is sponsored by DOE's Federal Energy Management Program (FEMP), describes the basic types of cool storage technologies and cooling system integration options. In addition, it defines the savings potential in the federal sector, presents application advice, and describes the performance experience of specific federal users. The results of a case study of a GSA building using cool storage technology are also provided.

Diffusion of a Distress Management Guideline into practice.

Science.gov (United States)

Tavernier, Susan S; Beck, Susan L; Dudley, William N

2013-10-01

The purpose of this study was to explore system and clinician-related barriers, and predictors for the adoption of the National Comprehensive Cancer Network Distress Management Guideline (DMG) into oncology outpatient practice. This descriptive, correlational study surveyed a national sample of oncology nurses working in an outpatient setting who completed the survey electronically or by mail. Study respondents (n = 409) were predominantly certified nurses (84%) yet largely unfamiliar with the DMG; 17% of respondents were using the DMG. Time, staff uncertainties and ambiguous accountability were the largest barriers to not assessing distress. Compared with those not using any assessment tool, those using the DMG were more comfortable discussing distress, worked as an oncology nurse longer, scored colleagues higher on valuing distress screening and had more organizational processes in place to support evidence-based practices. Significant predictors of DMG use included higher familiarity with the DMG (OR 3.81, p DMG, which are amenable to interventions. DMG adoption may be augmented by interventions, which increase familiarity with the guideline. Additionally, adoption of the DMG may improve through explicit articulation of the responsibilities oncology team members have in cancer-related distress screening and management. Further studies are needed to evaluate the efficacy of such interventions and their impact on patient care outcomes. Copyright © 2013 John Wiley & Sons, Ltd.

Executive Summary: Transforming Moral Distress into Moral Resilience in Nursing.

Science.gov (United States)

Rushton, Cynda Hylton; Schoonover-Shoffner, Kathy; Kennedy, Maureen Shawn

To examine practices for addressing moral distress, a collaborative project was developed by the Johns Hopkins Berman Institute of Bioethics, the Johns Hopkins School of Nursing, the American Journal of Nursing, and the Journal of Christian Nursing, along with the American Association of Critical-Care Nurses and the American Nurses Association. Its purpose was to identify strategies that individuals and systems can use to mitigate the detrimental effects of moral distress and foster moral resilience. On August 11 and 12, 2016, an invitational symposium, State of the Science: Transforming Moral Distress into Moral Resilience in Nursing, was held at the Johns Hopkins School of Nursing in Baltimore, Maryland. Forty-five nurse clinicians, researchers, ethicists, organization representatives, and other stakeholders took part. The result of the symposium was group consensus on recommendations for addressing moral distress and building moral resilience in four areas: practice, education, research, and policy. Participants and the organizations represented were energized and committed to moving this agenda forward. The full report is available online at http://journals.lww.com/ajnonline/Pages/Moral-Distress-Supplement.aspx.

Multichannel micromanipulator and chamber system for recording multineuronal activity in alert, non-human primates.

Science.gov (United States)

Gray, Charles M; Goodell, Baldwin; Lear, Alex

2007-07-01

We describe the design and performance of an electromechanical system for conducting multineuron recording experiments in alert non-human primates. The system is based on a simple design, consisting of a microdrive, control electronics, software, and a unique type of recording chamber. The microdrive consists of an aluminum frame, a set of eight linear actuators driven by computer-controlled miniature stepping motors, and two printed circuit boards (PCBs) that provide connectivity to the electrodes and the control electronics. The control circuitry is structured around an Atmel RISC-based microcontroller, which sends commands to as many as eight motor control cards, each capable of controlling eight motors. The microcontroller is programmed in C and uses serial communication to interface with a host computer. The graphical user interface for sending commands is written in C and runs on a conventional personal computer. The recording chamber is low in profile, mounts within a circular craniotomy, and incorporates a removable internal sleeve. A replaceable Sylastic membrane can be stretched across the bottom opening of the sleeve to provide a watertight seal between the cranial cavity and the external environment. This greatly reduces the susceptibility to infection, nearly eliminates the need for routine cleaning, and permits repeated introduction of electrodes into the brain at the same sites while maintaining the watertight seal. The system is reliable, easy to use, and has several advantages over other commercially available systems with similar capabilities.

Generator replacement is associated with an increased rate of ICD lead alerts.

Science.gov (United States)

Lovelock, Joshua D; Cruz, Cesar; Hoskins, Michael H; Jones, Paul; El-Chami, Mikhael F; Lloyd, Michael S; Leon, Angel; DeLurgio, David B; Langberg, Jonathan J

2014-10-01

Lead malfunction is an important cause of morbidity and mortality in patients with an implantable cardioverter-defibrillator (ICD). We have shown that the failure of recalled high-voltage leads significantly increases after ICD generator replacement. However, generator replacement has not been recognized as a predictor of lead failure in general. The purpose of this study is to assess the effect of ICD generator exchange on the rate of ICD lead alerts. A time-dependent Cox proportional hazards model was used to analyze a database of remotely monitored ICDs. The model assessed the impact of generator exchange on the rate of lead alerts after ICD generator replacement. The analysis included 60,219 patients followed for 37 ± 19 months. The 5-year lead survival was 99.3% (95% confidence interval 99.2%-99.4%). Of 60,219 patients, 7458 patients (12.9%) underwent ICD generator exchange without lead replacement. After generator replacement, the rate of lead alerts was more than 5-fold higher than in controls with leads of the same age without generator replacement (hazard ratio 5.19; 95% confidence interval 3.45-7.84). A large number of lead alerted within 3 months of generator replacement. Lead alerts were more common in patients with single- vs dual-chamber ICDs and in younger patients. Sex was not associated with lead alerts. Routine generator replacement is associated with a 5-fold higher risk of lead alert compared to age-matched leads without generator replacement. This suggests the need for intense surveillance after generator replacement and the development of techniques to minimize the risk of lead damage during generator replacement. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Alertness management : strategic naps in operational settings

Science.gov (United States)

1995-01-01

Managing fatigue in complex operational settings requires attention to multiple factors, including hours of service, scheduling, education and training, countermeasures, technology, and research. Alertness-management strategies can be used to promote...

Turning Off Frequently Overridden Drug Alerts: Limited Opportunities for Doing It Safely

NARCIS (Netherlands)

I.H. van der Sijs (Heleen); J.E.C.M. Aarts (Jos); T. van Gelder (Teun); M. Berg (Marc); A.G. Vulto (Arnold)

2008-01-01

textabstractObjectives: This study sought to identify opportunities to safely turn off frequently overridden drug-drug interaction alerts (DDIs) in computerized physician order entry (CPOE). Design: Quantitative retrospective analysis of drug safety alerts overridden during 1 month and qualitative

Road safety alerting system with radar and GPS cooperation in a VANET environment

Science.gov (United States)

Santamaria, Amilcare Francesco; Sottile, Cesare; De Rango, Floriano; Voznak, Miroslav

2014-05-01

New applications in wireless environments are increasing and keeping even more interests from the developer companies and researchers. In particular, in these last few years the government and institutional organization for road safety spent a lot of resources and money to promote Vehicular Ad-Hoc Network (VANET) technology, also car manufactures are giving a lot of contributions on this field as well. In our paper, we propose an innovative system to increase road safety, matching the requests of the market allowing a cooperation between on-board devices. The vehicles are equipped with On Board Unit (OBU) and On Board Radar Unit (OBRU), which can spread alerting messages around the network regarding warning and dangerous situations exploiting IEEE802.llp standard. Vehicles move along roads observing the environment, traffic and road conditions, and vehicles parameters as well. These information can be elaborated and shared between neighbors, Road Side Unit (RSU)s and, of course, with Internet, allowing inter-system communications exploiting an Road Traffic Manager (RTM). Radar systems task it the detection of the environment in order to increase the knowledge of current conditions of the roads, for example it is important to identify obstacles, road accidents, dangerous situations and so on. Once detected exploiting onboard devices, such as Global Position System (GPS) receiver it is possible to know the exact location of the caught event and after a data elaboration the information is spread along the network. Once the drivers are advised, they can make some precautionary actions such as reduction of traveling speed or modification of current road path. In this work the routing algorithms, which have the main goal to rapidly disseminate information, are also been investigated.

USGS earthquake hazards program (EHP) GPS use case : earthquake early warning (EEW) and shake alert

Science.gov (United States)

2017-03-30

GPS Adjacent Band Workshop VI RTCA Inc., Washington D.C., 30 March 2017. USGS GPS receiver use case - Real-Time GPS for EEW -Continued: CRITICAL EFFECT - The GNSS component of the Shake Alert system augments the inertial sensors and is especial...

Crew Factors in Flight Operations XIV: Alertness Management in Regional Flight Operations Education Module

Science.gov (United States)

Rosekind, Mark R.; Co, Elizabeth L.; Neri, David F.; Oyung, Raymond L.; Mallis, Melissa M.

2002-01-01

Regional operations encompass a broad range of pilots and equipment. This module is intended to help all those involved in regional aviation, including pilots, schedulers, dispatchers, maintenance technicians, policy makers, and others, to understand the physiological factors underlying fatigue, how flight operations affect fatigue, and what can be done to counteract fatigue and maximize alertness and performance in their operations. The overall purpose of this module is to promote aviation safety, performance, and productivity. It is intended to meet three specific objectives: (1) to explain the current state of knowledge about the physiological mechanisms underlying fatigue; (2) to demonstrate how this knowledge can be applied to improving flight crew sleep, performance, and alertness; and (3) to offer strategies for alertness management. Aviation Safety Reporting System (ASRS) and National Transportation Safety Board (NISH) reports are used throughout this module to demonstrate that fatigue is a safety issue in the regional operations community. The appendices at the end of this module include the ASRS reports used for the examples contained in this publication, brief introductions to sleep disorders and relaxation techniques, summaries of relevant NASA publications, and a list of general readings on sleep, sleep disorders, and circadian rhythms.

Behavioral and Brain Measures of Phasic Alerting Effects on Visual Attention

DEFF Research Database (Denmark)

Wiegand, Iris Michaela; Petersen, Anders; Finke, Kathrin

2017-01-01

In the present study, we investigated effects of phasic alerting on visual attention in a partial report task, in which half of the displays were preceded by an auditory warning cue. Based on the computational Theory of Visual Attention (TVA), we estimated parameters of spatial and non......-spatial aspects of visual attention and measured event-related lateralizations (ERLs) over visual processing areas. We found that the TVA parameter sensory effectiveness a, which is thought to reflect visual processing capacity, significantly increased with phasic alerting. By contrast, the distribution of visual....... These results suggest that phasic alerting facilitates visual processing in a general, unselective manner and that this effect originates in early stages of visual information processing....

Winter Weather Tips: Understanding Alerts and Staying Safe this Season | Poster

Science.gov (United States)

By Jenna Seiss and Kylie Tomlin, Guest Writers, and Ashley DeVine, Staff Writer Maryland residents face the possibility of dangerous winter weather each year—from icy conditions to frigid temperatures. You may be familiar with the different types of winter weather alerts issued by the National Weather Service (NWS), but do you know what each alert means?  

Workplace lighting for improving alertness and mood in daytime workers.

Science.gov (United States)

Pachito, Daniela V; Eckeli, Alan L; Desouky, Ahmed S; Corbett, Mark A; Partonen, Timo; Rajaratnam, Shantha Mw; Riera, Rachel

2018-03-02

Exposure to light plays a crucial role in biological processes, influencing mood and alertness. Daytime workers may be exposed to insufficient or inappropriate light during daytime, leading to mood disturbances and decreases in levels of alertness. To assess the effectiveness and safety of lighting interventions to improve alertness and mood in daytime workers. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, seven other databases; ClinicalTrials.gov and the World Health Organization trials portal up to January 2018. We included randomised controlled trials (RCTs), and non-randomised controlled before-after trials (CBAs) that employed a cross-over or parallel-group design, focusing on any type of lighting interventions applied for daytime workers. Two review authors independently screened references in two stages, extracted outcome data and assessed risk of bias. We used standardised mean differences (SMDs) and 95% confidence intervals (CI) to pool data from different questionnaires and scales assessing the same outcome across different studies. We combined clinically homogeneous studies in a meta-analysis. We used the GRADE system to rate quality of evidence. The search yielded 2844 references. After screening titles and abstracts, we considered 34 full text articles for inclusion. We scrutinised reports against the eligibility criteria, resulting in the inclusion of five studies (three RCTs and two CBAs) with 282 participants altogether. These studies evaluated four types of comparisons: cool-white light, technically known as high correlated colour temperature (CCT) light versus standard illumination; different proportions of indirect and direct light; individually applied blue-enriched light versus no treatment; and individually applied morning bright light versus afternoon bright light for subsyndromal seasonal affective disorder.We found no studies comparing one level of illuminance versus another.We found two CBA

Alert management for home healthcare based on home automation analysis.

Science.gov (United States)

Truong, T T; de Lamotte, F; Diguet, J-Ph; Said-Hocine, F

2010-01-01

Rising healthcare for elder and disabled people can be controlled by offering people autonomy at home by means of information technology. In this paper, we present an original and sensorless alert management solution which performs multimedia and home automation service discrimination and extracts highly regular home activities as sensors for alert management. The results of simulation data, based on real context, allow us to evaluate our approach before application to real data.

Moral distress in nursing personnel

OpenAIRE

Barlem,Edison Luiz Devos; Lunardi,Valéria Lerch; Lunardi,Guilherme Lerch; Tomaschewski-Barlem,Jamila Geri; Silveira,Rosemary Silva da; Dalmolin,Graziele de Lima

2013-01-01

OBJECTIVE: to analyze the frequency and intensity of moral distress experienced by nursing personnel in southern Brazil, covering elements of their professional practice. METHOD: a survey was undertaken in two hospitals in Rio Grande do Sul, Brazil, with 247 nurses. Data was collected by means of the adapted Moral Distress Scale. RESULTS: the perception of situations that lead to moral distress is enhanced in nurses and in nursing staff working in institutions with greater openness to dialogu...

Building a Communication, Education, an Outreach Program for the ShakeAlert National Earthquake Early Warning Program

Science.gov (United States)

DeGroot, R. M.; Strauss, J. A.; Given, D. D.; Cochran, E. S.; Burkett, E. R.; Long, K.

2016-12-01

Earthquake Early Warning (EEW) systems can provide as much as tens of seconds of warning to people and automated systems before strong shaking arrives. The United States Geological Survey (USGS) and its partners are developing an EEW system for the West Coast of the United States. To be an integral part of successful implementation, EEW engagement programs and materials must integrate with and leverage broader earthquake risk programs. New methods and products for dissemination must be multidisciplinary, cost effective, and consistent with existing hazards education efforts. Our presentation outlines how the USGS and its partners will approach this effort in the context of the EEW system through the work of a multistate and multiagency committee that participates in the design, implementation, and evaluation of a portfolio of programs and products. This committee, referred to as the ShakeAlert Joint Committee for Communication, Education, and Outreach (ShakeAlert CEO), is working to identify, develop, and cultivate partnerships with EEW stakeholders including Federal, State, academic partners, private companies, policy makers, and local organizations. Efforts include developing materials, methods for delivery, and reaching stakeholders with information on EEW, earthquake preparedness, and emergency protective actions. It is essential to develop standards to ensure information communicated via the EEW alerts is consistent across the public and private sector and achieving a common understanding of what actions users take when they receive an EEW warning. The USGS and the participating states and agencies acknowledge that the implementation of EEW is a collective effort requiring the participation of hundreds of stakeholders committed to ensuring public accessibility.

Moral distress and moral conflict in clinical ethics.

Science.gov (United States)

Fourie, Carina

2015-02-01

Much research is currently being conducted on health care practitioners' experiences of moral distress, especially the experience of nurses. What moral distress is, however, is not always clearly delineated and there is some debate as to how it should be defined. This article aims to help to clarify moral distress. My methodology consists primarily of a conceptual analysis, with especial focus on Andrew Jameton's influential description of moral distress. I will identify and aim to resolve two sources of confusion about moral distress: (1) the compound nature of a narrow definition of distress which stipulates a particular cause, i.e. moral constraint, and (2) the distinction drawn between moral dilemma (or, more accurately, moral conflict) and moral distress, which implies that the two are mutually exclusive. In light of these concerns, I argue that the definition of moral distress should be revised so that moral constraint should not be a necessary condition of moral distress, and that moral conflict should be included as a potential cause of distress. Ultimately, I claim that moral distress should be understood as a specific psychological response to morally challenging situations such as those of moral constraint or moral conflict, or both. © 2013 John Wiley & Sons Ltd.

Design and implementation of a marine animal alert system to support Marine Renewable Energy

Energy Technology Data Exchange (ETDEWEB)

Deng, Zhiqun; Carlson, Thomas J.; Fu, Tao; Ren, Huiying; Martinez, Jayson J.; Myers, Joshua R.; Matzner, Shari; Choi, Eric Y.; Copping, Andrea E.

2013-08-08

Power extracted from fast moving tidal currents has been identified as a potential commercial-scale source of renewable energy. Device developers and utilities are pursuing deployment of prototype tidal turbines to assess technology viability, site feasibility, and environmental interactions. Deployment of prototype turbines requires permits from a range of regulatory authorities. Ensuring the safety of marine animals, particularly those under protection of the Endangered Species Act of 1973 (ESA) and the Marine Mammal Protection Act of 1972 has emerged as a key regulatory challenge for initial MHK deployments. The greatest perceived risk to marine animals is from strike by the rotating blades of tidal turbines. Development of the marine mammal alert system (MAAS) was undertaken to support monitoring and mitigation requirements for tidal turbine deployments. The prototype system development focused on Southern Resident killer whales (SRKW), an endangered population of killer whales that frequents Puget Sound and is intermittently present in the part of the sound where deployment of prototype tidal turbines is being considered. Passive acoustics were selected as the primary means because of the vocal nature of these animals. The MAAS passive acoustic system consists of two-stage process involving the use of an energy detector and a spectrogram-based classifier to distinguish between SKRW’s calls and noise. A prototype consisting of two 2D symmetrical star arrays separated by 20 m center to center was built and evaluated in the waters of Sequim Bay using whale call playback.

Brain-computer interface for alertness estimation and improving

Science.gov (United States)

Hramov, Alexander; Maksimenko, Vladimir; Hramova, Marina

2018-02-01

Using wavelet analysis of the signals of electrical brain activity (EEG), we study the processes of neural activity, associated with perception of visual stimuli. We demonstrate that the brain can process visual stimuli in two scenarios: (i) perception is characterized by destruction of the alpha-waves and increase in the high-frequency (beta) activity, (ii) the beta-rhythm is not well pronounced, while the alpha-wave energy remains unchanged. The special experiments show that the motivation factor initiates the first scenario, explained by the increasing alertness. Based on the obtained results we build the brain-computer interface and demonstrate how the degree of the alertness can be estimated and controlled in real experiment.

ARDS (Acute Respiratory Distress Syndrome)

Science.gov (United States)

... Also known as What Is ARDS, or acute respiratory distress syndrome, is a lung condition that leads ... treat ARDS. Other Names Acute lung injury Adult respiratory distress syndrome Increased-permeability pulmonary edema Noncardiac pulmonary ...

Negotiating Gender Norms to Support Men in Psychological Distress.

Science.gov (United States)

Keohane, Aisling; Richardson, Noel

2018-01-01

Underpinning a general pattern of higher suicide rates in men is the assumption that men do not ask for help or utilize the health-care system during times of psychological distress. There has been a failure to grapple with the dynamic of when, how and from whom men might ask for help during times of psychological distress, and what key barriers or enabling factors are likely to influence potential help-givers' capacity or willingness to offer help to men in psychological distress. The aim of this study was to investigate how masculine norms impact men's help-seeking as well as care givers' behaviors and willingness to support men in need of psychological help or perceived to be at risk of suicide. Focus groups ( n = 13) were used with "high-risk suicide" groups of men and community gatekeepers. The principles of grounded theory were used for data analysis. Three themes emerged: "negotiating ways to ask for, offer and accept help without compromising masculinity"; "making and sustaining contact with men in psychological distress"; and "navigating roles responsibilities and boundaries to support men in psychological distress." Approaches to suicide prevention need to take account of how masculine norms shape men's willingness to ask for and accept help during times of psychological distress as well as care givers willingness to offer help. The findings address a gap in the literature by looking beyond men's help-seeking as a passive, one dimensional construct, to a more dynamic triad of help-seeking/giving/taking behaviors that are embedded in the sociocultural context of men's lives.

Psychological distress among women with newly diagnosed breast cancer

DEFF Research Database (Denmark)

Mertz, Birgitte; Bistrup, Pernille Envold; Johansen, Christoffer

2012-01-01

PURPOSE: Psychological distress is common in the cancer continuum. Our objectives were to determine the prevalence of distress and to investigate the related problems and the characteristics of women with breast cancer who experienced psychological distress at the time of diagnosis. METHODS: We...... thermometer' to measure psychological distress and the accompanying 'problem list' to identify related problems. Logistic regression models with 95% confidence intervals were used to estimate the associations between psychological distress, age, social support and domains on the problem list. RESULTS......: With a cut-off of 3 on the distress thermometer, 77% of women with breast cancer reported distress, whereas when the cut-off was 7, 43% were distressed. The mean distress score was 5.4 (SD, 3.1). The most frequently reported problems were worry (77%) and nervousness (71%). Distress was significantly...

Pattern recognition applied to infrared images for early alerts in fog

Science.gov (United States)

Boucher, Vincent; Marchetti, Mario; Dumoulin, Jean; Cord, Aurélien

2014-09-01

Fog conditions are the cause of severe car accidents in western countries because of the poor induced visibility. Its forecast and intensity are still very difficult to predict by weather services. Infrared cameras allow to detect and to identify objects in fog while visibility is too low for eye detection. Over the past years, the implementation of cost effective infrared cameras on some vehicles has enabled such detection. On the other hand pattern recognition algorithms based on Canny filters and Hough transformation are a common tool applied to images. Based on these facts, a joint research program between IFSTTAR and Cerema has been developed to study the benefit of infrared images obtained in a fog tunnel during its natural dissipation. Pattern recognition algorithms have been applied, specifically on road signs which shape is usually associated to a specific meaning (circular for a speed limit, triangle for an alert, …). It has been shown that road signs were detected early enough in images, with respect to images in the visible spectrum, to trigger useful alerts for Advanced Driver Assistance Systems.

Framing the issues: moral distress in health care.

Science.gov (United States)

Pauly, Bernadette M; Varcoe, Colleen; Storch, Jan

2012-03-01

Moral distress in health care has been identified as a growing concern and a focus of research in nursing and health care for almost three decades. Researchers and theorists have argued that moral distress has both short and long-term consequences. Moral distress has implications for satisfaction, recruitment and retention of health care providers and implications for the delivery of safe and competent quality patient care. In over a decade of research on ethical practice, registered nurses and other health care practitioners have repeatedly identified moral distress as a concern and called for action. However, research and action on moral distress has been constrained by lack of conceptual clarity and theoretical confusion as to the meaning and underpinnings of moral distress. To further examine these issues and foster action on moral distress, three members of the University of Victoria/University of British Columbia (UVIC/UVIC) nursing ethics research team initiated the development and delivery of a multi-faceted and interdisciplinary symposium on Moral Distress with international experts, researchers, and practitioners. The goal of the symposium was to develop an agenda for action on moral distress in health care. We sought to develop a plan of action that would encompass recommendations for education, practice, research and policy. The papers in this special issue of HEC Forum arose from that symposium. In this first paper, we provide an introduction to moral distress; make explicit some of the challenges associated with theoretical and conceptual constructions of moral distress; and discuss the barriers to the development of research, education, and policy that could, if addressed, foster action on moral distress in health care practice. The following three papers were written by key international experts on moral distress, who explore in-depth the issues in three arenas: education, practice, research. In the fifth and last paper in the series, we highlight

The Influence of Alertness on Spatial and Nonspatial Components of Visual Attention

Science.gov (United States)

Matthias, Ellen; Bublak, Peter; Muller, Hermann J.; Schneider, Werner X.; Krummenacher, Joseph; Finke, Kathrin

2010-01-01

Three experiments investigated whether spatial and nonspatial components of visual attention would be influenced by changes in (healthy, young) subjects' level of alertness and whether such effects on separable components would occur independently of each other. The experiments used a no-cue/alerting-cue design with varying cue-target stimulus…

Association between age, distress, and orientations to happiness in individuals with disabilities.

Science.gov (United States)

Terrill, Alexandra L; Müller, Rachel; Jensen, Mark P; Molton, Ivan R; Ipsen, Catherine; Ravesloot, Craig

2015-02-01

To determine how age and distress are associated in individuals with disabilities, and how happiness and its components (meaning, pleasure, and engagement) mediate or moderate this relationship. These were cross-sectional analyses of survey data from 508 community-dwelling adults with a variety of self-reported health conditions and functional disabilities. Measures included the Orientations to Happiness Questionnaire and items from the Behavior Risk Factor Surveillance System. Greater distress was associated with lower global happiness in both mediation and moderation models. The mediation model showed that middle-aged participants (age: 45-64) scored lowest in global happiness, and the effect of age on distress was partially mediated by happiness. None of the happiness components mediated the relationship of age on distress. The moderation model showed a significant interaction effect for age and global happiness on distress, where younger participants low on happiness were significantly more distressed. Of the three happiness components, only meaning was significantly associated with distress. There was a significant interaction between age and meaning, where participants who were younger and scored low on the meaning scale reported significantly higher distress. Findings from this study lay groundwork for the development of clinical interventions to address distress in individuals with functional disabilities. Middle-aged and younger people with disabilities may be particularly affected by lower levels of happiness and might benefit from psychological interventions that focus on increasing overall well-being and providing meaning and purpose in life. PsycINFO Database Record (c) 2015 APA, all rights reserved.

The cultural expression of spiritual distress in Israel.

Science.gov (United States)

Schultz, Michael; Meged-Book, Tehilah; Mashiach, Tanya; Bar-Sela, Gil

2018-03-30

Although spiritual distress is present across cultures, the ways in which patients experience it vary between cultures. Our goal was to examine the cultural expression and key indicators of spiritual distress in Israel. We conducted a structured interview of 202 oncology outpatients in a cross-sectional study. Self-diagnosis of spiritual distress, which is a demonstrated gold standard for identifying its presence, was compared with the Facit-Sp-12 and a number of other items (from the Spiritual Injury Scale and newly developed Israeli items) hypothesized as Israeli cultural expressions of spiritual distress, demographic and medical data, and patient desire to receive spiritual care. Significant variation was found between Israeli cultural expression of spiritual distress and that found in studies from other countries. Key expressions of spiritual distress in this study included lack of inner peace, grief, and an inability to accept what is happening. Items related to faith were not significant, and loss of meaning showed mixed results. Patients requesting spiritual care were more likely to be in spiritual distress. No demographic or medical data correlated with spiritual distress. Specially designed interventions to reduce spiritual distress should address the expressions of the distress specific to that culture. Studies of the efficacy of spiritual care can examine the extent of spiritual distress in general or of its specific cultural expressions.

Prediksi Financial Distress Bank Umum di Indonesia: Analisis Diskriminan dan Regresi Logistik

Directory of Open Access Journals (Sweden)

Imaduddin Shidiq

2017-02-01

Full Text Available Financial Distress Prediction in The Indonesian Banks: Discriminant Analysis and Logistic RegressionThis research aims to create early warning models for predicting financial distress on Indonesian commercial banks. Early warning models is made by estimating bank indicators that led bank run into financial problems which to be shut down by the government. Estimation use two methods, discriminant analysis, logistic regression. The data used to create models is bank's financial ratios in 1994-1997 gathered from Direktori Perbankan Indonesia (DPI. Out of the sample test use the data in 1998. All model were used to predict the bank's financial distress after 2000. This study found some characteristics of distressed banks that will be in the state of failure in two or three years. Finally, this research found that early warning system models is able to predict the probability of financial distress on commercial banks.DOI:  10.15408/ess.v7i1.4686 

Distress intolerance and clinical functioning in persons with schizophrenia

Science.gov (United States)

Nugent, Katie L.; Chiappelli, Joshua; Rowland, Laura M.; Daughters, Stacey B.; Hong, L. Elliot

2014-01-01

Impaired tolerance to distress may help explain part of the cognitive and functional impairments in schizophrenia. This project investigated distress intolerance in schizophrenia patients (SZ) as compared to controls, and whether distress intolerance represented an independent domain in relationship to symptoms, cognition, and functional capacity. Healthy controls (n=43) and SZ (n=65) completed a psychological distress challenge experiment and their levels of intolerance to distress were estimated. SZ showed increased distress intolerance such that they were significantly more likely to terminate the distress challenge session early compared to controls. Greater distress intolerance was associated with reduced functional capacity and worse cognitive performance in SZ. Mediation analyses suggested that distress intolerance had an independent effect on functional capacity, while some of this effect was mediated by cognitive performance. Our results suggest that distress intolerance is a promising domain for treatment research, and functional capacity may be improved by targeting treatments towards SZ patient’s ability to tolerate distress. PMID:25107316

Reasons for Distress Among Burn Survivors at 6, 12, and 24 Months Postdischarge: A Burn Injury Model System Investigation.

Science.gov (United States)

Wiechman, Shelley A; McMullen, Kara; Carrougher, Gretchen J; Fauerbach, Jame A; Ryan, Colleen M; Herndon, David N; Holavanahalli, Radha; Gibran, Nicole S; Roaten, Kimberly

2017-12-16

To identify important sources of distress among burn survivors at discharge and 6, 12, and 24 months postinjury, and to examine if the distress related to these sources changed over time. Exploratory. Outpatient burn clinics in 4 sites across the country. Participants who met preestablished criteria for having a major burn injury (N=1009) were enrolled in this multisite study. Participants were given a previously developed list of 12 sources of distress among burn survivors and asked to rate on a 10-point Likert-type scale (0=no distress to 10=high distress) how much distress each of the 12 issues was causing them at the time of each follow-up. The Medical Outcomes Study 12-Item Short-Form Health Survey was administered at each time point as a measure of health-related quality of life. The Satisfaction With Appearance Scale was used to understand the relation between sources of distress and body image. Finally, whether a person returned to work was used to determine the effect of sources of distress on returning to employment. It was encouraging that no symptoms were worsening at 2 years. However, financial concerns and long recovery time are 2 of the highest means at all time points. Pain and sleep disturbance had the biggest effect on ability to return to work. These findings can be used to inform burn-specific interventions and to give survivors an understanding of the temporal trajectory for various causes of distress. In particular, it appears that interventions targeted at sleep disturbance and high pain levels can potentially effect distress over financial concerns by allowing a person to return to work more quickly. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

School-Based Drug Prevention among At-Risk Adolescents: Effects of ALERT Plus

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Longshore, Douglas; Ellickson, Phyllis L.; McCaffrey, Daniel F.; St. Clair, Patricia A.

2007-01-01

In a recent randomized field trial, Ellickson et al. found the Project ALERT drug prevention curriculum curbed alcohol misuse and tobacco and marijuana use among eighth-grade adolescents. This article reports effects among ninth-grade at-risk adolescents. Comparisons between at-risk girls in ALERT Plus schools (basic curriculum extended to ninth…

Maternal psychological distress and child decision-making.

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Flouri, Eirini; Ioakeimidi, Sofia; Midouhas, Emily; Ploubidis, George B

2017-08-15

There is much research to suggest that maternal psychological distress is associated with many adverse outcomes in children. This study examined, for the first time, if it is related to children's affective decision-making. Using data from 12,080 families of the Millennium Cohort Study, we modelled the effect of trajectories of maternal psychological distress in early-to-middle childhood (3-11 years) on child affective decision-making, measured with a gambling task at age 11. Latent class analysis showed four longitudinal types of maternal psychological distress (chronically high, consistently low, moderate-accelerating and moderate-decelerating). Maternal distress typology predicted decision-making but only in girls. Specifically, compared to girls growing up in families with never-distressed mothers, those exposed to chronically high maternal psychological distress showed more risk-taking, bet more and exhibited poorer risk-adjustment, even after correction for confounding. Most of these effects on girls' decision-making were not robust to additional controls for concurrent internalising and externalising problems, but chronically high maternal psychological distress was associated positively with risk-taking even after this adjustment. Importantly, this association was similar for those who had reached puberty and those who had not. Given the study design, causality cannot be inferred. Therefore, we cannot propose that treating chronic maternal psychological distress will reduce decision-making pathology in young females. Our study suggests that young daughters of chronically distressed mothers tend to be particularly reckless decision-makers. Copyright © 2017. Published by Elsevier B.V.

Design of anti-theft/cable cut real time alert system for copper cable using microcontroller and GSM technology

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Lim, E. K.; Norizan, M. N.; Mohamad, I. S.; Yasin, M. N. M.; Murad, S. A. Z.; Baharum, N. A.; Jamalullail, N.

2017-09-01

This paper presents the design of anti-theft/cable cut real time alert system using microcontroller and GSM technology. The detection part is using the electrical circuit wire connection in detecting the voltage drop of the cable inside the microcontroller digital input port. The GSM wireless modem is used to send the location of cable cut directly to the authority mobile phone. Microcontroller SK40C with Microchip PIC16F887 is used as a controller to control the wireless modem and also the detection device. The device is able to detect and display the location of the cable cut on the LCD display besides of and sending out the location of the cable break to the authority mobile phone wirelessly via SMS.

Self systems, cultural idioms of distress, and the psycho-bodily consequences of childhood suffering.

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Hollan, Douglas

2004-03-01

In this article, I examine the effects of childhood suffering in two cases--one from my anthropological fieldwork in the central highlands of Sulawesi in Indonesia and one from my psychotherapeutic practice in Los Angeles. I argue that although people will always carry with them the psycho-bodily signature of their past social experience, these signatures are affected by the cultural idioms of distress into which they are woven and from which psycho-bodily attention is channeled and given meaning (or not). However, I also suggest that past social experiences are related to life trajectories in very complicated ways. For example, while the enactment of a cultural idiom of distress may help to resolve or give meaning to a form of illness or distress, it also may cause or exacerbate other forms of suffering--depending on how it is used and articulated by any given individual.

The relationship between unmet needs and distress amongst young people with cancer.

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Dyson, Gavin J; Thompson, Kate; Palmer, Susan; Thomas, David M; Schofield, Penelope

2012-01-01

Most psychosocial research in cancer has been restricted to paediatric or older adult populations. This study aimed to explore psychological distress and unmet needs in adolescents and young adults (AYA) with cancer and identify predictors of distress among demographic and illness characteristics and supportive care needs. Fifty-three patients between 16 and 30 years completed a cross-sectional survey, administered shortly after presentation to an AYA oncology service and within 4 months of diagnosis. Measures included the Beck Depression Inventory-Fast Screen (BDI-FS), State-Trait Anxiety Inventory-State Form (STAI-S) and the Supportive Care Needs Survey. Level of distress-related sypmtomatology in this population was based on previous work, whereby a cut-off score of 4 or greater was used for the BDI-FS, and one standard deviation above the sample population mean was used for the STAI-S. Prevalence of distress (25%) was lower than that found previously in AYA with cancer. Physical and daily living needs were the most frequently unmet needs overall, followed by psychological needs, health system and information needs and care and support needs. Lastly, being pre-treatment predicted increased depression and state anxiety, while having treatment post-surgery predicted reduced state anxiety. After controlling for treatment status, however, the main predictors of depression and state anxiety were physical and daily living needs and health system and information needs, respectively. Lower levels of distress and unmet psychological needs were related to the few participants (17%) in this study who were pre-treatment, when distress was most likely. However, physical needs and information needs, which are almost inevitable throughout treatment and beyond, were more important predictors of distress. Further exploration must consider the psychosocial difficulties underlying this association and the needs of AYA at transitions between critical periods in their cancer journey

The spiritual distress assessment tool: an instrument to assess spiritual distress in hospitalised elderly persons

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Martin Estelle

2010-12-01

Full Text Available Abstract Background Although spirituality is usually considered a positive resource for coping with illness, spiritual distress may have a negative influence on health outcomes. Tools are needed to identify spiritual distress in clinical practice and subsequently address identified needs. This study describes the first steps in the development of a clinically acceptable instrument to assess spiritual distress in hospitalized elderly patients. Methods A three-step process was used to develop the Spiritual Distress Assessment Tool (SDAT: 1 Conceptualisation by a multidisciplinary group of a model (Spiritual Needs Model to define the different dimensions characterizing a patient's spirituality and their corresponding needs; 2 Operationalisation of the Spiritual Needs Model within geriatric hospital care leading to a set of questions (SDAT investigating needs related to each of the defined dimensions; 3 Qualitative assessment of the instrument's acceptability and face validity in hospital chaplains. Results Four dimensions of spirituality (Meaning, Transcendence, Values, and Psychosocial Identity and their corresponding needs were defined. A formalised assessment procedure to both identify and subsequently score unmet spiritual needs and spiritual distress was developed. Face validity and acceptability in clinical practice were confirmed by chaplains involved in the focus groups. Conclusions The SDAT appears to be a clinically acceptable instrument to assess spiritual distress in elderly hospitalised persons. Studies are ongoing to investigate the psychometric properties of the instrument and to assess its potential to serve as a basis for integrating the spiritual dimension in the patient's plan of care.

Identification of potentially emerging food safety issues by analysis of reports published by the European Community's Rapid Alert System for Food and Feed (RASFF) during a four-year period

NARCIS (Netherlands)

Kleter, G.A.; Prandini, A.; Filippi, L.; Marvin, H.J.P.

2009-01-01

The SAFE FOODS project undertakes to design a new approach towards the early identification of emerging food safety hazards. This study explored the utility of notifications filed through RASFF, the European Commission¿s Rapid Alert System for Food and Feed, to identify emerging trends in food

Electronic alerts and clinician turnover: the influence of user acceptance.

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Hysong, Sylvia J; Spitzmuller, Christiane; Espadas, Donna; Sittig, Dean F; Singh, Hardeep

2014-11-01

Use of certain components of electronic health records (EHRs), such as EHR-based alerting systems (EASs), might reduce provider satisfaction, a strong precursor to turnover. We examined the impact of factors likely to influence providers' acceptance of an alerting system, designed to facilitate electronic communication in outpatient settings, on provider satisfaction, intentions to quit, and turnover. We conducted a cross-sectional Web-based survey of EAS-related practices from a nationwide sample of primary care providers (PCPs) practicing at Department of Veterans Affairs (VA) medical facilities. Of 5001 invited VA PCPs, 2590 completed the survey. We relied on Venkatesh's Unified Theory of Acceptance and Use of Technology to create survey measures of 4 factors likely to impact user acceptance of EAS: supportive norms, monitoring/ feedback, training, and providers' perceptions of the value (PPOV) of EASs to provider effectiveness. Facility-level PCP turnover was measured via the VA's Service Support Center Human Resources Cube. Hypotheses were tested using structural equation modeling. After accounting for intercorrelations among predictors, monitoring/feedback regarding EASs significantly predicted intention to quit (b = 0.30, P < .01), and PPOV of EASs predicted both overall provider satisfaction (b = 0.58, P < .01) and facility-level provider turnover levels (b = -0.19, P < .05), all without relying on any intervening mechanisms. Design, implementation, and use of EASs might impact provider satisfaction and retention. Institutions should consider strategies to help providers perceive greater value in these clinical tools.

How Does Distress Acquisition Incentivized by Government Purchases of Distressed Loans Affect Bank Default Risk?

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Jyh-Jiuan Lin

2018-04-01

Full Text Available The topic of bank default risk in connection with government bailouts has recently attracted a great deal of attention. In this paper, the question of how a bank’s default risk is affected by a distress acquisition is investigated. Specifically, the government provides a bailout program of distressed loan purchases for a strong bank to acquire a bank in distress. The acquirer bank may likely refuse the acquisition with a bailout when the amount of distressed loan purchases is large or the knock-out value of the acquired bank is high. When the acquirer bank realizes acquisition gains, the default risk in the consolidated bank’s equity return is negatively related to loan purchases, but positively to the knock-out value of the acquired bank. The government bailout, as such, in large part contributes to banking stability.

A model for abnormal activity recognition and alert generation system for elderly care by hidden conditional random fields using R-transform and generalized discriminant analysis features.

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Khan, Zafar Ali; Sohn, Won

2012-10-01

The growing population of elderly people living alone increases the need for automatic healthcare monitoring systems for elderly care. Automatic vision sensor-based systems are increasingly used for human activity recognition (HAR) in recent years. This study presents an improved model, tested using actors, of a sensor-based HAR system to recognize daily life activities of elderly people at home and generate an alert in case of abnormal HAR. Datasets consisting of six abnormal activities (falling backward, falling forward, falling rightward, falling leftward, chest pain, and fainting) and four normal activities (walking, rushing, sitting down, and standing up) are generated from different view angles (90°, -90°, 45°, -45°). Feature extraction and dimensions reduction are performed by R-transform followed by generalized discriminant analysis (GDA) methods. R-transform extracts symmetric, scale, and translation-invariant features from the sequences of activities. GDA increases the discrimination between different classes of highly similar activities. Silhouette sequences are quantified by the Linde-Buzo-Gray algorithm and recognized by hidden conditional random fields. Experimental results provide an average recognition rate of 94.2% for abnormal activities and 92.7% for normal activities. The recognition rate for the highly similar activities from different view angles shows the flexibility and efficacy of the proposed abnormal HAR and alert generation system for elderly care.

Impact of Entrepreneurship Training on Entrepreneurial Efficacy and Alertness among Adolescent Youth

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Moon-Ho Ringo Ho

2018-03-01

Full Text Available Our study focuses on the impact of systematic entrepreneurship training comprising both active and passive learning activities on entrepreneurial alertness and efficacy among adolescent youth. Reports from a two-wave online survey among 328 students from five secondary schools (aged 13–16 years; 34.8% male and 65.2% female reveal that those who went through entrepreneurship training (treatment group, N = 142 had significantly higher entrepreneurial alertness and efficacy levels compared to those who did not go through training (control group, N = 186. We also find that even with gender effects accounted for, the higher entrepreneurial alertness and efficacy levels in the treatment group are due in part to both passive and active/hands-on elements of the program. Our study offers direct evidence that conducting entrepreneurship training programs among secondary school students could be an effective means to enhance entrepreneurial competencies among the youth. Specifically, our findings highlight the value of entrepreneurial training in improving age-appropriate competencies of entrepreneurial alertness and efficacy.

Application of Short-Range LIDAR in Early Alerting for Low-Level Windshear and Turbulence at Hong Kong International Airport

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K. K. Hon

2014-01-01

Full Text Available Hong Kong Observatory currently uses a series of meteorological instruments, including long-range LIDAR (light detection and ranging systems, to provide alerting services of low-level windshear and turbulence for Hong Kong International Airport. For some events that are smaller in spatial dimensions and are rapidly changing, such as low altitude windshear and turbulence associated with buildings or man-made structures, it would be necessary to involve meteorological instruments that offer greater spatial resolution. Therefore, the Observatory has set up a short-range LIDAR on the roof of the AsiaWorld-Expo during the summers over the past several years, conducting field research on the feasibility of strengthening early alerting for windshear and turbulence over the north runway’s eastern arrival runway (Runway 25RA and developing an automated early alerting algorithm. This paper takes the pilot reports for Runway 25RA during the 2013 field research as verification samples, using different thresholds for radial wind velocity spatial and temporal changes detected by the short-range LIDAR to calculate the relative operating characteristic (ROC curve, and analyzes its early alerting performance.

Effects of dietary tryptophan and phenylalanine–tyrosine depletion on phasic alertness in healthy adults – A pilot study

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Patricia Hildebrand

2015-04-01

Full Text Available Background: The synthesis of the neurotransmitters serotonin (5-HT and dopamine (DA in the brain can be directly altered by dietary manipulation of their relevant precursor amino acids (AA. There is evidence that altered serotonergic and dopaminergic neurotransmission are both associated with impaired attentional control. Specifically, phasic alertness is one specific aspect of attention that has been linked to changes in 5-HT and DA availability in different neurocircuitries related to attentional processes. The present study investigated the impact of short-term reductions in central nervous system 5-HT and DA synthesis, which was achieved by dietary depletion of the relevant precursor AA, on phasic alertness in healthy adult volunteers; body weight–adapted dietary tryptophan and phenylalanine–tyrosine depletion (PTD techniques were used. Methods: The study employed a double-blind between-subject design. Fifty healthy male and female subjects were allocated to three groups in a randomized and counterbalanced manner and received three different dietary challenge conditions: acute tryptophan depletion (ATD, for the depletion of 5-HT; N=16, PTD (for the depletion of DA; N=17, and a balanced AA load (BAL; N=17, which served as a control condition. Three hours after challenge intake (ATD/PTD/BAL, phasic alertness was assessed using a standardized test battery for attentional performance (TAP. Blood samples for AA level analyses were obtained at baseline and 360 min after the challenge intake. Results: Overall, there were no significant differences in phasic alertness for the different challenge conditions. Regarding PTD administration, a positive correlation between the reaction times and the DA-related depletion magnitude was detected via the lower plasma tyrosine levels and the slow reaction times of the first run of the task. In contrast, higher tryptophan concentrations were associated with slower reaction times in the fourth run of the

Partner personality in distressed relationships

NARCIS (Netherlands)

Barelds, D.P.H.; Barelds-Dijkstra, P.

2006-01-01

The present study examines the personality characteristics of partners receiving marital therapy. On the basis of previous research, we expected partners in distressed relationships to be more neurotic and more introverted and to have lower self-esteem than partners in non-distressed relationships.

Distress During the Menopause Transition

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Marcianna Nosek

2012-07-01

Full Text Available In 2010, nearly 400 million women worldwide were of menopause age (45-54. Although many women transition through menopause with ease, some experience distress and a subsequent decrease in quality of life. The purpose of this qualitative study was to examine the experiences of distress in women during the menopause transition. A narrative analysis methodology was used maintaining participants’ complete narratives when possible. In-person interviews of 15 midlife women were digitally audio recorded and transcribed verbatim. Women shared narratives of distress related to menstrual changes, emotional instability, vaginal dryness, and decreased libido affected by their relationships with self, partners, work, and family. Some experiences were presented against a backdrop of the past and influenced by concerns for the future. Detailed stories illuminated the effect that distressful symptoms had on quality of life and captured how intricately woven symptoms were with the women’s interpersonal and social lives.

Turnaround distressed physician practices. 20 tips for success.

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Wolper, L F

1999-01-01

Physician practices are restructuring through merger and acquisition, and sale to practice management companies and to hospital systems. Many also are expanding internally by recruiting new physicians and opening additional offices. For many these strategies are working, but many others are experiencing operational and financial distress and failure that arise from rapid organizational growth without concomitant infrastructural change. Further, in the last several months, many national and regional practice management companies have decided to withdraw from the business, and others have declared bankruptcy. The number of physician practices that are in financial and operational distress is unprecedented. These groups require a solution, as proposed in this article.

A proposal for a pharmacokinetic interaction significance classification system (PISCS) based on predicted drug exposure changes and its potential application to alert classifications in product labelling.

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Hisaka, Akihiro; Kusama, Makiko; Ohno, Yoshiyuki; Sugiyama, Yuichi; Suzuki, Hiroshi

2009-01-01

Pharmacokinetic drug-drug interactions (DDIs) are one of the major causes of adverse events in pharmacotherapy, and systematic prediction of the clinical relevance of DDIs is an issue of significant clinical importance. In a previous study, total exposure changes of many substrate drugs of cytochrome P450 (CYP) 3A4 caused by coadministration of inhibitor drugs were successfully predicted by using in vivo information. In order to exploit these predictions in daily pharmacotherapy, the clinical significance of the pharmacokinetic changes needs to be carefully evaluated. The aim of the present study was to construct a pharmacokinetic interaction significance classification system (PISCS) in which the clinical significance of DDIs was considered with pharmacokinetic changes in a systematic manner. Furthermore, the classifications proposed by PISCS were compared in a detailed manner with current alert classifications in the product labelling or the summary of product characteristics used in Japan, the US and the UK. A matrix table was composed by stratifying two basic parameters of the prediction: the contribution ratio of CYP3A4 to the oral clearance of substrates (CR), and the inhibition ratio of inhibitors (IR). The total exposure increase was estimated for each cell in the table by associating CR and IR values, and the cells were categorized into nine zones according to the magnitude of the exposure increase. Then, correspondences between the DDI significance and the zones were determined for each drug group considering the observed exposure changes and the current classification in the product labelling. Substrate drugs of CYP3A4 selected from three therapeutic groups, i.e. HMG-CoA reductase inhibitors (statins), calcium-channel antagonists/blockers (CCBs) and benzodiazepines (BZPs), were analysed as representative examples. The product labelling descriptions of drugs in Japan, US and UK were obtained from the websites of each regulatory body. Among 220

Piracetam for fetal distress in labour.

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Hofmeyr, G Justus; Kulier, Regina

2012-06-13

Piracetam is thought to promote the metabolism of brain cells when they are hypoxic. It has been used to prevent adverse effects of fetal distress. The objective of this review was to assess the effects of piracetam for suspected fetal distress in labour on method of delivery and perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 February 2012). Randomised trials of piracetam compared with placebo or no treatment for suspected fetal distress in labour. Both review authors assessed eligibility and trial quality. One study of 96 women was included. Piracetam compared with placebo was associated with a trend to reduced need for caesarean section (risk ratio 0.57, 95% confidence interval 0.32 to 1.03). There were no statistically significant differences between the piracetam and placebo group for neonatal morbidity (measured by neonatal respiratory distress) or Apgar score. There is not enough evidence to evaluate the use of piracetam for fetal distress in labour.

Correlated colour temperature of morning light influences alertness and body temperature.

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Te Kulve, Marije; Schlangen, Luc; Schellen, Lisje; Souman, Jan L; van Marken Lichtenbelt, Wouter

2018-03-01

Though several studies have reported human alertness to be affected by the intensity and spectral composition of ambient light, the mechanism behind this effect is still largely unclear, especially for daytime exposure. Alerting effects of nocturnal light exposure are correlated with melatonin suppression, but melatonin levels are generally low during the day. The aim of this study was to explore the alerting effect of light in the morning for different correlated colour temperature (CCT) values, as well as its interaction with ambient temperature. Body temperature and perceived comfort were included in the study as possible mediating factors. In a randomized crossover design, 16 healthy females participated in two sessions, once under 2700K and once under 6500K light (both 55lx). Each session consisted of a baseline, a cool, a neutral and a warm thermal environment. Alertness as measured in a reaction time task was lower for the 6500K exposure, while subjective sleepiness was not affected by CCT. Also, core body temperature was higher under 6500K. Skin temperature parameters and perceived comfort were positively correlated with subjective sleepiness. Reaction time correlated with heat loss, but this association did not explain why the reaction time was improved for 2700K. Copyright © 2017 Elsevier Inc. All rights reserved.

The Indirect Costs of Financial Distress in Indonesia

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Wijantini Wijantini

2007-06-01

Full Text Available This paper presents quantitative estimates of the indirect cost of financial distress and its determinants. In order to measure the cost, this study estimates the annualized changes in industry-adjusted operation profit and sales from a year before the onset of distress to the resolution year. Using those approaches, the median of indirect financial distress cost is estimated between three and 11 percent annually. To the extent that the direct cost of financial distress reduces reported operating income, the estimated costs are overstated. The simple regressions analysis suggest that the indirect cost of financial distress significantly increases with size, leverage, number of creditors, and poor industry performance, but is not related to degree of bank loan reliance. The findings provide a weak support for the financial distress theory which suggests that conflicts of interest render the costs of financial distress.

Distress risk and leverage puzzles: Evidence from Taiwan

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Kung-Cheng Ho

2016-05-01

Full Text Available Financial distress has been invoked in the asset pricing literature to explain the anomalous patterns in the cross-section of stock returns. The risk of financial distress can be measured using indexes. George and Hwang (2010 suggest that leverage can explain the distress risk puzzle and that firms with high costs choose low leverage to reduce distress intensities and earn high returns. This study investigates whether this relationship exists in the Taiwan market. When examined separately, distress intensity is found to be negatively related to stock returns, but leverage is found to not be significantly related to stock returns. The results are the same when distress intensity and leverage are examined simultaneously. After assessing the robustness by using O-scores, distress risk puzzle is found to exist in the Taiwan market, but the leverage puzzle is not

Translating 'distress' and screening for emotional distress in multicultural cancer patients in Israel.

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Cohen, Miri; Gagin, Roni; Cinamon, Tali; Stein, Tamar; Moscovitz, Marian; Kuten, Abraham

2012-05-01

The adaptability of the distress thermometer (DT) to multicultural groups has rarely been assessed. To assess DT adaptability to the Israeli population as a multicultural society. Participants were 496 cancer patients. They were recruited for 3 days a week in 2009-2010 (97% response rate). Participants completed the DT, a problem list, Hospital Anxiety and Depression Scale (HADS), and the Brief Symptom Inventory (BSI-18). Receiver-operating characteristic (ROC) curve analyses of DT scores yielded area under the curve (AUC) of 0.63 as against HADS and of 0.78 as against BSI-18. ROC analysis revealed that the optimal cutoff score was ≥ 3. It yielded sensitivity and specificity of 0.74 and 0.65, as against the HADS, and 0.64 and 0.64, as against the BSI-18. The Jewish participants reported higher distress than the Arab participants, and the ROC properties were markedly higher for the Jewish subgroup alone. The adapted DT was moderately efficient for detecting emotional distress in cancer patients in Israel. Cultural aspects related to distress should be taken into account for administration of the DT in multicultural societies.

[Effects of Home Care Services Use by Older Adults on Family Caregiver Distress].

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Kim, Jiyeon; Kim, Hongsoo

2016-12-01

The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, χ² test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Presence of family caregiver distress was significantly associated with days of nurse visits (β=-.89, p=caregiver distress was also significantly associated with days of nurse visits (β=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.

Mutagenic and carcinogenic structural alerts and their mechanisms of action.

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Plošnik, Alja; Vračko, Marjan; Dolenc, Marija Sollner

2016-09-01

Knowing the mutagenic and carcinogenic properties of chemicals is very important for their hazard (and risk) assessment. One of the crucial events that trigger genotoxic and sometimes carcinogenic effects is the forming of adducts between chemical compounds and nucleic acids and histones. This review takes a look at the mechanisms related to specific functional groups (structural alerts or toxicophores) that may trigger genotoxic or epigenetic effects in the cells. We present up-to-date information about defined structural alerts with their mechanisms and the software based on this knowledge (QSAR models and classification schemes).

Perceived organizational support and moral distress among nurses.

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Robaee, Navideh; Atashzadeh-Shoorideh, Foroozan; Ashktorab, Tahereh; Baghestani, Ahmadreza; Barkhordari-Sharifabad, Maasoumeh

2018-01-01

Moral distress is prevalent in the health care environment at different levels. Nurses in all roles and positions are exposed to ethically challenging conditions. Development of supportive climates in organizations may drive nurses towards coping moral distress and other related factors. This study aimed at determining the level of perceived organizational support and moral distress among nurses and investigating the relationship between the two variables. This was a correlational-descriptive study. A total of 120 nurses were selected using random quota sampling method. A demographic questionnaire, Survey of Perceived Organizational Support, and Moral Distress Scale were used to collect the data which were analyzed using descriptive and analytical tests in SPSS20. The mean perceived organizational support was low (2.63 ± 0.79). The mean moral distress was 2.19 ± 0.58, which shows a high level of moral distress. Moreover, Statistical analysis showed no significant relationship between perceived organizational support and moral distress ( r  = 0.01, p  = 0.86). Given the low level of perceived organizational support and high moral distress among nurses in this study, it is necessary to provide a supportive environment in hospitals and to consider strategies for diminishing moral distress.

Do family physicians retrieve synopses of clinical research previously read as email alerts?

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Grad, Roland; Pluye, Pierre; Johnson-Lafleur, Janique; Granikov, Vera; Shulha, Michael; Bartlett, Gillian; Marlow, Bernard

2011-11-30

A synopsis of new clinical research highlights important aspects of one study in a brief structured format. When delivered as email alerts, synopses enable clinicians to become aware of new developments relevant for practice. Once read, a synopsis can become a known item of clinical information. In time-pressured situations, remembering a known item may facilitate information retrieval by the clinician. However, exactly how synopses first delivered as email alerts influence retrieval at some later time is not known. We examined searches for clinical information in which a synopsis previously read as an email alert was retrieved (defined as a dyad). Our study objectives were to (1) examine whether family physicians retrieved synopses they previously read as email alerts and then to (2) explore whether family physicians purposefully retrieved these synopses. We conducted a mixed-methods study in which a qualitative multiple case study explored the retrieval of email alerts within a prospective longitudinal cohort of practicing family physicians. Reading of research-based synopses was tracked in two contexts: (1) push, meaning to read on email and (2) pull, meaning to read after retrieval from one electronic knowledge resource. Dyads, defined as synopses first read as email alerts and subsequently retrieved in a search of a knowledge resource, were prospectively identified. Participants were interviewed about all of their dyads. Outcomes were the total number of dyads and their type. Over a period of 341 days, 194 unique synopses delivered to 41 participants resulted in 4937 synopsis readings. In all, 1205 synopses were retrieved over an average of 320 days. Of the 1205 retrieved synopses, 21 (1.7%) were dyads made by 17 family physicians. Of the 1205 retrieved synopses, 6 (0.5%) were known item type dyads. However, dyads also occurred serendipitously. In the single knowledge resource we studied, email alerts containing research-based synopses were rarely retrieved

Enhancing clinical effectiveness of pre-radiotherapy workflow by using multidisciplinary-cooperating e-control and e-alerts: A SQUIRE-compliant quality-improving study.

Science.gov (United States)

Lin, Yung-Hsiang; Hung, Shih-Kai; Lee, Moon-Sing; Chiou, Wen-Yen; Lai, Chun-Liang; Shih, Yi-Ting; Yeh, Pei-Han; Lin, Yi-An; Tsai, Wei-Ta; Hsieh, Hui-Ling; Chen, Liang-Cheng; Huang, Li-Wen; Lin, Po-Hao; Liu, Dai-Wei; Hsu, Feng-Chun; Tsai, Shiang-Jiun; Liu, Jia-Chi; Chung, En-Seu; Lin, Hon-Yi

2017-06-01

Radiotherapy (RT) is useful in managing cancer diseases. In clinical practice, early initiation of RT is crucial for enhancing tumor control. But, delivering precise RT requires a series of pre-RT working processes in a tight staff-cooperation manner. In this regard, using information system to conduct e-control and e-alerts has been suggested to improve practice effectiveness; however, this effect is not well defined in a real-world RT setting.We designed an information system to perform e-control and e-alerts for the whole process of pre-RT workflow to shorten processing time, to improve overall staff satisfaction, and to enhance working confidence.A quality-improving study conducted in a large RT center.Externally validated data were retrospectively analyzed for comparison before (from Sep. 2012 to Dec. 2012, n = 223) and after (from Sep. 2013 to Dec. 2013, n = 240) implementation of pre-RT e-control and e-alerts.Applying the e-control with delay-working e-alerts in pre-RT workflow was the main intervention.Nine workstations were identified in pre-RT workflow. The primary outcome measure was the processing time in each pre-RT workstations before and after implementing the e-control and e-alerts. Secondary measures were staff-working confidence and near-missing cases during the process of pre-RT workflow.After implementing e-control, overall processing time of pre-RT workflow was shortened from 12.2 days to 8.9 days (P workflow. Clinical effectiveness, staff satisfaction, and working confidence are able to be enhanced obviously.

Marital Adjustment and Psychological Distress in Japan

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Li, Angela; Robustelli, Briana L.; Whisman, Mark A.

2016-01-01

This study was conducted to examine the association between marital adjustment and psychological distress in a large, probability sample of married adults in Japan (N = 710) from the Midlife Development in Japan (MIDJA) study. Results indicate that positive and negative dimensions of marital adjustment were significantly associated with dimensional and categorical measures of psychological distress. Furthermore, the associations between marital adjustment and psychological distress remained significant when statistically controlling for neuroticism, quality of friend and family relationships, and demographic variables. These results demonstrate that the well-established association between marital adjustment and psychological distress found in European-American countries is also found in Japan. Findings support continued research on marital functioning and psychological distress in East Asian countries. PMID:28082761

Healthcare Engagement as a Potential Source of Psychological Distress among People without Religious Beliefs: A Systematic Review.

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Weber, Samuel R; Lomax, James W; Pargament, Kenneth I

2017-04-05

Research into religion and mental health is increasing, but nonbelievers in terms of religion are often overlooked. Research has shown that nonbelievers experience various forms of psychological distress and that the negative perception of nonbelievers by others is a potential source of distress. This review builds on that research by identifying another potential source of psychological distress for nonbelievers: engagement with the healthcare system. Poor understanding of nonbelievers by healthcare professionals may lead to impaired communication in the healthcare setting, resulting in distress. Attempts by nonbelievers to avoid distress may result in different patterns of healthcare utilization. Awareness of these concerns may help healthcare providers to minimize distress among their nonbelieving patients.

Healthcare Engagement as a Potential Source of Psychological Distress among People without Religious Beliefs: A Systematic Review

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Samuel R. Weber

2017-04-01

Full Text Available Research into religion and mental health is increasing, but nonbelievers in terms of religion are often overlooked. Research has shown that nonbelievers experience various forms of psychological distress and that the negative perception of nonbelievers by others is a potential source of distress. This review builds on that research by identifying another potential source of psychological distress for nonbelievers: engagement with the healthcare system. Poor understanding of nonbelievers by healthcare professionals may lead to impaired communication in the healthcare setting, resulting in distress. Attempts by nonbelievers to avoid distress may result in different patterns of healthcare utilization. Awareness of these concerns may help healthcare providers to minimize distress among their nonbelieving patients.

The symbolic power of money: reminders of money alter social distress and physical pain.

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Zhou, Xinyue; Vohs, Kathleen D; Baumeister, Roy F

2009-06-01

People often get what they want from the social system, and that process is aided by social popularity or by having money. Money can thus possibly substitute for social acceptance in conferring the ability to obtain benefits from the social system. Moreover, past work has suggested that responses to physical pain and social distress share common underlying mechanisms. Six studies tested relationships among reminders of money, social exclusion, and physical pain. Interpersonal rejection and physical pain caused desire for money to increase. Handling money (compared with handling paper) reduced distress over social exclusion and diminished the physical pain of immersion in hot water. Being reminded of having spent money, however, intensified both social distress and physical pain.

Comparing the meanings of living with advanced breast cancer between women resilient to distress and women with persistent distress: a qualitative study.

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Lam, W W T; Yoon, S W; Sze, W K; Ng, A W Y; Soong, I; Kwong, A; Suen, D; Tsang, J; Yeo, W; Wong, K Y; Fielding, R

2017-02-01

Most women with advanced breast cancer (ABC) show little distress, but about one in ten show persistent distress over time. It remains unclear if meanings ascribed by patients to ABC differentiate these distress trajectories. This qualitative study (a) compared illness meanings of ABC between women with persistent psychological distress and those with low/transient distress, and (b) examined how illness meanings might influence coping strategies. The sample was drawn from a prior quantitative study exploring psychological distress trajectories following ABC diagnosis. Overall, 42 Cantonese- or Mandarin-speaking Chinese women diagnosed with locally advanced or metastatic ABC were recruited based on their distress trajectory status (low-stable, transient, or persistent distress). Interviews were recorded, transcribed, and analyzed following grounded theory approach using simultaneous analysis. Women with persistent distress viewed their diagnosis as another blow in life, the illness was global, permeating every aspect of their life. Maladaptive rumination and thought suppression were common responses to illness demands. These women had poor social support. A sense of demoralization stood out in their narratives. In contrast, women with transient/low-stable distress encapsulated the illness, with minimum impacts of their life. They did not evidence dysfunctional repetitive thoughts. Living in a supportive environment, they were able to accept and/or live in the present-moment. Rumination, thought suppression, social constraints, and pre-existing exposure to life stress may be potential risks for chronic distress in response to advanced breast cancer. Persistent and transient distress responses to cancer may have different underpinnings. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Maternal postpartum distress and childhood overweight

DEFF Research Database (Denmark)

Adeltoft, Teresa Ajslev; Andersen, Camilla S; Ingstrup, Katja Glejsted

2010-01-01

We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight.......We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight....

Psychological distress of adolescents exposed to Hurricane Hugo.

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Hardin, S B; Weinrich, M; Weinrich, S; Hardin, T L; Garrison, C

1994-07-01

To ascertain the effects of a natural disaster on adolescents, 1482 South Carolina high school students who were exposed to Hurricane Hugo were surveyed 1 year after the disaster. Subjects completed a self-administered questionnaire measuring Hugo exposure, nonviolent and violent life events, social support, self-efficacy, and psychological distress. Results showed that the students reported minimal exposure to the hurricane and psychological distress variables approximated national norms. As exposure increased, adolescents reported increased symptoms of psychological distress; i.e., anger, depression, anxiety, and global mental distress. Females and white students experienced higher levels of distress. In most cases, other stressful life events were at least as strong a predictor of psychological distress as was exposure to the hurricane. Self-efficacy and social support were protective.

Relationships among neighborhood environment, racial discrimination, psychological distress, and preterm birth in African American women.

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Giurgescu, Carmen; Zenk, Shannon N; Dancy, Barbara L; Park, Chang G; Dieber, William; Block, Richard

2012-01-01

To (a) examine the relationships among objective and perceived indicators of neighborhood environment, racial discrimination, psychological distress, and gestational age at birth; (b) determine if neighborhood environment and racial discrimination predicted psychological distress; (c) determine if neighborhood environment, racial discrimination, and psychological distress predicted preterm birth; and (d) determine if psychological distress mediated the effects of neighborhood environment and racial discrimination on preterm birth. Descriptive correlational comparative. Postpartum unit of a medical center in Chicago. African American women (n(1)  = 33 with preterm birth; n(2)  = 39 with full-term birth). Women completed the instruments 24 to 72 hours after birth. Objective measures of the neighborhood were derived using geographic information systems (GIS). Women who reported higher levels of perceived social and physical disorder and perceived crime also reported higher levels of psychological distress. Women who reported more experiences of racial discrimination also had higher levels of psychological distress. Objective social disorder and perceived crime predicted psychological distress. Objective physical disorder and psychological distress predicted preterm birth. Psychological distress mediated the effect of objective social disorder and perceived crime on preterm birth. Women's neighborhood environments and racial discrimination were related to psychological distress, and these factors may increase the risk for preterm birth. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Automated acute kidney injury alerts.

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Kashani, Kianoush B

2018-05-02

Acute kidney injury (AKI) is one of the most common and probably one of the more consequential complications of critical illnesses. Recent information indicates that it is at least partially preventable; however, progress in its prevention, management, and treatment has been hindered by the scarcity of knowledge for effective interventions, inconsistencies in clinical practices, late identification of patients at risk for or with AKI, and limitations of access to best practices for prevention and management of AKI. Growing use of electronic health records has provided a platform for computer science to engage in data mining and processing, not only for early detection of AKI but also for the development of risk-stratification strategies and computer clinical decision-support (CDS) systems. Despite promising perspectives, the literature regarding the impact of AKI electronic alerts and CDS systems has been conflicting. Some studies have reported improvement in care processes and patient outcomes, whereas others have shown no effect on clinical outcomes and yet demonstrated an increase in the use of resources. These discrepancies are thought to be due to multiple factors that may be related to technology, human factors, modes of delivery of information to clinical providers, and level of expectations regarding the impact on patient outcomes. This review appraises the current body of knowledge and provides some outlines regarding research into and clinical aspects of CDS systems for AKI. Copyright © 2018 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Evaluation of a National Call Center and a Local Alerts System for Detection of New Cases of Ebola Virus Disease - Guinea, 2014-2015

Science.gov (United States)

2016-03-11

call centers were established in response to the Ebola epidemic in Guinea, Liberia , and Sierra Leone, the sensitivity of those call centers for...Control and Prevention Evaluation of a National Call Center and a Local Alerts System for Detection of New Cases of Ebola Virus Disease — Guinea, 2014...2015 Christopher T. Lee, MD1,2,3; Marc Bulterys, MD, PhD2,4,5; Lise D. Martel, PhD2,6; Benjamin A. Dahl PhD2,5 The epidemic of Ebola virus disease ( Ebola

Decreased functional connectivity and structural deficit in alertness network with right-sided temporal lobe epilepsy.

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Gao, Yujun; Zheng, Jinou; Li, Yaping; Guo, Danni; Wang, Mingli; Cui, Xiangxiang; Ye, Wei

2018-04-01

Patients with temporal lobe epilepsy (TLE) often suffer from alertness alterations. However, specific regions connected with alertness remain controversial, and whether these regions have structural impairment is also elusive. This study aimed to investigate the characteristics and neural mechanisms underlying the functions and structures of alertness network in patients with right-sided temporal lobe epilepsy (rTLE) by performing the attentional network test (ANT), resting-state functional magnetic resonance imaging (R-SfMRI), and diffusion tensor imaging (DTI).A total of 47 patients with rTLE and 34 healthy controls underwent ANT, R-SfMRI, and DTI scan. The seed-based functional connectivity (FC) method and deterministic tractography were used to analyze the data.Patients with rTLE had longer reaction times in the no-cue and double-cue conditions. However, no differences were noted in the alertness effect between the 2 groups. The patient group had lower FC compared with the control group in the right inferior parietal lobe (IPL), amygdala, and insula. Structural deficits were found in the right parahippocampal gyrus, superior temporal pole, insula, and amygdala in the patient group compared with the control group. Also significantly negative correlations were observed between abnormal fractional anisotropy (between the right insula and the superior temporal pole) and illness duration in the patients with rTLE.The findings of this study suggested abnormal intrinsic and phasic alertness, decreased FC, and structural deficits within the alerting network in the rTLE. This study provided new insights into the mechanisms of alertness alterations in rTLE.

Intensity cut-points for the Respiratory Distress Observation Scale

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Campbell, Margaret L; Templin, Thomas N

2015-01-01

Background The Respiratory Distress Observation Scale© is an innovative solution to assessment when a dyspnea report cannot be elicited. The Respiratory Distress Observation Scale has acceptable reliability and validity psychometrics. Aim To identify distress-intensity cut-points of the Respiratory Distress Observation Scale. Design Receiver operating characteristic curve analysis was conducted with inpatients stratified by four levels of respiratory distress—none, mild, moderate, or severe. Patients provided three self-report measures of dyspnea: dichotomous (yes/no); a ranking of none, mild, moderate, or severe; and a numerical rating scale. Respiratory distress was assessed using the Respiratory Distress Observation Scale instrument. Setting/participants Participants were 136 adult inpatients, mean age 61.8 years (standard deviation = 13.18 years), 89.7% African American, and 56.6% female, who were recruited from an urban, tertiary care hospital in the Midwest of the United States. Results In all, 47% (n = 64) self-reported dyspnea (yes/no). Ranking was distributed as follows: none = 36, mild = 35, moderate = 40, and severe = 25. Numerical rating scale scores ranged from 0 to 10, mean = 4.99 (standard deviation = 2.9). Respiratory Distress Observation Scale scores ranged from 0 to 7, median (interquartile range) = 2 (1–3). Receiver operating characteristic curve analysis–determined Respiratory Distress Observation Scale score of 0–2 suggests little or no respiratory distress; score ≥3 signified moderate to severe distress. Conclusion A Respiratory Distress Observation Scale score ≥3 signifies a patient’s need for palliation of respiratory distress. An end-point for identifying responsiveness to treatment, in other words, respiratory comfort, is Respiratory Distress Observation Scale <3. Because patients with imminent respiratory failure, as typified by dying patients, were not represented yielding lower than expected Respiratory Distress

BABY EMPATHY: INFANT DISTRESS AND PEER PROSOCIAL RESPONSES.

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Liddle, Mitzi-Jane E; Bradley, Ben S; Mcgrath, Andrew

2015-01-01

Empathy is an important competence in our social world, a motivator of prosocial behavior, and thought to develop throughout the second year of life. The current study examined infants' responses to naturalistic peer distress to explore markers of empathy and prosocial behavior in young babies. Seventeen 8-month-old infants participated in a repeated measures design using the "babies-in-groups" paradigm, with maternal presence as the independent variable. Significant differences were found between response types: Gaze was the standard response to infant distress, followed by socially directed behaviors and affect, with self-distress rarely occurring. Maternal presence was not found to impact the nature or frequency of babies' responses to peer distress. During distress episodes, babies looked preferentially at the distressed peer, then other mothers, and least to their own mother. Data revealed that infant responses to peer distress resulted in a successful cessation of that distress episode over one third of the time. Case studies are provided to illustrate the quantitative data. The results provided evidence of empathic concern and prosocial behavior in the first year of life, and provoke a challenge to developmental theories of empathy. © 2015 Michigan Association for Infant Mental Health.

Symptom distress in older adults following cancer surgery.

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Van Cleave, Janet H; Egleston, Brian L; Ercolano, Elizabeth; McCorkle, Ruth

2013-01-01

Symptom distress remains a significant health problem among older adults with cancer following surgery. Understanding factors influencing older adults' symptom distress may lead to early identification and interventions, decreasing morbidity and improving outcomes. We conducted this study to identify factors associated with symptom distress following surgery among 326 community-residing patients 65 years or older with a diagnosis of thoracic, digestive, gynecologic, and genitourinary cancers. This secondary analysis used combined subsets of data from 5 nurse-directed intervention clinical trials targeting patients after surgery at academic cancer centers in northwest and northeastern United States. Symptom distress was assessed by the Symptom Distress Scale at baseline and at 3 and 6 months. A multivariable analysis, using generalized estimating equations, showed that symptom distress was significantly less at 3 and 6 months (3 months: P psychological, treatment, and function covariates. Thoracic cancer, comorbidities, worse mental health, and decreased function were, on average, associated with increased symptom distress (all P cancer, comorbidities, mental health, and function may influence older adults' symptom distress following cancer surgery. Older adults generally experience decreasing symptom distress after thoracic, abdominal, or pelvic cancer surgery. Symptom management over time for those with thoracic cancer, comorbidities, those with worse mental health, those with decreased function, and those 75 years or older may prevent morbidity and improve outcomes of older adults following surgery.

Prevalence and related factors of psychological distress among cancer inpatients using routine Distress Thermometer and Chinese Health Questionnaire screening

Directory of Open Access Journals (Sweden)

Chiou YJ

2016-10-01

Full Text Available Yu-Jie Chiou,1 Nien-Mu Chiu,1 Liang-Jen Wang,2 Shau-Hsuan Li,3 Chun-Yi Lee,1 Ming-Kung Wu,1 Chien-Chih Chen,1 Yi-Shan Wu,1 Yu Lee1 1Department of Psychiatry, 2Department of Child and Adolescent Psychiatry, 3Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China Background: Clinical practice guidelines suggest routine screening for distress among cancer patients for immediate early psychiatric care. However, previous studies focusing on routine screening for psychological distress among cancer inpatients in Taiwan are scant. Thus, the aim of this study was to evaluate the prevalence and related factors of psychological distress and mental illness among cancer inpatients in Taiwan. Patients and methods: This study was conducted as a retrospective chart review in a general hospital in southern Taiwan. Cancer inpatients were regularly screened by nursing staff using the Distress Thermometer and the 12-item Chinese Health Questionnaire. Positive screening results on either instrument were followed by a non-commanded referral to psychiatrists for clinical psychiatric diagnosis and treatment. Results: Of the 810 participants in this study, 179 (22.1% were recognized as having psychological distress. Younger age (odds ratio [OR] =1.82, having head and neck cancer (OR =2.43, and having not received chemotherapy (OR =1.58 were significantly related to psychological distress. Among the 56 patients (31.3% with psychological distress who were referred to psychiatrists, the most common mental illness was adjustment disorder (n=22, 39.2%, followed by major depressive disorder (n=13, 23.2%, depressive disorder not otherwise specified (n=6, 10.7%, and anxiety disorder not otherwise specified (n=4, 7.1%. Conclusion: Our study indicated that cancer inpatients with psychological distress were more likely to be younger in age, have head and neck cancer, and have not

A volcanic activity alert-level system for aviation: review of its development and application in Alaska

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Guffanti, Marianne; Miller, Thomas P.

2013-01-01

An alert-level system for communicating volcano hazard information to the aviation industry was devised by the Alaska Volcano Observatory (AVO) during the 1989–1990 eruption of Redoubt Volcano. The system uses a simple, color-coded ranking that focuses on volcanic ash emissions: Green—normal background; Yellow—signs of unrest; Orange—precursory unrest or minor ash eruption; Red—major ash eruption imminent or underway. The color code has been successfully applied on a regional scale in Alaska for a sustained period. During 2002–2011, elevated color codes were assigned by AVO to 13 volcanoes, eight of which erupted; for that decade, one or more Alaskan volcanoes were at Yellow on 67 % of days and at Orange or Red on 12 % of days. As evidence of its utility, the color code system is integrated into procedures of agencies responsible for air-traffic management and aviation meteorology in Alaska. Furthermore, it is endorsed as a key part of globally coordinated protocols established by the International Civil Aviation Organization to provide warnings of ash hazards to aviation worldwide. The color code and accompanying structured message (called a Volcano Observatory Notice for Aviation) comprise an effective early-warning message system according to the United Nations International Strategy for Disaster Reduction. The aviation color code system currently is used in the United States, Russia, New Zealand, Iceland, and partially in the Philippines, Papua New Guinea, and Indonesia. Although there are some barriers to implementation, with continued education and outreach to Volcano Observatories worldwide, greater use of the aviation color code system is achievable.

Female sexual distress in infertile Turkish women

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Serdar Aydın

2015-12-01

Full Text Available Objective: To evaluate the effect of infertility on sexual distress in women attending the infertility clinic. 
 Materials and Methods: In a cross-sectional study we evaluated sexual distress among 88 women who attended the infertility clinic in our institute between January and June 2015. All women who were experiencing primary or secondary infertility during the study sampling were included in the sudy. Sexual distress was measured using the Female sexual distress scale-revised (FSDS-R, a cross-validated patient-reported outcomes measure. Correlations of FSDS-R with patient characteristics and laboratory measurements were calculated using Spearman’s rank correlation tests. Results: With the exceptions of the age of couples and serum anti-mullerian hormone (AMH levels, no predictor of high sexual distress was found in the univariate analysis when comparing groups with regard to the FSDS-R cut-off score. The mean age of the sexually distressed women (33.6±5.8 years vs. 29.3±5.1 years and their partners (35.4±4.8 years vs. 31.6±4.2 years was significantly higher than those of the non distressed women, according to a FSDS-R score over 11 (p<0.05. The serum level of AMH was significantly lower in infertile women with high total sexual distress scores (1.4 vs. 7.6 ng/mL (p<0.001. Conclusion: In infertile women, age of woman, age of partner, and serum AMH levels are related with the hope of women to have a child despite an association with sexual distress. Serum AMH, which is perceived as necessary for fertility, had a significant inverse correlation with levels of sexual stress.

A philosophical taxonomy of ethically significant moral distress.

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Thomas, Tessy A; McCullough, Laurence B

2015-02-01

Moral distress is one of the core topics of clinical ethics. Although there is a large and growing empirical literature on the psychological aspects of moral distress, scholars, and empirical investigators of moral distress have recently called for greater conceptual clarity. To meet this recognized need, we provide a philosophical taxonomy of the categories of what we call ethically significant moral distress: the judgment that one is not able, to differing degrees, to act on one's moral knowledge about what one ought to do. We begin by unpacking the philosophical components of Andrew Jameton's original formulation from his landmark 1984 work and identify two key respects in which that formulation remains unclear: the origins of moral knowledge and impediments to acting on that moral knowledge. We then selectively review subsequent literature that shows that there is more than one concept of moral distress and that explores the origin of the values implicated in moral distress and impediments to acting on those values. This review sets the stage for identifying the elements of a philosophical taxonomy of ethically significant moral distress. The taxonomy uses these elements to create six categories of ethically significant moral distress: challenges to, threats to, and violations of professional integrity; and challenges to, threats to, and violations of individual integrity. We close with suggestions about how the proposed philosophical taxonomy of ethically significant moral distress sheds light on the concepts of moral residue and crescendo effect of moral distress and how the proposed taxonomy might usefully guide prevention of and future qualitative and quantitative empirical research on ethically significant moral distress. © The Author 2014. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

NAPS as an Alertness Management Strategy

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Rosekind, Mark R.; Smith, Roy M.; Miller, Donna L.; Co, Elizabeth L.; Gregory, Kevin B.; Gander, Philippa H.; Lebacqz, J. Victor

2001-01-01

Today, 24-hour operations are necessary to meet the demands of our society and the requirements of our industrialized global economy. These around-the-clock demands pose unique physiological challenges for the humans who remain central to safe and productive operations. Optimal alertness and performance are critical factors that are increasingly challenged by unusual, extended, or changing work/rest schedules. Technological advancements and automated systems can exacerbate the challenges faced by the human factor in these environments. Shift work, transportation demands, and continuous operations engender sleep loss and circadian disruption. Both of these physiological factors can lead to increased sleepiness, decreased performance, and a reduced margin of safety. These factors can increase vulnerability to incidents and accidents in operational settings. The consequences can have both societal effects (e.g., major destructive accidents such as Three Mile Island, Exxon Valdez, Bhopal) and personal effects (e.g., an accident driving home after a night shift).

Psychological distress: precursor or consequence of dating infidelity?

Science.gov (United States)

Hall, Julie H; Fincham, Frank D

2009-02-01

Research on infidelity-related distress has focused on victims with little attention to perpetrators. Two studies therefore explore the psychological functioning of individuals who have engaged in dating infidelity. Study 1 showed that, compared to faithful partners, individuals who had engaged in infidelity showed more psychological distress. Study 2 investigated the interrelationships among infidelity, psychological distress, and relationship satisfaction over time. Results suggested that initial levels of psychological distress predicted later infidelity but infidelity did not predict subsequent psychological distress. Findings are interpreted in light of the broader infidelity literature, potential mechanisms are suggested, and avenues for future research are recommended.

Does integrating nonurgent, clinically significant radiology alerts within the electronic health record impact closed-loop communication and follow-up?

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O'Connor, Stacy D; Dalal, Anuj K; Sahni, V Anik; Lacson, Ronilda; Khorasani, Ramin

2016-03-01

To assess whether integrating critical result management software--Alert Notification of Critical Results (ANCR)--with an electronic health record (EHR)-based results management application impacts closed-loop communication and follow-up of nonurgent, clinically significant radiology results by primary care providers (PCPs). This institutional review board-approved study was conducted at a large academic medical center. Postintervention, PCPs could acknowledge nonurgent, clinically significant ANCR-generated alerts ("alerts") within ANCR or the EHR. Primary outcome was the proportion of alerts acknowledged via EHR over a 24-month postintervention. Chart abstractions for a random sample of alerts 12 months preintervention and 24 months postintervention were reviewed, and the follow-up rate of actionable alerts (eg, performing follow-up imaging, administering antibiotics) was estimated. Pre- and postintervention rates were compared using the Fisher exact test. Postintervention follow-up rate was compared for EHR-acknowledged alerts vs ANCR. Five thousand nine hundred and thirty-one alerts were acknowledged by 171 PCPs, with 100% acknowledgement (consistent with expected ANCR functionality). PCPs acknowledged 16% (688 of 4428) of postintervention alerts in the EHR, with the remaining in ANCR. Follow-up was documented for 85 of 90 (94%; 95% CI, 88%-98%) preintervention and 79 of 84 (94%; 95% CI, 87%-97%) postintervention alerts (P > .99). Postintervention, 11 of 14 (79%; 95% CI, 52%-92%) alerts were acknowledged via EHR and 68 of 70 (97%; 95% CI, 90%-99%) in ANCR had follow-up (P = .03). Integrating ANCR and EHR provides an additional workflow for acknowledging nonurgent, clinically significant results without significant change in rates of closed-loop communication or follow-up of alerts. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Elevated plasma fibrinogen, psychological distress, antidepressant use, and hospitalization with depression

DEFF Research Database (Denmark)

Wium-Andersen, Marie Kim; Ørsted, David Dynnes; Nordestgaard, Børge Grønne

2013-01-01

with depression in the general population. METHODS: We examined 73,367 20-100 year old men and women from two large population-based studies, the Copenhagen General Population Study and the Copenhagen City Heart Study. We measured plasma fibrinogen and recorded symptoms of psychological distress, use......OBJECTIVES: Low-grade systemic inflammation may contribute to the development of depression. We tested the hypothesis that elevated plasma levels of the inflammatory marker fibrinogen are associated with psychological distress, use of antidepressant medication, and with hospitalization...... of antidepressant medication, and hospitalization with depression in both cross-sectional and prospective studies. RESULTS: In cross-sectional analyses, a stepwise increase in fibrinogen percentile categories was associated with a stepwise increase in risk of psychological distress, use of antidepressant medication...

Design of an electronic medical record (EMR-based clinical decision support system to alert clinicians to the onset of severe sepsis

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Fountain S

2016-04-01

Full Text Available Background: The aim of our study was to design an electronic medical record ­based alert system to detect the onset of severe sepsis with sensitivity and positive predictive value (PPV above 50%. Methods: The PPV for each of seven potential criteria for suspected infection (white blood cell count (WBCC >12 or 0.1 K/uL or immature granulocyte % >1%, temperature >38 C. or 50%, the charts of sixty consecutive patients who met CMS criteria for severe sepsis were reviewed to calculate the sensitivity of organ dysfunction plus any one of the suspected infection criteria. Results: Four proposed criteria for suspected infection had PPV >50%: WBCC >12 x 10 9 /L (69%; 95%CI:53­84%, Temperature >38C. (84%; 95%CI:68­100%, Temperature <36C. (57% 95%CI:36­78%, and initiation of antibiotics (70% 95%CI:56­84%. These four criteria were present in 53/60 of the patients with severe sepsis by CMS criteria, yielding a sensitivity of 88.3% (95%CI: 80.2­96.4%. Alert criteria were satisfied before the onset of severe sepsis in 25/53 cases, and within 90 minutes afterwards in 28/53 cases. Conclusions: Our criteria for suspected infection plus organ dysfunction yields reasonable sensitivity and PPV for the detection of severe sepsis in real­time.

Psychological distress associated with cancer screening: A systematic review.

Science.gov (United States)

Chad-Friedman, Emma; Coleman, Sarah; Traeger, Lara N; Pirl, William F; Goldman, Roberta; Atlas, Steven J; Park, Elyse R

2017-10-15

Current national cancer screening recommendations include the potential risk of psychological harm related to screening. However, data on the relation of psychological distress to cancer screening is limited. The authors conducted a systematic review to assess psychological distress associated with cancer screening procedures. Studies that administered measures of psychological distress between 2 weeks before and 1 month after the screening procedure were included. In total, 22 eligible studies met criteria for review, including 13 observational trials and 9 randomized controlled trials. Eligible studies used a broad range of validated and unvalidated measures. Anxiety was the most commonly assessed construct and was measured using the State Trait Anxiety Inventory. Studies included breast, colorectal, prostate, lung, and cervical screening procedures. Distress was low across procedures, with the exception of colorectal screening. Distress did not vary according to the time at which distress was measured. None of the studies were conducted exclusively with the intention of assessing distress at the time of screening. Evidence of low distress during the time of cancer screening suggests that distress might not be a widespread barrier to screening among adults who undergo screening. However, more studies are needed using validated measures of distress to further understand the extent to which screening may elicit psychological distress and impede adherence to national screening recommendations. Cancer 2017;123:3882-94. © 2017 American Cancer Society. © 2017 American Cancer Society.

Metabolic acidosis as an underlying mechanism of respiratory distress in children with severe acute asthma.

Science.gov (United States)

Meert, Kathleen L; Clark, Jeff; Sarnaik, Ashok P

2007-11-01

1) To alert the clinician that increasing rate and depth of breathing during treatment of acute asthma may be a manifestation of metabolic acidosis with hyperventilation rather than worsening airway obstruction; and 2) to describe the frequency of metabolic acidosis with hyperventilation in children with severe acute asthma admitted to our pediatric intensive care unit. Retrospective medical record review. University-affiliated children's hospital. All patients admitted to the pediatric intensive care unit with a diagnosis of asthma between January 1, 2005, and December 31, 2005. None. Fifty-three patients with asthma (median age 7.8 yrs, range 0.7-17.9 yrs; 35 [66%] male; 46 [87%] black and 7 [13%] white) were admitted to the pediatric intensive care unit during the study period. Fifteen (28%) patients developed metabolic acidosis with hyperventilation (pH 120 mg/dL [6.7 mmol/L]). Patients who developed metabolic acidosis with hyperventilation received asthma therapy similar to that received by patients who did not develop the disorder. Metabolic acidosis resolved contemporaneously with tapering of beta2-adrenergic agonists and administration of supportive care. All patients survived. Metabolic acidosis with hyperventilation manifesting as respiratory distress can occur in children with severe acute asthma. A pathophysiologic rationale exists for the contribution of beta2-adrenergic agents to the development of this acid-base disorder. Failure to recognize metabolic acidosis as the underlying mechanism of respiratory distress may lead to inappropriate intensification of bronchodilator therapy. Supportive care and tapering of beta2-adrenergic agents are recommended to resolve this condition.

The ethics of distress: toward a framework for determining the ethical acceptability of distressing health promotion advertising.

Science.gov (United States)

Brown, Stephen L; Whiting, Demian

2014-04-01

Distressing health promotion advertising involves the elicitation of negative emotion to increase the likelihood that health messages will stimulate audience members to adopt healthier behaviors. Irrespective of its effectiveness, distressing advertising risks harming audience members who do not consent to the intervention and are unable to withdraw from it. Further, the use of these approaches may increase the potential for unfairness or stigmatization toward those targeted, or be considered unacceptable by some sections of the public. We acknowledge and discuss these concerns, but, using the public health ethics literature as a guide, argue that distressing advertising can be ethically defensible if conditions of effectiveness, proportionality necessity, least infringement, and public accountability are satisfied. We do not take a broad view as to whether distressing advertising is ethical or unethical, because we see the evidence for both the effectiveness of distressing approaches and their potential to generate iatrogenic effects to be inconclusive. However, we believe it possible to use the current evidence base to make informed estimates of the likely consequences of specific message presentations. Messages can be pre-tested and monitored to identify and deal with potential problems. We discuss how advertisers can approach the problems of deciding on the appropriate intensity of ethical review, and evaluating prospective distressing advertising campaigns against the conditions outlined. © 2013 International Union of Psychological Science.

[Summarizing of medicinal alerts in Ivory Coast from 2001 till 2010].

Science.gov (United States)

N'Guessan-Irié, Amenan Geneviève; Yavo, Jean-Claude; Guillaume Amari, Antoine Serge; Yapi, Ange Désiré

2012-01-01

STUDY'S AIM: This study aims a more efficient follow-up of the safety of medicines with human usage on the Ivory Coast territory. The structure responsible for pharmacovigilance in Ivory Coast i.e. DPM listed the medicinal alerts from 2001 till 2010. It emerges 237 medicinal alerts among which 145 stops of marketing, 55 withdrawals of lots, 33 information notes and 4 levying of suspension of medicines. These alerts result mainly from pharmaceutical companies (49%) and the French Drug Agency or ANSM (ex-Afssaps) (43%). They mainly concern drugs of infectious target (22%) and pneumology (18%) and their motivations are so much industrial with mainly commercial reasons (27%) as of pharmacovigilance dominated by unfavorable profit/risk connections. These results constitute an important database for the survey of the medicines market in Ivory Coast and an additional motivation to accelerate the implementation of a real national center of pharmacovigilance. © 2012 Société Française de Pharmacologie et de Thérapeutique.

47 CFR 80.1069 - Maritime sea areas.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Maritime sea areas. 80.1069 Section 80.1069... MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) General Provisions § 80.1069 Maritime... continuous DSC alerting is available as defined by the International Maritime Organization. (2) Sea area A2...

Metaphorical profile of distress in English media discourse

Directory of Open Access Journals (Sweden)

Verbytska Anna

2017-12-01

Full Text Available The current research is directed towards the transition of distress studies in the English speaking culture from the prototype towards the conceptual metaphor approach. It enables the enlightenment of mental images, which underlie distress language usage in modern mass communication. The analysis involves identification of conceptual distress metaphors and metonymies within the image-schematic structure. The study includes a cognitive semantic analysis of linguistic units of the distress lexicon retrieved from the GloWbE, BNC, COCA, English newspapers and media platforms. Figurative language reveals conventional beliefs about distress represented in English media discourse, such as strong associations of emotion with darkness and coldness. Metaphorical mappings contain views about the reasons for distress experience which lie in the loss of balance or inner equilibrium, loss of control, and convictions about the reaction characterizing a person as being weak and brittle. The findings of data analysis are summed up in a metaphorical profile of distress (MPD which discloses the behavioural patterns (communicative behaviour, adequacy/inadequacy of behaviour, ability to socialize and physical effects including health issues.

44 CFR 208.36 - Reimbursement for Alert.

Science.gov (United States)

2010-10-01

... § 208.41 of this part. (4) Food and beverages for Task Force Members and Support Specialists when DHS does not provide meals during the Alert. DHS will limit food and beverage reimbursement to the amount... where such food and beverages were provided, multiplied by the number of personnel who received them. (b...

Commercial Mobile Alert Service (CMAS) Scenarios

Science.gov (United States)

2012-05-01

Commercial Mobile Alert Service (CMAS) Scenarios The WEA Project Team May 2012 SPECIAL REPORT CMU/SEI-2012-SR-020 CERT® Division, Software ...Homeland Security under Contract No. FA8721-05-C-0003 with Carnegie Mellon University for the operation of the Software Engineering Institute, a federally...DISTRIBUTES IT “AS IS.” References herein to any specific commercial product, process, or service by trade name, trade mark, manufacturer, or otherwise

The Indirect Costs of Financial Distress in Indonesia

OpenAIRE

Wijantini, Wijantini

2007-01-01

This paper presents quantitative estimates of the indirect cost of financial distress and its determinants. In order to measure the cost, this study estimates the annualized changes in industry-adjusted operation profit and sales from a year before the onset of distress to the resolution year. Using those approaches, the median of indirect financial distress cost is estimated between three and 11 percent annually. To the extent that the direct cost of financial distress reduces reported opera...

Changes in decibel scale wavelength properties of EEG with alertness levels while performing sustained attention tasks.

Science.gov (United States)

Arjunan, Sridhar P; Kumar, Dinesh K; Jung, Tzyy-Ping

2009-01-01

Loss of alertness can have dire consequences for people controlling motorized equipment or for people in professions such as defense. Electroencephalogram (EEG) is known to be related to alertness of the person, but due to high level of noise and low signal strength, the use of EEG for such applications has been considered to be unreliable. This study reports the fractal analysis of EEG and identifies the use of maximum fractal length (MFL) as a feature that is inversely correlated with the alertness of the subject. The results show that MFL (of only single channel of EEG) indicates the loss of alertness of the individual with mean (inverse) correlation coefficient = 0.82.

Impact of e-alert for detection of acute kidney injury on processes of care and outcomes: protocol for a systematic review and meta-analysis.

Science.gov (United States)

Lachance, Philippe; Villeneuve, Pierre-Marc; Wilson, Francis P; Selby, Nicholas M; Featherstone, Robin; Rewa, Oleksa; Bagshaw, Sean M

2016-05-05

Acute kidney injury (AKI) is a common complication in hospitalised patients. It imposes significant risk for major morbidity and mortality. Moreover, patients suffering an episode of AKI consume considerable health resources. Recently, a number of studies have evaluated the implementation of automated electronic alerts (e-alerts) configured from electronic medical records (EMR) and clinical information systems (CIS) to warn healthcare providers of early or impending AKI in hospitalised patients. The impact of e-alerts on care processes, patient outcomes and health resource use, however, remains uncertain. We will perform a systematic review to describe and appraise e-alerts for AKI, and evaluate their impact on processes of care, clinical outcomes and health services use. In consultation with a research librarian, a search strategy will be developed and electronic databases (ie, MEDLINE, EMBASE, CINAHL, Cochrane Library and Inspec via Engineering Village) searched. Selected grey literature sources will also be searched. Search themes will focus on e-alerts and AKI. Citation screening, selection, quality assessment and data abstraction will be performed in duplicate. The primary analysis will be narrative; however, where feasible, pooled analysis will be performed. Each e-alert will be described according to trigger, type of alert, target recipient and degree of intrusiveness. Pooled effect estimates will be described, where applicable. Our systematic review will synthesise the literature on the value of e-alerts to detect AKI, and their impact on processes, patient-centred outcomes and resource use, and also identify key knowledge gaps and barriers to implementation. This is a fundamental step in a broader research programme aimed to understand the ideal structure of e-alerts, target population and methods for implementation, to derive benefit. Research ethics approval is not required for this review. CRD42016033033. Published by the BMJ Publishing Group Limited

A review on automated pavement distress detection methods

NARCIS (Netherlands)

Coenen, Tom B.J.; Golroo, Amir

2017-01-01

In recent years, extensive research has been conducted on pavement distress detection. A large part of these studies applied automated methods to capture different distresses. In this paper, a literature review on the distresses and related detection methods are presented. This review also includes

Spiritual well-being and moral distress among Iranian nurses.

Science.gov (United States)

Soleimani, Mohammad Ali; Sharif, Saeed Pahlevan; Yaghoobzadeh, Ameneh; Sheikhi, Mohammad Reza; Panarello, Bianca; Win, Ma Thin Mar

2016-06-16

Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to study the determinant factors of moral distress and spiritual well-being in nurses. A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised. This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. Mean scores of spiritual well-being and moral distress were 94.73 ± 15.89 and 109.56 ± 58.70, respectively. There was no significant correlation between spiritual well-being and moral distress (r = -.053, p = .462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress. This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress and its consequences, establishing periodic consultations, and making some organizational arrangement may play an important role in the identification and management of moral distress and

What is the best measure for assessing diabetes distress? A comparison of the Problem Areas in Diabetes and Diabetes Distress Scale

DEFF Research Database (Denmark)

Fenwick, Eva K.; Rees, Gwyn; Holmes-Truscott, Elizabeth

2018-01-01

This study used Rasch analysis to examine the psychometric validity of the Diabetes Distress Scale and the Problem Areas in Diabetes scale to assess diabetes distress in 3338 adults with diabetes (1609 completed the Problem Areas in Diabetes scale (n = 675 type 1 diabetes; n = 934 type 2 diabetes......) and 1705 completed the Diabetes Distress Scale (n = 693 type 1 diabetes; n = 1012 type 2 diabetes)). While criterion and convergent validity were good, Rasch analysis revealed suboptimal precision and targeting, and item misfit. Unresolvable multidimensionality within the Diabetes Distress Scale suggests...... a total score should be avoided, while suboptimal precision suggests that the Physician-related and Interpersonal distress subscales should be used cautiously....

Characterizing Pavement Surface Distress Conditions with Hyper-Spatial Resolution Natural Color Aerial Photography

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Su Zhang

2016-05-01

Full Text Available Roadway pavement surface distress information is critical for effective pavement asset management, and subsequently, transportation management agencies at all levels (i.e., federal, state, and local dedicate a large amount of time and money to routinely evaluate pavement surface distress conditions as the core of their asset management programs. However, currently adopted ground-based evaluation methods for pavement surface conditions have many disadvantages, like being time-consuming and expensive. Aircraft-based evaluation methods, although getting more attention, have not been used for any operational evaluation programs yet because the acquired images lack the spatial resolution to resolve finer scale pavement surface distresses. Hyper-spatial resolution natural color aerial photography (HSR-AP provides a potential method for collecting pavement surface distress information that can supplement or substitute for currently adopted evaluation methods. Using roadway pavement sections located in the State of New Mexico as an example, this research explored the utility of aerial triangulation (AT technique and HSR-AP acquired from a low-altitude and low-cost small-unmanned aircraft system (S-UAS, in this case a tethered helium weather balloon, to permit characterization of detailed pavement surface distress conditions. The Wilcoxon Signed Rank test, Mann-Whitney U test, and visual comparison were used to compare detailed pavement surface distress rates measured from HSR-AP derived products (orthophotos and digital surface models generated from AT with reference distress rates manually collected on the ground using standard protocols. The results reveal that S-UAS based hyper-spatial resolution imaging and AT techniques can provide detailed and reliable primary observations suitable for characterizing detailed pavement surface distress conditions comparable to the ground-based manual measurement, which lays the foundation for the future application

Comparison of Overridden Medication-related Clinical Decision Support in the Intensive Care Unit between a Commercial System and a Legacy System.

Science.gov (United States)

Wong, Adrian; Wright, Adam; Seger, Diane L; Amato, Mary G; Fiskio, Julie M; Bates, David

2017-08-23

Electronic health records (EHRs) with clinical decision support (CDS) have shown to be effective at improving patient safety. Despite this, alerts delivered as part of CDS are overridden frequently, which is of concern in the critical care population as this group may have an increased risk of harm. Our organization recently transitioned from an internally-developed EHR to a commercial system. Data comparing various EHR systems, especially after transitions between EHRs, are needed to identify areas for improvement. To compare the two systems and identify areas for potential improvement with the new commercial system at a single institution. Overridden medication-related CDS alerts were included from October to December of the systems' respective years (legacy, 2011; commercial, 2015), restricted to three intensive care units. The two systems were compared with regards to CDS presentation and override rates for four types of CDS: drug-allergy, drug-drug interaction (DDI), geriatric and renal alerts. A post hoc analysis to evaluate for adverse drug events (ADEs) potentially resulting from overridden alerts was performed for 'contraindicated' DDIs via chart review. There was a significant increase in provider exposure to alerts and alert overrides in the commercial system (commercial: n=5,535; legacy: n=1,030). Rates of overrides were higher for the allergy and DDI alerts (pcommercial system. Geriatric and renal alerts were significantly different in incidence and presentation between the two systems. No ADEs were identified in an analysis of 43 overridden contraindicated DDI alerts. The vendor system had much higher rates of both alerts and overrides, although we did not find evidence of harm in a review of DDIs which were overridden. We propose recommendations for improving our current system which may be helpful to other similar institutions; improving both alert presentation and the underlying knowledge base appear important.

Authenticity, life satisfaction, and distress: a longitudinal analysis.

Science.gov (United States)

Boyraz, Güler; Waits, J Brandon; Felix, Victoria A

2014-07-01

The purpose of the present study was to examine the reciprocal relationships between authenticity and measures of life satisfaction and distress using a 2-wave panel study design. Data were collected from 232 college students attending 2 public universities. Structural equation modeling was used to analyze the data. The results of the cross-lagged panel analysis indicated that after controlling for temporal stability, initial authenticity (Time 1) predicted later distress and life satisfaction (Time 2). Specifically, higher levels of authenticity at Time 1 were associated with increased life satisfaction and decreased distress at Time 2. Neither distress nor life satisfaction at Time 1 significantly predicted authenticity at Time 2. However, the relationship between Time 1 distress and Time 2 authenticity was not significantly different from the relationship between Time 1 authenticity and Time 2 distress. Results are discussed in light of humanistic-existential theories and the empirical research on well-being. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Perceptions of friendship among youth with distressed friends.

Science.gov (United States)

Hill, Erin N; Swenson, Lance P

2014-02-01

This cross-sectional study examined the relationship between a friend's level of internalizing distress and the focal child's perceptions of friendship amongst 5th, 8th, and 11th grade youth. Participants completed the Youth Self-Report to assess internalizing distress and measures assessing perceptions of friendship quality, social support, and self-disclosure within reciprocal, same-sex friendship dyads. Results indicated that youth with friends experiencing low levels of internalizing distress reported poorer friendship quality and decreased levels of social support and self-disclosure within the friendship compared to youth with friends experiencing average or high internalizing distress. In a second set of analyses controlling for the focal child's own internalizing symptoms, gender, and age, friend's level of internalizing distress remained a significant, unique predictor of target participants' self-disclosure about their own problems within the friendship. The findings suggest that a mild degree of internalizing distress may enhance, rather than harm, friendships amongst youth.

Factors associated with financial distress of nonprofit hospitals.

Science.gov (United States)

Kim, Tae Hyun

2010-01-01

Financial distress can have a detrimental influence on the performance of hospitals. Hospital management needs to monitor potential financial distress effectively and know how it will respond depending on the severity of the circumstances. This study examined the multiple factors that may explain the financial distress of nonprofit hospitals during 1998 to 2001 and discussed their importance. To obtain more robust results, financial distress was assessed in 2 ways: first, financial strength index was used to incorporate 4 financial dimensions including profitability, liquidity, leverage, and physical facilities; second, cash flow (CF) was used to address the issues of accrual-based accounting in hospitals. This study finds that decrease in occupancy rate and increase in Medicaid payer mix, health maintenance organization penetration, market competition, physician supply, and percentage of the elderly are associated with increased likelihood of financial distress of urban hospitals. Increases in both Medicare and Medicaid payer mix, however, are related to higher likelihood of financial distress of rural hospitals.

Implementation of the ALERT algorithm, a new dispatcher-assisted telephone cardiopulmonary resuscitation protocol, in non-Advanced Medical Priority Dispatch System (AMPDS) Emergency Medical Services centres.

Science.gov (United States)

Stipulante, Samuel; Tubes, Rebecca; El Fassi, Mehdi; Donneau, Anne-Francoise; Van Troyen, Barbara; Hartstein, Gary; D'Orio, Vincent; Ghuysen, Alexandre

2014-02-01

Early bystander cardiopulmonary resuscitation (CPR) is a key factor in improving survival from out-of-hospital cardiac arrest (OHCA). The ALERT (Algorithme Liégeois d'Encadrement à la Réanimation par Téléphone) algorithm has the potential to help bystanders initiate CPR. This study evaluates the effectiveness of the implementation of this protocol in a non-Advanced Medical Priority Dispatch System area. We designed a before and after study based on a 3-month retrospective assessment of victims of OHCA in 2009, before the implementation of the ALERT protocol in Liege emergency medical communication centre (EMCC), and the prospective evaluation of the same 3 months in 2011, immediately after the implementation. At the moment of the call, dispatchers were able to identify 233 OHCA in the first period and 235 in the second. Victims were predominantly male (59%, both periods), with mean ages of 64.1 and 63.9 years, respectively. In 2009, only 9.9% victims benefited from bystander CPR, this increased to 22.5% in 2011 (p<0.0002). The main reasons for protocol under-utilisation were: assistance not offered by the dispatcher (42.3%), caller physically remote from the victim (20.6%). Median time from call to first compression, defined here as no flow time, was 253s in 2009 and 168s in 2011 (NS). Ten victims were admitted to hospital after ROSC in 2009 and 13 in 2011 (p=0.09). From the beginning and despite its under-utilisation, the ALERT protocol significantly improved the number of patients in whom bystander CPR was attempted. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Investigating Visual Alerting in the Maritime Domain; Report on 3 Experiments, With Supporting Documentation

Science.gov (United States)

2010-04-01

opérateurs les états ou événements critiques qui requièrent leur attention. La recherche dont il est question ici vise principalement à alerter...Visual alerting in complex command and control environments. Poster presented at the Human Factors and Ergonomics Society 53rd Annual Meeting, San

Financial Distress in Small and Medium Enterprises (SMES of Bangladesh: Determinants and Remedial Measures

Directory of Open Access Journals (Sweden)

Mohammad Saleh JAHUR

2012-06-01

Full Text Available Financial distress in SMEs is a common phenomenon across the world, which has been a subject matter of academicians, professionals and government. Although SMEs are contributing to the economy in the form of employment, supply of products and services by using indigenous technologies, social entrepreneurship, income generating activities etc. SMEs are found most vulnerable to the macro-economic as well as internal management crises. Consequently, they fall into financial distress. In view of this, the present study has been undertaken aiming at identifying the causes of financial distress in SMEs of Bangladesh. The study has employed both financial and statistical techniques for analyzing the data collected for the study. The study has identified some potential problem areas related to financial distress such as rate adequacy, sales trends, indebtedness, management capability, financial planning, etc. The study has also identified some most important causes of financial distress such as fund management & resource crunch, poor accounting system, poor financial control, poor productivity and profitability and management succession. The study has finally come out some strategic and policy related measures for both viable and financially distressed SMEs for preventing them from the exposition to financial and operating risk.

Analysis and evaluation of the moral distress theory.

Science.gov (United States)

Wilson, Melissa A

2018-04-01

Moral distress is a pervasive problem in nursing resulting in a detriment to patient care, providers, and organizations. Over a decade ago, the moral distress theory (MDT) was proposed and utilized in multiple research studies. This middle range theory explains and predicts the distress that occurs in a nurse because of moral conflict. The research findings born from this theory have been substantial. Since inception of this theory, moral distress has been extensively examined which has further elaborated its understanding. This paper provides an analysis and evaluation of the MDT according to applicable guidelines. Current understanding of the phenomenon indicates that a new theory may be warranted to better predict, treat, and manage moral distress. © 2017 Wiley Periodicals, Inc.

Screening for distress in cancer patients

DEFF Research Database (Denmark)

Grassi, Luigi; Johansen, Christoffer; Annunziata, Maria Antonietta

2013-01-01

Routine screening for distress is internationally recommended as a necessary standard for good cancer care, given its high prevalence and negative consequences on quality of life. The objective of the current study was to contribute to the Italian validation of the Distress Thermometer (DT...

Toxic substances alert program

Science.gov (United States)

Junod, T. L.

1978-01-01

A toxicity profile is provided, of 187 toxic substances procured by NASA Lewis Research Center during a 3 1/2 year period, including 27 known or suspected carcinogens. The goal of the program is to assure that the center's health and safety personnel are aware of the procurement and use of toxic substances and to alert and inform the users of these materials as to the toxic characteristics and the control measures needed to ensure their safe use. The program also provides a continuing record of the toxic substances procured, who procured them, what other toxic substances the user has obtained in the past, and where similar materials have been used elsewhere at the center.

The effect of an electronic "hard-stop" alert on HIV testing rates in the emergency department.

Science.gov (United States)

Schnall, Rebecca; Sperling, Jeremy D; Liu, Nan; Green, Robert A; Clark, Sunday; Vawdrey, David K

2013-01-01

Use of electronic alerts in clinical practice has had mixed effects on providers' prescribing practices. Little research has explored the use of electronic alerts for improving screening practices. New York City has one of the highest rates of HIV in the United States. Recent New York State legislation requires healthcare providers to offer an HIV test to patients aged 13-64 years during a clinical encounter. Adhering to this requirement is particularly challenging in emergency department (ED) settings, which are frequently overcrowded and under-resourced. The purpose of this study was to evaluate the effect of an electronic "hard-stop" alert on HIV testing rates in the ED. Approximately four months of data were reviewed before and after the implementation of the alert. We found that use of the electronic alert significantly increased documentation of offering an HIV test (O.R. = 267.27, p<0.001) and resulted in a significant increase in HIV testing. Findings from this study add to the current knowledge about the use of electronic alertsfor improving disease screening.

Distress Propagation in Complex Networks: The Case of Non-Linear DebtRank.

Directory of Open Access Journals (Sweden)

Marco Bardoscia

Full Text Available We consider a dynamical model of distress propagation on complex networks, which we apply to the study of financial contagion in networks of banks connected to each other by direct exposures. The model that we consider is an extension of the DebtRank algorithm, recently introduced in the literature. The mechanics of distress propagation is very simple: When a bank suffers a loss, distress propagates to its creditors, who in turn suffer losses, and so on. The original DebtRank assumes that losses are propagated linearly between connected banks. Here we relax this assumption and introduce a one-parameter family of non-linear propagation functions. As a case study, we apply this algorithm to a data-set of 183 European banks, and we study how the stability of the system depends on the non-linearity parameter under different stress-test scenarios. We find that the system is characterized by a transition between a regime where small shocks can be amplified and a regime where shocks do not propagate, and that the overall stability of the system increases between 2008 and 2013.

CAUSES OF RESPIRATORY DISTRESS IN CHILDREN

Directory of Open Access Journals (Sweden)

M M Karambin

2008-11-01

Full Text Available "nThere is a lack of large, prospective epidemiologic studies concerning acute lung injury (ALI and acute respiratory distress syndrome (ARDS in pediatric population. To determine the different causes of respiratory distress in children, we prepared a retrospective study and included the whole 567 children with respiratory distress referred to 17-Shahrivar Hospital, Rasht, Guilan. Using their medical files, data including age, sex, and causes of respiratory distress were collected. SPSS 13.0 (statistical software applied for statistical analysis. Pneumonia, asthma, and croup were the major causes of ARDS in children with a rate of 38.4, 19.04, and 16.5 percent, respectively. It seems that infectious factors are at the top of the list of ARDS causing factors which can be helpful to approach and manage such patients. We suggest vaccinating these at risk groups against common infectious factors such as H. Influenza and RSV which can cause either pneumonia or inducing asthma.

76 FR 28789 - Draft Alert Entitled “Preventing Occupational Respiratory Disease From Dampness in Office...

Science.gov (United States)

2011-05-18

... NIOSH-238] Draft Alert Entitled ``Preventing Occupational Respiratory Disease From Dampness in Office... Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC), announces the availability of a draft Alert entitled ``Preventing Occupational Respiratory Disease from...

Development of a distress inventory for cancer: preliminary results.

Directory of Open Access Journals (Sweden)

Thomas B

2002-01-01

Full Text Available CONTEXT: Advances in cancer treatment have led to cure and prolongation of patients′ lives; however associated psychosocial problems, including distress, can detrimentally affect patients′ compliance with treatment and ultimately, their outcome. Symptom distress has been well addressed in many studies; however, psychological distress has only been quantified by using depression or anxiety scales/checklists or quality of life scales containing a distress sub scale/component or by the use of scales that are not psychological distress-specific. AIMS: The present study is an attempt to construct a psychological distress inventory for specific use with cancer patients. SETTINGS AND DESIGN: The standardisation sample consisted of 63 randomly selected patients with head and neck cancer who had undergone/ were undergoing curative treatment at the Regional Cancer Centre, Trivandrum. PATIENTS AND METHODS: The Distress Inventory for Cancer contained 57 positively and negatively toned items. An item analysis was conducted, followed by a factor analysis, thereby identifying the domains influencing distress. RESULTS: The final questionnaire contained 26 items subdivided into four domains viz. the personal, spiritual, physical, and the family domains, with each domain providing a sub score. The reliability coefficient (Cronbach′s alpha of the scale was found to be 0.85. CONCLUSIONS: These are the preliminary results of an ongoing study on global distress and tool development process. Reported here is the first step towards development of such tool.

Do repeated rumble strip hits improve driver alertness?

NARCIS (Netherlands)

Watling, C.N.; Akerstedt, T.; Kecklund, L.G.; Anund, A.

2016-01-01

Driving while sleepy is associated with increased crash risk. Rumble strips are designed to alert a sleepy or inattentive driver when they deviate outside their driving lane. The current study sought to examine the effects of repeated rumble strip hits on levels of physiological and subjective

HYBRID HUMAN-ARTIFICIAL INTELLIGENCE APPROACH FOR PAVEMENT DISTRESS ASSESSMENT (PICUCHA

Directory of Open Access Journals (Sweden)

Reus Salini

2017-07-01

Full Text Available The pavement surface condition assessment is a critical component for a proper pavement management system as well as for pavement rehabilitation design. A number of devices were developed to automatically record surface distresses in a continuous survey mode, but the software required for automatic distress identification remains a big challenge. In this study, a new method named PICture Unsupervised Classification with Human Analysis (PICUCHA is proposed to circumvent many of the limitations of existing approaches, based on a combination of human and artificial intelligence. It was designed from scratch to be capable to identify sealed and unsealed cracks, potholes, patches, different types of pavements and others. The self-learning algorithms do not use any distresses predefinition and can process images taken by cameras with different brands, technologies and resolution. This study describes some key aspects of the new method and provides examples in which PICUCHA was tested in real conditions showing accuracy up to 96.9% in image pattern detection and classification.

Non-visual biological effects of light on human cognition, alertness, and mood

Science.gov (United States)

Li, Huaye; Wang, Huihui; Shen, Junfei; Sun, Peng; Xie, Ting; Zhang, Siman; Zheng, Zhenrong

2017-09-01

Light exerts non-visual effects on a wide range of biological functions and behavior apart from the visual effect. Light can regulate human circadian rhythms, like the secretion of melatonin and cortisol. Light also has influence on body's physiological parameters, such as blood pressure, heart rate and body temperature. However, human cognitive performance, alertness and mood under different lighting conditions have not been considered thoroughly especially for the complicated visual task like surgical operating procedure. In this paper, an experiment was conducted to investigate the cognition, alertness and mood of healthy participants in a simulated operating room (OR) in the hospital. A LED surgical lamp was used as the light source, which is mixed by three color LEDs (amber, green and blue). The surgical lamp is flexible on both spectrum and intensity. Exposed to different light settings, which are varied from color temperature and luminance, participants were asked to take psychomotor vigilance task (PVT) for alertness measurement, alphabet test for cognitive performance measurement, positive and negative affect schedule (PANAS) for mood measurement. The result showed the participants' cognitive performance, alertness and mood are related to the color temperature and luminance of the LED light. This research will have a guidance for the surgical lighting environment, which can not only enhance doctors' efficiency during the operations, but also create a positive and peaceful surgical lighting environment.

Intermittent fasting could ameliorate cognitive function against distress by regulation of inflammatory response pathway

Directory of Open Access Journals (Sweden)

Marjan Shojaie

2017-11-01

Full Text Available Undesirable and desirable effects of stressors on the body are assigned to distress and eustress, respectively. Immune system and brain are the most susceptible parts to stressful conditions, whereas long-lasting alterations in putative immune proteins involved in tension such as corticosterone (CORT, interleukin 6 (IL-6, and tumor necrosis factor-alpha (TNF-α can impact learning and memory. Intermittent fasting (IF is a repeated regular cycle of dietary restriction with well-known beneficial properties on the body. The aim of this study was to identify the eustress effects of IF on cognitive function by assessing the critical inflammatory factors in chronic distress. Forty male mice were divided into four groups (n = 10/group. Distress and control normally received food and water, whereas IF and IF with distress groups were daily deprived of food and water for two hours. In the second week, the electrical foot shock was induced to distress and IF with distress groups. Finally, the cognitive functions of all mice were evaluated by Barnes maze, their blood samples were taken to determine the plasma level of CORT, IL-6 and TNF-α, and the removed brain and adrenal glands were weighed in the third week. A significant gain in plasma level of CORT, IL-6 and TNF-α with a considerable brain hypotrophy and adrenal hypertrophy was found in distress group, whereas IF caused a remarkable reduction of the plasma inflammatory factors, especially in IF with distress mice (P ≤ 0.05. In conclusion, IF could improve cognitive function and preserve the brain against distress by regulation of inflammatory response pathway.

Intermittent fasting could ameliorate cognitive function against distress by regulation of inflammatory response pathway.

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Shojaie, Marjan; Ghanbari, Farzane; Shojaie, Nasrin

2017-11-01

Undesirable and desirable effects of stressors on the body are assigned to distress and eustress, respectively. Immune system and brain are the most susceptible parts to stressful conditions, whereas long-lasting alterations in putative immune proteins involved in tension such as corticosterone (CORT), interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNF-α) can impact learning and memory. Intermittent fasting (IF) is a repeated regular cycle of dietary restriction with well-known beneficial properties on the body. The aim of this study was to identify the eustress effects of IF on cognitive function by assessing the critical inflammatory factors in chronic distress. Forty male mice were divided into four groups (n = 10/group). Distress and control normally received food and water, whereas IF and IF with distress groups were daily deprived of food and water for two hours. In the second week, the electrical foot shock was induced to distress and IF with distress groups. Finally, the cognitive functions of all mice were evaluated by Barnes maze, their blood samples were taken to determine the plasma level of CORT, IL-6 and TNF-α, and the removed brain and adrenal glands were weighed in the third week. A significant gain in plasma level of CORT, IL-6 and TNF-α with a considerable brain hypotrophy and adrenal hypertrophy was found in distress group, whereas IF caused a remarkable reduction of the plasma inflammatory factors, especially in IF with distress mice ( P  ≤ 0.05). In conclusion, IF could improve cognitive function and preserve the brain against distress by regulation of inflammatory response pathway.

Continuous positive airway pressure (CPAP) to treat respiratory distress in newborns in low- and middle-income countries.

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Dewez, Juan Emmanuel; van den Broek, Nynke

2017-01-01

Severe respiratory distress is a serious complication common to the three major causes of neonatal mortality and morbidity (prematurity, intra-partum-related hypoxia and infections). In low- and middle-income countries (LMICs), 20% of babies presenting with severe respiratory distress die.Continuous positive airway pressure (CPAP), is an effective intervention for respiratory distress in newborns and widely used in high-income countries. Following the development of simple, safe and relatively inexpensive CPAP devices, there is potential for large-scale implementation in the developing world.In this article, we describe existing CPAP systems and present a review of the current literature examining the effectiveness of CPAP compared to standard care (oxygen) in newborns with respiratory distress. We also discuss the evidence gap which needs to be addressed prior to its integration into health systems in LMICs. © The Author(s) 2016.

Consequences of Split Shift Work in Indian Traffic Police Personnel: Daytime Sleepiness, Stressors and Psychological Distress

Directory of Open Access Journals (Sweden)

Rakesh Kumar Soni

2016-12-01

Full Text Available The present study was aimed to measure the daily routine preference, daytime sleepiness, and psychological distress experiences, because of split shift system job in a sample in traffic police personnel of Raipur city, India. To measure such parameters we used the Morningness-Eveningness Questionnaire, Epworth Sleepiness Scale (ESS, Operational Police Stress Questionnaire (OPSQ, General Health Questionnaire and the Distress. To evaluate differences between age, body mass index, period of service length and drug / alcohol use for all the subjects (traffic police personnel the t-test and chi-square test were used. Total Hundred male traffic police personnel participated and out of which most of them were found to belong in the evening active category. This study also indicates increased prevalence of excessive daytime sleepiness and (EDS high level of psychological distress as measured by the GHQ-12 among few police workers. Moreover, a number of participants reported significant distress levels, when measured with distress thermometer. In nutshell, the study sample suggests adaptive coping strategies of traffic police personnel working in split shift system profession can be attributed to their evening (E-type circadian preferences.

The Diagnostic Utility of Bact/ALERT and Nested PCR in the Diagnosis of Tuberculous Meningitis.

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Sastry, Apurba Sankar; Bhat K, Sandhya; Kumudavathi

2013-01-01

The early laboratory diagnosis of Tuberculous Meningitis (TBM) is crucial, to start the antitubercular chemotherapy and to prevent its complications. However, the conventional methods are either less sensitive or time consuming. Hence, the diagnostic potentials of BacT/ALERT and Polymerase Chain Reaction (PCR) was evaluated in this study. The study group comprised of 62 cases and 33 controls. The cases were divided according to Ahuja's criteria into the confirmed (two cases), highly probable (19 cases), probable (26 cases) and the possible (15 cases) subgroups. Ziehl Neelsen's (ZN) and Auramine Phenol (AP) staining, Lowenstein Jensen (LJ) medium culture, BacT/ALERT and nested Polymerase Chain Reaction (PCR) which targeted IS6110 were carried out on all the patients. The sensitivity of the LJ culture was 3.22%. BacT/ALERT showed a sensitivity and a specificity of 25.80% and 100% and those of nested PCR were found to be 40.32% and 96.97% respectively. The mean detection time of growth of the LJ culture was 31.28 days, whereas that of BacT/ALERT was 20.68 days. The contamination rate in the LJ culture and BacT/ALERT were 7.2% and 5.8% respectively. Nested PCR was found to be more sensitive, followed by BacT/ALERT as compared to the LJ culture and smear microscopy. As both false negative and false positive results have been reported for nested PCR, so it should not be used alone as a criterion for initiating or terminating the therapy, but it should be supported by clinical, radiological, cytological and other microbiological findings.

Late Financial Distress Process Stages and Financial Ratios

DEFF Research Database (Denmark)

Sormunen, Nina; Laitinen, Teija

2012-01-01

stage affects the classification ability of single financial ratios and financial distress prediction models in short-term financial distress prediction. The study shows that the auditor's GC task could be supported by paying attention to the financial distress process stage. The implications...... of these findings for auditors and every stakeholder of business firms are considered....

Evidence behind FDA alerts for drugs with adverse cardiovascular effects: implications for clinical practice.

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Rackham, Daniel M; C Herink, Megan; Stevens, Ian G; Cardoza, Natalie M; Singh, Harleen

2014-01-01

The U.S. Food and Drug Administration (FDA) periodically publishes Drug Safety Communications and Drug Alerts notifying health care practitioners and the general public of important information regarding drug therapies following FDA approval. These alerts can result in both positive and negative effects on patient care. Most clinical trials are not designed to detect long-term safety end points, and postmarketing surveillance along with patient reported events are often instrumental in signaling the potential harmful effect of a drug. Recently, many cardiovascular (CV) safety announcements have been released for FDA-approved drugs. Because a premature warning could discourage a much needed treatment or prompt a sudden discontinuation, it is essential to evaluate the evidence supporting these FDA alerts to provide effective patient care and to avoid unwarranted changes in therapy. Conversely, paying attention to these warnings in cases involving high-risk patients can prevent adverse effects and litigation. This article reviews the evidence behind recent FDA alerts for drugs with adverse CV effects and discusses the clinical practice implications. © 2013 Pharmacotherapy Publications, Inc.

Understanding psychological distress among pediatric cancer caregivers.

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Nam, Gina E; Warner, Echo L; Morreall, Deborah K; Kirchhoff, Anne C; Kinney, Anita Y; Fluchel, Mark

2016-07-01

Few studies have examined distress in caregivers of pediatric cancer patients. We evaluated the association of socioeconomic, demographic, and patient clinical factors on caregivers' self-reported psychological distress associated with having a child with cancer. N = 366 pediatric cancer caregivers completed a self-administered questionnaire from July 2010 to July 2012. The Impact of Event Scale (IES), along with two subscales "intrusion" and "avoidance" measured caregiver cancer-specific distress, with higher scores indicating greater distress. Multivariable linear regression models were used to calculate coefficients (β) and 95 % confidence intervals (95 % CI) of IES by socioeconomic, demographic, and clinical factors. Average caregiver IES score was 31.2 (standard deviation (SD) = 16.9, range 0-75). Mean intrusion score was 18.1 (SD 9.8, range 0-35) and avoidance score was 12.8 (SD 9.0, range 0-40). Caregivers with household incomes psychological distress for caregivers of pediatric oncology patients. These findings underscore the importance of developing and testing interventions aimed at evaluating and addressing the psychosocial needs for high-risk caregivers in addition to those of patients.

Comparing alertness and injury severity following motor vehicular ...

African Journals Online (AJOL)

Background: From casual observation of injury patterns in Motor Vehicular Accidents (MVAs), it was sometimes observed that if the victim had been more alert and reacts protectively, injury severity might be reduced. Protective response is often expected to minimize the severity of injuries. Objective: To determine the ...

ALERT. Adverse late effects of cancer treatment. Vol. 2. Normal tissue specific sites and systems