WorldWideScience

Sample records for enhancing pediatric safety

  1. Enhancing operational safety

    Energy Technology Data Exchange (ETDEWEB)

    Wiebe, J S

    1997-09-01

    The presentation briefly considers the following aspects concerning enhancing operational safety of NPP: licensed control room supervision, reactivity changes, personnel access to control room, simulator training.

  2. Enhancing operational nuclear safety

    International Nuclear Information System (INIS)

    Sengoku, Katsuhisa

    2008-01-01

    's safety standards and program which provides the safety objective following the 10 fundamental safety principles. The safety requirements defines the functional conditions required for safety and the safety guides provides user-friendly and up-to-date practical guidance representing good/best practices to fulfill the requirements. The IAEA provides safety review services and fields safety review teams upon request of member states for the regulatory, the International Regulatory Review Team (IRRT) and Operational Safety Review Team (OSART) and Peer Review of the Operational and Safety Performance Experience Review (PROSPER). The OSART programme's purpose is to assist member states in enhancing the operational safety of individual nuclear power plants and to promote the continuous development of operational safety within all member states by the dissemination of information on good practice. The OSART Mission Results (OSMIR) database contains the results from 73 OSART missions and 54 follow up visits from 1991 and its continually updated. The Asian Nuclear Safety Network (ANSN) was established to pool and share existing and new technical knowledge and practical experience to further improve the safety of nuclear installation in Asia. In summary, the enhancement of the GNSR is anchored in the recognition that all the states are in the same boat and the increasing importance of sharing and mutual learning, sharing knowledge and experience through regional and global networking. It requires joint and coordinated strategy by all states. The IAEA is willing and ready to support the GNSR through the establishment and application of safety standards, and safety review and advisory services and international instruments. (Author)

  3. Biologics in pediatric psoriasis - efficacy and safety.

    Science.gov (United States)

    Dogra, Sunil; Mahajan, Rahul

    2018-01-01

    Childhood psoriasis is a special situation that is a management challenge for the treating dermatologist. As is the situation with traditional systemic agents, which are commonly used in managing severe psoriasis in children, the biologics are being increasingly used in the recalcitrant disease despite limited data on long term safety. Areas covered: We performed an extensive literature search to collect evidence-based data on the use of biologics in pediatric psoriasis. The relevant literature published from 2000 to September 2017 was obtained from PubMed, using the MeSH words 'biologics', 'biologic response modifiers' and 'treatment of pediatric/childhood psoriasis'. All clinical trials, randomized double-blind or single-blind controlled trials, open-label studies, retrospective studies, reviews, case reports and letters concerning the use of biologics in pediatric psoriasis were screened. Articles covering the use of biologics in pediatric psoriasis were screened and reference lists in the selected articles were scrutinized to identify other relevant articles that had not been found in the initial search. Articles without relevant information about biologics in general (e.g. its mechanism of action, pharmacokinetics and adverse effects) and its use in psoriasis in particular were excluded. We screened 427 articles and finally selected 41 relevant articles. Expert opinion: The available literature on the use of biologics such as anti-tumor necrosis factor (TNF)-α agents, and anti-IL-12/23 agents like ustekinumab suggests that these are effective and safe in managing severe pediatric psoriasis although there is an urgent need to generate more safety data. Dermatologists must be careful about the potential adverse effects of the biologics before administering them to children with psoriasis. It is likely that with rapidly evolving scenario of biologics in psoriasis, these will prove to be very useful molecules particularly in managing severe and recalcitrant

  4. Safety Profile of Cough and Cold Medication Use in Pediatrics.

    Science.gov (United States)

    Green, Jody L; Wang, George Sam; Reynolds, Kate M; Banner, William; Bond, G Randall; Kauffman, Ralph E; Palmer, Robert B; Paul, Ian M; Dart, Richard C

    2017-06-01

    The safety of cough and cold medication (CCM) use in children has been questioned. We describe the safety profile of CCMs in children pediatric (75.5%), and single-ingredient (77.5%) formulations were most commonly involved. AEs occurring in >20% of all cases included tachycardia, somnolence, hallucinations, ataxia, mydriasis, and agitation. Twenty cases (0.6%) resulted in death; most were in children pediatric liquid formulations were the most commonly reported products. These characteristics present an opportunity for targeted prevention efforts. Copyright © 2017 by the American Academy of Pediatrics.

  5. Enhancing pediatric safety: assessing and improving resident competency in life-threatening events with a computer-based interactive resuscitation tool

    International Nuclear Information System (INIS)

    Lerner, Catherine; Gaca, Ana M.; Frush, Donald P.; Ancarana, Anjanette; Hohenhaus, Sue; Seelinger, Terry A.; Frush, Karen

    2009-01-01

    Though rare, allergic reactions occur as a result of administration of low osmolality nonionic iodinated contrast material to pediatric patients. Currently available resuscitation aids are inadequate in guiding radiologists' initial management of such reactions. To compare radiology resident competency with and without a computer-based interactive resuscitation tool in the management of life-threatening events in pediatric patients. The study was approved by the IRB. Radiology residents (n=19; 14 male, 5 female; 19 certified in basic life support/advanced cardiac life support; 1 certified in pediatric advanced life support) were videotaped during two simulated 5-min anaphylaxis scenarios involving 18-month-old and 8-year-old mannequins (order randomized). No advance warning was given. In half of the scenarios, a computer-based interactive resuscitation tool with a response-driven decision tree was available to residents (order randomized). Competency measures included: calling a code, administering oxygen and epinephrine, and correctly dosing epinephrine. Residents performed significantly more essential interventions with the computer-based resuscitation tool than without (72/76 vs. 49/76, P<0.001). Significantly more residents appropriately dosed epinephrine with the tool than without (17/19 vs. 1/19; P<0.001). More residents called a code with the tool than without (17/19 vs. 14/19; P = 0.08). A learning effect was present: average times to call a code, request oxygen, and administer epinephrine were shorter in the second scenario (129 vs. 93 s, P=0.24; 52 vs. 30 s, P<0.001; 152 vs. 82 s, P=0.025, respectively). All the trainees found the resuscitation tool helpful and potentially useful in a true pediatric emergency. A computer-based interactive resuscitation tool significantly improved resident performance in managing pediatric emergencies in the radiology department. (orig.)

  6. Surgical Safety in Pediatrics: practical application of the Pediatric Surgical Safety Checklist

    Directory of Open Access Journals (Sweden)

    Maria Paula de Oliveira Pires

    2015-12-01

    Full Text Available Objectives: to assess the practical application of the Pediatric Surgical Safety Checklist on the preoperative period and to verify family satisfaction regarding the use of the material. Method: exploratory study that aimed to analyze the use of the checklist by children who underwent surgical interventions. The sample was constituted by 60 children (from preschoolers to teens and 60 family members. The variables related to demographic characterization, filling out the checklist, and family satisfaction, being evaluated through inferential and descriptive statistical analysis. Results: most children (71.7% were male, with a median age of 7.5 years. We identified the achievement of 65.3% of the checklist items, 30.0% were not filled due to non-performance of the team and 4.7% for children and family reasons. In the association analysis, we found that the removal of accessories item (p = 0.008 was the most checked by older children. Regarding satisfaction, the family members evaluated the material as great (63.3% and good (36.7% and believed that there was a reduction of the child's anxiety (83.3%. Conclusion: the use of the checklist in clinical practice can change health services regarding safety culture and promote customer satisfaction.

  7. Pediatric interventional radiography equipment: safety considerations

    International Nuclear Information System (INIS)

    Strauss, Keith J.

    2006-01-01

    This paper discusses pediatric image quality and radiation dose considerations in state-of-the-art fluoroscopic imaging equipment. Although most fluoroscopes are capable of automatically providing good image quality on infants, toddlers, and small children, excessive radiation dose levels can result from design deficiencies of the imaging device or inappropriate configuration of the equipment's capabilities when imaging small body parts. Important design features and setup choices at installation and during the clinical use of the imaging device can improve image quality and reduce radiation exposure levels in pediatric patients. Pediatric radiologists and cardiologists, with the help of medical physicists, need to understand the issues involved in creating good image quality at reasonable pediatric patient doses. The control of radiographic technique factors by the generator of the imaging device must provide a large dynamic range of mAs values per exposure pulse during both fluoroscopy and image recording as a function of patient girth, which is the thickness of the patient in the posterior-anterior projection at the umbilicus (less than 10 cm to greater than 30 cm). The range of pulse widths must be limited to less than 10 ms in children to properly freeze patient motion. Variable rate pulsed fluoroscopy can be leveraged to reduce radiation dose to the patient and improve image quality. Three focal spots with nominal sizes of 0.3 mm to 1 mm are necessary on the pediatric unit. A second, lateral imaging plane might be necessary because of the child's limited tolerance of contrast medium. Spectral and spatial beam shaping can improve image quality while reducing the radiation dose. Finally, the level of entrance exposure to the image receptor of the fluoroscope as a function of operator choices, of added filter thickness, of selected pulse rate, of the selected field-of-view and of the patient girth all must be addressed at installation. (orig.)

  8. The safety of pharmacologic treatment for pediatric obesity.

    Science.gov (United States)

    Chao, Ariana M; Wadden, Thomas A; Berkowitz, Robert I

    2018-04-01

    Pediatric obesity is a serious public health concern. Five medications have been approved by the Food and Drug Administration (FDA) for chronic weight management in adults with obesity, when used as an adjunct to lifestyle modification. Orlistat is the only FDA-approved medication for pediatric patients aged 12 years and above. Areas covered: This paper summarizes safety and efficacy data from clinical trials of weight loss medications conducted among pediatric samples. Relevant studies were identified through searches in PubMed. Expert opinion: Orlistat, as an adjunct to lifestyle modification, results in modest weight losses and may be beneficial for some pediatric patients with obesity. However, gastrointestinal side effects are common and may limit use. In adults taking orlistat, rare but severe adverse events, including liver and renal events, have been reported. Recent pediatric pharmacokinetic studies of liraglutide have demonstrated similar safety and tolerability profiles as found in adults, with gastrointestinal disorders being the most common adverse events. Clinical trials are needed of liraglutide, as well as other medications for obesity, that systematically evaluate their risks and benefits in pediatric patients.

  9. [Perception of safety climate in outpatient pediatric care].

    Science.gov (United States)

    Baldegger, Claudia; Zeller, Adelheid

    2013-02-01

    In ambulant pediatric care, patients situations are becoming increasingly complex, because the lenght of hospital stay is reduced since the introduction of Diagnosis Related Groups (DRG). Consequently, the patients' safety is constantly becoming more important. The patients' safety is closely associated with the nurses' awareness of risks and the safety climate within the institution. This study is investigating how nurses of a pediatric outpatient service estimate the patients' safety and how that can be optimized, if necessary. As part of a cross-sectional study, a total of 106 nurses of the pediatric outpatient service were interviewed with a modified German version of the "Patient Safety Climate Inventory (Patientensicherheitsklima-Inventar, PaSKI)". Data was analysed by a descriptive statistical method. The return rate was 80.2 percent. The results show a very high awareness of patients' safety issues as well as a high level of satisfaction concerning team collaboration. Both results have a positive influence on the safety-climate. Problems are associated mainly with the incident reporting system, e.g. with reporting critical incidents and communicating after reporting. This indicates the importance of a useable incident reporting system, which--in combination with staff training--may be an important step towards a structured risk management. Furthermore, it clarifies the importance of transparent communication after a reported incident, as also described in the literature.

  10. Safety and usefulness of outreach clinic conducted by pediatric echosonographers

    International Nuclear Information System (INIS)

    Al Harbi, Badr; Al Akhfash, Ali A.; Al Ghamdi, Abdullah; Al-Mesned, Abdulrahman

    2012-01-01

    Outreach echocardiographic services led by cardiac sonographers may help district level hospitals in the management of patients suspected to have cardiac anomalies. However, the safety and utility of such an approach is not tested. We retrospectively reviewed our experience of patients seen in the outreach visits by the echocardiographers alone and subsequently reviewed in the pediatric cardiology clinic. Comparison between the diagnosis made by the echocardiographer and the consultant pediatric cardiologist were done. We defined safety as no change in patient management plan between the outreach evaluation and the pediatric cardiology clinic evaluation, and we defined usefulness as being beneficial, serviceable and of practical use. Two senior echocardiographic technicians did 41 clinic visits and over a period of 17 months, 623 patients were seen. Patients less than 3 months of age constitute 63% of the total patients seen. Normal echocardiographic examinations were found in 342 (55%) of patients. These patients were not seen in our cardiology clinic. Abnormal echocardiographic examinations were found in 281 (45%) of patients. Among the 281 patients with abnormal echos in the outreach visits, 251 patients (89.3%) were seen in the pediatric cardiology clinic. Comparing the results of the outreach clinic evaluation to that of the pediatric cardiology clinic, 73 patients (29%) diagnosed to have a minor CHD turned to have normal echocardiographic examinations. In all patients seen in both the outreach clinics and the pediatric tertiary cardiac clinics there was no change in patient's management plan. Outreach clinic conducted by pediatric echo sonographers could be useful and safe. It may help in reducing unnecessary visits to pediatric cardiology clinics, provide parental reassurance, and help in narrowing the differential diagnosis in critically ill patient unable to be transferred to tertiary cardiac centers provided it is done by experienced echosonographers

  11. Research for enhancing reactor safety

    International Nuclear Information System (INIS)

    1989-05-01

    Recent research for enhanced reactor safety covers extensive and numerous experiments and computed modelling activities designed to verify and to improve existing design requirements. The lectures presented at the meeting report GRS research results and the current status of reactor safety research in France. The GRS experts present results concerning expert systems and their perspectives in safety engineering, large-scale experiments and their significance in the development and verification of computer codes for thermohydraulic modelling of safety-related incidents, the advanced system code ATHLET for analysis of thermohydraulic processes of incidents, the analysis simulator which is a tool for fast evaluation of accident management measures, and investigations into event sequences and the required preventive emergency measures within the German Risk Study. (DG) [de

  12. Pediatric regional anesthesia: what is the current safety record?

    Science.gov (United States)

    Polaner, David M; Drescher, Jessica

    2011-07-01

    The use of regional anesthetics, whether as adjuncts, primary anesthetics or postoperative analgesia, is increasingly common in pediatric practice. Data on safety remain limited because of the paucity of very large-scale prospective studies that are necessary to detect low incidence events, although several studies either have been published or have reported preliminary results. This paper will review the data on complications and risk in pediatric regional anesthesia. Information currently available suggests that regional blockade, when performed properly, carries a very low risk of morbidity and mortality in appropriately selected infants and children. © 2010 Blackwell Publishing Ltd.

  13. Patient Safety in Pediatrics: a Developing Discipline

    NARCIS (Netherlands)

    C. van der Starre (Cynthia)

    2011-01-01

    markdownabstract__Abstract__ The publication of the breakthrough report “To Err is Human” by the Institute of Medicine was the launch of patient safety initiatives all over the world. In the intensive care unit (ICU) of the Erasmus MC-Sophia Children’s Hospital this resulted in the institution

  14. Safety enhancement in NPP Bohunice

    International Nuclear Information System (INIS)

    Lipar, M.; Mihalik, M.

    1997-01-01

    The upgrading and safety enhancement of both the Bohunice V-1 and V-2 reactors is described in detail. The total estimated cost of the gradual reconstruction of these two units during 1996 to 1999 is 180 mil. US dollars. For the 1995 to 1997 period, the actions common for both units include a quality assurance programme, a personnel training programme, installation of a multifunction simulator, implementation of symptom-oriented operation procedures, installation of diagnostic systems, of a site security system, and of a teledosimetric system. At present, the main maintenance tasks are: to carry out major repair of units, to remedy service interruptions, to enhance equipment service availability, to enhance the technical level of corrective actions at equipment. Investment into maintenance level upgrade has grown from 7.5 mil. Slovak crowns in 1994 to estimated 32 mil. in 2000. The partners of international cooperation are mentioned. (M.D.)

  15. Evaluation of three-dimensional contrast-enhanced MR angiography in pediatric body vascular lesions

    International Nuclear Information System (INIS)

    Tanaka, Yasunori; Katayama, Hiroshi; Yamamoto, Kazuhiro; Shimizu, Tadafumi; Narabayashi, Isamu

    1998-01-01

    Evaluation of three-dimensional contrast-enhanced MR angiography in the pediatric body vascular lesions. This study examined the usefulness of three-dimensional gadolinium-enhanced magnetic resonance angiography (3D-enhanced MRA) for pediatric body vascular lesions. Fifteen 3D-enhanced MRAs were performed on fourteen pediatric patients aged from one month to fifteen years, using a 3D fast SPGR sequence. Maximum intensity projection (MIP) and multiplanar reconstruction (MPR) images were obtained from the imaging data in all cases, and eleven MIP images were obtained after subtraction of precontrast-enhanced imaging data from postcontrast-enhanced imaging data. In six cases, MIP and MPR images were correlated with cine or digital subtraction angiographies, and the eleven subtracted MIP images were compared with those before subtraction. Clinical usefulness was demonstrated in fourteen (93%) of the fifteen cases, and in seven (64%) of the eleven cases in which subtraction was performed, image quality was improved. In comparison with cine or digital subtraction angiographies, however, only one (17%) MRA was superior. It was considered that 3D-enhanced MRA was useful for pediatric body vascular lesions because of advantages such as lower invasiveness compared with that of conventional angiography, absence of radiation exposure, safety of contrast media, easy availability of MPR images, and short scanning time. In conclusion, if a pediatric body vascular lesion is suspected, 3D-enhanced MRA should be performed before conventional angiography. It also seems that 3D-enhanced MRA may be useful for follow-up. (author)

  16. Post Fukushima safety enhancements in Indian PHWRS

    International Nuclear Information System (INIS)

    Ramasomayajulu, M.; Khot, Pankaj; Chauhan, Ashok

    2016-01-01

    Fukushima event was reviewed in Nuclear Power Corporation of India (NPCIL) and based on these reviews, safety enhancements were identified for Indian PHWRs. Safety enhancements such as additional emergency power sources, enhanced onsite water inventories, external water injection arrangements (Hook up points), measures related to hydrogen management, containment venting provision, seismic trip, mobile pumps, onsite emergency support Centre. These safety enhancements were reviewed by the regulatory body (Atomic Energy Regulatory Board, AERB) and were approved for implementation. Most of these are either implemented or in the advance stage of implementation. The paper elaborates above safety enhancements implemented post Fukushima accident; and preparedness to use these provisions. (author)

  17. Enhancing the Pediatric Drug Development Framework to Deliver Better Pediatric Therapies Tomorrow.

    Science.gov (United States)

    Bucci-Rechtweg, Christina

    2017-10-01

    Health care professionals involved in the clinical management of children have long appreciated the limited number of therapies suitably evaluated for their optimal use in the pediatric population. In the past century, advances in regulatory policy significantly evolved adult drug evaluation. The scarcity of available patient populations, practical complexities of drug development research, and minimal financial returns have hampered pharmaceutical investment in the study of therapies for children. More recently, pediatric policy and legislation in the United States and Europe have instituted a system of obligations and incentives to stimulate investment in pediatric drug development. These initiatives, in conjunction with a more sophisticated process of drug discovery and development, have led to significant advancements in the labeling of drugs for pediatric use. Facilitated by the emergence of new targets, precision medicine, and innovations in regulatory science, there is now a subtle shift in focus toward drug development research for children rather than simply in children. Although there has been an increase in pediatric studies of investigational agents and labeling of pediatric information for use, there have been unintended consequences of existing policies. As a result, limited progress has been made in certain therapeutic areas and for off-patent therapies. Future policy reform to enhance the availability and accessibility of pediatric medicines should not only reflect an understanding not only of the successes of existing policy and legislative initiatives but also constructively address failures and unintended consequences. Taken together, policy reform, global cooperation, and innovation in regulatory science will more ably deliver better pediatric therapies tomorrow. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

  18. Update on radiation safety and dose reduction in pediatric neuroradiology

    Energy Technology Data Exchange (ETDEWEB)

    Mahesh, Mahadevappa [Johns Hopkins University School of Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States)

    2015-09-15

    The number of medical X-ray imaging procedures is growing exponentially across the globe. Even though the overall benefit from medical X-ray imaging procedures far outweighs any associated risks, it is crucial to take all necessary steps to minimize radiation risks to children without jeopardizing image quality. Among the X-ray imaging studies, except for interventional fluoroscopy procedures, CT studies constitute higher dose and therefore draw considerable scrutiny. A number of technological advances have provided ways for better and safer CT imaging. This article provides an update on the radiation safety of patients and staff and discusses dose optimization in medical X-ray imaging within pediatric neuroradiology. (orig.)

  19. Update on radiation safety and dose reduction in pediatric neuroradiology

    International Nuclear Information System (INIS)

    Mahesh, Mahadevappa

    2015-01-01

    The number of medical X-ray imaging procedures is growing exponentially across the globe. Even though the overall benefit from medical X-ray imaging procedures far outweighs any associated risks, it is crucial to take all necessary steps to minimize radiation risks to children without jeopardizing image quality. Among the X-ray imaging studies, except for interventional fluoroscopy procedures, CT studies constitute higher dose and therefore draw considerable scrutiny. A number of technological advances have provided ways for better and safer CT imaging. This article provides an update on the radiation safety of patients and staff and discusses dose optimization in medical X-ray imaging within pediatric neuroradiology. (orig.)

  20. How could intelligent safety transport systems enhance safety ?

    NARCIS (Netherlands)

    Wiethoff, M. Heijer, T. & Bekiaris, E.

    2017-01-01

    In Europe, many deaths and injured each years are the cost of today's road traffic. Therefore, it is wise to look for possible solutions for enhancing traffic safety. Some Advanced Driver Assistance Systems (ADAS) are expected to increase safety, but they may also evoke new safety hazards. Only

  1. Nursing safety management in onco-hematology pediatric wards

    Directory of Open Access Journals (Sweden)

    Marcelle Miranda da Silva

    2015-02-01

    Full Text Available This study aimed at identifying how safety management is applied by nurses to manage the nursing care, and at analyzing their challenges in onco-hematology pediatric wards. Descriptive and qualitative research, conducted at the Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti, Rio de Janeiro, Brazil, in August 2013. Six nurses were interviewed, and the content analysis was used. The key aspects relate to the importance of training and continuing education, teamwork, with the challenges in the care of hospitalized children and particularities of the disease, and the systematization, use of instruments and protocols. For child safety, the relationship between the administration and support is critical to the quality of care.

  2. Pediatric post-marketing safety systems in North America: assessment of the current status.

    Science.gov (United States)

    McMahon, Ann W; Wharton, Gerold T; Bonnel, Renan; DeCelle, Mary; Swank, Kimberley; Testoni, Daniela; Cope, Judith U; Smith, Phillip Brian; Wu, Eileen; Murphy, Mary Dianne

    2015-08-01

    It is critical to have pediatric post-marketing safety systems that contain enough clinical and epidemiological detail to draw regulatory, public health, and clinical conclusions. The pediatric safety surveillance workshop (PSSW), coordinated by the Food and Drug Administration (FDA), identified these pediatric systems as of 2010. This manuscript aims to update the information from the PSSW and look critically at the systems currently in use. We reviewed North American pediatric post-marketing safety systems such as databases, networks, and research consortiums found in peer-reviewed journals and other online sources. We detail clinical examples from three systems that FDA used to assess pediatric medical product safety. Of the 59 systems reviewed for pediatric content, only nine were pediatric-focused and met the inclusion criteria. Brief descriptions are provided for these nine. The strengths and weaknesses of three systems (two of the nine pediatric-focused and one including both children and adults) are illustrated with clinical examples. Systems reviewed in this manuscript have strengths such as clinical detail, a large enough sample size to capture rare adverse events, and/or a patient denominator internal to the database. Few systems include all of these attributes. Pediatric drug safety would be better informed by utilizing multiple systems to take advantage of their individual characteristics. Copyright © 2015 John Wiley & Sons, Ltd.

  3. Child Passenger Safety Training for Pediatric Interns: Does it Work?

    Science.gov (United States)

    Morrissey, Dina; Riese, Alison; Violano, Pina; Lapidus, Garry; Baird, Janette; Mello, Michael J

    2016-03-01

    Evaluate the efficacy of a child passenger safety (CPS) educational intervention on the CPS-related knowledge, attitude and anticipatory guidance behaviors of pediatric interns. All subjects were surveyed at baseline and 6 months. Intervention interns attended a CPS training module which included viewing an educational video, observing a car seat inspection appointment, hands-on practice and completion of a post-intervention survey. All 16 intervention interns completed the initial survey, the intervention and the immediate-post questionnaire. Thirteen (81%) completed the 6-month follow-up. The baseline survey was completed by 27/40 (67%) of control interns, 28/40 (70%) submitted a follow-up. The proportion of intervention interns who self-reported giving CPS guidance at all well-child visits increased by 31.3% (95% CI 6.1,56.5%); the control group had no change. Similar results were seen with self-reported knowledge and attitude. A CPS training module increases pediatric interns' knowledge, improves attitudes, and self-reported behaviors regarding CPS-related anticipatory guidance.

  4. Iohexol for contrast enhancement of bowel in pediatric abdominal CT

    International Nuclear Information System (INIS)

    Smevik, B.; Westvik, J.

    1990-01-01

    Abdominal CT scans from 160 examinations performed on pediatric patients using iohexol 2 percent as contrast medium for bowel enhancement were evaluated retrospectively. When diluted with a beverage of the child's choice, iohexol has a neutral taste and cannot be detected, and 139 out of 142 patients drank the full amount of dilute contrast offered to them. The enhancement of bowel in the area of interest was graded as good (58%), reasonable (23%), or poor (19%). The contrast medium was prepared from leftovers from our angiocardiography studies. We conclude that the use of water-soluble contrast medium in a low concentration is a safe and cost-effective way of facilitating ingesion of sufficient amounts of the medium in oncologic pediatric patients undergoing cytotoxic and/or radiation treatment. (orig.)

  5. Suitable footwear for enhanced safety

    CERN Document Server

    2004-01-01

    Safety shoes are the theme of a new safety campaign. Always remember that accidents can happen - even to your feet! When entering hazardous areas such as underground halls, work sites, experiment assembly sites, workshops etc., sandals, ordinary shoes or similar light footwear should not be worn. Whatever the risks to which you may be exposed, always think safety and wear suitable footwear, i.e. safety shoes, which have non-slip soles and steel reinforcements to protect your feet from being crushed, fractured or pierced. Is it serious, Doctor? "Some traumas resulting from foot-related accidents - open fractures for instance - can be quite serious," explains CERN Works Doctor Véronique Fassnacht. "But the most common injuries are sprained ankles sustained during simple falls caused by differences in floor-levels (e.g. false floors). Fractures, bruising, surface wounds or deep wounds caused by objects falling onto the top of the foot are also quite common." ...

  6. Enhancement of nuclear safety culture

    International Nuclear Information System (INIS)

    Anderson, Stanley J.

    1996-01-01

    Throughout the 40-year history of the commercial nuclear power industry, improvements have continually been made in the design of nuclear power plants and the equipment in them. In one sense, we have reached an enviable point -- in most plants, equipment failures have become relatively rare. Yet events continue to occur. Regardless of how much the plants are improved, that equipment is operated by people -- highly motivated, well-trained people -- but people nonetheless. And people occasionally make mistakes. By setting the right climate and by setting high standards, good plant management can reduce the number of mistakes made ? and also reduce their potential consequences. Another way to say this is that the proper safety culture must be established and continually improved upon in our nuclear plants. Safety culture is defined by the International Atomic Energy Agency as 'that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance.' In short, we must make safety our top priority

  7. Enhancing Safety through Generic Competencies

    Directory of Open Access Journals (Sweden)

    S. Mockel

    2014-03-01

    Full Text Available This article provides insights into proactive safety management and mitigation. An analysis of accident reports reveals categories of supervening causes of accidents which can be directly linked to the concept of generic competencies (information management, communication and coordination, problem solving, and effect control. These findings strongly suggest adding the human element as another safety-constituting pillar to the concept of ship safety next to technology and regulation. We argue that the human element has unique abilities in dealing with critical and highly dynamic situations which can contribute to the system's recovery from non-routine or critical situations. By educating seafarers in generic competencies we claim to enable the people onboard to successfully deal with critical situations.

  8. NPP Mochovce nuclear safety enhancement program

    International Nuclear Information System (INIS)

    Cech, J.; Baumester, P.

    1997-01-01

    Nuclear power plant Mochovce is currently under construction and an extensive nuclear safety enhancement programme is under way. The upgrading and modifications are based on IAEA documents and on those of the Nuclear Regulatory Authority of the Slovak Republic. Based on a contract concluded with Riskaudit from the CEC, safety examinations of the Mochovce design were performed. An extensive list of technical specifications of safety measures is given. (M.D.)

  9. Fellows as teachers: a model to enhance pediatric resident education.

    Science.gov (United States)

    Backes, Carl H; Reber, Kris M; Trittmann, Jennifer K B; Huang, Hong; Tomblin, Jordanna; Moorehead, Pamela A; Bauer, John A; Smith, Charles V; Mahan, John D

    2011-01-01

    Pressures on academic faculty to perform beyond their role as educators has stimulated interest in complementary approaches in resident medical education. While fellows are often believed to detract from resident learning and experience, we describe our preliminary investigations utilizing clinical fellows as a positive force in pediatric resident education. Our objectives were to implement a practical approach to engage fellows in resident education, evaluate the impact of a fellow-led education program on pediatric resident and fellow experience, and investigate if growth of a fellowship program detracts from resident procedural experience. This study was conducted in a neonatal intensive care unit (NICU) where fellows designed and implemented an education program consisting of daily didactic teaching sessions before morning clinical rounds. The impact of a fellow-led education program on resident satisfaction with their NICU experience was assessed via anonymous student evaluations. The potential value of the program for participating fellows was also evaluated using an anonymous survey. The online evaluation was completed by 105 residents. Scores were markedly higher after the program was implemented in areas of teaching excellence (4.44 out of 5 versus 4.67, pteaching skills and enhanced knowledge of neonatal pathophysiology as the most valuable aspects of their participation in the education program. The anonymous survey revealed that 87.5% of participating residents believed that NICU fellows were very important to their overall training and education. While fellows are often believed to be a detracting factor to residency training, we found that pediatric resident attitudes toward the fellows were generally positive. In our experience, in the specialty of neonatology a fellow-led education program can positively contribute to both resident and fellow learning and satisfaction. Further investigation into the value of utilizing fellows as a positive force in

  10. The culture of patient safety from the perspective of the pediatric emergency nursing team

    Directory of Open Access Journals (Sweden)

    Taise Rocha Macedo

    Full Text Available Abstract OBJECTIVE To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. METHOD A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. RESULTS Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. CONCLUSION Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario.

  11. Efficacy and safety of granulocyte, monocyte/macrophage adsorptive in pediatric ulcerative colitis

    DEFF Research Database (Denmark)

    Ruuska, Tarja; Küster, Peter; Grahnquist, Lena

    2016-01-01

    AIM: To investigate efficacy and safety for granulocyte, monocyte apheresis in a population of pediatric patients with ulcerative colitis. METHODS: The ADAPT study was a prospective, open-label, multicenter study in pediatric patients with moderate, active ulcerative colitis with pediatric...... ulcerative colitis activity index (PUCAI) of 35-64. Patients received one weekly apheresis with Adacolumn(®) granulocyte, monocyte/macrophage adsorptive (GMA) apheresis over 5 consecutive weeks, optionally followed by up to 3 additional apheresis treatments over 3 consecutive weeks. The primary endpoint...... mg daily on average from Baseline to week 12. CONCLUSION: Adacolumn(®) GMA apheresis treatment was effective in pediatric patients with moderate active Ulcerative Colitis. No new safety signals were reported. The present data contribute to considering GMA apheresis as a therapeutic option...

  12. Identification of quality improvement areas in pediatric MRI from analysis of patient safety reports

    International Nuclear Information System (INIS)

    Jaimes, Camilo; Murcia, Diana J.; Miguel, Karen; DeFuria, Cathryn; Sagar, Pallavi; Gee, Michael S.

    2018-01-01

    Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population. To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors. In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015. The safety report database was queried for events matching the same demographic and dates. Data on patient age, gender, location (inpatient, outpatient, emergency room [ER]), and the use of sedation/general anesthesia were recorded. Safety reports were grouped into categories based on the cause and their severity. Descriptive statistics were used to summarize continuous variables. Chi-square analyses were performed for univariate determination of statistical significance of variables associated with safety report rates. A multivariate logistic regression was used to control for possible confounding effects. A total of 16,749 pediatric MRI studies and 88 safety reports were analyzed, yielding a rate of 0.52%. There were significant differences in the rate of safety reports between patients younger than 6 years (0.89%) and those older (0.41%) (P<0.01), sedated (0.8%) and awake children (0.45%) (P<0.01), and inpatients (1.1%) and outpatients (0.4%) (P<0.01). The use of sedation/general anesthesia is an independent risk factor for a safety report (P=0.02). The most common causes for safety reports were service coordination (34%), drug reactions (19%), and diagnostic test and ordering errors (11%). The overall rate of safety reports in pediatric MRI is 0.52%. Interventions should focus on vulnerable populations, such as younger patients, those requiring sedation, and those in need of acute medical attention. (orig.)

  13. Identification of quality improvement areas in pediatric MRI from analysis of patient safety reports

    Energy Technology Data Exchange (ETDEWEB)

    Jaimes, Camilo [Massachusetts General Hospital, Harvard Medical School, Division of Neuroradiology, Department of Radiology, Boston, MA (United States); Murcia, Diana J. [Massachusetts General Hospital, Harvard Medical School, Division of Abdominal Imaging, Department of Radiology, Boston, MA (United States); Miguel, Karen; DeFuria, Cathryn [Massachusetts General Hospital, Harvard Medical School, Quality and Safety Office, Department of Radiology, Boston, MA (United States); Sagar, Pallavi; Gee, Michael S. [Massachusetts General Hospital for Children, Harvard Medical School, Division of Pediatric Imaging, Department of Radiology, Boston, MA (United States)

    2018-01-15

    Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population. To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors. In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015. The safety report database was queried for events matching the same demographic and dates. Data on patient age, gender, location (inpatient, outpatient, emergency room [ER]), and the use of sedation/general anesthesia were recorded. Safety reports were grouped into categories based on the cause and their severity. Descriptive statistics were used to summarize continuous variables. Chi-square analyses were performed for univariate determination of statistical significance of variables associated with safety report rates. A multivariate logistic regression was used to control for possible confounding effects. A total of 16,749 pediatric MRI studies and 88 safety reports were analyzed, yielding a rate of 0.52%. There were significant differences in the rate of safety reports between patients younger than 6 years (0.89%) and those older (0.41%) (P<0.01), sedated (0.8%) and awake children (0.45%) (P<0.01), and inpatients (1.1%) and outpatients (0.4%) (P<0.01). The use of sedation/general anesthesia is an independent risk factor for a safety report (P=0.02). The most common causes for safety reports were service coordination (34%), drug reactions (19%), and diagnostic test and ordering errors (11%). The overall rate of safety reports in pediatric MRI is 0.52%. Interventions should focus on vulnerable populations, such as younger patients, those requiring sedation, and those in need of acute medical attention. (orig.)

  14. 78 FR 53790 - Public Forum-Safety Culture: Enhancing Transportation Safety

    Science.gov (United States)

    2013-08-30

    ... NATIONAL TRANSPORTATION SAFETY BOARD Public Forum--Safety Culture: Enhancing Transportation Safety On Tuesday and Wednesday, September 10-11, 2013, the National Transportation Safety Board (NTSB) will convene a forum titled, ``Safety Culture: Enhancing Transportation Safety.'' The forum will begin at 9:00...

  15. Utility of late gadolinium enhancement in pediatric cardiac MRI

    International Nuclear Information System (INIS)

    Etesami, Maryam; Gilkeson, Robert C.; Rajiah, Prabhakar

    2016-01-01

    Late gadolinium enhancement (LGE) cardiac magnetic resonance (MR) imaging sequence is increasingly used in the evaluation of pediatric cardiovascular disorders, and although LGE might be a normal feature at the sites of previous surgeries, it is pathologically seen as a result of extracellular space expansion, either from acute cell damage or chronic scarring or fibrosis. LGE is broadly divided into ischemic and non-ischemic patterns. LGE caused by myocardial infarction occurs in a vascular distribution and always involves the subendocardial portion, progressively involving the outer regions in a waveform pattern. Non-ischemic cardiomyopathies can have a mid-myocardial (either linear or patchy), subepicardial or diffuse subendocardial distribution. Idiopathic dilated cardiomyopathy can have a linear mid-myocardial pattern, while hypertrophic cardiomyopathy can have fine, patchy enhancement in hypertrophied and non-hypertrophied segments as well as right ventricular insertion points. Myocarditis and sarcoidosis have a mid-myocardial or subepicardial pattern of LGE. Fabry disease typically affects the basal inferolateral segment while Danon disease typically spares the septum. Pericarditis is characterized by diffuse or focal pericardial thickening and enhancement. Thrombus, the most common non-neoplastic cardiac mass, is characterized by absence of enhancement in all sequences, while neoplastic masses show at least some contrast enhancement, depending on the pathology. Regardless of the etiology, presence of LGE is associated with a poor prognosis. In this review, we describe the technical modifications required for performing LGE cardiac MR sequence in children, review and illustrate the patterns of LGE in children, and discuss their clinical significance. (orig.)

  16. Utility of late gadolinium enhancement in pediatric cardiac MRI.

    Science.gov (United States)

    Etesami, Maryam; Gilkeson, Robert C; Rajiah, Prabhakar

    2016-07-01

    Late gadolinium enhancement (LGE) cardiac magnetic resonance (MR) imaging sequence is increasingly used in the evaluation of pediatric cardiovascular disorders, and although LGE might be a normal feature at the sites of previous surgeries, it is pathologically seen as a result of extracellular space expansion, either from acute cell damage or chronic scarring or fibrosis. LGE is broadly divided into ischemic and non-ischemic patterns. LGE caused by myocardial infarction occurs in a vascular distribution and always involves the subendocardial portion, progressively involving the outer regions in a waveform pattern. Non-ischemic cardiomyopathies can have a mid-myocardial (either linear or patchy), subepicardial or diffuse subendocardial distribution. Idiopathic dilated cardiomyopathy can have a linear mid-myocardial pattern, while hypertrophic cardiomyopathy can have fine, patchy enhancement in hypertrophied and non-hypertrophied segments as well as right ventricular insertion points. Myocarditis and sarcoidosis have a mid-myocardial or subepicardial pattern of LGE. Fabry disease typically affects the basal inferolateral segment while Danon disease typically spares the septum. Pericarditis is characterized by diffuse or focal pericardial thickening and enhancement. Thrombus, the most common non-neoplastic cardiac mass, is characterized by absence of enhancement in all sequences, while neoplastic masses show at least some contrast enhancement, depending on the pathology. Regardless of the etiology, presence of LGE is associated with a poor prognosis. In this review, we describe the technical modifications required for performing LGE cardiac MR sequence in children, review and illustrate the patterns of LGE in children, and discuss their clinical significance.

  17. PET imaging in pediatric oncology

    International Nuclear Information System (INIS)

    Shulkin, B.L.

    2004-01-01

    High-quality PET imaging of pediatric patients is challenging and requires attention to issues commonly encountered in the practice of pediatric nuclear medicine, but uncommon to the imaging of adult patients. These include intravenous access, fasting, sedation, consent, and clearance of activity from the urinary tract. This paper discusses some technical differences involved in pediatric PET to enhance the quality of scans and assure the safety and comfort of pediatric patients. (orig.)

  18. Fellows as teachers: a model to enhance pediatric resident education

    Directory of Open Access Journals (Sweden)

    Charles V. Smith

    2011-09-01

    Full Text Available Pressures on academic faculty to perform beyond their role as educators has stimulated interest in complementary approaches in resident medical education. While fellows are often believed to detract from resident learning and experience, we describe our preliminary investigations utilizing clinical fellows as a positive force in pediatric resident education. Our objectives were to implement a practical approach to engage fellows in resident education, evaluate the impact of a fellow-led education program on pediatric resident and fellow experience, and investigate if growth of a fellowship program detracts from resident procedural experience.This study was conducted in a neonatal intensive care unit (NICU where fellows designed and implemented an education program consisting of daily didactic teaching sessions before morning clinical rounds. The impact of a fellow-led education program on resident satisfaction with their NICU experience was assessed via anonymous student evaluations. The potential value of the program for participating fellows was also evaluated using an anonymous survey.The online evaluation was completed by 105 residents. Scores were markedly higher after the program was implemented in areas of teaching excellence (4.44 out of 5 versus 4.67, p<0.05 and overall resident learning (3.60 out of 5 versus 4.61, p<0.001. Fellows rated the acquisition of teaching skills and enhanced knowledge of neonatal pathophysiology as the most valuable aspects of their participation in the education program. The anonymous survey revealed that 87.5% of participating residents believed that NICU fellows were very important to their overall training and education.While fellows are often believed to be a detracting factor to residency training, we found that pediatric resident attitudes toward the fellows were generally positive. In our experience, in the specialty of neonatology a fellow-led education program can positively contribute to both

  19. The enhancement of Ignalina NPP in design and operational safety

    International Nuclear Information System (INIS)

    Negrivoda, G.

    1999-01-01

    Enhancement of Ignalina NPP design include: core design improvements; fuel channel integrity (multiple pressure tube rupture); improvements of shutdown systems; improvements of instrumentation and control devices; containment strength and tightness; design basis accident analysis; improvements of safety and support systems; seismic safety enhancement; Year 2000 project; cracks in pipes. Enhancement of operational safety includes: quality assurance; configuration management; safety management and safety culture; emergency operating procedures; training and full scope simulator; in-service inspection; fire protection and ageing monitoring and management

  20. Safety of Systemic Agents for the Treatment of Pediatric Psoriasis

    DEFF Research Database (Denmark)

    Bronckers, Inge M G J; Seyger, Marieke M B; West, Dennis P

    2017-01-01

    Importance: Use of systemic therapies for moderate to severe psoriasis in children is increasing, but comparative data on their use and toxicities are limited. Objective: To assess patterns of use and relative risks of systemic agents for moderate to severe psoriasis in children. Design, Setting,...... per week protected more against methotrexate-induced gastrointestinal AEs than did weekly administration. A prospective registry is needed to track the long-term risks of systemic agents for pediatric psoriasis....

  1. The Evidence Base on the Efficacy and Safety of Ibuprofen in Pediatrics

    Directory of Open Access Journals (Sweden)

    Yu.V. Marushko

    2013-10-01

    Full Text Available The article deals with an analysis of the world literature of recent years, the aim of which was to study the efficacy and safety of ibuprofen use as first-line antipyretic in pediatric practice. Special attention was paid to researches on the study the pharmacokinetics, efficacy and safety of ibuprofen in fever in children of all ages, as well as the use of different forms of ibuprofen (suspension, suppositories.

  2. Sociodrama approach for enhancing nuclear safety

    International Nuclear Information System (INIS)

    Choi, K. S.; Kim, C. B.; Ha, Y. H.

    2004-01-01

    A role playing or sociodrama has been experimentally conducted among residents from 4 NPP sites in Korea and KINS employees as a psychological approach for enhancing nuclear safety and improving public communication and public confidence in regulator in Dec. 2004. In this paper, the results were analyzed and presented and future plan and area of further study were suggested. This socio-psychological approach can be used as a new communication method for improving mutual understanding between residents and NPP operators at sites. It can be also used to solve conflicts among stakeholders and interest groups in nuclear industry

  3. New developments enhancing MCNP for criticality safety

    International Nuclear Information System (INIS)

    Hendricks, J.S.; McKinney, G.W.; Forster, R.A.

    1993-01-01

    Since the early 80's MCNP has had three estimates of k eff : collision, absorption, and track length. MCNP has also had collision and absorption estimators of removal lifetime. These are calculated for every cycle and are averaged over the cycles as simple averages and covariance weighted averages. Correlation coefficients between estimators are also calculated. These criticality estimators are all in addition to the extensive summary information and tally edits used in shielding and other problems. A number of significant new developments have been made to enhance the MCNP Monte Carlo radiation transport code for criticality safety applications. These are available in the newly released MCNP4A version of the code

  4. Children's safety initiative: a national assessment of pediatric educational needs among emergency medical services providers.

    Science.gov (United States)

    Hansen, Matthew; Meckler, Garth; Dickinson, Caitlyn; Dickenson, Kathryn; Jui, Jonathan; Lambert, William; Guise, Jeanne-Marie

    2015-01-01

    Emergency medical services (EMS) providers may have critical knowledge gaps in pediatric care due to lack of exposure and training. There is currently little evidence to guide educators to the knowledge gaps that most need to be addressed to improve patient safety. The objective of this study was to identify educational needs of EMS providers related to pediatric care in various domains in order to inform development of curricula. The Children's Safety Initiative-EMS performed a three-phase Delphi survey on patient safety in pediatric emergencies among providers and content experts in pediatric emergency care, including physicians, nurses, and prehospital providers of all levels. Each round included questions related to educational needs of providers or the effect of training on patient safety events. We identified knowledge gaps in the following domains: case exposure, competency and knowledge, assessment and decision making, and critical thinking and proficiency. Individual knowledge gaps were ranked by portion of respondents who ranked them "highly likely" (Likert-type score 7-10 out of 10) to contribute to safety events. There were 737 respondents who were included in analysis of the first phase of the survey. Paramedics were 50.8% of respondents, EMT-basics/first responders were 22%, and physicians 11.4%. The top educational priorities identified in the final round of the survey include pediatric airway management, responder anxiety when working with children, and general pediatric skills among providers. The top three needs in decision-making include knowing when to alter plans mid-course, knowing when to perform an advanced airway, and assessing pain in children. The top 3 technical or procedural skills needs were pediatric advanced airway, neonatal resuscitation, and intravenous/intraosseous access. For neonates, specific educational needs identified included knowing appropriate vital signs and preventing hypothermia. This is the first large-scale Delphi

  5. Methods and Effects of Safety Enhancement in Korean PSR

    International Nuclear Information System (INIS)

    Kim, Young Gab; Park, Jong Woon

    2009-01-01

    Periodic Safety Review (PSR) is a comprehensive study on a nuclear power plant safety, taking into account aspects such as operational history, ageing, safety analyses and advances in code and standards since the time of construction. In Korea, PSRs have been performed for 20 units and have been effectively used to obtain an overall view of actual plant safety to determine reasonable and practical modifications that should be made in order to obtain a higher level of safety approaching that of modern plants. Among many safety enhancements achieved from Korean PSRs, new safety analyses are the important methods to confirm plant safety by increasing safety margin for specific safety issues. Methods and effects of safety enhancements applied in Korean PSRs are reviewed in this paper in light of new safety analyses to obtain additional safety margins

  6. On safety enhancements for medical robots

    International Nuclear Information System (INIS)

    Ng, W.S.; Tan, C.K.

    1996-01-01

    Both software and hardware methods to enhance safety are discussed for active medical robots applied to, among others, neurosurgery, orthopaedic surgery and prostatectomy. This paper advocates that while it is practically difficult, if not impossible, for software reliability to be 100%, there are positive measures by which a medical robot system can be made adequately or inherently safe. Such measures avoid the problems of software reliability but turn to mathematical logic directly to build a safer system. Examples in a newly developed prototype, known as surgeon assistant robot for selected urological disorders (SARUD), are given to illustrate the concept. Although software measures to promote reliability of a system is less preferred compared to hardware measures, as it can never escape from operating on a hardware platform, it is suggested that a complementary/ hybrid approach can be a good solution for achieving a safe and flexible (by being reprogrammable) system. A totally independent safety monitor is being built. It can arrest a servo runaway and detect out-of-safe-boundary conditions, using encoder pulses as input. This dedicated system can resolve some major safety concerns of a medical robot such as SARUD

  7. Software diversity: way to enhance safety?

    International Nuclear Information System (INIS)

    Dahll, G.; Bishop, P.

    1990-01-01

    The topic of the paper is the use of diversely produced programs to enhance the safety of computer-based systems applied in safety-critical areas. The paper starts with a survey of scientific investigations on the impact of software redundancy made at various institutions around the world. Main emphasis will, however, be put on the PODS/STEM projects, which have been performed at the OECD Halden Project in cooperation with the Technical Research Center of Finland, the Safety and Reliability Directorate, AEA Technology, UK, and Central Electricity Research Laboratory (now National Power Technology and Environment Centre), UK. In these projects, three program versions were made independently by three different teams, all based on the same specification. The three programs were tested back-to-back with a large amount of test data. The experience and results from this process were carefully logged and used for further analysis. Various strategies for test data selection were compared, with respect to fault finding strategies, as well as to branch and statement coverages of the tested programs. The assumption of independence of failures in diversely produced programs was investigated. A particularly interesting effect, namely failure masking due to program structure, was revealed. Static analysis techniques, software measures, and software reliability estimates were also studied. (author)

  8. Evolution of the Pediatric Advanced Life Support course: enhanced learning with a new debriefing tool and Web-based module for Pediatric Advanced Life Support instructors.

    Science.gov (United States)

    Cheng, Adam; Rodgers, David L; van der Jagt, Élise; Eppich, Walter; O'Donnell, John

    2012-09-01

    To describe the history of the Pediatric Advanced Life Support course and outline the new developments in instructor training that will impact the way debriefing is conducted during Pediatric Advanced Life Support courses. The Pediatric Advanced Life Support course, first released by the American Heart Association in 1988, has seen substantial growth and change over the past few decades. Over that time, Pediatric Advanced Life Support has become the standard for resuscitation training for pediatric healthcare providers in North America. The incorporation of high-fidelity simulation-based learning into the most recent version of Pediatric Advanced Life Support has helped to enhance the realism of scenarios and cases, but has also placed more emphasis on the importance of post scenario debriefing. We developed two new resources: an online debriefing module designed to introduce a new model of debriefing and a debriefing tool for real-time use during Pediatric Advanced Life Support courses, to enhance and standardize the quality of debriefing by Pediatric Advanced Life Support instructors. In this article, we review the history of Pediatric Advanced Life Support and Pediatric Advanced Life Support instructor training and discuss the development and implementation of the new debriefing module and debriefing tool for Pediatric Advanced Life Support instructors. The incorporation of the debriefing module and debriefing tool into the 2011 Pediatric Advanced Life Support instructor materials will help both new and existing Pediatric Advanced Life Support instructors develop and enhance their debriefing skills with the intention of improving the acquisition of knowledge and skills for Pediatric Advanced Life Support students.

  9. Implementing a pediatric surgical safety checklist in the OR and beyond.

    Science.gov (United States)

    Norton, Elizabeth K; Rangel, Shawn J

    2010-07-01

    An international study about implementation of the World Health Organization Surgical Safety Checklist showed that use of the checklist reduced complication and death rates in adult surgical patients. Clinicians at Children's Hospital Boston, Massachusetts, modified the Surgical Safety Checklist for pediatric populations. We pilot tested the Pediatric Surgical Safety Checklist and created a large checklist poster for each OR to allow the entire surgical team to view the checklist simultaneously and to promote shared responsibility for conducting the time out. Results of the pilot test showed improvements in teamwork, communication, and adherence to process measures. Parallel efforts were made in other areas of the hospital where invasive procedures are performed. Compliance with the checklist at our facility has been good, and team members have expressed satisfaction with the flow and content of the checklist. Copyright (c) 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  10. Safety Culture Enhancement Project. Final Report. A Field Study on Approaches to Enhancement of Safety Culture

    International Nuclear Information System (INIS)

    Lowe, Andrew; Hayward, Brent

    2006-08-01

    This report documents a study with the objective of enhancing safety culture in the Swedish nuclear power industry. A primary objective of this study was to ensure that the latest thinking on human factors principles was being recognised and applied by nuclear power operators as a means of ensuring optimal safety performance. The initial phase of the project was conducted as a pilot study, involving the senior management group at one Swedish nuclear power-producing site. The pilot study enabled the project methodology to be validated after which it was repeated at other Swedish nuclear power industry sites, providing a broad-ranging analysis of opportunities across the industry to enhance safety culture. The introduction to this report contains an overview of safety culture, explains the background to the project and sets out the project rationale and objectives. The methodology used for understanding and analysing the important safety culture issues at each nuclear power site is then described. This section begins with a summary of the processes used in the information gathering and data analysis stage. The six components of the Management Workshops conducted at each site are then described. These workshops used a series of presentations, interactive events and group exercises to: (a) provide feedback to site managers on the safety culture and safety leadership issues identified at their site, and (b) stimulate further safety thinking and provide 'take-away' information and leadership strategies that could be applied to promote safety culture improvements. Section 3, project Findings, contains the main observations and output from the project. These include: - a brief overview of aspects of the local industry operating context that impinge on safety culture; - a summary of strengths or positive attributes observed within the safety culture of the Swedish nuclear industry; - a set of identified opportunities for further improvement; - the aggregated results of the

  11. Electronuclear's safety culture assessment and enhancement program

    International Nuclear Information System (INIS)

    Selvatici, E.; Diaz-Francisco, J.M.; Diniz de Souza, V.

    2002-01-01

    The present paper describes the Eletronuclear's safety culture assessment and enhancement program. The program was launched by the company's top management one year after the creation of Eletronuclear in 1997, from the merging of two companies with different organizational cultures, the design and engineering company Nuclen and the nuclear directorate of the Utility Furnas, Operator of the Angra1 NPP. The program consisted of an assessment performed internally in 1999 with the support and advice of the IAEA. This assessment, performed with the help of a survey, pooled about 80% of the company's employees. The overall result of the assessment was that a satisfactory level of safety culture existed; however, a number of points with a considerable margin for improvement were also identified. These points were mostly related with behavioural matters such as motivation, stress in the workplace, view of mistakes, handling of conflicts, and last but not least a view by a considerable number of employees that a conflict between safety and production might exist. An Action Plan was established by the company managers to tackle these weak points. This Plan was issued as company guideline by the company's Directorate. The subsequent step was to detail and implement the different actions of the Plan, which is the phase that we are at present. In the detailing of the Action Plan, special care was taken to sum up efforts, avoiding duplication of work or competition with already existing programs. In this process it was identified that the company had a considerable number of initiatives directly related to organizational and safety culture improvement, already operational. These initiatives have been integrated in the detailed Action Plan. A new assessment, for checking the effectiveness of the undertaken actions, is planned for 2003. (author)

  12. Safety Culture Enhancement Project. Final Report. A Field Study on Approaches to Enhancement of Safety Culture

    Energy Technology Data Exchange (ETDEWEB)

    Lowe, Andrew; Hayward, Brent (Dedale Asia Pacific, Albert Park VIC 3206 (Australia))

    2006-08-15

    This report documents a study with the objective of enhancing safety culture in the Swedish nuclear power industry. A primary objective of this study was to ensure that the latest thinking on human factors principles was being recognised and applied by nuclear power operators as a means of ensuring optimal safety performance. The initial phase of the project was conducted as a pilot study, involving the senior management group at one Swedish nuclear power-producing site. The pilot study enabled the project methodology to be validated after which it was repeated at other Swedish nuclear power industry sites, providing a broad-ranging analysis of opportunities across the industry to enhance safety culture. The introduction to this report contains an overview of safety culture, explains the background to the project and sets out the project rationale and objectives. The methodology used for understanding and analysing the important safety culture issues at each nuclear power site is then described. This section begins with a summary of the processes used in the information gathering and data analysis stage. The six components of the Management Workshops conducted at each site are then described. These workshops used a series of presentations, interactive events and group exercises to: (a) provide feedback to site managers on the safety culture and safety leadership issues identified at their site, and (b) stimulate further safety thinking and provide 'take-away' information and leadership strategies that could be applied to promote safety culture improvements. Section 3, project Findings, contains the main observations and output from the project. These include: - a brief overview of aspects of the local industry operating context that impinge on safety culture; - a summary of strengths or positive attributes observed within the safety culture of the Swedish nuclear industry; - a set of identified opportunities for further improvement; - the aggregated

  13. Safety and effects of two red blood cell transfusion strategies in pediatric cardiac surgery patients: a randomized controlled trial

    NARCIS (Netherlands)

    de Gast-Bakker, D. H.; de Wilde, R. B. P.; Hazekamp, M. G.; Sojak, V.; Zwaginga, J. J.; Wolterbeek, R.; de Jonge, E.; Gesink-van der Veer, B. J.

    2013-01-01

    To investigate the safety and effects of a restrictive red blood cell (RBC) transfusion strategy in pediatric cardiac surgery patients. Randomized controlled trial. Pediatric ICU in an academic tertiary care center, Leiden University Medical Center, Leiden, The Netherlands. One hundred seven

  14. Enhanced Contribution of HLA in Pediatric Onset Ulcerative Colitis.

    Science.gov (United States)

    Venkateswaran, Suresh; Prince, Jarod; Cutler, David J; Marigorta, Urko M; Okou, David T; Prahalad, Sampath; Mack, David; Boyle, Brendan; Walters, Thomas; Griffiths, Anne; Sauer, Cary G; LeLeiko, Neal; Keljo, David; Markowitz, James; Baker, Susan S; Rosh, Joel; Pfefferkorn, Marian; Heyman, Melvin B; Patel, Ashish; Otley, Anthony; Baldassano, Robert; Noe, Joshua; Rufo, Paul; Oliva-Hemker, Maria; Davis, Sonia; Zwick, Michael E; Gibson, Greg; Denson, Lee A; Hyams, Jeffrey; Kugathasan, Subra

    2018-03-19

    The genetic contributions to pediatric onset ulcerative colitis (UC), characterized by severe disease and extensive colonic involvement, are largely unknown. In adult onset UC, Genome Wide Association Study (GWAS) has identified numerous loci, most of which have a modest susceptibility risk (OR 0.84-1.14), with the exception of the human leukocyte antigen (HLA) region on Chromosome 6 (OR 3.59). To study the genetic contribution to exclusive pediatric onset UC, a GWAS was performed on 466 cases with 2099 healthy controls using UK Biobank array. SNP2HLA was used to impute classical HLA alleles and their corresponding amino acids, and the results are compared with adult onset UC. HLA explained the almost entire association signal, dominated with 191 single nucleotide polymorphisms (SNPs) (p = 5 x 10-8 to 5 x 10-10). Although very small effects, established SNPs in adult onset UC loci had similar direction and magnitude in pediatric onset UC. SNP2HLA imputation identified HLA-DRB1*0103 (odds ratio [OR] = 6.941, p = 1.92*10-13) as the most significant association for pediatric UC compared with adult onset UC (OR = 3.59). Further conditioning showed independent effects for HLA-DRB1*1301 (OR = 2.25, p = 7.92*10-9) and another SNP rs17188113 (OR = 0.48, p = 7.56*10-9). Two HLA-DRB1 causal alleles are shared with adult onset UC, while at least 2 signals are unique to pediatric UC. Subsequent stratified analyses indicated that HLA-DRB1*0103 has stronger association for extensive disease (E4: OR = 8.28, p = 4.66x10-10) and female gender (OR = 8.85, p = 4.82x10-13). In pediatric onset UC, the HLA explains almost the entire genetic associations. In addition, the HLA association is approximately twice as strong in pediatric UC compared with adults, due to a combination of novel and shared effects. We speculate the paramount importance of antigenic stimulation either by infectious or noninfectious stimuli as a causal event in pediatric UC onset.

  15. The culture of patient safety from the perspective of the pediatric emergency nursing team.

    Science.gov (United States)

    Macedo, Taise Rocha; Rocha, Patricia Kuerten; Tomazoni, Andreia; Souza, Sabrina de; Anders, Jane Cristina; Davis, Karri

    2016-01-01

    To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario. Identificar a cultura de segurança do paciente em emergências pediátricas, na perspectiva da equipe de enfermagem. Pesquisa quantitativa, tipo survey transversal. Amostra composta por 75 profissionais da equipe de enfermagem. Dados coletados entre setembro e novembro de 2014, em três Emergências Pediátricas, aplicando o instrumento Hospital Survey on Patient Safety Culture. Dados submetidos à análise descritiva. Não foram encontradas áreas de força para a segurança do paciente, sendo identificadas áreas com potencial de assim se tornarem: Expectativas e ações do supervisor/chefia para promoção da segurança do paciente e Trabalho em equipe. Como área crítica identificaram-se: Resposta não punitiva ao erro e Apoio da gestão hospitalar para segurança do paciente. O estudo apontou distanciamento

  16. Pediatrics

    Science.gov (United States)

    Spackman, T. J.

    1978-01-01

    The utilization of the Lixiscope in pediatrics was investigated. The types of images that can presently be obtained are discussed along with the problems encountered. Speculative applications for the Lixiscope are also presented.

  17. Pediatrics

    NARCIS (Netherlands)

    Rasheed, Shabana; Teo, Harvey James Eu Leong; Littooij, Annemieke Simone

    2015-01-01

    Imaging of pediatric patients involves many diverse modalities, including radiography, ultrasound imaging, computed tomography, magnetic resonance imaging, and scintigraphic and angiographic studies. It is therefore important to be aware of potential pitfalls that may be related to these modalities

  18. Enhancing the ED Approach to Pediatric Sexual Assault Care: Implementation of a Pediatric SART Program

    Science.gov (United States)

    Goyal, MK; Mollen, CJ; Hayes, KL; Molnar, J; Christian, CW; Scribano, PV; Lavelle, J

    2013-01-01

    Objective Describe the experience of a novel pediatric Sexual Assault Response Team (SART) program in the first three years of implementation, and compare patient characteristics, evaluation, and treatment among subpopulations of patients. Methods Retrospective chart review of a consecutive sample of patients evaluated at a pediatric ED who met institutional criteria for a SART evaluation. Associations of evaluation and treatment with gender, menarchal status, and presence of injuries were measured using logistic regression. Results One hundred and eighty-four patients met criteria for SART evaluation, of whom 87.5% were female; mean age was 10.1 years (+/− 4.6 years). The majority of patients underwent forensic evidence collection (89.1%), which varied by menarchal status among females (p<0.01), but not by gender. Evidence of acute anogenital injury on physical exam was found in 20.6% of patients. As per the Center for Disease Control and Prevention guidelines for acute sexual assault evaluations in pediatric patients, menarchal females were more likely to undergo testing for sexually transmitted infections (STI) and pregnancy (p<0.01) and to be offered pregnancy, STI, and HIV prophylaxis (p<0.01). Conclusions In an effort to improve quality and consistency of acute sexual assault examinations in a pediatric ED, development of a SART program supported the majority of eligible patients undergoing forensic evidence collection. Furthermore, a substantial number of patients had evidence of injury on exam. These findings underscore the importance of having properly trained personnel to support ED care for pediatric victims of acute sexual assault. PMID:23974714

  19. Barriers to Implementing a Reporting and Learning Patient Safety System: Pediatric Chiropractic Perspective.

    Science.gov (United States)

    Pohlman, Katherine A; Carroll, Linda; Hartling, Lisa; Tsuyuki, Ross T; Vohra, Sunita

    2016-04-01

    A reporting and learning system is a method of monitoring the occurrence of incidents that affect patient safety. This cross-sectional survey asked pediatric chiropractors about factors that may limit their participation in such a system. The list of potential barriers for participation was developed using a systematic approach. All members of the 2 pediatric councils associated with US national chiropractic organizations were invited to complete the survey (N = 400). The cross-sectional survey was created using an online survey tool (REDCap) and sent directly to member emails addressed by the respective executive committees. Of the 400 potential respondents, 81 responded (20.3%). The most common limitations to participating were identified as time pressure (96%) and patient concerns (81%). Reporting and learning systems have been utilized to increase safety awareness in many high-risk industries. To be successful, future patient safety studies with pediatric chiropractors need to ensure these barriers are understood and addressed. © The Author(s) 2015.

  20. Challenges and strategies to facilitate formulation development of pediatric drug products: Safety qualification of excipients.

    Science.gov (United States)

    Buckley, Lorrene A; Salunke, Smita; Thompson, Karen; Baer, Gerri; Fegley, Darren; Turner, Mark A

    2018-02-05

    A public workshop entitled "Challenges and strategies to facilitate formulation development of pediatric drug products" focused on current status and gaps as well as recommendations for risk-based strategies to support the development of pediatric age-appropriate drug products. Representatives from industry, academia, and regulatory agencies discussed the issues within plenary, panel, and case-study breakout sessions. By enabling practical and meaningful discussion between scientists representing the diversity of involved disciplines (formulators, nonclinical scientists, clinicians, and regulators) and geographies (eg, US, EU), the Excipients Safety workshop session was successful in providing specific and key recommendations for defining paths forward. Leveraging orthogonal sources of data (eg. food industry, agro science), collaborative data sharing, and increased awareness of the existing sources such as the Safety and Toxicity of Excipients for Paediatrics (STEP) database will be important to address the gap in excipients knowledge needed for risk assessment. The importance of defining risk-based approaches to safety assessments for excipients vital to pediatric formulations was emphasized, as was the need for meaningful stakeholder (eg, patient, caregiver) engagement. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Safety of gadobutrol in more than 1,000 pediatric patients: subanalysis of the GARDIAN study, a global multicenter prospective non-interventional study

    International Nuclear Information System (INIS)

    Glutig, Katja; Bhargava, Ravi; Hahn, Gabriele; Hirsch, Wolfgang; Kunze, Christian; Mentzel, Hans-Joachim; Schaefer, Juergen F.; Willinek, Winfried; Palkowitsch, Petra

    2016-01-01

    Gadobutrol is a gadolinium-based contrast agent, uniquely formulated at 1.0 mmol/ml. Although there is extensive safety evidence on the use of gadobutrol in adults, few studies have addressed the safety and tolerability of gadobutrol in pediatric patients. This subanalysis of data from the GARDIAN study evaluated the safety and use of gadobutrol in pediatric patients (age <18 years). The GARDIAN study was a large phase IV non-interventional prospective multicenter post-authorization safety study performed in Europe, Asia, North America and Africa. A total of 23,708 patients were included who were scheduled to undergo cranial or spinal MRI, liver or kidney MRI, or MR angiography with gadobutrol enhancement. The primary study endpoint was the overall incidence of adverse drug reactions (ADRs) and serious adverse events (SAEs) following gadobutrol administration. The GARDIAN study included 1,142 children (age <18 years) who received gadobutrol at a mean dose of 0.13 (range 0.04-0.50) mmol/kg body weight. Gadobutrol was well tolerated in these children, with low rates of ADRs (0.5%) and no SAEs, consistent with results in adults enrolled in the GARDIAN study. Rates of adverse events and ADRs were unrelated to pediatric age or gadobutrol weight-adjusted dose. There were no symptoms suggestive of nephrogenic systemic fibrosis. Investigators rated the contrast quality of gadobutrol-enhanced images as good or excellent in 97.8% of pediatric patients, similar to the main study population. Gadobutrol is very well tolerated and provides excellent contrast quality at the recommended weight-adjusted dose in children (age <18 years), similar to the profile in adults. (orig.)

  2. Efficacy and safety of lung recruitment in pediatric patients with acute lung injury.

    Science.gov (United States)

    Boriosi, Juan P; Sapru, Anil; Hanson, James H; Asselin, Jeanette; Gildengorin, Ginny; Newman, Vivienne; Sabato, Katie; Flori, Heidi R

    2011-07-01

    To assess the safety and efficacy of a recruitment maneuver, the Open Lung Tool, in pediatric patients with acute lung injury and acute respiratory distress syndrome. Prospective cohort study using a repeated-measures design. Pediatric intensive care unit at an urban tertiary children's hospital. Twenty-one ventilated pediatric patients with acute lung injury. Recruitment maneuver using incremental positive end-expiratory pressure. The ratio of partial pressure of arterial oxygen over fraction of inspired oxygen (Pao2/Fio2 ratio) increased 53% immediately after the recruitment maneuver. The median Pao2/Fio2 ratio increased from 111 (interquartile range, 73-266) prerecruitment maneuver to 170 (interquartile range, 102-341) immediately postrecruitment maneuver (p interquartile range, 116-257) 4 hrs postrecruitment maneuver (p interquartile range, 127-236) 12 hrs postrecruitment maneuver (p interquartile range, 44-60) prerecruitment maneuver compared with 48 torr (interquartile range, 43-50) immediately postrecruitment maneuver (p = .69), 45 torr (interquartile range, 41-50) at 4 hrs postrecruitment maneuver (p interquartile range, 38-51) at 12 hrs postrecruitment maneuver. Recruitment maneuvers were well tolerated except for significant increase in Paco2 in three patients. There were no serious adverse events related to the recruitment maneuver. Using the modified open lung tool recruitment maneuver, pediatric patients with acute lung injury may safely achieve improved oxygenation and ventilation with these benefits potentially lasting up to 12 hrs postrecruitment maneuver.

  3. Non-contrast MRA using an inflow-enhanced, inversion recovery SSFP technique in pediatric abdominal imaging

    International Nuclear Information System (INIS)

    Serai, Suraj; Towbin, Alexander J.; Podberesky, Daniel J.

    2012-01-01

    Abdominal contrast-enhanced MR angiography (CE-MRA) is routinely performed in children. CE-MRA is challenging in children because of patient motion, difficulty in obtaining intravenous access, and the inability of young patients to perform a breath-hold during imaging. The combination of pediatric-specific difficulties in imaging and the safety concerns regarding the risk of gadolinium-based contrast agents in patients with impaired renal function has renewed interest in the use of non-contrast (NC) MRA techniques. At our institution, we have optimized 3-D NC-MRA techniques for abdominal imaging. The purpose of this work is to demonstrate the utility of an inflow-enhanced, inversion recovery balanced steady-state free precession-based (b-SSFP) NC-MRA technique. (orig.)

  4. Performance and safety of femoral central venous catheters in pediatric autologous peripheral blood stem cell collection.

    Science.gov (United States)

    Cooling, Laura; Hoffmann, Sandra; Webb, Dawn; Yamada, Chisa; Davenport, Robertson; Choi, Sung Won

    2017-12-01

    Autologous peripheral blood hematopoietic progenitor cell collection (A-HPCC) in children typically requires placement of a central venous catheter (CVC) for venous access. There is scant published data regarding the performance and safety of femoral CVCs in pediatric A-HPCC. Seven-year, retrospective study of A-HPCC in pediatric patients collected between 2009 and January 2017. Inclusion criteria were an age ≤ 21 years and A-HPCC using a femoral CVC for venous access. Femoral CVC performance was examined by CD34 collection rate, inlet rate, collection efficiency (MNC-FE, CD34-FE), bleeding, flow-related adverse events (AE), CVC removal, and product sterility testing. Statistical analysis and graphing were performed with commercial software. A total of 75/119 (63%) pediatric patients (median age 3 years) met study criteria. Only 16% of children required a CVC for ≥ 3 days. The CD34 collect rate and CD34-FE was stable over time whereas MNC-FE decreased after day 4 in 80% of patients. CD34-FE and MNC-FE showed inter- and intra-patient variability over time and appeared sensitive to plerixafor administration. Femoral CVC showed fewer flow-related AE compared to thoracic CVC, especially in pediatric patients (6.7% vs. 37%, P = 0.0005; OR = 0.12 (95%CI: 0.03-0.45). CVC removal was uneventful in 73/75 (97%) patients with hemostasis achieved after 20-30 min of pressure. In a 10-year period, there were no instances of product contamination associated with femoral CVC colonization. Femoral CVC are safe and effective for A-HPCC in young pediatric patients. Femoral CVC performance was maintained over several days with few flow-related alarms when compared to thoracic CVCs. © 2017 Wiley Periodicals, Inc.

  5. Incident Reporting to Improve Patient Safety: The Effects of Process Variance on Pediatric Patient Safety in the Emergency Department.

    Science.gov (United States)

    OʼConnell, Karen J; Shaw, Kathy N; Ruddy, Richard M; Mahajan, Prashant V; Lichenstein, Richard; Olsen, Cody S; Funai, Tomohiko; Blumberg, Stephen; Chamberlain, James M

    2018-04-01

    Medical errors threaten patient safety, especially in the pediatric emergency department (ED) where overcrowding, multiple handoffs, and workflow interruptions are common. Errors related to process variance involve situations that are not consistent with standard ED operations or routine patient care. We performed a planned subanalysis of the Pediatric Emergency Care Applied Research Network incident reporting data classified as process variance events. Confidential deidentified incident reports (IRs) were collected and classified by 2 independent investigators. Events categorized as process variance were then subtyped for severity and contributing factors. Data were analyzed using descriptive statistics. The study intention was to describe and measure reported medical errors related to process variance in 17 EDs in the Pediatric Emergency Care Applied Research Network from 2007 to 2008. Between July 2007 and June 2008, 2906 eligible reports were reviewed. Process variance events were identified in 15.4% (447/2906). The majority were related to patient flow (35.4%), handoff communication (17.2%), and patient identification errors (15.9%). Most staff involved included nurses (47.9%) and physicians (28%); trainees were infrequently reported. The majority of events did not result in harm (65.7%); 17.9% (80/447) of cases were classified as unsafe conditions but did not reach the patient. Temporary harm requiring further treatment or hospitalization was reported in 5.6% (25/447). No events resulted in permanent harm, near death, or death. Contributing factors included human factors (92.1%), in particular handoff communication, interpersonal skills, and compliance with established procedures, and system-level errors (18.1%), including unclear or unavailable policies and inadequate staffing levels. Although process variance events accounted for approximately 1 in 6 reported safety events, very few led to patient harm. Because human and system-level factors contributed to

  6. Child Passenger Safety Technician Consultation in the Pediatric Primary Care Setting.

    Science.gov (United States)

    Burstein, Dina; Zonfrillo, Mark R; Baird, Janette; Mello, Michael J

    2017-09-01

    Correct use of a child safety seat (CSS) can reduce the risk of fatal motor vehicle crash-related injury by up to 71%; however, misuse rates for CSS are as high as 70%. We recruited 189 caregivers at 2 large suburban pediatric office practices; 94 in the intervention group and 95 in the control group. All participants completed a baseline survey and received a CSS safety brochure. Intervention participants had their CSS installation checked at enrollment by a certified child passenger safety (CPS) technician. Follow-up was conducted 4 months post enrollment. Intervention group participants had a 21.3% reduction in critical misuse at follow-up, whereas control participants critical misuse rate at follow-up was identical to the intervention group at baseline. A consult with a certified CPS technician, at the time of a routine visit to the pediatrician, resulted in a reduction in CSS misuse rates.

  7. Enhancement of safety for reprocessing facilities

    International Nuclear Information System (INIS)

    2012-06-01

    The adequacy of the safety measures for utility loss accidents in nuclear fuel reprocessing facilities which have been formulated by the nuclear enterprises is investigated in JNES which organizes an advanced committee to specifically study this problem. The results are reviewed in the present report including the case of such severe accidents as in Fukushima Daiichi Nuclear Power Plant. The report also represents a tentative proposal for examination standards of such unimaginable severe accidents as 'station blackout,' urgent safety measures necessary for reoperation of nuclear power plants and requested by nuclear and industrial safety agency, and pointing out and clarification of the potential weakness from the safety point of view, and collective and composite evaluation of safety of the relevant facilities. Furthermore, the definition of accident management is given as of controlled condition and the authorized way of thinking for the cases of plural events happening at the same time and the cases when risks exist radioactivity emits with explosion. (S. Ohno)

  8. Pediatric excretory MR urography: comparative study of enhanced and non-enhanced techniques

    Energy Technology Data Exchange (ETDEWEB)

    Borthne, Arne S. [Department of Pediatric Radiology, Kirkeveien 166, Ullevaal University Hospital, 0407 Oslo (Norway); Pierre-Jerome, Claude [Department of Central Radiology, Ullevaal University Hospital, Kirkeveien 166, 0407 Oslo (Norway); Gjesdal, Kjell I.; Storaas, Tryggve; Courivaud, Frederic [Department of Medical Physics, Ullevaal University Hospital, Kirkeveien 166, 0407 Oslo (Norway); Eriksen, Morten [Institute of Experimental Research, Ullevaal University Hospital, Kirkeveien 166, 0407 Oslo (Norway)

    2003-06-01

    Our purpose was to compare the quality of ureteral imaging in pediatric patients using two different MR sequences: the non-enhanced heavily T2-weighted (W) turbo spin-echo sequence (TSE) and the gadolinium-enhanced T1W fast-field-echo sequence (T1 FFE). An experimental study on three pigs was first performed. The TSE, before and after furosemide injection, was followed by the T1 FFE sequence. The clinical study included 11 infants and 10 children. With some modifications the same MR parameters and techniques were used as in the animal study. The TSE with TR 8000 ms and TE 650 ms implied 6 radial stacks each of 40 mm thickness. The T1 FFE included TR 18 ms, TE 2.9 ms, flip angle 60, and 50 slices with thickness 0.7 mm. After post-processing, image reconstructions qualitative and quantitative analysis were performed. Complete visualization of the ureters was achieved in 35 of 42 (83%) cases. Seventy-four percent of the ureters were completely visualized with T1 FFE compared with only 19% with TSE. Sixty-nine percent of the ureters were better imaged with T1 FFE than TSE and 21% equally well imaged. Four ureters (10%), either obstructed or due to poor renal function, were better imaged with TSE. The two sequences are complementary. Visualization of non-obstructed ureters is excellent with T1 FFE and the sequence is superior to TSE. The TSE, however, may be equal to or even better than T1 FFE in visualizing obstructed ureters or ureters draining malfunctioning kidneys. (orig.)

  9. Risk and safety of pediatric sedation/anesthesia for procedures outside the operating room.

    Science.gov (United States)

    Cravero, Joseph P

    2009-08-01

    Sedation and anesthesia outside the operating room represents a rapidly growing field of practice that involves a number of different specialty providers including anesthesiology. The literature surrounding this work is found in a variety of journals - many outside anesthesiology. This review is intended to inform readers about the current status of risk and safety involving sedation/anesthesia for tests and minor procedures utilizing a wide range of sources. Two large database studies have helped to define the frequency and nature of adverse events in pediatric sedation/anesthesia practice from a multispecialty perspective. A number of papers describing respiratory and hemodynamic aspects of dexmedetomidine sedation have also been published. Finally, a number of studies relating to training sedation providers, reporting of sedation adverse events, sedation for vulnerable populations, and (in particular) ketamine sedation adverse respiratory events have also come to light. The latest publications continue to document a relatively low risk to pediatric sedation yet also warn us about the potential adverse events in this field. The results help to define competencies required to deliver pediatric sedation and make this practice even safer. Particularly interesting are new jargon and methodologies for defining adverse events and the use of new methods for training sedation providers.

  10. Safety enhancement through calibration and maintenance

    International Nuclear Information System (INIS)

    Mohammad Ali Khalid; Taiman Kadni

    2000-01-01

    Although radiation causes an alarming effect to living organism, it has been accepted for diagnostic and therapy in medicine as well as quality control and test method in industry. Due to the benefit gained, public at large is willing to accept the risk on condition that proper protection and safety standard is implemented and practised. Instrument plays a very important role not only in generation radiation but also measuring it. Therefore to ensure safety it is fair to say that all instrument must be calibrated to a certain standard and maintained to operate to its design specifications from time to time. (author)

  11. Safety and feasibility of inpatient exercise training in pediatric heart failure: a preliminary report.

    Science.gov (United States)

    McBride, Michael G; Binder, Tracy Jo; Paridon, Stephen M

    2007-01-01

    To determine the safety and feasibility of an inpatient exercise training program for a group of pediatric heart transplantation candidates on multiple inotropic support. Children with end-stage heart disease often require heart transplantation. Currently, no data exist on the safety and feasibility of an inpatient exercise training program in pediatric patients awaiting heart transplantation while on inotropic support. Twenty ambulatory patients (11 male; age, 13.6 +/- 3.2 years) were admitted, listed, and subsequently enrolled into an exercise training program while awaiting heart transplantation. Patient diagnoses consisted of dilated cardiomyopathy (n = 15), restrictive cardiomyopathy (n = 1), and failing single-ventricle physiology (n = 4). Inotropic support consisted of a combination of dobutamine, dopamine, or milrinone. Exercise sessions were scheduled three times a week lasting from 30 to 60 minutes and consisted of aerobic and musculoskeletal conditioning. Over 6.2 +/- 4.2 months, 1,251 of a possible 1,508 exercise training sessions were conducted, with a total of 615 hours (26.3 +/- 2.7 min/session) dedicated to low-intensity aerobic exercise. Reasons for noncompliance included a change in medical status, staffing, or patient cooperation. Two adverse episodes (seizures) occurred, neither of which resulted in termination from the program. No adverse episodes of hypotension or significant complex arrhythmias occurred. No complication of medication administration or loss of intravenous access occurred. Data from this study indicate that pediatric patients on inotropic support as a result of systemic ventricular or biventricular heart failure can safely participate in exercise training programs with relatively moderate to high compliance.

  12. Pediatric Nurses' Perceptions of Medication Safety and Medication Error: A Mixed Methods Study.

    Science.gov (United States)

    Alomari, Albara; Wilson, Val; Solman, Annette; Bajorek, Beata; Tinsley, Patricia

    2017-05-30

    This study aims to outline the current workplace culture of medication practice in a pediatric medical ward. The objective is to explore the perceptions of nurses in a pediatric clinical setting as to why medication administration errors occur. As nurses have a central role in the medication process, it is essential to explore nurses' perceptions of the factors influencing the medication process. Without this understanding, it is difficult to develop effective prevention strategies aimed at reducing medication administration errors. Previous studies were limited to exploring a single and specific aspect of medication safety. The methods used in these studies were limited to survey designs which may lead to incomplete or inadequate information being provided. This study is phase 1 on an action research project. Data collection included a direct observation of nurses during medication preparation and administration, audit based on the medication policy, and guidelines and focus groups with nursing staff. A thematic analysis was undertaken by each author independently to analyze the observation notes and focus group transcripts. Simple descriptive statistics were used to analyze the audit data. The study was conducted in a specialized pediatric medical ward. Four key themes were identified from the combined quantitative and qualitative data: (1) understanding medication errors, (2) the busy-ness of nurses, (3) the physical environment, and (4) compliance with medication policy and practice guidelines. Workload, frequent interruptions to process, poor physical environment design, lack of preparation space, and impractical medication policies are identified as barriers to safe medication practice. Overcoming these barriers requires organizations to review medication process policies and engage nurses more in medication safety research and in designing clinical guidelines for their own practice.

  13. Health Professionals and hand hygiene: a question of pediatric patient safety

    Directory of Open Access Journals (Sweden)

    Daisy Zanchi de Abreu Botene

    Full Text Available This paper is a qualitative descriptive study, which aims to analyze how the academic education concerning hand hygiene contributes to the pediatric patient safety. This research was developed in an university hospital in Southern Brazil, in the pediatric unit, during the period of August to December, 2012. Sixteen healthcare professionals participated (doctors, nurses and physical therapists. A semi-structured interview was used to gather information. Data was organized by the software QSR Nvivo and analyzed using the content analysis technique. The results allowed us to list two thematic categories: "Hand hygiene and healthcare professionals' academic education"; and "Hand hygiene and professional life". The first thematic category will be presented in this paper. It was identified that the academic education contributes in an ineffective way to the creation of a patient safety culture. According to the professionals, there are gaps during the educational process regarding hand hygiene. The topic is treated in an ineffective and not very significant way to the learning and adhesion of hand hygiene in the professional life. It is recommended that, for the internalization of the practice by future professionals, a transversal, continuous and systematical approach is adopted during the professional's training, evaluations concerning the hand hygiene are done throughout the academic life as well as healthcare professors bethink the topic.

  14. Enhancing Safety at Airline Operations Control Centre

    Directory of Open Access Journals (Sweden)

    Lukáš Řasa

    2015-04-01

    Full Text Available In recent years a new term of Safety Management System (SMS has been introduced into aviation legislation. This system is being adopted by airline operators. One of the groundbased actors of everyday operations is Operations Control Centre (OCC. The goal of this article has been to identify and assess risks and dangers which occur at OCC and create a template for OCC implementation into SMS.

  15. Advanced repair methods for enhanced reactor safety

    International Nuclear Information System (INIS)

    Kornfeldt, H.

    1993-01-01

    A few innovative concepts are described of the ABB Atom Service Division for repair and mitigation techniques for primary systems in nuclear power plants. The concepts are based on Shape Memory Alloy (SMA) technology. A basic feature of all methods is that welding and component replacement is being avoided and the radiation dose imposed on maintenance personnel reduced. The SMA-based repair methods give plant operators new ways to meet increased safety standards and rising maintenance costs. (Z.S.) 4 figs

  16. Physician attitudes towards pharmacological cognitive enhancement: safety concerns are paramount.

    Directory of Open Access Journals (Sweden)

    Opeyemi C Banjo

    2010-12-01

    Full Text Available The ethical dimensions of pharmacological cognitive enhancement have been widely discussed in academic circles and the popular media, but missing from the conversation have been the perspectives of physicians - key decision makers in the adoption of new technologies into medical practice. We queried primary care physicians in major urban centers in Canada and the United States with the aim of understanding their attitudes towards cognitive enhancement. Our primary hypothesis was that physicians would be more comfortable prescribing cognitive enhancers to older patients than to young adults. Physicians were presented with a hypothetical pharmaceutical cognitive enhancer that had been approved by the regulatory authorities for use in healthy adults, and was characterized as being safe, effective, and without significant adverse side effects. Respondents overwhelmingly reported increasing comfort with prescribing cognitive enhancers as the patient age increased from 25 to 65. When asked about their comfort with prescribing extant drugs that might be considered enhancements (sildenafil, modafinil, and methylphenidate or our hypothetical cognitive enhancer to a normal, healthy 40 year old, physicians were more comfortable prescribing sildenafil than any of the other three agents. When queried as to the reasons they answered as they did, the most prominent concerns physicians expressed were issues of safety that were not offset by the benefit afforded the individual, even in the face of explicit safety claims. Moreover, many physicians indicated that they viewed safety claims with considerable skepticism. It has become routine for safety to be raised and summarily dismissed as an issue in the debate over pharmacological cognitive enhancement; the observation that physicians were so skeptical in the face of explicit safety claims suggests that such a conclusion may be premature. Thus, physician attitudes suggest that greater weight be placed upon the

  17. Quality of prescription of high-alert medication and patient safety in pediatric emergency

    Directory of Open Access Journals (Sweden)

    V. Vieira de Melo

    2014-01-01

    Full Text Available Objective: Verify the importance of compliance by prescribed doses of high-alert medications in unit of pediatric emergency in patient safety. Method: This was a cross-sectional descriptive study conducted in a unit of pediatric emergency, for March to April of 2012. This study included all prescriptions that contained at least one high-alert medication, excluding all of others. The data were analyzed using Microsoft Office Excel® version 2007, and the study was approved by the Research Ethics Committee of the Hospital. Results: This study included prescriptions for 100 patients with a mean age of 5.2 ± 4.2 years. Were identified 983 (40.1% high-alert medications (21 different, with predominance of injectable solutions (834, 84,8%, and of these 727 (73.95% were electrolytes. The analysis of the dose was possible for 641 electrolytes and 104 non-electrolytes, being the dose inadequacies observed for some medications. Was observed concentration absent to 189 (18.9% prescribed medications, these with liquid pharmaceutical form or aerosol. Was observed also the absence of maximum dose for 8 (36.3% prescribed drugs “if necessary”. Conclusión: The inadequacies of doses of high-alert medications identified in this study may compromise patient safety, demonstrating the importance of knowledge of multidisciplinary health care team by this subject, in this context, it is noteworthy that the acting of a clinical pharmacist together with the health multidisciplined team can contributes with the review of drug prescriptions, reducing potential errors and collaborating with patient safety.

  18. Pediatric dental sedation: challenges and opportunities

    OpenAIRE

    Nelson, Travis; Xu,Zheng

    2015-01-01

    Travis M Nelson, Zheng Xu Department of Pediatric Dentistry, University of Washington, Seattle, WA, USA Abstract: High levels of dental caries, challenging child behavior, and parent expectations support a need for sedation in pediatric dentistry. This paper reviews modern developments in pediatric sedation with a focus on implementing techniques to enhance success and patient safety. In recent years, sedation for dental procedures has been implicated in a disproportionate number of cases th...

  19. Defining safety culture and the nexus between safety goals and safety culture. 4. Enhancing Safety Culture Through the Establishment of Safety Goals

    International Nuclear Information System (INIS)

    Tateiwa, Kenji; Miyata, Koichi; Yahagi, Kimitoshi

    2001-01-01

    Safety culture is the perception of each individual and organization of a nuclear power plant that safety is the first priority, and at Tokyo Electric Power Company (TEPCO), we have been practicing it in everyday activities. On the other hand, with the demand for competitiveness of nuclear power becoming even more intense these days, we need to pursue efficient management while maintaining the safety level at the same time. Below, we discuss how to achieve compatibility between safety culture and efficient management as well as enhance safety culture. Discussion at Tepco: safety culture-nurturing activities such as the following are being implemented: 1. informing the employees of the 'Declaration of Safety Promotion' by handing out brochures and posting it on the intranet home page; 2. publishing safety culture reports covering stories on safety culture of other industry sectors, recent movements on safety culture, etc.; 3. conducting periodic questionnaires to employees to grasp how deeply safety culture is being established; 4. carrying out educational programs to learn from past cases inside and outside the nuclear industry; 5. committing to common ownership of information with the public. The current status of safety culture in Japan sometimes seems to be biased to the quest of ultimate safety; rephrasing it, there have been few discussions regarding the sufficiency of the quantitative safety level in conjunction with the safety culture. Safety culture is one of the most crucial foundations guaranteeing the plant's safety, and for example, the plant safety level evaluated by probabilistic safety assessment (PSA) could be said to be valid only on the ground that a sound and sufficient safety culture exists. Although there is no doubt that the safety culture is a fundamental and important attitude of an individual and organization that keeps safety the first priority, the safety culture in itself should not be considered an obstruction to efforts to implement

  20. [Informed consent consultation as a part of patient safety in pediatric traumatology].

    Science.gov (United States)

    Kraus, R; Heberer, J

    2013-10-01

    In pediatric traumatology as in any other surgical specialty, every treatment measure has to be protected by an adequate clarification. A legally effective clarification has to cover various aspects, such as diagnosis, treatment, risk and safety clarification and leads to an informed consent consultation. The contents of this informed consent discussion must be documented. The nature and extent of clarification, among other things depend on the urgency of the procedure and in an emergency it can be dispensed with in pediatric traumatology. In the case of minors the conversation must be conducted basically in the presence of both parents as they alone are legally entitled to give approval. General treatment proxies are not allowed. If it is not possible to talk to both parents the physician is allowed to trust that the parent present represents the will of the absent parent. Intervention cannot be carried out against the will of adolescents capable of self-determination even with the consent of the parents. The application of these rules is illustrated by means of practical examples.

  1. The Safety and Efficacy of the Continuous Peripheral Nerve Block in Postoperative Analgesia of Pediatric Patients

    Directory of Open Access Journals (Sweden)

    Dušica Simić

    2018-03-01

    Full Text Available Postoperative analgesia is imperative in the youngest patients. Pain, especially if experienced during childhood, has numerous adverse effects—from psychological, through complications of the underlying disease (prolonged treatment, hospital stay, and increased costs of the treatment to an increase in the incidence of death due to the onset of the systemic inflammatory response. Peripheral blocks provide analgesia for 12–16 h, and are safer due to rare side effects that are easier to treat. The continuous peripheral block (CPNB has been increasingly used in recent years for complete and prolonged analgesia of pediatric patients, as well as a part of multidisciplinary treatment of complex regional pain syndrome. It has been shown that outpatient CPNB reduces the need for parenteral administration of opioid analgetics. It has also been proved that this technique can be used in pediatric patients in home conditions. Safety of CPNB is based on the increasing use of ultrasound as well as on the introduction of single enantiomers local anesthetics (ropivacaine and levobupivacaine in lower concentrations. It is possible to discharge patient home with catheter, but it is necessary to provide adequate education for staff, patients, and parents, as well as to have dedicated anesthesiology team. Postoperative period without major pain raises the morale of the child, parents. and medical staff.

  2. Documentation of pediatric drug safety in manufacturers' product monographs: a cross-sectional evaluation of the canadian compendium of pharmaceuticals and specialities.

    Science.gov (United States)

    Uppal, Navjeet K; Dupuis, Lee L; Parshuram, Christopher S

    2008-01-01

    To describe the provision of pediatric drug safety information in a national formulary of manufacturers' drug product monographs. We performed a cross-sectional evaluation of comprehensive product monographs contained in the 2005 Canadian Compendium of Pharmaceuticals and Specialities (CPS). We abstracted data describing indications for prescription, statements about pediatric safety, available preparations, and provision of dosing guidelines. For each monograph we classified pediatric safety data as either present, present but limited or absent. We then described the pediatric safety data in CPS monographs for drugs listed in the published formulary of the Hospital for Sick Children, Toronto, Ontario, Canada. A total of 2232 product monographs were screened; 684 were excluded and 1548 (66%) were further analyzed. 1462 (94%) had indications that did not exclude children. Pediatric safety information was present in 592 (38%), present but limited in 148 (10%), and absent in 808 (52%) drug monographs. Safety statements were absent in 224 (14%) drug monographs that provided both dosing guidelines and formulations suitable for administration to children, and in 214 (52%) of 411 drugs in the pediatric hospital formulary. We evaluated a widely available national source of pediatric prescribing information. Safety data for children was not mentioned in more than half of the product monographs. Moreover, the provision of safety data was discordant with indications for prescription, the availability of pediatric formulations, and dosing guidelines within the monographs, and with inclusion in a pediatric hospital formulary. Our study suggests that the presentation of pediatric safety data in drug product monographs can be improved to better inform prescribing and to optimize pharmacotherapy in children.

  3. Enhancing Safety of Artificially Ventilated Patients Using Ambient Process Analysis.

    Science.gov (United States)

    Lins, Christian; Gerka, Alexander; Lüpkes, Christian; Röhrig, Rainer; Hein, Andreas

    2018-01-01

    In this paper, we present an approach for enhancing the safety of artificially ventilated patients using ambient process analysis. We propose to use an analysis system consisting of low-cost ambient sensors such as power sensor, RGB-D sensor, passage detector, and matrix infrared temperature sensor to reduce risks for artificially ventilated patients in both home and clinical environments. We describe the system concept and our implementation and show how the system can contribute to patient safety.

  4. Regional anesthesia for pediatric knee surgery: a review of the indications, procedures, outcomes, safety, and challenges

    Directory of Open Access Journals (Sweden)

    Muhly WT

    2015-11-01

    Full Text Available Wallis T Muhly, Harshad G Gurnaney, Arjunan GaneshDepartment of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Pennsylvania, PA, USAAbstract: The indications for surgery on the knee in children and adolescents share some similarity to adult practice in that there are an increasing number of sports-related injuries requiring surgical repair. In addition, there are some unique age-related conditions or congenital abnormalities that may present as indications for orthopedic intervention at the level of the knee. The efficacy and safety of peripheral nerve blocks (PNBs for postoperative analgesia following orthopedic surgery has been well established in adults. Recent studies have also demonstrated earlier functional recovery after surgery in patients who received PNBs. In children, PNB is gaining popularity, and increasing data are emerging to demonstrate the feasibility, efficacy, and safety in this population. In this paper, we will review some of the most common indications for surgery involving the knee in children and the anatomy of knee, associated dermatomal and osteotomal innervation, and the PNBs most commonly used to produce analgesia at the level of the knee. We will review the evidence in support of regional anesthesia in children in terms of both the quality conferred to the immediate postoperative care and the role of continuous PNBs in maintaining effective analgesia following discharge. Also we will discuss some of the subtle challenges in utilizing regional anesthesia in the pediatric patient including the use of general anesthesia when performing regional anesthesia and the issue of monitoring for compartment syndrome. Finally, we will offer some thoughts about areas of practice that are in need of further investigation.Keywords: pediatric surgery, regional anesthesia, analgesia, knee surgery

  5. PNRA Process for Utilizing Experience Feedback for Enhancing Nuclear Safety

    International Nuclear Information System (INIS)

    Shah, Z.H.

    2016-01-01

    One of the elements essential for any organization to become a learning organization is to learn from its own and others experience. The importance of utilizing experience feedback for enhancing operational safety is highlighted in nuclear industry again and again and this has resulted in establishment of several national and international forums. In addition, IAEA action plan on nuclear safety issued after Fukushima accident further highlighted the importance of experience sharing among nuclear community to enhance global nuclear safety regime. PNRA utilizes operating experience feedback gathered through different sources in order to improve its regulatory processes. During the review of licensing submissions, special emphasis is given to utilize the lessons learnt from experience feedback relating to nuclear industry within and outside the country. This emphasis has gradually resulted in various safety improvements in the facilities and processes. Accordingly, PNRA has developed a systematic process of evaluation of international operating experience feedback with the aim to create safety conscious approach. This process includes collecting information from different international forums such as IAEA, regulatory bodies of other countries and useful feedback of past accidents followed by its screening, evaluation and suggesting recommendations both for PNRA and its licensees. As a result of this process, several improvements concerning regulatory inspection plans of PNRA as well as in regulatory decision making and operational practices of licensees have been highlighted. This paper will present PNRA approach for utilizing experience feedback in its regulatory processes for enhancing / improving nuclear safety. (author)

  6. Enhancing Pediatric Trainees' and Students' Knowledge in Providing Care to Transgender Youth.

    Science.gov (United States)

    Vance, Stanley R; Deutsch, Madeline B; Rosenthal, Stephen M; Buckelew, Sara M

    2017-04-01

    To enhance pediatric trainees' and students' knowledge of the psychosocial and medical issues facing transgender youth through a comprehensive curriculum. During the 2015-2016 academic year, we administered a transgender youth curriculum to fourth-year medical students, pediatric interns, psychiatry interns, and nurse practitioner students on their 1-month adolescent and young adult medicine rotation. The curriculum included six interactive, online modules and an observational experience in a multidisciplinary pediatric gender clinic. The online modules had a primary care focus with topics of general transgender terminology, taking a gender history, taking a psychosocial history, performing a sensitive physical examination, and formulating an assessment, psychosocial plan, and medical plan. At the completion of the curriculum, learners completed an evaluation that assessed change in perceived awareness and knowledge of transgender-related issues and learner satisfaction with the curriculum. Twenty learners participated in the curriculum with 100% completing the curriculum evaluations, 100% reporting completing all six online modules, and 90% attending the gender clinic. Learners demonstrated a statistically significant improvement in all pre-post knowledge/awareness measures. On a Likert scale where 5 indicated very satisfied, learners' mean rating of the quality of the curriculum was 4.5 ± .7; quality of the modules was 4.4 ± .7; and satisfaction with the observational experience was 4.5 ± .8. A comprehensive curriculum comprised interactive online modules and an observational experience in a pediatric gender clinic was effective at improving pediatric learners' perceived knowledge of the medical and psychosocial issues facing transgender youth. Learners also highly valued the curriculum. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  7. Experience gained in enhancing operational safety at ComEd`s nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Elias, D [Commonwealth Edison Co. (United States)

    1997-09-01

    The following aspects of experience gained in enhancing operational safety at Comed`s nuclear power plants are discussed: nuclear safety policy; centralization/decentralization; typical nuclear operating organization; safety review boards; human performance enhancement; elements of effective nuclear oversight.

  8. Experience gained in enhancing operational safety at ComEd's nuclear power plants

    International Nuclear Information System (INIS)

    Elias, D.

    1997-01-01

    The following aspects of experience gained in enhancing operational safety at Comed's nuclear power plants are discussed: nuclear safety policy; centralization/decentralization; typical nuclear operating organization; safety review boards; human performance enhancement; elements of effective nuclear oversight

  9. Leadership and Safety Management: Regulatory Initiatives for Enhancing Nuclear Safety in the Republic of Korea

    International Nuclear Information System (INIS)

    Yun, C.H.; Park, Y.W.; Choi, K.S.

    2010-01-01

    Since the construction of the first nuclear power plant (NPP) in the Republic of Korea in 1978, a high level of nuclear safety has continued to be maintained. This has been the important basis on which the continuous construction of NPPs has been possible in the country. To date, regulatory initiatives, leaderships and strategies adopting well harmonized regulatory systems and practices of advanced countries have contributed to improving the effectiveness and efficiency of safety regulation and further enhancing nuclear safety. The outcomes have resulted in a high level of safety and performance of Korean NPPs, attributing largely to the safety promotion policy. Recently, with the support of the Korean Ministry of Education, Science and Technology (MEST), the Korea Institute of Nuclear Safety (KINS) established the International Nuclear Safety School and created a Nuclear Safety Master's Degree Programme. Further, it developed multilateral and bilateral cooperation with other agencies to promote global nuclear safety, with the aim of providing knowledge and training to new entrant countries in establishing the safety infrastructure necessary for ensuring an acceptable level of nuclear safety. (author)

  10. Patient Safety Culture Survey in Pediatric Complex Care Settings: A Factor Analysis.

    Science.gov (United States)

    Hessels, Amanda J; Murray, Meghan; Cohen, Bevin; Larson, Elaine L

    2017-04-19

    Children with complex medical needs are increasing in number and demanding the services of pediatric long-term care facilities (pLTC), which require a focus on patient safety culture (PSC). However, no tool to measure PSC has been tested in this unique hybrid acute care-residential setting. The objective of this study was to evaluate the psychometric properties of the Nursing Home Survey on Patient Safety Culture tool slightly modified for use in the pLTC setting. Factor analyses were performed on data collected from 239 staff at 3 pLTC in 2012. Items were screened by principal axis factoring, and the original structure was tested using confirmatory factor analysis. Exploratory factor analysis was conducted to identify the best model fit for the pLTC data, and factor reliability was assessed by Cronbach alpha. The extracted, rotated factor solution suggested items in 4 (staffing, nonpunitive response to mistakes, communication openness, and organizational learning) of the original 12 dimensions may not be a good fit for this population. Nevertheless, in the pLTC setting, both the original and the modified factor solutions demonstrated similar reliabilities to the published consistencies of the survey when tested in adult nursing homes and the items factored nearly identically as theorized. This study demonstrates that the Nursing Home Survey on Patient Safety Culture with minimal modification may be an appropriate instrument to measure PSC in pLTC settings. Additional psychometric testing is recommended to further validate the use of this instrument in this setting, including examining the relationship to safety outcomes. Increased use will yield data for benchmarking purposes across these specialized settings to inform frontline workers and organizational leaders of areas of strength and opportunity for improvement.

  11. Implementing a pediatric obesity care guideline in a freestanding children's hospital to improve child safety and hospital preparedness.

    Science.gov (United States)

    Porter, Renee M; Thrasher, Jodi; Krebs, Nancy F

    2012-12-01

    Medical and surgical care of children with severe obesity is complicated and requires recognition of the problem, appropriate equipment, and safe management. There is little literature describing patient, provider, and institutional needs for the severely obese pediatric patient. Nonetheless, the limited data suggest 3 broad categories of needs unique to this population: (a) airway management, (b) drug dosing and pharmacology, and (c) equipment and infrastructure. We describe an opportunity at the Children's Hospital Colorado to better prepare and optimize care for this patient population by creation of a Pediatric Obesity Care Guideline that focused on key areas of quality and safety. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Safety culture in nuclear installations. Guidance for the use in enhancement of safety culture

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-12-01

    IAEA Assessment of the Safety Culture in Organizations Team (ASCOT) activities, significant work has been done with respect to indicators to determine the effectiveness of safety culture. IAEA-TECDOC-860, ASCOT Guidelines, issued in 1996, proposed key indicators for the different areas that need to be considered when assessing safety culture. A number of other INSAG reports and Safety Series reports have been published by the IAEA to provide information that will be helpful to organizations that are interested in developing or enhancing their safety culture. Recently the IAEA perspective on safety culture has broadened even further with attention focused on obtaining a deeper understanding of the actual concept of culture and particularly organizational culture. The approach supplements the IAEA previous efforts to promote a better understanding of safety culture, but does not replace them. It can be argued that the IAEA perspective of safety culture has evolved in stages. The first stage was associated with the definition of safety culture; the second stage with how to assess it; the third stage on how to enhance it; and the fourth and current stage on obtaining a deeper understanding of the actual concept of culture. The hope is that the more sophisticated understanding obtained in the fourth stage will lead to improved ways of assessing safety culture, and also increase our ability to detect changes in safety culture at an early point in time. This ability will enable corrective actions to be taken to avoid the consequences of a deteriorating safety culture.

  13. Safety culture in nuclear installations. Guidance for the use in enhancement of safety culture

    International Nuclear Information System (INIS)

    2002-12-01

    IAEA Assessment of the Safety Culture in Organizations Team (ASCOT) activities, significant work has been done with respect to indicators to determine the effectiveness of safety culture. IAEA-TECDOC-860, ASCOT Guidelines, issued in 1996, proposed key indicators for the different areas that need to be considered when assessing safety culture. A number of other INSAG reports and Safety Series reports have been published by the IAEA to provide information that will be helpful to organizations that are interested in developing or enhancing their safety culture. Recently the IAEA perspective on safety culture has broadened even further with attention focused on obtaining a deeper understanding of the actual concept of culture and particularly organizational culture. The approach supplements the IAEA previous efforts to promote a better understanding of safety culture, but does not replace them. It can be argued that the IAEA perspective of safety culture has evolved in stages. The first stage was associated with the definition of safety culture; the second stage with how to assess it; the third stage on how to enhance it; and the fourth and current stage on obtaining a deeper understanding of the actual concept of culture. The hope is that the more sophisticated understanding obtained in the fourth stage will lead to improved ways of assessing safety culture, and also increase our ability to detect changes in safety culture at an early point in time. This ability will enable corrective actions to be taken to avoid the consequences of a deteriorating safety culture

  14. [Analysis of development, safety and efficacy of percutaneous nephrolithotomy for management of upper urinary tract calculi in pediatric patients].

    Science.gov (United States)

    Yu, L P; Xu, T

    2017-08-18

    To evaluate the development, safety and efficacy of percutaneous nephrolithotomy(PNL) for management of upper urinary tract calculi in pediatric patients. In the study, 77 pediatric patients undergoing 87 PNLs through mini or standard tract for upper urinary tract calculi between January 2005 and December 2016 in Peking University People's hospital were reviewed, including 69 renal calculi, 6 upper ureteral calculi, 12 renal and upper ureteral calculi, 35 single calculi, 43 multiple calculi and 9 staghorn calculi. The development and efficacy of PNL in pediatric patients were studied by analyzing the characteristics and clinical indexes, and by reviewing the associated literature. The Clavien classification system was used to evaluate the complications after PNL. A total of 87 PNLs were performed in 77 pediatric patients. Eighty-one upper urinary tract calculi were managed through a single tract(93.1%), 5 pediatric patients were managed through 2 tracts(5.7%), and 1 pediatric patient was managed through 3 tracts(1.2%). The mean operating time was (77.0±29.8) min. The stone-free rate after one session was 100% for single calculi and 71.2% for multiple or staghorn calculi, 5(5.8%) children underwent auxiliary procedure to remove the residual calculi and the final stone-free rate of PNL was 88.5%. One of the main complications of pediatric PNL was fever. Sixteen (18.4%) had moderate fever(38-39 °C), 5 (5.7%) had high fever (39-40 °C) and there were no severe complications of infection, such as sepsis or septic shock. The mean hemoglobin loss was (10.3±16.1) g/L and the serum creatinine rise was (7.0±13.3) μmol/L. One(1.2%) pediatric patient suffered ureteroscopic lithotripsy because of the obstruction by the residual stone in ureter. No injury of organs or retroperitoneal urinary extravasation occurred. General assessment of the complications showed Clavien grade I complications in 14 (16.1%) pediatric patients, grade II in 7(8.0%) children and grade III in 1

  15. New enhancements to SCALE for criticality safety analysis

    International Nuclear Information System (INIS)

    Hollenbach, D.F.; Bowman, S.M.; Petrie, L.M.; Parks, C.V.

    1995-01-01

    As the speed, available memory, and reliability of computer hardware increases and the cost decreases, the complexity and usability of computer software will increase, taking advantage of the new hardware capabilities. Computer programs today must be more flexible and user friendly than those of the past. Within available resources, the SCALE staff at Oak Ridge National Laboratory (ORNL) is committed to upgrading its computer codes to keep pace with the current level of technology. This paper examines recent additions and enhancements to the criticality safety analysis sections of the SCALE code package. These recent additions and enhancements made to SCALE can be divided into nine categories: (1) new analytical computer codes, (2) new cross-section libraries, (3) new criticality search sequences, (4) enhanced graphical capabilities, (5) additional KENO enhancements, (6) enhanced resonance processing capabilities, (7) enhanced material information processing capabilities, (8) portability of the SCALE code package, and (9) other minor enhancements, modifications, and corrections to SCALE. Each of these additions and enhancements to the criticality safety analysis capabilities of the SCALE code system are discussed below

  16. What You Should Know About Pediatric Nuclear Medicine and Radiation Safety

    Science.gov (United States)

    ... What is nuclear medicine? Nuclear medicine uses radioactive isotopes to create pictures of the human body. These ... The Society for Pediatric Radiology and the Pediatric Imaging Council of ... medical physics and radiation protection. More information can be ...

  17. Safety and feasibility of transcranial direct current stimulation in pediatric hemiparesis: randomized controlled preliminary study.

    Science.gov (United States)

    Gillick, Bernadette T; Feyma, Tim; Menk, Jeremiah; Usset, Michelle; Vaith, Amy; Wood, Teddi Jean; Worthington, Rebecca; Krach, Linda E

    2015-03-01

    Transcranial direct current stimulation (tDCS) is a form of noninvasive brain stimulation that has shown improved adult stroke outcomes. Applying tDCS in children with congenital hemiparesis has not yet been explored. The primary objective of this study was to explore the safety and feasibility of single-session tDCS through an adverse events profile and symptom assessment within a double-blind, randomized placebo-controlled preliminary study in children with congenital hemiparesis. A secondary objective was to assess the stability of hand and cognitive function. A double-blind, randomized placebo-controlled pretest/posttest/follow-up study was conducted. The study was conducted in a university pediatric research laboratory. Thirteen children, ages 7 to 18 years, with congenital hemiparesis participated. Adverse events/safety assessment and hand function were measured. Participants were randomly assigned to either an intervention group or a control group, with safety and functional assessments at pretest, at posttest on the same day, and at a 1-week follow-up session. An intervention of 10 minutes of 0.7 mA tDCS was applied to bilateral primary motor cortices. The tDCS intervention was considered safe if there was no individual decline of 25% or group decline of 2 standard deviations for motor evoked potentials (MEPs) and behavioral data and no report of adverse events. No major adverse events were found, including no seizures. Two participants did not complete the study due to lack of MEP and discomfort. For the 11 participants who completed the study, group differences in MEPs and behavioral data did not exceed 2 standard deviations in those who received the tDCS (n=5) and those in the control group (n=6). The study was completed without the need for stopping per medical monitor and biostatisticial analysis. A limitation of the study was the small sample size, with data available for 11 participants. Based on the results of this study, tDCS appears to be safe

  18. An evaluation of the safety and efficacy of bimatoprost for eyelash growth in pediatric subjects

    Directory of Open Access Journals (Sweden)

    Borchert M

    2016-03-01

    Full Text Available Mark Borchert,1 Suzanne Bruce,2 David Wirta,3 Steven G Yoelin,4 Sungwook Lee,5 Cheri Mao,5 Amanda VanDenburgh5 1Children’s Hospital Los Angeles, Los Angeles, CA, USA; 2Suzanne Bruce and Associates, PA, Houston, TX, USA; 3David Wirta and Associates, Newport Beach, CA, USA; 4Medical Associates Inc., Newport Beach, CA, USA; 5Allergan plc, Irvine, CA, USA Purpose: Evaluate the safety and effectiveness of bimatoprost 0.03% for treatment of eyelash hypotrichosis in a pediatric population. Patients and methods: This multicenter, randomized, double-masked, parallel-group study was conducted at seven sites in the US and Brazil. Subjects with eyelash hypotrichosis caused by chemotherapy or alopecia areata (aged 5–17 years or healthy adolescents aged 15–17 years were enrolled (N=71. Subjects applied bimatoprost 0.03% or vehicle to upper eyelid margins once nightly for 4 months and were followed for 1 month post-treatment. Eyelash prominence was assessed using the validated 4-grade Global Eyelash Assessment scale with photonumeric guide. Changes in eyelash length, thickness, and darkness were measured by digital image analysis. Safety was assessed by adverse events and ophthalmic observations. Results: Eyelash prominence improved in a significantly greater proportion of subjects treated with bimatoprost compared with vehicle at month 4 (70.8% versus 26.1%; P<0.001. This benefit was sustained at month 5 post-treatment assessment. Digital image analysis measures were significantly improved with bimatoprost. Significant treatment benefits with bimatoprost versus vehicle were evident among the healthy adolescents but not in the postchemotherapy or alopecia areata subgroups. The safety profile of bimatoprost was consistent with previous studies in adults. Conclusion: Bimatoprost was safe and well tolerated in pediatric subjects with eyelash hypotrichosis. In this study with limited sample size, subgroup analyses showed that treatment was effective in

  19. Knowledge management and networking for enhancing nuclear safety

    International Nuclear Information System (INIS)

    Taniguchi, T.; Lederman, L.

    2004-01-01

    Striving for innovative solutions to enhance efficiency of programme delivery and a wider outreach of its nuclear safety activities, the International Atomic Energy Agency (IAEA) has developed an Integrated Safety Approach as a platform for linking its safety related statutory functions and its many associated activities. The approach recognizes the vital importance of effective management of the knowledge base and builds on the integration between the IAEA's safety standards and all aspects of the provision for their application, including peer reviews and technical meetings to share lessons learned. The IAEA is using knowledge management techniques to develop process flows, map safety knowledge and to promote knowledge sharing. The first practical application was the establishment of a knowledge base related to safety aspects of ageing and long-term operation of nuclear power plants. The IAEA is also promoting and facilitating the establishment of regional nuclear and radiation safety networks to preserve existing knowledge and expertise as well as to strengthen sharing and creation of new knowledge in these fields. Prominent examples are the Asian Nuclear Safety Network established in the frame of the IAEA's Programme on the Safety of Nuclear Installations in South East Asia, Pacific and Far East Countries, and the Ibero-American Radiation Safety Network in the frame of the Ibero-American Forum of Nuclear Regulators. Results to date are most encouraging and suggest that this pioneer work should be extended to other regions and eventually to a global nuclear safety network. Responsive to the need of Member States, the IAEA Secretariat has prepared and made available a large number of up-to-date training packages in nuclear, radiation, transport and waste safety, using IAEA safety standards as a basis. It is also providing instruction to trainers in Member States on the use of these modules. This ensures that the material is properly used and that the IAEA

  20. Ultrasound-guided lumbar puncture in pediatric patients: technical success and safety.

    Science.gov (United States)

    Pierce, David B; Shivaram, Giri; Koo, Kevin S H; Shaw, Dennis W W; Meyer, Kirby F; Monroe, Eric J

    2018-06-01

    Disadvantages of fluoroscopically guided lumbar puncture include delivery of ionizing radiation and limited resolution of incompletely ossified posterior elements. Ultrasound (US) allows visualization of critical soft tissues and the cerebrospinal fluid (CSF) space without ionizing radiation. To determine the technical success and safety of US-guided lumbar puncture in pediatric patients. A retrospective review identified all patients referred to interventional radiology for lumbar puncture between June 2010 and June 2017. Patients who underwent lumbar puncture with fluoroscopic guidance alone were excluded. For the remaining procedures, technical success and procedural complications were assessed. Two hundred and one image-guided lumbar punctures in 161 patients were included. Eighty patients (43%) had previously failed landmark-based attempts. One hundred ninety-six (97.5%) patients underwent lumbar puncture. Five procedures (2.5%) were not attempted after US assessment, either due to a paucity of CSF or unsafe window for needle placement. Technical success was achieved in 187 (95.4%) of lumbar punctures attempted with US guidance. One hundred seventy-seven (90.3%) were technically successful with US alone (age range: 2 days-15 years, weight range: 1.9-53.1 kg) and an additional 10 (5.1%) were successful with US-guided thecal access and subsequent fluoroscopic confirmation. Three (1.5%) cases were unsuccessful with US guidance but were subsequently successful with fluoroscopic guidance. Of the 80 previously failed landmark-based lumbar punctures, 77 (96.3%) were successful with US guidance alone. There were no reported complications. US guidance is safe and effective for lumbar punctures and has specific advantages over fluoroscopy in pediatric patients.

  1. External Port Tissue Expansion in the Pediatric Population: Confirming Its Safety and Efficacy.

    Science.gov (United States)

    Azadgoli, Beina; Fahradyan, Artur; Wolfswinkel, Erik M; Tsuha, Michaela; Magee, William; Hammoudeh, Jeffrey A; Urata, Mark M; Howell, Lori K

    2018-06-01

    External filling ports in tissue expander-based reconstruction have the advantages of being associated with less pain and emotional distress. However, among practicing surgeons using tissue expansion, a theoretical concern remains regarding higher risk of infection. The authors' goal was to evaluate external port safety in the pediatric population by looking at the complications and overall success rate of reconstruction. A retrospective review of all patients undergoing tissue expansion using external ports at Children's Hospital Los Angeles between January of 2008 and June of 2016 was conducted. Patient demographic and perioperative data were collected and analyzed. Two hundred forty-one expanders were placed in 100 pediatric patients, resulting in 123 procedures for congenital and acquired conditions, with an average age at the time of surgery of 7.1 years (range, 1 month to 19.9 years) and average follow-up length of 2.5 years (range, 2.8 months to 8.8 years). The overall complication rate was 29.9 percent, and the infection rate was 17 percent. The majority of these cases were treated conservatively without additional need for surgery. Of 123 cases, 25 required premature expander removal because of complications. Despite early intervention, 21 of these cases underwent successful completion of their reconstruction according to the preoperative plan, resulting in an overall 96.7 percent success rate of tissue expander reconstruction. In children, who are often less tolerant of the pain and distress associated with internal port expansion, the authors encourage the use of external ports. This study found a high success rate in terms of successful reconstruction, with the majority of complications being treated conservatively. Therapeutic, IV.

  2. Interferon-Beta in Pediatric Multiple Sclerosis Patients: Safety in Short-Term Prescription

    Directory of Open Access Journals (Sweden)

    Amir Hadi Maghzi

    2012-02-01

    Full Text Available Introduction: None of the approved immunomodulatory drugs in adults Multiple Sclerosis (MS patients have been officially approved for the pediatric patients and are currently used off-label in this population. Objectives: In this study, we evaluated the effectiveness and tolerability of intramuscular interferon beta1-a (Avonex® and subcutaneously injected interferon beta1-b (Betaferon® in children with definite relapsing-remitting MS (RRMS. Thirteen patients aged younger than 16, who were recently diagnosed with definite RRMS according to the McDonalds criteria, were enrolled in this study. Six patients were treated with Avonex® 30 μg, intramuscularly every week, and seven patients were treated with Betaferon® 250 μg, subcutaneously every other day. All patients were treated with adult doses; initially interferon-beta was prescribed with half dose, and it was increased to full adult dose steadily. Results: Eleven girls and two boys, mean (SD age of 14.7 (1.9 years, were studied. Following nine months of using interferon-beta, nine patients (69.2% had no relapses and the remaining four, experienced only one relapse. The mean EDSS score was decreased significantly after the study period. Conclusion: The present study provides reasonable data for the use of interferon-beta in Pediatric MS due to lack of short-term complications and safety. Studies with larger sample size and longer follow up duration are required to shed light on the long term impact of the interferon-beta therapy in children.

  3. Use of a web site to enhance criticality safety training

    International Nuclear Information System (INIS)

    Huang, Song T.; Morman, James A.

    2003-01-01

    Establishment of the NCSP (Nuclear Criticality Safety Program) website represents one attempt by the NCS (Nuclear Criticality Safety) community to meet the need to enhance communication and disseminate NCS information to a wider audience. With the aging work force in this important technical field, there is a common recognition of the need to capture the corporate knowledge of these people and provide an easily accessible, web-based training opportunity to those people just entering the field of criticality safety. A multimedia-based site can provide a wide range of possibilities for criticality safety training. Training modules could range from simple text-based material, similar to the NCSET (Nuclear Criticality Safety Engineer Training) modules, to interactive web-based training classes, to video lecture series. For example, the Los Alamos National Laboratory video series of interviews with pioneers of criticality safety could easily be incorporated into training modules. Obviously, the development of such a program depends largely upon the need and participation of experts who share the same vision and enthusiasm of training the next generation of criticality safety engineers. The NCSP website is just one example of the potential benefits that web-based training can offer. You are encouraged to browse the NCSP website at http://ncsp.llnl.gov. We solicit your ideas in the training of future NCS engineers and welcome your participation with us in developing future multimedia training modules. (author)

  4. Enhancing Road Safety Behaviour Using a Psychological and Spiritual Approaches

    Directory of Open Access Journals (Sweden)

    Ghous Mohd Tarmizi

    2017-01-01

    Full Text Available Main causes of accident is due to driver itself that is influenced by their bad attitude while driving. Human attitude is closely related to the human psychology. Apart from that, spiritual aspect also influence human attitude. Hence, this study carried out to improve driver safety using a new approach through psychology and spiritual factors. Objectives of this study are to identify then analyze factors of psychological and spiritual that contribute towards safety driving. A self-administered questionnaire were distributed among 256 respondents from various type of background. An analysis descriptive statistics show demographic and experience of respondents. Chi-square analysis showed only education level and traffic summon are significant to safety driving. Furthermore, correlation analysis shows psychological factors has strong linear relationship on attitude of drivers towards safety driving while spiritual factor, the perception of the spiritual and practices, both have a strong relationship to safety driving. Regression analysis demonstrates boths psychological and spiritual factors have strong evidence and significant relationship with safety driving. Thus, it can be identified that spiritual psychological factors encourage drivers to drive more safely and reduce road accidents. Therefore, this study propose useful guidelines to related agencies in order to enhance safety among drivers to be able drive safely on the road.

  5. Enhancing Safety Culture in Complex Nuclear Industry Projects

    International Nuclear Information System (INIS)

    Gotcheva, N.

    2016-01-01

    This paper presents an on-going research project “Management principles and safety culture in complex projects” (MAPS), supported by the Finnish Research Programme on Nuclear Power Plant Safety 2015-2018. The project aims at enhancing safety culture and nuclear safety by supporting high quality execution of complex projects in the nuclear industry. Safety-critical industries are facing new challenges, related to increased outsourcing and complexity in technology, work tasks and organizational structures (Milch and Laumann, 2016). In the nuclear industry, new build projects, as well as modernisation projects are temporary undertakings often carried out by networks of companies. Some companies may have little experience in the nuclear industry practices or consideration of specific national regulatory requirements. In large multinational subcontractor networks, the challenge for assuring nuclear safety arises partly from the need to ensure that safety and quality requirements are adequately understood and fulfilled by each partner. Deficient project management practices and unsatisfactory nuclear safety culture in project networks have been recognised as contributing factors to these challenges (INPO, 2010). Prior evidence indicated that many recent major projects have experienced schedule, quality and financial challenges both in the nuclear industry (STUK, 2011) and in the non-nuclear domain (Ahola et al., 2014; Brady and Davies, 2010). Since project delays and quality issues have been perceived mainly as economic problems, project management issues remain largely understudied in safety research. However, safety cannot be separated from other performance aspects if a systemic view is applied. Schedule and quality challenges may reflect deficiencies in coordination, knowledge and competence, distribution of roles and responsibilities or attitudes among the project participants. It is increasingly understood that the performance of the project network in all

  6. Use of a Web Site to Enhance Criticality Safety Training

    International Nuclear Information System (INIS)

    Huang, S T; Morman, J

    2003-01-01

    Currently, a website dedicated to enhancing communication and dissemination of criticality safety information is sponsored by the U.S. Department of Energy (DOE) Nuclear Criticality Safety Program (NCSP). This website was developed as part of the DOE response to the Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 97-2, which reflected the need to make criticality safety information available to a wide audience. The website is the focal point for DOE nuclear criticality safety (NCS) activities, resources and references, including hyperlinks to other sites actively involved in the collection and dissemination of criticality safety information. The website is maintained by the Lawrence Livermore National Laboratory (LLNL) under auspices of the NCSP management. One area of the website contains a series of Nuclear Criticality Safety Engineer Training (NCSET) modules. During the past few years, many users worldwide have accessed the NCSET section of the NCSP website and have downloaded the training modules as an aid for their training programs. This trend was remarkable in that it points out a continuing need of the criticality safety community across the globe. It has long been recognized that training of criticality safety professionals is a continuing process involving both knowledge-based training and experience-based operations floor training. As more of the experienced criticality safety professionals reach retirement age, the opportunities for mentoring programs are reduced. It is essential that some method be provided to assist the training of young criticality safety professionals to replenish this limited human expert resource to support on-going and future nuclear operations. The main objective of this paper is to present the features of the NCSP website, including its mission, contents, and most importantly its use for the dissemination of training modules to the criticality safety community. We will discuss lessons learned and several ideas

  7. Safety parameter display system: an operator support system for enhancement of safety in Indian PHWRs

    International Nuclear Information System (INIS)

    Subramaniam, K.; Biswas, T.

    1994-01-01

    Ensuring operational safety in nuclear power plants is important as operator errors are observed to contribute significantly to the occurrence of accidents. Computerized operator support systems, which process and structure information, can help operators during both normal and transient conditions, and thereby enhance safety and aid effective response to emergency conditions. An important operator aid being developed and described in this paper, is the safety parameter display system (SPDS). The SPDS is an event-independent, symptom-based operator aid for safety monitoring. Knowledge-based systems can provide operators with an improved quality of information. An information processing model of a knowledge based operator support system (KBOSS) developed for emergency conditions using an expert system shell is also presented. The paper concludes with a discussion of the design issues involved in the use of a knowledge based systems for real time safety monitoring and fault diagnosis. (author). 8 refs., 4 figs., 1 tab

  8. A Pharmacokinetics, Efficacy, and Safety Study of Gadoterate Meglumine in Pediatric Subjects Aged Younger Than 2 Years.

    Science.gov (United States)

    Scala, Mario; Koob, Meriam; de Buttet, Sophie; Bourrinet, Philippe; Felices, Mathieu; Jurkiewicz, Elzbieta

    2018-02-01

    The primary objective of this study was to investigate the pharmacokinetic profile of gadoterate meglumine in pediatric patients younger than 2 years; the secondary objectives were to document its efficacy and safety. This was a Phase IV open-label, prospective study conducted in 9 centers (4 countries). Forty-five patients younger than 2 years with normal estimated glomerular filtration rate and scheduled to undergo routine gadolinium-enhanced magnetic resonance imaging (MRI) of any organ were included and received a single intravenous injection of gadoterate meglumine (0.1 mmol/kg). To perform the population pharmacokinetics analysis, 3 blood samples per subject were drawn during 3 time windows at time points allocated by randomization. Gadoterate meglumine concentrations were best fitted using a 2-compartmental model with linear elimination from central compartment. The median total clearance adjusted to body weight was estimated at 0.06 L/h per kg and increased with estimated glomerular filtration rate according to a power model. The median volume of distribution at steady state (Vss) adjusted to body weight was estimated at 0.047 L/kg. Estimated median terminal half-life (t1/2β) was 1.35 h, and the median systemic exposure (area under the curve) was 1591 μmol h/L. Efficacy was assessed by comparing precontrast +postcontrast images to precontrast images in a subset of 28 subjects who underwent an MRI examination of brain, spine, and associated tissues. A total of 28 lesions were identified and analyzed in 15 subjects with precontrast images versus 30 lesions in 16 subjects with precontrast + postcontrast images. Lesion visualization was improved with a mean (SD) increase in scores at subject level of 0.7 (1.0) for lesion border delineation, 0.9 (1.6) for internal morphology, and 3.1 (3.2) for contrast enhancement. Twenty-six adverse events occurred postinjection in 13 subjects (28.9%), including 3 serious reported in 1 subject (2.2%). One subject (2

  9. Criticality safety enhancements for SCALE 6.2 and beyond

    International Nuclear Information System (INIS)

    Rearden, Bradley T.; Bekar, Kursat B.; Celik, Cihangir; Clarno, Kevin T.; Dunn, Michael E.; Hart, Shane W.; Ibrahim, Ahmad M.; Johnson, Seth R.; Langley, Brandon R.; Lefebvre, Jordan P.; Lefebvre, Robert A.; Marshall, William J.; Mertyurek, Ugur; Mueller, Don; Peplow, Douglas E.; Perfetti, Christopher M.; Petrie Jr, Lester M.; Thompson, Adam B.; Wiarda, Dorothea; Wieselquist, William A.; Williams, Mark L.

    2015-01-01

    SCALE is a widely used suite of tools for nuclear systems modeling and simulation that provides comprehensive, verified and validated, user-friendly capabilities for criticality safety, reactor physics, radiation shielding, and sensitivity and uncertainty analysis. Since 1980, regulators, industry, and research institutions around the world have relied on SCALE for nuclear safety analysis and design. SCALE 6.2 provides several new capabilities and significant improvements in many existing features for criticality safety analysis. Enhancements are realized for nuclear data; multigroup resonance self-shielding; continuous-energy Monte Carlo analysis for sensitivity/uncertainty analysis, radiation shielding, and depletion; and graphical user interfaces. An overview of these capabilities is provided in this paper, and additional details are provided in several companion papers.

  10. Safety culture enhancement through the implementation of IAEA guidelines

    International Nuclear Information System (INIS)

    Mengolini, A.; Debarberis, L.

    2007-01-01

    This paper presents the methodology applied and the results achieved in adapting and implementing the IAEA guidelines on safety culture to a research reactor as a step towards supporting its Life Management Program. The background is presented together with the effort undertaken to develop awareness on safety culture and the enhancement programme hereafter developed. The present study shows how issues of safety culture, management awareness and commitment deserve attention and can be of fundamental relevance also for research reactors. The study presents how guidelines developed specifically for nuclear power installations (NPPs) can be adapted to meet the needs and peculiarities of other nuclear installations. Moreover, the difficulties met during the implementation of the guidelines are discussed and important information and lessons can be learnt for the nuclear industry in general

  11. Safety profile of parental ketamine and lignocaine infiltration in pediatric operations

    Energy Technology Data Exchange (ETDEWEB)

    Osifo, David O; Emeagui, Kennedy N [Dept. of Surgery, Pediatric Surgery Unit, Univ. of Benin (Nigeria); Aghahowa, Sylvester E [Pharmacy Dept., Univ. of Benin, Benin City (Nigeria)

    2008-07-01

    Objective was to study the safety and benefits of parenteral ketamine and lignocaine infiltration among pediatric surgical patients with co-morbidities that would preclude the use of general anesthesia requiring endotracheal intubation/ face mask in a developing country. This prospective study was undertaken at the Leadeks Medical Centre, Benin City Edo State, Nigeria between January 2002 and December 2006. Patients requiring surgery were safely operated even in the presence of co-morbidity. A total of 416 children were recruited and they were aged 6 days to16 years (mean 12-/+ 2.04 years) with a male/ female ratio of 1:1.1. Appendectomy (33.2%), herniotomy (20.2%) and suturing of laceration (15.9%) were the most common indications for surgery. Anemia, upper respiratory tract infections, malnutrition, malaria fever, typhoid fever and retroviral infections were co-morbidities. Ambulatory surgery was carried out in 48.6% patients. Overall, only 23.3% experienced postoperative pain which was statistically significant in those that had laparotomy and appendectomy (p<0.0001) and analgesics such as paracetamol were enough to relieve the pain. Complications recorded such as postoperative vomiting, emergence reaction, wound infection, post operative fever and apnea occurring after ketamine injections were tolerated and no mortality was recorded. The satisfactory anesthesia and analgesia recorded with this combination and the low complications observed in the presence of co-morbidity showed that these agents have much to offer in a developing country. (author)

  12. Safety profile of parental ketamine and lignocaine infiltration in pediatric operations

    International Nuclear Information System (INIS)

    Osifo, David O.; Emeagui, Kennedy N.; Aghahowa, Sylvester E.

    2008-01-01

    Objective was to study the safety and benefits of parenteral ketamine and lignocaine infiltration among pediatric surgical patients with co-morbidities that would preclude the use of general anesthesia requiring endotracheal intubation/ face mask in a developing country. This prospective study was undertaken at the Leadeks Medical Centre, Benin City Edo State, Nigeria between January 2002 and December 2006. Patients requiring surgery were safely operated even in the presence of co-morbidity. A total of 416 children were recruited and they were aged 6 days to16 years (mean 12-/+ 2.04 years) with a male/ female ratio of 1:1.1. Appendectomy (33.2%), herniotomy (20.2%) and suturing of laceration (15.9%) were the most common indications for surgery. Anemia, upper respiratory tract infections, malnutrition, malaria fever, typhoid fever and retroviral infections were co-morbidities. Ambulatory surgery was carried out in 48.6% patients. Overall, only 23.3% experienced postoperative pain which was statistically significant in those that had laparotomy and appendectomy (p<0.0001) and analgesics such as paracetamol were enough to relieve the pain. Complications recorded such as postoperative vomiting, emergence reaction, wound infection, post operative fever and apnea occurring after ketamine injections were tolerated and no mortality was recorded. The satisfactory anesthesia and analgesia recorded with this combination and the low complications observed in the presence of co-morbidity showed that these agents have much to offer in a developing country. (author)

  13. Enhanced Maritime Safety through Diagnosis and Fault Tolerant Control

    DEFF Research Database (Denmark)

    Blanke, Mogens

    2001-01-01

    Faults in steering, navigation instruments or propulsion machinery are serious on a marine vessel since the consequence could be loss of maneuvering ability, and imply risk of damage to vessel personnel or environment. Early diagnosis and accomodation of faults could enhance safety. Fault...... of properties of a falty system; means to determine remedial actions. The paper illustrates the techniques by two marine examples, sensor fusion for automatic steering and control of the main engine....

  14. Perspective channel-type reactor with enhanced safety

    International Nuclear Information System (INIS)

    Adamov, E.O.; Grozdov, I.I.; Kuznetsov, S.P.; Petrov, A.A.; Rozhdestvensky, M.I.; Cherkashov, Yu.M.

    1994-01-01

    Following the search for new design solutions to develop within the framework of channel trends the reactor with enhanced safety the Research and Development Institute of Power Engineering has developed the design of the multiloop boiling water reactor (MKER). The MKER enhanced safety is attained when involving the inherent safety features, passive safety systems as well as the accident consequences confinement devices. The design realizes several advantages which are typical of the channel-type reactors, namely: The design desintegration simplifying the manufacture, control, equipment delivery and decreasing, versus the pressure vessel reactors, the accident effect if it proceeds in an explosive manner; small operating reactivity margin and fuel burnup increased due to continuous refuelling; fuel cycle flexibility allowing comparatively easily to adopt the reactor to the conjuncture of the country fuel balance; multiloop circuit of the main coolant which reduces the degree and effect of the accidents connected with the equipment and pipings rupture; monitoring of the channels and fuel assemblies leak-tightness. (orig.)

  15. Safety enhancement efforts after Fukushima accident in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Lee, U.C., E-mail: uclee@nssc.go.kr [Nuclear Safety & Security Commission, Seoul (Korea, Republic of)

    2014-07-01

    On March 11 of 2011, a massive earthquake and powerful tsunami hit the north-eastern region of Japan and the Fukushima Daiichi Nuclear Power Plant was massively damaged. Korea which is located closest to Japan was not directly affected, however, its people were shocked. They were concerned over the possibility of being exposed to radiation as well as for the safety of domestic nuclear power plants. The Korean government recognized the need to take prompt and immediate actions to alleviate these concerns. The Korean government immediately implemented special safety inspection and derived 50 long and short-term improvement action items to ensure safety of NPPs under extreme hazard conditions. At present, stage 3 of implementation strategy is being implemented, with completion of 22 items including ASTS (Automatic Seismic Trip System) as well as revision of 14 items including suitability review of action measures taken for investigation and research of maximum earthquake at NPP sites. The IAEA Integrated Regulatory Review Service (IRRS) mission was conducted for two weeks during July 10 and 22, 2011, which happened to be the very first review mission to be carried out since the Fukushima disaster. A module on the policy issues related to the actions taken after the Fukushima accident was newly added to the mission. The mission highlighted positive aspects of Korea's safety regulatory program, praising its technical competence and effectiveness. Additionally it concluded that Korea has been responding to the accident in a timely and an effective manner. The follow-up review mission is scheduled in December of this year, expanding the scope to include radiation safety as well. The most noteworthy change in Korea since the Fukushima accident is independence of the regulatory body. Not only to enhance effectiveness and independence of the regulatory body but to secure nuclear safety, the Nuclear Safety and Security Commission (NSSC) was established on October 26

  16. Simulation-based medical education in pediatrics.

    Science.gov (United States)

    Lopreiato, Joseph O; Sawyer, Taylor

    2015-01-01

    The use of simulation-based medical education (SBME) in pediatrics has grown rapidly over the past 2 decades and is expected to continue to grow. Similar to other instructional formats used in medical education, SBME is an instructional methodology that facilitates learning. Successful use of SBME in pediatrics requires attention to basic educational principles, including the incorporation of clear learning objectives. To facilitate learning during simulation the psychological safety of the participants must be ensured, and when done correctly, SBME is a powerful tool to enhance patient safety in pediatrics. Here we provide an overview of SBME in pediatrics and review key topics in the field. We first review the tools of the trade and examine various types of simulators used in pediatric SBME, including human patient simulators, task trainers, standardized patients, and virtual reality simulation. Then we explore several uses of simulation that have been shown to lead to effective learning, including curriculum integration, feedback and debriefing, deliberate practice, mastery learning, and range of difficulty and clinical variation. Examples of how these practices have been successfully used in pediatrics are provided. Finally, we discuss the future of pediatric SBME. As a community, pediatric simulation educators and researchers have been a leading force in the advancement of simulation in medicine. As the use of SBME in pediatrics expands, we hope this perspective will serve as a guide for those interested in improving the state of pediatric SBME. Published by Elsevier Inc.

  17. 2016 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards, Including Standards for Pediatric Oncology.

    Science.gov (United States)

    Neuss, Michael N; Gilmore, Terry R; Belderson, Kristin M; Billett, Amy L; Conti-Kalchik, Tara; Harvey, Brittany E; Hendricks, Carolyn; LeFebvre, Kristine B; Mangu, Pamela B; McNiff, Kristen; Olsen, MiKaela; Schulmeister, Lisa; Von Gehr, Ann; Polovich, Martha

    2016-12-01

    Purpose To update the ASCO/Oncology Nursing Society (ONS) Chemotherapy Administration Safety Standards and to highlight standards for pediatric oncology. Methods The ASCO/ONS Chemotherapy Administration Safety Standards were first published in 2009 and updated in 2011 to include inpatient settings. A subsequent 2013 revision expanded the standards to include the safe administration and management of oral chemotherapy. A joint ASCO/ONS workshop with stakeholder participation, including that of the Association of Pediatric Hematology Oncology Nurses and American Society of Pediatric Hematology/Oncology, was held on May 12, 2015, to review the 2013 standards. An extensive literature search was subsequently conducted, and public comments on the revised draft standards were solicited. Results The updated 2016 standards presented here include clarification and expansion of existing standards to include pediatric oncology and to introduce new standards: most notably, two-person verification of chemotherapy preparation processes, administration of vinca alkaloids via minibags in facilities in which intrathecal medications are administered, and labeling of medications dispensed from the health care setting to be taken by the patient at home. The standards were reordered and renumbered to align with the sequential processes of chemotherapy prescription, preparation, and administration. Several standards were separated into their respective components for clarity and to facilitate measurement of adherence to a standard. Conclusion As oncology practice has changed, so have chemotherapy administration safety standards. Advances in technology, cancer treatment, and education and training have prompted the need for periodic review and revision of the standards. Additional information is available at http://www.asco.org/chemo-standards .

  18. 78 FR 76391 - Proposed Enhancements to the Motor Carrier Safety Measurement System (SMS) Public Web Site

    Science.gov (United States)

    2013-12-17

    ...-0392] Proposed Enhancements to the Motor Carrier Safety Measurement System (SMS) Public Web Site AGENCY... proposed enhancements to the display of information on the Agency's Safety Measurement System (SMS) public Web site. On December 6, 2013, Advocates [[Page 76392

  19. Enhancing Pediatric Asthma Care and Nursing Education Through an Academic Practice Partnership.

    Science.gov (United States)

    McClure, Natasha; Lutenbacher, Melanie; O'Kelley, Ellen; Dietrich, Mary S

    Home environmental assessments and interventions delivered via academic practice partnerships (APP) between clinics and schools of nursing may be a low or no cost delivery model of pediatric asthma care and professional education. Patients receive enhanced clinical resources that can improve self-management and healthcare utilization. Additionally, students can practice chronic disease management skills in actual patient encounters. To describe outcomes of the implementation of an APP between a school of nursing and a pediatric asthma specialty clinic (PASC) to deliver a home visit program (HVP). The HVP was designed to reduce emergency department visits and asthma related hospitalizations in PASC patients and provide clinical experiences for nursing students. PASC referred patients to the HVP based on their level of asthma control. Students provided an individualized number of home visits to 17 participants over a nine month period. A 12-month pre- and post-HVP comparison of emergency department visits and asthma related hospitalizations was conducted. Additional information was gathered from stakeholders via an online survey, and interviews with APP partners and HVP families. Children had fewer asthma related hospitalizations post HVP. Findings suggest a reduction in exposure to environmental triggers, improved patient and family management of asthma, and increased PASC knowledge of asthma triggers in the home and increased student knowledge and skills related to asthma management. Multiple clinical and educational benefits may be realized through the development of APPs as an infrastructure supporting targeted interventions in home visits to pediatric asthma patients and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Nicotine disrupts safety learning by enhancing fear associated with a safety cue via the dorsal hippocampus.

    Science.gov (United States)

    Connor, David A; Kutlu, Munir G; Gould, Thomas J

    2017-07-01

    Learned safety, a learning process in which a cue becomes associated with the absence of threat, is disrupted in individuals with post-traumatic stress disorder (PTSD). A bi-directional relationship exists between smoking and PTSD and one potential explanation is that nicotine-associated changes in cognition facilitate PTSD emotional dysregulation by disrupting safety associations. Therefore, we investigated whether nicotine would disrupt learned safety by enhancing fear associated with a safety cue. In the present study, C57BL/6 mice were administered acute or chronic nicotine and trained over three days in a differential backward trace conditioning paradigm consisting of five trials of a forward conditioned stimulus (CS)+ (Light) co-terminating with a footshock unconditioned stimulus followed by a backward CS- (Tone) presented 20 s after cessation of the unconditioned stimulus. Summation testing found that acute nicotine disrupted learned safety, but chronic nicotine had no effect. Another group of animals administered acute nicotine showed fear when presented with the backward CS (Light) alone, indicating the formation of a maladaptive fear association with the backward CS. Finally, we investigated the brain regions involved by administering nicotine directly into the dorsal hippocampus, ventral hippocampus, and prelimbic cortex. Infusion of nicotine into the dorsal hippocampus disrupted safety learning.

  1. Enhancing the emergency department approach to pediatric sexual assault care: implementation of a pediatric sexual assault response team program.

    Science.gov (United States)

    Goyal, Monika K; Mollen, Cynthia J; Hayes, Katie L; Molnar, Jennifer; Christian, Cindy W; Scribano, Philip V; Lavelle, Jane

    2013-09-01

    The objectives of this study were to describe the experience of a novel pediatric sexual assault response team (SART) program in the first 3 years of implementation and compare patient characteristics, evaluation, and treatment among subpopulations of patients. This was a retrospective chart review of a consecutive sample of patients evaluated at a pediatric emergency department (ED) who met institutional criteria for a SART evaluation. Associations of evaluation and treatment with sex, menarchal status, and presence of injuries were measured using logistic regression. One hundred eighty-four patients met criteria for SART evaluation, of whom 87.5% were female; mean age was 10.1 (SD, 4.6) years. The majority of patients underwent forensic evidence collection (89.1%), which varied by menarchal status among girls (P < 0.01), but not by sex. Evidence of acute anogenital injury on physical examination was found in 20.6% of patients. As per the Centers for Disease Control and Prevention guidelines for acute sexual assault evaluations in pediatric patients, menarchal girls were more likely to undergo testing for sexually transmitted infections and pregnancy (P < 0.01) and to be offered pregnancy, sexually transmitted infection, and HIV prophylaxis (P < 0.01). In an effort to improve quality and consistency of acute sexual assault examinations in a pediatric ED, development of a SART program supported the majority of eligible patients undergoing forensic evidence collection. Furthermore, a substantial number of patients had evidence of injury on examination. These findings underscore the importance of having properly trained personnel to support ED care for pediatric victims of acute sexual assault.

  2. Enhancement of safety at nuclear facilities in Pakistan

    International Nuclear Information System (INIS)

    Ahmad, S.A.; Hayat, T.; Azhar, W.

    2006-01-01

    Pakistan is benefiting from nuclear technology mostly in health and energy sectors as well as agriculture and industry and has an impeccable safety record. At the national level uses of nuclear technology started in 1955 resulting in the operation of Karachi Radioisotope Center, Karachi, in December 1960. Pakistan Nuclear Safety Committee (PNSC) was formulated in 1964 with subsequent promulgation of Pakistan Atomic Energy Commission (PAEC) Ordinance in 1965 to cope with the anticipated introduction of a research reactor, namely PARR-I, and a nuclear power plant, namely KANUPP. Since then Pakistan's nuclear program has expanded to include numerous nuclear facilities of varied nature. This program has definite economic and social impacts by producing electricity, treating and diagnosing cancer patients, and introducing better crop varieties. Appropriate radiation protection includes a number of measures including database of sealed radiation sources at PAEC operated nuclear facilities, see Table l, updated during periodic physical verification of these sources, strict adherence to the BSS-115, IAEA recommended enforcement of zoning at research reactors and NPPs, etc. Pakistan is party to several international conventions and treaties, such as Convention of Nuclear Safety and Early Notification, to improve and enhance safety at its nuclear facilities. In addition Pakistan generally and PAEC particularly believes in a blend of prudent regulations and good/best practices. This is described in this paper. (Author)

  3. Surgical checklist application and its impact on patient safety in pediatric surgery

    Directory of Open Access Journals (Sweden)

    S N Oak

    2015-01-01

    Full Text Available Background: Surgical care is an essential component of health care of children worldwide. Incidences of congenital anomalies, trauma, cancers and acquired diseases continue to rise and along with that the impact of surgical intervention on public health system also increases. It then becomes essential that the surgical teams make the procedures safe and error proof. The World Health Organization (WHO has instituted the surgical checklist as a global initiative to improve surgical safety. Aims: To assess the acceptance, application and adherence to the WHO Safe Surgery Checklist in Pediatric Surgery Practice at a university teaching hospital. Materials and Methods: In a prospective study, spanning 2 years, the checklist was implemented for all patients who underwent operative procedures under general anesthesia. The checklist identified three phases of an operation, each corresponding to a specific period in the normal flow of work: Before the induction of anesthesia ("sign in", before the skin incision ("time out" and before the patient leaves the operating room ("sign out". In each phase, an anesthesiologist,-"checklist coordinator," confirmed that the anesthesia, surgery and nursing teams have completed the listed tasks before proceeding with the operation and exit. The checklist was used for 3000 consecutive patients. Results: No major perioperative errors were noted. In 54 (1.8% patients, children had the same names and identical surgical procedure posted on the same operation list. The patient identification tag was missing in four (0.1% patients. Mention of the side of procedures was missing in 108 (3.6% cases. In 0.1% (3 of patients there was mix up of the mention of side of operation in the case papers and consent forms. In 78 (2.6% patients, the consent form was not signed by parents/guardians or the side of the procedure was not quoted. Antibiotic orders were missing in five (0.2% patients. In 12 (0.4% cases, immobilization of the

  4. Inhibition of histone deacetylases 1 and 6 enhances cytarabine-induced apoptosis in pediatric acute myeloid leukemia cells.

    Science.gov (United States)

    Xu, Xuelian; Xie, Chengzhi; Edwards, Holly; Zhou, Hui; Buck, Steven A; Ge, Yubin

    2011-02-16

    Pediatric acute myeloid leukemia (AML) remains a challenging disease to treat even with intensified cytarabine-based chemotherapy. Histone deacetylases (HDACs) have been reported to be promising therapeutic targets for treating AML. However, HDAC family members that are involved in chemotherapy sensitivities remain unknown. In this study, we sought to identify members of the HDAC family that are involved in cytarabine sensitivities, and to select the optimal HDACI that is most efficacious when combined with cytarabine for treating children with AML. Expression profiles of classes I, II, and IV HDACs in 4 pediatric AML cell lines were determined by Western blotting. Inhibition of class I HDACs by different HDACIs was measured post immnunoprecipitation. Individual down-regulation of HDACs in pediatric AML cells was performed with lentiviral shRNA. The effects of cytarabine and HDACIs on apoptosis were determined by flow cytometry analysis. Treatments with structurally diverse HDACIs and HDAC shRNA knockdown experiments revealed that down-regulation of both HDACs 1 and 6 is critical in enhancing cytarabine-induced apoptosis in pediatric AML, at least partly mediated by Bim. However, down-regulation of HDAC2 may negatively impact cytarabine sensitivities in the disease. At clinically achievable concentrations, HDACIs that simultaneously inhibited both HDACs 1 and 6 showed the best anti-leukemic activities and significantly enhanced cytarabine-induced apoptosis. Our results further confirm that HDACs are bona fide therapeutic targets for treating pediatric AML and suggest that pan-HDACIs may be more beneficial than isoform-specific drugs.

  5. Effective corrective actions to enhance operational safety of nuclear installations

    International Nuclear Information System (INIS)

    2005-07-01

    The safe operation of nuclear power plants around the world and the prevention of incidents in these installations remain key concerns for the nuclear community. In this connection the feedback of operating experience plays a major role: every nuclear plant operator needs to have a system in place to identify and feed back the lessons learned from operating experience and to implement effective corrective actions to prevent safety events from reoccurring. An effective operating experience programme also includes a proactive approach that is aimed at preventing the first-time occurrence of safety events. In April 2003, the IAEA issued the PROSPER guidelines for nuclear installations to strengthen and enhance their own operating experience process and for self-assessment on the effectiveness of the feedback process. Subsequently, in the course of the Operational Safety Review Teams missions conducted by the IAEA that focused on the operational safety practices of nuclear power plants, the IAEA enhanced the review of the operating experience in nuclear power plants by implementing a new module that is derived from these guidelines. In order to highlight the effective implementation of the operating experience programme and to provide practical assistance in this area, the IAEA organized workshops and conferences to discuss recent trends in operating experience. The IAEA also performed assistance and review missions at plants and corporate organizations. The IAEA is further developing advice and assistance on operating experience feedback programmes and is reporting on good practices. The present publication is the outcome of two years of coordinated effort involving the participation of experts of nuclear organizations in several Member States. It provides information and good practices for successfully establishing an effective corrective actions programme. This publication forms part of a series that develops the principles set forth in these guidelines

  6. National plan to enhance aviation safety through human factors improvements

    Science.gov (United States)

    Foushee, Clay

    1990-01-01

    The purpose of this section of the plan is to establish a development and implementation strategy plan for improving safety and efficiency in the Air Traffic Control (ATC) system. These improvements will be achieved through the proper applications of human factors considerations to the present and future systems. The program will have four basic goals: (1) prepare for the future system through proper hiring and training; (2) develop a controller work station team concept (managing human errors); (3) understand and address the human factors implications of negative system results; and (4) define the proper division of responsibilities and interactions between the human and the machine in ATC systems. This plan addresses six program elements which together address the overall purpose. The six program elements are: (1) determine principles of human-centered automation that will enhance aviation safety and the efficiency of the air traffic controller; (2) provide new and/or enhanced methods and techniques to measure, assess, and improve human performance in the ATC environment; (3) determine system needs and methods for information transfer between and within controller teams and between controller teams and the cockpit; (4) determine how new controller work station technology can optimally be applied and integrated to enhance safety and efficiency; (5) assess training needs and develop improved techniques and strategies for selection, training, and evaluation of controllers; and (6) develop standards, methods, and procedures for the certification and validation of human engineering in the design, testing, and implementation of any hardware or software system element which affects information flow to or from the human.

  7. EC6 safety enhancement - including impact of Fukushima lessons learned

    Energy Technology Data Exchange (ETDEWEB)

    Yu, S.; Zemdegs, R.; Boyle, S.; Soulard, M., E-mail: stephen.yu@candu.com [Candu Energy Inc., Mississauga, Ontario (Canada)

    2012-09-15

    The Enhanced CANDU 6 (EC6) is the new Generation III CANDU reactor design that meets the most up to date regulatory requirements and customer expectations. EC6 builds on the proven high performance design inch as the Qinshan CANDU 6 units and has made improvements to safety and operational performance, and has incorporated extensive operational feedback including Fukushima. The Fukushima Dai-ichi March 11, 2011 event has demonstrated the importance of defence-in-depth considerations for beyond-design basis events, including severe accidents. The EC6 design is based on the defence-in-depth principles and provides further design features that address the lessons learned from Fukushima. (author)

  8. Survey of gadolinium-based contrast agent utilization among the members of the Society for Pediatric Radiology: a Quality and Safety Committee report

    International Nuclear Information System (INIS)

    Blumfield, Einat; Moore, Michael M.; Drake, Mary K.; Goodman, Thomas R.; Lewis, Kristopher N.; Meyer, Laura T.; Ngo, Thang D.; Sammet, Christina; Stanescu, Arta Luana; Iyer, Ramesh S.; Swenson, David W.; Slovis, Thomas L.

    2017-01-01

    Gadolinium-based contrast agents (GBCAs) have been used for magnetic resonance (MR) imaging over the last three decades. Recent reports demonstrated gadolinium retention in patients' brains following intravenous administration. Since gadolinium is a highly toxic heavy metal, there is a potential for adverse effects from prolonged retention or deposition, particularly in children. For this reason, the Society (SPR) for Pediatric Radiology Quality and Safety committee conducted a survey to evaluate the current status of GBCAs usage among pediatric radiologists. To assess the usage of GBCAs among SPR members. An online 15-question survey was distributed to SPR members. Survey questions pertained to the type of GBCAs used, protocoling workflow, requirement of renal function or pregnancy tests, and various clinical indications for contrast-enhanced MRI examinations. A total of 163 survey responses were compiled (11.1% of survey invitations), the majority of these from academic institutions in the United States. Ninety-four percent reported that MR studies are always or usually protocoled by pediatric radiologists. The most common GBCA utilized by survey respondents were Eovist (60.7%), Ablavar (45.4%), Gadovist (38.7%), Magnevist (34.4%) and Dotarem (32.5%). For several clinical indications, survey responses regarding GBCA administration were concordant with American College of Radiology (ACR) Appropriateness Criteria, including seizures, headache and osteomyelitis. For other indications, including growth hormone deficiency and suspected vascular ring, survey responses revealed potential overutilization of GBCAs when compared to ACR recommendations. Survey results demonstrate that GBCAs are administered judiciously in children, yet there is an opportunity to improve their utilization with the goal of reducing potential future adverse effects. (orig.)

  9. Survey of gadolinium-based contrast agent utilization among the members of the Society for Pediatric Radiology: a Quality and Safety Committee report.

    Science.gov (United States)

    Blumfield, Einat; Moore, Michael M; Drake, Mary K; Goodman, Thomas R; Lewis, Kristopher N; Meyer, Laura T; Ngo, Thang D; Sammet, Christina; Stanescu, Arta Luana; Swenson, David W; Slovis, Thomas L; Iyer, Ramesh S

    2017-05-01

    Gadolinium-based contrast agents (GBCAs) have been used for magnetic resonance (MR) imaging over the last three decades. Recent reports demonstrated gadolinium retention in patients' brains following intravenous administration. Since gadolinium is a highly toxic heavy metal, there is a potential for adverse effects from prolonged retention or deposition, particularly in children. For this reason, the Society (SPR) for Pediatric Radiology Quality and Safety committee conducted a survey to evaluate the current status of GBCAs usage among pediatric radiologists. To assess the usage of GBCAs among SPR members. An online 15-question survey was distributed to SPR members. Survey questions pertained to the type of GBCAs used, protocoling workflow, requirement of renal function or pregnancy tests, and various clinical indications for contrast-enhanced MRI examinations. A total of 163 survey responses were compiled (11.1% of survey invitations), the majority of these from academic institutions in the United States. Ninety-four percent reported that MR studies are always or usually protocoled by pediatric radiologists. The most common GBCA utilized by survey respondents were Eovist (60.7%), Ablavar (45.4%), Gadovist (38.7%), Magnevist (34.4%) and Dotarem (32.5%). For several clinical indications, survey responses regarding GBCA administration were concordant with American College of Radiology (ACR) Appropriateness Criteria, including seizures, headache and osteomyelitis. For other indications, including growth hormone deficiency and suspected vascular ring, survey responses revealed potential overutilization of GBCAs when compared to ACR recommendations. Survey results demonstrate that GBCAs are administered judiciously in children, yet there is an opportunity to improve their utilization with the goal of reducing potential future adverse effects.

  10. Survey of gadolinium-based contrast agent utilization among the members of the Society for Pediatric Radiology: a Quality and Safety Committee report

    Energy Technology Data Exchange (ETDEWEB)

    Blumfield, Einat [Jacobi Medical Center, Department of Radiology, Albert Einstein College of Medicine, South Bronx, NY (United States); Moore, Michael M. [The Pennsylvania State University College of Medicine, Department of Radiology, Penn State Hershey Children' s Hospital, Hershey, PA (United States); Drake, Mary K. [University of Nebraska Medical Center, Department of Radiology, Children' s Hospital and Medical Center, Omaha, NE (United States); Goodman, Thomas R. [Yale School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States); Lewis, Kristopher N. [Augusta University, Department of Radiology, Children' s Hospital of Georgia, Augusta, GA (United States); Meyer, Laura T. [Wake Radiology, Raleigh, NC (United States); Ngo, Thang D. [Nemours Children' s Hospital, Department of Medical Imaging, Orlando, FL (United States); Sammet, Christina [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Radiology, Chicago, IL (United States); Stanescu, Arta Luana; Iyer, Ramesh S. [Seattle Children' s Hospital, University of Washington School of Medicine, Department of Radiology, Seattle, WA (United States); Swenson, David W. [Warren Alpert Medical School of Brown University, Department of Diagnostic Imaging, Providence, RI (United States); Slovis, Thomas L. [Children' s Hospital of Michigan, Wayne State University School of Medicine, Department of Radiology, Detroit, MI (United States)

    2017-05-15

    Gadolinium-based contrast agents (GBCAs) have been used for magnetic resonance (MR) imaging over the last three decades. Recent reports demonstrated gadolinium retention in patients' brains following intravenous administration. Since gadolinium is a highly toxic heavy metal, there is a potential for adverse effects from prolonged retention or deposition, particularly in children. For this reason, the Society (SPR) for Pediatric Radiology Quality and Safety committee conducted a survey to evaluate the current status of GBCAs usage among pediatric radiologists. To assess the usage of GBCAs among SPR members. An online 15-question survey was distributed to SPR members. Survey questions pertained to the type of GBCAs used, protocoling workflow, requirement of renal function or pregnancy tests, and various clinical indications for contrast-enhanced MRI examinations. A total of 163 survey responses were compiled (11.1% of survey invitations), the majority of these from academic institutions in the United States. Ninety-four percent reported that MR studies are always or usually protocoled by pediatric radiologists. The most common GBCA utilized by survey respondents were Eovist (60.7%), Ablavar (45.4%), Gadovist (38.7%), Magnevist (34.4%) and Dotarem (32.5%). For several clinical indications, survey responses regarding GBCA administration were concordant with American College of Radiology (ACR) Appropriateness Criteria, including seizures, headache and osteomyelitis. For other indications, including growth hormone deficiency and suspected vascular ring, survey responses revealed potential overutilization of GBCAs when compared to ACR recommendations. Survey results demonstrate that GBCAs are administered judiciously in children, yet there is an opportunity to improve their utilization with the goal of reducing potential future adverse effects. (orig.)

  11. Mochovce NPP safety measures evaluation from point of view of operational safety enhancement

    International Nuclear Information System (INIS)

    Cillik, I.; Vrtik, L.

    2000-01-01

    Mochovce NPP consists of four reactor units of WWER 440/V213 type and it is located in the south-middle part of Slovakia. At present first unit operated and the second one under the construction finishing. As these units represent second generation of WWER reactor design, the additional safety measures (SM) were implemented to enhance operational and nuclear safety according to the recommendations of performed international audits and operational experience based on exploitation of other similar units (as Dukovany and J. Bohunice NPPs). These requirements result into a number of SMs grouped according to their purpose to reach recent international requirements on nuclear and operational safety. The paper presents the bases used for safety measures establishing including their grouping into the comprehensive tasks covering different areas of safety goals as well as structural organization of a project management of including participating companies and work performance. More, results are given regarding contribution of selected SMs to the total core damage frequency decreasing. (author)

  12. Safety, Efficacy, and Exposure-Response of Voriconazole in Pediatric Patients With Invasive Aspergillosis, Invasive Candidiasis or Esophageal Candidiasis.

    Science.gov (United States)

    Martin, Judith M; Macias-Parra, Mercedes; Mudry, Peter; Conte, Umberto; Yan, Jean L; Liu, Ping; Capparella, M Rita; Aram, Jalal A

    2017-01-01

    Data on safety and efficacy of voriconazole for invasive aspergillosis (IA) and invasive candidiasis/esophageal candidiasis (IC/EC) in pediatric patients are limited. Patients aged 2-<18 years with IA and IC/EC were enrolled in 2 prospective open-label, non-comparative studies of voriconazole. Patients followed dosing regimens based on age, weight and indication, with adjustments permitted. Treatment duration was 6-12 weeks for IA patients, ≥14 days after last positive Candida culture for IC patients and ≥7 days after signs/symptoms resolution for EC patients. Primary analysis for both the studies was safety and tolerability of voriconazole. Secondary end points included global response success at week 6 and end of treatment (EOT), all-causality mortality and time to death. Voriconazole exposure-response relationship was explored. Of 53 voriconazole-treated pediatric patients (31 IA; 22 IC/EC), 14 had proven/probable IA, 7 had confirmed IC and 10 had confirmed EC. Treatment-related hepatic and visual adverse events, respectively, were reported in 22.6% and 16.1% of IA patients, and 22.7% and 27.3% of IC/EC patients. All-causality mortality in IA patients was 14.3% at week 6; no deaths were attributed to voriconazole. No deaths were reported for IC/EC patients. Global response success rate was 64.3% (week 6 and EOT) in IA patients and 76.5% (EOT) in IC/EC patients. There was no association between voriconazole exposure and efficacy; however, a slight positive association between voriconazole exposure and hepatic adverse events was established. Safety and efficacy outcomes in pediatric patients with IA and IC/EC were consistent with previous findings in adult patients.

  13. Enhancement of Nuclear Safety in Korea: A Regulatory Perspective

    International Nuclear Information System (INIS)

    Chung, K.Y.

    2016-01-01

    In the aftermath of Fukushima Daiichi accident in 2011 Korean regulatory body immediately performed special inspections on nuclear power plants (NPPs) and a research reactor in Korea, and issued an enforcement order for the licensees to implement fifty Fukushima action items to address the safety issues identified by the inspections. Subsequently, the licensees have established the implementation plans for resolution of the action items. By the implementation of the action items, the possibility of severe accident due to the extreme hazards has been greatly reduced and the capabilities to mitigate the severe accident, should it occur, have been upgraded. To improve the consistency and predictability of the regulation on severe accidents, Nuclear Safety and Security Commission (NSSC) the regulatory body in Korea, is revising the regulatory framework for severe accidents. The new framework will require the licensee to enhance the capabilities for prevention and mitigation of severe accidents in view of the defence in depth principle, to assess the radiological effects from the severe accidents, and to improve current accident management procedures and guidelines necessary for the prevention and mitigation of severe accidents. This rulemaking also considers the safety principles provided by the IAEA Vienna Declaration in 2015, which require new NPPs to prevent large radioactive releases. (author)

  14. Enhancement of pressurizer safety valve operability by seating design improvement

    International Nuclear Information System (INIS)

    Moisidis, N.T.; Ratiu, M.D.

    1995-01-01

    Operating conditions specific to pressurizer safety valves (PSVs) have led to numerous problems and have caused industry and NRC concerns regarding the adequacy of spring-loaded self-actuated safety valves for reactor coolant system (RCS) overpressure protection. Specific concerns are: setpoint drift, spurious actuations, and pressure protection. Specific concerns are: setpoint drift, spurious actuations, and leakage. Based on testing and valve construction analysis of a Crosby model 6M6 PSV (Moisidis and Ratiu, 1992), it was established that the primary contributor to the valve problems is a susceptibility to weak seating. To eliminate spring instability, a new spring washer was designed, which guides the spring and precludes its rotation from the reference installed position. Results of tests performed on a prototype PSV equipped with the modified upper spring washer has shown significant improvements in valve operability and a consistent setpoint reproducibility to less than ±1% of the PSV setpoint (testing of baseline, unmodified valve, resulted in a setpoint drift of ± 2%). Enhanced valve operability will result in a significant decrease in operating and maintenance costs associated with valve maintenance and testing. In addition, the enhanced setpoint reproducibility will allow the development of a nitrogen to steam correlation for future in-house PSV testing which will result in further reductions in costs associated with valve testing

  15. Enhancement of pressurizer safety valve operability by seating design improvement

    International Nuclear Information System (INIS)

    Moisidis, N.T.; Ratiu, M.D.

    1994-01-01

    Operating conditions specific to Pressurizer Safety Valves (PSVs) have led to numerous problems and have caused industry and NRC concerns regarding the adequacy of spring loaded self-actuated safety valves for Reactor Coolant System (RCS) overpressure protection. Specific concerns are: setpoint drift, spurious actuations and leakage. Based on testing and valve construction analysis of a Crosby model 6M6 PSV, it was established that the primary contributor to the valve problems is a susceptibility to weak seating. To eliminate spring instability, a new spring washer was designed, which guides the spring and precludes its rotation from the reference installed position. Results of tests performed on a prototype PSV equipped with the modified upper spring washer has shown significant improvements in valve operability and a consistent setpoint reproducibility to less than ±1% of the PSV setpoint (testing of baseline, unmodified valve, resulted in a setpoint drift of ±2%). Enhanced valve operability will result in a significant decrease in operating and maintenance costs associated with valve maintenance and testing. In addition, the enhanced setpoint reproducibility will allow the development of a nitrogen to steam correlation for future in-house PSV testing which will result in further reductions in costs associated with valve testing

  16. New Horizons in Pediatric Psychopharmacology.

    Science.gov (United States)

    Khan, Sarah; Rathore, Vijaylaxmi; Khan, Shahida

    2016-12-01

    Preclinical Research Recent advances in pediatric psychopharmacology have been rather uneven. Increased use of psychotropic drugs among the pediatric population has raised concerns regarding their inappropriate use and safety. While clinical trials have been conducted on various pediatric psychopharmacological drugs, there has been an insignificant amount of importance to innovation in holistic treatment. A rational approach toward elucidating the various challenges would be contingent on the convergence of the development of novel efficacious psychotropic drugs with concrete conceptual frameworks and guidelines fostering enhanced outcomes. A research infrastructure concerning the relevance of the clinician's perspective, combining drugs with alternative therapies, the need for pediatric specific formulations and relevance of these in developing countries provides a basis on which innovative treatment/development can be constructed. The current commentary highlights these comprehensive and targeted treatment guidelines as aspects necessary for building the future of the field. Drug Dev Res 77 : 474-478, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  17. Britain's Nuclear Electric pursues a major programme to enhance safety

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    The UK state-owned nuclear utility, Nuclear Electric, is actively pursuing a major initiative inherited from its predecessor the Central Electricity Generating Board, known as the Station Enhancement Programme. The Enhancement Programme is a multi-million pound project and covers all Nuclear Electric's stations (including relevant aspects of the de-commissioning site at Berkeley). Its fundamental objective is to enhance the arrangements, practices and attitudes on the power stations to create an overall environment likely to promote ever safer and more reliable operation, and to take full account of the best international practices. The four year programme started in the spring of 1989, and is expected to be completed in 1993. Key elements of the programme include quality assurance based management systems; improvements to site and plant material conditions; a more formal approach to training; additional resources and controls to aid the management of maintenance defects; higher profile for the feedback of operational experience; management targets; a station evaluation programme; and formal feedback of lessons learned from the IAEA operational and safety review team visit to the Oldbury-on-Severn station in 1989. (author)

  18. Enhancing pediatric workforce diversity and providing culturally effective pediatric care: implications for practice, education, and policy making.

    Science.gov (United States)

    2013-10-01

    This policy statement serves to combine and update 2 previously independent but overlapping statements from the American Academy of Pediatrics (AAP) on culturally effective health care (CEHC) and workforce diversity. The AAP has long recognized that with the ever-increasing diversity of the pediatric population in the United States, the health of all children depends on the ability of all pediatricians to practice culturally effective care. CEHC can be defined as the delivery of care within the context of appropriate physician knowledge, understanding, and appreciation of all cultural distinctions, leading to optimal health outcomes. The AAP believes that CEHC is a critical social value and that the knowledge and skills necessary for providing CEHC can be taught and acquired through focused curricula across the spectrum of lifelong learning. This statement also addresses workforce diversity, health disparities, and affirmative action. The discussion of diversity is broadened to include not only race, ethnicity, and language but also cultural attributes such as gender, religious beliefs, sexual orientation, and disability, which may affect the quality of health care. The AAP believes that efforts must be supported through health policy and advocacy initiatives to promote the delivery of CEHC and to overcome educational, organizational, and other barriers to improving workforce diversity.

  19. Enhanced safety in the storage of fissile materials

    International Nuclear Information System (INIS)

    Williams, G.E.; Alvares, N.J.

    1978-01-01

    An inexpensive boron-loaded liner of epoxy resin for fissile-material storage containers was developed that can be easily fabricated of readily available, low-cost materials. Computer calculations indicate reactivity will be reduced substantially if this neutron-absorbing liner is added to containers in a typical storage array. These calculations compare favorably with neutron-attenuation experiments with thermal and fission neutron spectra, and tests at the Fire Test Facility indicate the epoxy resin will survive extreme environmental and accident conditions. The fire-resistant and insulating properties of the epoxy-resin liner further augment its ability to protect fissile materials. Boron-loaded epoxy resin is adaptable to many tasks but is particularly useful for providing enhanced criticality safety in the packaging and storage of fissile materials

  20. Distributed fiber optic sensing enhances pipeline safety and security

    Energy Technology Data Exchange (ETDEWEB)

    Frings, Jochen; Walk, Tobias [ILF Consulting Engineers, Munich (Germany)

    2011-09-15

    Pipelines are efficient, highly reliable and safe means of transportation. However, despite intensive right of way surveillance by foot, car and out of the air, pipeline leaks and illegal tappings are a reality - sometimes with catastrophic results. These events show a gap in real-time monitoring caused by the highly distributed nature of pipelines. Parts of this gap now can be closed with distributed fiber optic sensing technology. Using various physical effects this technology is apt to detect temperature, strain, vibrations and sound with very good localization over spans up to 50 km with a single sensor cable. Various field tested applications like leakage detection, third party activity monitoring and intrusion detection or ground movement detection as well as integrity monitoring proof that distributed fiber optic sensing can enhance pipeline safety and security. (orig.)

  1. The Alternative Design Features for Safety Enhancement in Shutdown Operation

    International Nuclear Information System (INIS)

    Oh, Hae Cheol; Kim, Myung Ki; Chung, Bag Soon; Seo, Mi Ro

    2009-01-01

    PSA can be used to confirm that the new plant design is complied with the applicable safety goals, and to select among the alternate design options. A shutdown PSA provides insight for outage planning schedule, outage management practices, and design modifications. Considering the results of both LPSD PSA studies and operating experiences for low power and shutdown, the improvements can be proposed to reduce the high risk contribution. The improvements/enhancements during shutdown operation may be divided into categories such as hardware, administrative management, and operational procedure. This paper presents on an example how the risk related to an accidental situation can be reduced, focusing the hardware design changes for the newly designed NPPs

  2. Engineering and Safety Partnership Enhances Safety of the Space Shuttle Program (SSP)

    Science.gov (United States)

    Duarte, Alberto

    2007-01-01

    difference for the safety of the Space Shuttle Vehicle, its crew, and personnel. Because of the MSERP's valuable contribution to the assessment of safety risk for the SSP, this paper also proposes an enhanced Panel concept that takes this successful partnership concept to a higher level of 'true partnership'. The proposed panel is aimed to be responsible for the review and assessment of all risk relative to Safety for new and future aerospace and related programs.

  3. Enhancing pediatric clinical trial feasibility through the use of Bayesian statistics.

    Science.gov (United States)

    Huff, Robin A; Maca, Jeff D; Puri, Mala; Seltzer, Earl W

    2017-11-01

    BackgroundPediatric clinical trials commonly experience recruitment challenges including limited number of patients and investigators, inclusion/exclusion criteria that further reduce the patient pool, and a competitive research landscape created by pediatric regulatory commitments. To overcome these challenges, innovative approaches are needed.MethodsThis article explores the use of Bayesian statistics to improve pediatric trial feasibility, using pediatric Type-2 diabetes as an example. Data for six therapies approved for adults were used to perform simulations to determine the impact on pediatric trial size.ResultsWhen the number of adult patients contributing to the simulation was assumed to be the same as the number of patients to be enrolled in the pediatric trial, the pediatric trial size was reduced by 75-78% when compared with a frequentist statistical approach, but was associated with a 34-45% false-positive rate. In subsequent simulations, greater control was exerted over the false-positive rate by decreasing the contribution of the adult data. A 30-33% reduction in trial size was achieved when false-positives were held to less than 10%.ConclusionReducing the trial size through the use of Bayesian statistics would facilitate completion of pediatric trials, enabling drugs to be labeled appropriately for children.

  4. Computer-assisted navigational surgery enhances safety in dental implantology.

    Science.gov (United States)

    Ng, F C; Ho, K H; Wexler, A

    2005-06-01

    Dental implants are increasingly used to restore missing dentition. These titanium implants are surgically installed in the edentulous alveolar ridge and allowed to osteointegrate with the bone during the healing phase. After osseo-integration, the implant is loaded with a prosthesis to replace the missing tooth. Conventional implant treatment planning uses study models, wax-ups and panoramic x-rays to prefabricate surgical stent to guide the preparation of the implant site. The drilling into the alveolar ridge is invariably a "blind" procedure as the part of the drill in bone is not visible. Stereotactic systems were first introduced into neurosurgery in 1986. Since then, computer-assisted navigational technology has brought major advances to neuro-, midface and orthopaedic surgeries, and more recently, to implant placement. This paper illustrates the use of real-time computer-guided navigational technology in enhancing safety in implant surgical procedures. Real-time computer-guided navigational technology enhances accuracy and precision of the surgical procedure, minimises complications and facilitates surgery in challenging anatomical locations.

  5. Inhibition of histone deacetylases 1 and 6 enhances cytarabine-induced apoptosis in pediatric acute myeloid leukemia cells.

    Directory of Open Access Journals (Sweden)

    Xuelian Xu

    Full Text Available BACKGROUND: Pediatric acute myeloid leukemia (AML remains a challenging disease to treat even with intensified cytarabine-based chemotherapy. Histone deacetylases (HDACs have been reported to be promising therapeutic targets for treating AML. However, HDAC family members that are involved in chemotherapy sensitivities remain unknown. In this study, we sought to identify members of the HDAC family that are involved in cytarabine sensitivities, and to select the optimal HDACI that is most efficacious when combined with cytarabine for treating children with AML. METHODOLOGY: Expression profiles of classes I, II, and IV HDACs in 4 pediatric AML cell lines were determined by Western blotting. Inhibition of class I HDACs by different HDACIs was measured post immnunoprecipitation. Individual down-regulation of HDACs in pediatric AML cells was performed with lentiviral shRNA. The effects of cytarabine and HDACIs on apoptosis were determined by flow cytometry analysis. RESULTS: Treatments with structurally diverse HDACIs and HDAC shRNA knockdown experiments revealed that down-regulation of both HDACs 1 and 6 is critical in enhancing cytarabine-induced apoptosis in pediatric AML, at least partly mediated by Bim. However, down-regulation of HDAC2 may negatively impact cytarabine sensitivities in the disease. At clinically achievable concentrations, HDACIs that simultaneously inhibited both HDACs 1 and 6 showed the best anti-leukemic activities and significantly enhanced cytarabine-induced apoptosis. CONCLUSION: Our results further confirm that HDACs are bona fide therapeutic targets for treating pediatric AML and suggest that pan-HDACIs may be more beneficial than isoform-specific drugs.

  6. Using Total Lightning Observations to Enhance Lightning Safety

    Science.gov (United States)

    Stano, Geoffrey T.

    2012-01-01

    Lightning is often the underrated threat faced by the public when it comes to dangerous weather phenomena. Typically, larger scale events such as floods, hurricanes, and tornadoes receive the vast majority of attention by both the general population and the media. This comes from the fact that these phenomena are large, longer lasting, can impact a large swath of society at one time, and are dangerous events. The threat of lightning is far more isolated on a case by case basis, although millions of cloud-to-ground lightning strikes hit this United States each year. While attention is given to larger meteorological events, lightning is the second leading cause of weather related deaths in the United States. This information raises the question of what steps can be taken to improve lightning safety. Already, the meteorological community s understanding of lightning has increased over the last 20 years. Lightning safety is now better addressed with the National Weather Service s access to the National Lightning Detection Network data and enhanced wording in their severe weather warnings. Also, local groups and organizations are working to improve public awareness of lightning safety with easy phrases to remember, such as "When Thunder Roars, Go Indoors." The impacts can be seen in the greater array of contingency plans, from airports to sports stadiums, addressing the threat of lightning. Improvements can still be made and newer technologies may offer new tools as we look towards the future. One of these tools is a network of sensors called a lightning mapping array (LMA). Several of these networks exist across the United States. NASA s Short-term Prediction Research and Transition Center (SPoRT), part of the Marshall Spaceflight Center, has access to three of these networks from Huntsville, Alabama, the Kennedy Space Center, and Washington D.C. The SPoRT program s mission is to help transition unique products and observations into the operational forecast environment

  7. Randomized clinical trial: pharmacokinetics and safety of multimatrix mesalamine for treatment of pediatric ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Cuffari C

    2016-02-01

    Full Text Available Carmen Cuffari,1 David Pierce,2 Bartosz Korczowski,3 Krzysztof Fyderek,4 Heather Van Heusen,5 Stuart Hossack,6 Hong Wan,5 Alena YZ Edwards,7 Patrick Martin5 1Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Shire, Basingstoke, UK; 3Medical College, University of Rzeszów, Rzeszów, Poland; 4University Children’s Hospital of Cracow, Cracow, Poland; 5Shire, Wayne, PA, USA; 6Covance Clinical Research Unit Limited, Leeds, UK; 7ICON Early Phase Services, Marlow, Buckinghamshire, UK Background: Limited data are available on mesalamine (5-aminosalicylic acid; 5-ASA use in pediatric ulcerative colitis (UC.Aim: To evaluate pharmacokinetic and safety profiles of 5-ASA and metabolite acetyl-5-ASA (Ac-5-ASA after once-daily, oral administration of multimatrix mesalamine to children and adolescents with UC.Methods: Participants (5–17 years of age; 18–82 kg, stratified by weight with UC received multimatrix mesalamine 30, 60, or 100 mg/kg/day once daily (to 4,800 mg/day for 7 days. Blood samples were collected pre-dose on days 5 and 6. On days 7 and 8, blood and urine samples were collected and safety was evaluated. 5-ASA and Ac-5-ASA plasma and urine concentrations were analyzed by non-compartmental methods and used to develop a population pharmacokinetic model.Results: Fifty-two subjects (21 [30 mg/kg]; 22 [60 mg/kg]; 9 [100 mg/kg] were randomized. On day 7, systemic exposures of 5-ASA and Ac-5-ASA exhibited a dose-proportional increase between 30 and 60 mg/kg/day cohorts. For 30, 60, and 100 mg/kg/day doses, mean percentages of 5-ASA absorbed were 29.4%, 27.0%, and 22.1%, respectively. Simulated steady-state exposures and variabilities for 5-ASA and Ac-5-ASA (coefficient of variation approximately 50% and 40%–45%, respectively were similar to those observed previously in adults at comparable doses. Treatment-emergent adverse events were

  8. Efficacy and safety of thymoglobulin induction as an alternative approach for steroid-free maintenance immunosuppression in pediatric renal transplantation.

    Science.gov (United States)

    Li, Li; Chaudhuri, Abanti; Chen, Amery; Zhao, Xinmeng; Bezchinsky, Maria; Concepcion, Waldo; Salvatierra, Oscar; Sarwal, Minnie M

    2010-12-27

    Given the recent withdrawal of daclizumab (DAC), the safety and efficacy of thymoglobulin (TMG) was tested as an alternative induction agent for steroid-free (SF) immunosuppression in pediatric kidney transplant recipients. Thirteen pediatric renal transplant recipients meeting defined high-risk criteria at transplantation were offered TMG induction and SF immunosuppression with maintenance mycophenolate mofetil and tacrolimus between October 2008 and January 2010. Patients were closely monitored at baseline, 3, 6, 9, and 12 months posttransplant for protocol biopsy and clinical outcomes. Outcomes were compared with 13 consecutively transplanted low-risk patients receiving an established DAC-based SF protocol (Sarwal et al., WA, American Transplant Congress 2003). There was a significant trend for overall decrease in the absolute lymphocyte counts in TMG group (F=5.86, mixed model group effect P=0.02), predominately at 3 months compared with DAC group (0.7±0.6 vs. 2.1±1.0, P=0.0004); however, lymphocyte count was recovered and was back to reference range by 6 months in TMG. There was trend toward more subclinical cytomegalovirus (15% vs. 0%) and BK viremia (17% vs. 0%) in the TMG group, with no differences in the incidence of subclinical Epstein Barr virus viremia (23% vs. 31%) or clinical viral disease. Mean graft function was excellent, and with a minimum follow-up of 6 months, there were no episodes of acute rejection. TMG seems to be a safe alternative induction strategy in patients for SF immunosuppression in pediatric renal transplantation. Extended follow-up and greater enrollment are necessary to fully explore the impact of TMG dosing on viral replication posttransplantation.

  9. Pediatric MS

    Science.gov (United States)

    ... Pediatric MS Share this page Facebook Twitter Email Pediatric MS Pediatric MS Pediatric MS Support Pediatric Providers ... system through the Pediatric MS Support Group . Treating pediatric MS In 2018 the U.S. Food and Drug ...

  10. Pediatric Drug Safety Signal Detection: A New Drug–Event Reference Set for Performance Testing of Data-Mining Methods and Systems

    NARCIS (Netherlands)

    O.U. Osokogu (Osemeke); F. Fregonese (Federica); C. Ferrajolo (Carmen); K.M.C. Verhamme (Katia); S. de Bie (Sandra); G. Jong (Geert’t); M. Catapano (Mariana); D. Weibel (Daniel); F. Kaguelidou (Florentia); W.M. Bramer (Wichor); Y. Hsia (Yingfen); I. Wong (Ian); M. Gazarian (Madlen); J. Bonhoeffer (Jan); M.C.J.M. Sturkenboom (Miriam)

    2015-01-01

    textabstractBackground: Better evidence regarding drug safety in the pediatric population might be generated from existing data sources such as spontaneous reporting systems and electronic healthcare records. The Global Research in Paediatrics (GRiP)–Network of Excellence aims to develop

  11. Food safety security: a new concept for enhancing food safety measures.

    Science.gov (United States)

    Iyengar, Venkatesh; Elmadfa, Ibrahim

    2012-06-01

    The food safety security (FSS) concept is perceived as an early warning system for minimizing food safety (FS) breaches, and it functions in conjunction with existing FS measures. Essentially, the function of FS and FSS measures can be visualized in two parts: (i) the FS preventive measures as actions taken at the stem level, and (ii) the FSS interventions as actions taken at the root level, to enhance the impact of the implemented safety steps. In practice, along with FS, FSS also draws its support from (i) legislative directives and regulatory measures for enforcing verifiable, timely, and effective compliance; (ii) measurement systems in place for sustained quality assurance; and (iii) shared responsibility to ensure cohesion among all the stakeholders namely, policy makers, regulators, food producers, processors and distributors, and consumers. However, the functional framework of FSS differs from that of FS by way of: (i) retooling the vulnerable segments of the preventive features of existing FS measures; (ii) fine-tuning response systems to efficiently preempt the FS breaches; (iii) building a long-term nutrient and toxicant surveillance network based on validated measurement systems functioning in real time; (iv) focusing on crisp, clear, and correct communication that resonates among all the stakeholders; and (v) developing inter-disciplinary human resources to meet ever-increasing FS challenges. Important determinants of FSS include: (i) strengthening international dialogue for refining regulatory reforms and addressing emerging risks; (ii) developing innovative and strategic action points for intervention {in addition to Hazard Analysis and Critical Control Points (HACCP) procedures]; and (iii) introducing additional science-based tools such as metrology-based measurement systems.

  12. Public safety investigations-A new evolutionary step in safety enhancement?

    International Nuclear Information System (INIS)

    Stoop, John; Roed-Larsen, Sverre

    2009-01-01

    A historical overview highlights the evolutionary nature of developments in accident investigations in the transport industry. Based on a series of major events outside transportation, the concept of accident investigations has broadened to other domains and to a widening of the scope of the investigation. Consequently, existing investigation boards are forced to adapt their mandates, missions and methods. With the introduction of social risk perception and application of the concept of safety investigation in the public sector, a change of focus towards the aftermath and non-technical issues of a more generic nature emerges. This expansion has also gained the interest of social sciences and public governance, generating new underlying models and theories on risk and responsibility. The evolutionary development of safety investigations is demonstrated by the various organisational forms which shaped accident investigations in different countries. Underneath these organisational differences, a need for a common methodology and a reflection on fundamental notions is discussed. In particular differences among human operator models, the allocation of responsibilities in design concepts and methodological issue are elaborated. The needs and opportunities for a transition from accident prevention towards systems change are indicated. At present, the situation is ambiguous. An encompassing inventory can only provide a general oversight over emerging trends and lacks analytic rigor on specific topics. The societal dimensions, institutional changes at the level of governance and control and the powers that advocate or challenge investigations are not yet fully described. Therefore, in the conclusions a small number of critical challenges and threats are identified that should be open to scrutiny in order to facilitate a new, evolutionary step in safety enhancement.

  13. Operating procedure automation to enhance safety of nuclear power plants

    International Nuclear Information System (INIS)

    Husseiny, A.A.; Sabri, Z.A.; Adams, S.K.; Rodriguez, R.J.; Packer, D.; Holmes, J.W.

    1989-01-01

    Use of logic statements and computer assist are explored as means for automation and improvement on design of operating procedures including those employed in abnormal and emergency situations. Operating procedures for downpower and loss of forced circulation are used for demonstration. Human-factors analysis is performed on generic emergency operating procedures for three strategies of control; manual, semi-automatic and automatic, using standard emergency operating procedures. Such preliminary analysis shows that automation of procedures is feasible provided that fault-tolerant software and hardware become available for design of the controllers. Recommendations are provided for tests to substantiate the promise of enhancement of plant safety. Adequate design of operating procedures through automation may alleviate several major operational problems of nuclear power plants. Also, automation of procedures is necessary for partial or overall automatic control of plants. Fully automatic operations are needed for space applications while supervised automation of land-based and offshore plants may become the thrust of new generation of nulcear power plants. (orig.)

  14. Acoustic Waves: A Route to Enhance Sodium Fast Reactor Safety

    International Nuclear Information System (INIS)

    Jeannot, Jean-Philippe; Baque, François; Cavaro, Matthieu; Gastaldi, Olivier; Lhuilier, Christian; Massacret, Nicolas; Moriot, Jérémy; Paumel, Kévin; Vandergaegen, Matthias; Rodriguez, Gilles

    2013-01-01

    Improvement to prevent core meltdown and to provide a more robust safety demonstration → Safety objectives: - A level of safety at least equivalent to EPR’s level, - Consolidation of the defence-in-depth principle, - A more robust safety demonstration than those of the Phenix and Superphenix reactor. Acoustic techniques: - Low attenuation by the sodium medium - High velocity of US wave (2289 m.s-1 at 550°C) →

  15. 76 FR 40648 - Safety Enhancements Part 139, Certification of Airports; Reopening of Comment Period

    Science.gov (United States)

    2011-07-11

    ... that was published on February 1, 2011. In that document, the FAA proposed several safety enhancements...-0247; Notice No. 11-01] RIN 2120-AJ70 Safety Enhancements Part 139, Certification of Airports... comment period for the NPRM published on February 1, 2011 (76 FR 5510) and reopened (76 FR 20570) April 13...

  16. Impact of resident duty hour limits on safety in the intensive care unit: a national survey of pediatric and neonatal intensivists.

    Science.gov (United States)

    Typpo, Katri V; Tcharmtchi, M Hossein; Thomas, Eric J; Kelly, P Adam; Castillo, Leticia D; Singh, Hardeep

    2012-09-01

    Resident duty-hour regulations potentially shift the workload from resident to attending physicians. We sought to understand how current or future regulatory changes might impact safety in academic pediatric and neonatal intensive care units. Web-based survey. U.S. academic pediatric and neonatal intensive care units. Attending pediatric and neonatal intensivists. We evaluated perceptions on four intensive care unit safety-related risk measures potentially affected by current duty-hour regulations: 1) attending physician and resident fatigue; 2) attending physician workload; 3) errors (self-reported rates by attending physicians or perceived resident error rates); and 4) safety culture. We also evaluated perceptions of how these risks would change with further duty-hour restrictions. We administered our survey between February and April 2010 to 688 eligible physicians, of whom 360 (52.3%) responded. Most believed that resident error rates were unchanged or worse (91.9%) and safety culture was unchanged or worse (84.4%) with current duty-hour regulations. Of respondents, 61.9% believed their own work-hours providing direct patient care increased and 55.8% believed they were more fatigued while providing direct patient care. Most (85.3%) perceived no increase in their own error rates currently, but in the scenario of further reduction in resident duty-hours, over half (53.3%) believed that safety culture would worsen and a significant proportion (40.3%) believed that their own error rates would increase. Pediatric intensivists do not perceive improved patient safety from current resident duty-hour restrictions. Policies to further restrict resident duty-hours should consider unintended consequences of worsening certain aspects of intensive care unit safety.

  17. Efficacy and safety of 5-grass-pollen sublingual immunotherapy tablets in pediatric allergic rhinoconjunctivitis

    DEFF Research Database (Denmark)

    Wahn, Ulrich; Tabar, Ana; Kuna, Piotr

    2009-01-01

    BACKGROUND: The efficacy and safety of the 300-index of reactivity (IR) dose of 5-grass-pollen sublingual immunotherapy (SLIT) tablets (Stallergènes, Antony, France) have been demonstrated for the treatment of hay fever in adults. OBJECTIVE: We sought to assess the efficacy and safety of this tab...

  18. Sedation in Pediatric Esophagogastroduodenoscopy

    Directory of Open Access Journals (Sweden)

    Seak Hee Oh

    2018-03-01

    Full Text Available Pediatric esophagogastroduodenoscopy (EGD has become an established diagnostic and therapeutic modality in pediatric gastroenterology. Effective sedation strategies have been adopted to improve patient tolerance during pediatric EGD. For children, safety is a fundamental consideration during this procedure as they are at a higher risk of severe adverse events from procedural sedation compared to adults. Therefore, a detailed risk evaluation is required prior to the procedure, and practitioners should be aware of the benefits and risks associated with sedation regimens during pediatric EGD. In addition, pediatric advanced life support by endoscopists or immediate intervention by anesthesiologists should be available in the event that severe adverse events occur during pediatric EGD.

  19. Strengthening leadership as a catalyst for enhanced patient safety culture

    DEFF Research Database (Denmark)

    Kristensen, Solvejg; Christensen, Karl Bang; Jaquet, Annette

    2016-01-01

    OBJECTIVES: Current literature emphasises that clinical leaders are in a position to enable a culture of safety, and that the safety culture is a performance mediator with the potential to influence patient outcomes. This paper aims to investigate staff's perceptions of patient safety culture...... in a Danish psychiatric department before and after a leadership intervention. METHODS: A repeated cross-sectional experimental study by design was applied. In 2 surveys, healthcare staff were asked about their perceptions of the patient safety culture using the 7 patient safety culture dimensions...... in the Safety Attitudes Questionnaire. To broaden knowledge and strengthen leadership skills, a multicomponent programme consisting of academic input, exercises, reflections and discussions, networking, and action learning was implemented among the clinical area level leaders. RESULTS: In total, 358 and 325...

  20. Parental Reflective Functioning: An Approach to Enhancing Parent-Child Relationships in Pediatric Primary Care.

    Science.gov (United States)

    Ordway, Monica Roosa; Webb, Denise; Sadler, Lois S; Slade, Arietta

    2015-01-01

    The current state of science suggests that safe, responsive, and nurturing parent-child relationships early in children's lives promotes healthy brain and child development and protection against lifelong disease by reducing toxic stress and promoting foundational social-emotional health. Pediatric health care providers (HCPs) have a unique opportunity to foster these relationships. However, such a role requires a shift in pediatric health care from a focus only on children to one that includes families and communities, as well as the inclusion of children's social and emotional health with their physical health. To foster healthy parent-child relationships, HCPs must develop the expertise to integrate approaches that support the family's socioemotional health into pediatric primary care. This article suggests ways in which pediatric HCPs can integrate a focus on parental reflective functioning into their clinical work, helping parents to understand some of the thoughts and feelings that underlie their children's behavior. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  1. Enhancing pediatric residents’ scholar role: the development of a Scholarly Activity Guidance and Evaluation program

    Directory of Open Access Journals (Sweden)

    Catherine M. Pound

    2015-06-01

    Full Text Available Background: Research training is essential to the development of well-rounded physicians. Although many pediatric residency programs require residents to complete a research project, it is often challenging to integrate research training into educational programs. Objective: We aimed to develop an innovative research program for pediatric residents, called the Scholarly Activity Guidance and Evaluation (SAGE program. Methods: We developed a competency-based program which establishes benchmarks for pediatric residents, while providing ongoing academic mentorship. Results: Feedback from residents and their research supervisors about the SAGE program has been positive. Preliminary evaluation data have shown that all final-year residents have met or exceeded program expectations. Conclusions: By providing residents with this supportive environment, we hope to influence their academic career paths, increase their research productivity, promote evidence-based practice, and ultimately, positively impact health outcomes.

  2. Enhancing Public Helicopter Safety as a Component of Homeland Security

    Science.gov (United States)

    2016-12-01

    Risk Assessment Tool GPS Global Positioning System IFR instrument flight rules ILS instrument landing system IMC instrument meteorological...daily operations. Additionally, the effectiveness of the standards is evaluated by determining if these standards would have prevented the accidents...trends, such as human behavior and lack of standards, that are common in public safety helicopter accidents. Public safety aviation agencies can use this

  3. Enhancing vaccine safety capacity globally: A lifecycle perspective

    NARCIS (Netherlands)

    R.T. Chen (Robert T.); T.T. Shimabukuro (Tom T.); D.B. Martin (David); P. Zuber (Patrick); D.M. Weibel (Daniel); M.C.J.M. Sturkenboom (Miriam)

    2015-01-01

    textabstractMajor vaccine safety controversies have arisen in several countries beginning in the last decades of 20th century. Such periodic vaccine safety controversies are unlikely to go away in the near future as more national immunization programs mature with near elimination of target

  4. EGP contribution to Mochovce completion, safety enhancement and operation

    International Nuclear Information System (INIS)

    Letko, A.; Matula, P.

    2000-01-01

    The Re-Evaluation Programme of Mochovce NPP was created in 1995 as an integral part of the completion of the Unit 1 and Unit 2. This program analyzed the general fulfillment of the principle of nuclear safety in the NPP Mochovce project. The analysis has required new corrections of the project, so that the project met the higher safety requirements when starting production. 87 safety measures represent the 'Program'. The basis for their creation were the international missions from 1992 to 1995 which defined. The final safety aim was represented by 'The Technical Specification of the Safety Measures' supported by The Nuclear Power Plant Research Institute and recommended by The Nuclear Regulatory Authority of the Slovak Republic. The technical specification served as a qualified base for the next steps in the pre-project, project and realization stages. (author)

  5. Contractors’ Attitude towards Enhancing Safety Performance: Case Study on Construction Firms in Penang

    Directory of Open Access Journals (Sweden)

    Ulang N. Md

    2014-01-01

    Full Text Available A qualitative study was conducted to investigate the contractors’ attitude towards enhancing the safety performance in construction site. Despite the fact that there are many safety initiatives established by the government, the rates of accidents are still in a critically high condition. Thus the purpose of this research is to study the contractors’ attitude towards enhancing the implementation of safety management system in construction site in order to increase the safety awareness of construction practitioners in construction site and improve the safety condition of construction sites. This study is conducted through oral interviews with the construction practitioners, and visual inspection of construction sites. The attitudes of contractors are evaluated from 3 aspects: Contractors’ efforts in implement and enforce the safety rules, Contractors efforts in overcoming the rate of accidents, and Reasons given by the contractors for not implement safety law.

  6. Efficacy of a radiation safety education initiative in reducing radiation exposure in the pediatric IR suite

    International Nuclear Information System (INIS)

    Sheyn, David D.; Racadio, John M.; Patel, Manish N.; Racadio, Judy M.; Johnson, Neil D.; Ying, Jun

    2008-01-01

    The use of ionizing radiation is essential for diagnostic and therapeutic imaging in the interventional radiology (IR) suite. As the complexity of procedures increases, radiation exposure risk increases. We believed that reinforcing staff education and awareness would help optimize radiation safety. To evaluate the effect of a radiation safety education initiative on IR staff radiation safety practices and patient radiation exposure. After each fluoroscopic procedure performed in the IR suite during a 4-month period, dose-area product (DAP), fluoroscopy time, and use of shielding equipment (leaded eyeglasses and hanging lead shield) by IR physicians were recorded. A lecture and article were then given to IR physicians and technologists that reviewed ALARA principles for optimizing radiation dose. During the following 4 months, those same parameters were recorded after each procedure. Before education 432 procedures were performed and after education 616 procedures were performed. Physician use of leaded eyeglasses and hanging shield increased significantly after education. DAP and fluoroscopy time decreased significantly for uncomplicated peripherally inserted central catheters (PICC) procedures and non-PICC procedures after education, but did not change for complicated PICC procedures. Staff radiation safety education can improve IR radiation safety practices and thus decrease exposure to radiation of both staff and patients. (orig.)

  7. Safety and efficacy of aripiprazole for the treatment of pediatric Tourette syndrome and other chronic tic disorders.

    Science.gov (United States)

    Cox, Joanna H; Seri, Stefano; Cavanna, Andrea E

    2016-01-01

    Tourette syndrome is a childhood-onset chronic tic disorder characterized by multiple motor and vocal tics and often accompanied by specific behavioral symptoms ranging from obsessionality to impulsivity. A considerable proportion of patients report significant impairment in health-related quality of life caused by the severity of their tics and behavioral symptoms and require medical intervention. The most commonly used medications are antidopaminergic agents, which have been consistently shown to be effective for tic control, but are also associated with poor tolerability because of their adverse effects. The newer antipsychotic medication aripiprazole is characterized by a unique mechanism of action (D2 partial agonism), and over the last decade has increasingly been used for the treatment of tics. We conducted a systematic literature review to assess the available evidence on the efficacy and safety of aripiprazole in pediatric patients with Tourette syndrome and other chronic tic disorders (age range: 4-18 years). Our search identified two randomized controlled trials (involving 60 and 61 participants) and ten open-label studies (involving between six and 81 participants). The majority of these studies used two validated clinician-rated instruments (Yale Global Tic Severity Scale and Clinical Global Impression scale) as primary outcome measures. The combined results from randomized controlled trials and open-label studies showed that aripiprazole is an effective, safe, and well-tolerated medication for the treatment of tics. Aripiprazole-related adverse effects (nausea, sedation, and weight gain) were less frequent compared to other antidopaminergic medications used for tic management and, when present, were mostly transient and mild. The reviewed studies were conducted on small samples and had relatively short follow-up periods, thus highlighting a need for further trials to assess the long-term use of aripiprazole in pediatric patients with Tourette syndrome

  8. Enhancing NPP Safety Through an Effective Dependability Management

    Energy Technology Data Exchange (ETDEWEB)

    Vieru, G., E-mail: g_vieru@yahoo.com [AREN, Bucharest (Romania)

    2014-10-15

    Taking into account the importance of the continuous improvement of the performance and reliability of a NPP and practical measures to strengthen nuclear safety and security, it is to be noted that a good management for a nuclear power reactor involves a ''good dependability management'' of the activities, such as: Reliability, Availability, Maintainability (RAM) and maintenance support. In order to evaluate certain safety assessment criteria intended to be applied at the level of the nuclear reactor unit management, equipment dependability indicators and their impact over the availability and reactor safety have to be evaluated. Reactor equipment dependability indicators provide a quantitative indication of equipment RAM performances (Reliability, Availability and Maintenance). One of the important benefits of maintenance and failure data gathering is that it can be used as a support of probabilistic safety assessment (PSA). Also, a good dependability management implementation may be used to complement reactor level unit performance indicators in the field of safe operation, maintenance and improving operating parameters, as well as for Strengthening Safety and Improving Reliability of a NPP. This paper underlines the importance of nuclear safety and security as prerequisites for nuclear power. In addition, it demonstrates how different technical aspects, through implementation of a good dependability management, contribute to a strengthened safety and an improvement of availability of the NPP through dependability indicators determination and evaluation. (author)

  9. IRSN - Annual Report 2013. Financial Report 2013. Enhancing nuclear safety

    International Nuclear Information System (INIS)

    Schuler, Matthieu; Marchal, Valerie; Albert, Marc-Gerard; Aurelle, Jacques; Bigot, Marie-Pierre; Bruna, Giovanni; Charron, Sylvie; Clavelle, Stephanie; Cousinou, Patrick; Deschamps, Patrice; Delattre, Aleth; Demeillers, Didier; Dumas, Agnes; Franquard, Dominique; Laloi, Patrick; Lorthioir, Stephane; Monti, Pascale; Rollinger, Francois; Rouyer, Veronique; Rutschkovsky, Nathalie; Scott De Martinville, Edouard; Tharaud, Christine; Verpeaux, Jean-Luc; Jaunet, Camille; Hedouin, Jean-Christophe; Pascal-Heuze, Charlotte

    2014-03-01

    IRSN, a public entity with industrial and commercial activities, is placed under the joint authority of the Ministries of Defense, Environment, Industry, Research, and Health. It is the nation's public service expert in nuclear and radiation risks, and its activities cover all the related scientific and technical issues. Its areas of specialization include the environment and radiological emergency response, human radiation protection in both a medical and professional capacity, and in both normal and post-accident situations, the prevention of major accidents, nuclear reactor safety, as well as safety in nuclear plants and laboratories, transport and waste treatment, and nuclear defense and security expertise. IRSN interacts with all parties concerned by these risks (public authorities, in particular nuclear safety and security authorities, local authorities, companies, research organizations, stakeholders' associations, etc.) to contribute to public policy issues relating to nuclear safety, human and environmental protection against ionizing radiation, and the protection of nuclear materials, facilities, and transport against the risk of malicious acts. This document is the 2013 issue of IRSN's activity report. Content: 1 - Organization, key figures; 2 - Strategy: Progress and main activities in 2013, Transparency and communications policy, Promoting a safety and radiation protection culture; 3 - Activities: Safety (Safety of existing facilities, Studies and researches, About defense, Conducting assessments of future facilities); Nuclear security and non-proliferation (Nuclear security activities, International non-proliferation controls); Radiation protection - environment and human health (Environmental and population exposure, Radiation protection in the workplace, Effects of chronic exposure, Protection in health care); Emergency and post-accident situations efficiency; 4 - Efficiency: Health, safety, environmental, protection and quality, Human resources

  10. Post-marketing safety and effectiveness evaluation of the intravenous anti-influenza neuraminidase inhibitor peramivir. II: a pediatric drug use investigation.

    Science.gov (United States)

    Komeda, Takuji; Ishii, Shingo; Itoh, Yumiko; Ariyasu, Yasuyuki; Sanekata, Masaki; Yoshikawa, Takayoshi; Shimada, Jingoro

    2015-03-01

    Peramivir is the only intravenous formulation among anti-influenza neuraminidase inhibitors currently available. Peramivir was approved for manufacturing and marketing in Japan in January 2010. In October 2010, an additional indication for pediatric use was approved. We conducted a pediatric drug use investigation of peramivir from October 2010 to February 2012 and evaluated its real-world safety and effectiveness in pediatric patients. We collected the data of 1254 peramivir-treated pediatric patients from 161 facilities across Japan and examined the safety in 1199 patients and effectiveness in 1188 patients. In total, 245 adverse events were observed with an incidence rate of 14.01% (168/1199). Of these, 115 events were adverse drug reactions (ADRs) with an incidence rate of 7.67% (92/1199). Common ADRs were diarrhea and abnormal behavior, with incidence rates of 2.50% (30/1199) and 2.25% (27/1199), respectively. Fourteen serious ADRs were observed in 12 patients (1.00%), including 5 cases each of abnormal behavior and neutrophil count decreased. While 87.0% (100 events) of ADRs occurred within 3 days after the initiation of peramivir administration, 87.8% (101 events) resolved or improved within 7 days after onset. Multivariate analyses indicated that the presence or absence of underlying diseases/complications was significantly related to ADR incidence. With regard to effectiveness, the median time to alleviation of both influenza symptoms and fever was 3 days, including the first day of administration. Thus, this study confirms the pediatric safety of peramivir without any concerns about effectiveness under routine clinical settings. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  11. Enhanced safety of radiation workers: a regulatory approach

    Energy Technology Data Exchange (ETDEWEB)

    Gopalakrishnan, A [Atomic Energy Regulatory Board, Bombay (India)

    1994-04-01

    Radiation safety should not only be strictly implemented, but also believed and understood by the workers, the unions, the media and the general public as being fairly and adequately enforced. It is not at all sufficient that only those in the operational management levels satisfy themselves that workers` safety is properly taken care of, but it is necessary that the workers and their unions are also convinced about it and share this management view.

  12. Enhanced safety of radiation workers: a regulatory approach

    International Nuclear Information System (INIS)

    Gopalakrishnan, A.

    1994-01-01

    Radiation safety should not only be strictly implemented, but also believed and understood by the workers, the unions, the media and the general public as being fairly and adequately enforced. It is not at all sufficient that only those in the operational management levels satisfy themselves that workers' safety is properly taken care of, but it is necessary that the workers and their unions are also convinced about it and share this management view

  13. A proposed approach for enhancing design safety assurance of future plants

    International Nuclear Information System (INIS)

    Oh, Kyu Myeng; Ahn, Sang Kyu; Lee, Chang Ju; Kim, Inn Seock

    2010-01-01

    This paper provides various insights from a detailed review of deterministic approaches typically applied to ensure design safety of nuclear power plants (NPPs) and risk-informed approaches proposed to evaluate safety of advanced reactors such as Generation IV reactors. Also considered herein are the risk-informed safety analysis (RISA) methodology suggested by Westinghouse as a means to improve the conventional accident analysis, together with the Technology Neutral Framework recently suggested by the U.S. NRC for safety evaluation of future plants. These insights from the comparative review of deterministic and risk-informed approaches could be used in further enhancing the methodology for design safety assurance of future plants

  14. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... your child. top of page Additional Information and Resources The Alliance for Radiation Safety in Pediatric Imaging's " ... A child being prepared for a CT scan. View full size with caption Pediatric Content Some imaging ...

  15. Simulation research to enhance patient safety and outcomes: recommendations of the Simnovate Patient Safety Domain Group

    OpenAIRE

    Pucher, PH; Tamblyn, R; Boorman, D; Dixon-Woods, Mary Margaret; Donaldson, L; Draycott, T; Forster, A; Nadkarni, V; Power, C; Sevdalis, N; Aggarwal, R

    2017-01-01

    The use of simulation-based training has established itself in healthcare but its implementation has been varied and mostly limited to technical and non-technical skills training. This article discusses the possibilities of the use of simulation as part of an overarching approach to improving patient safety, and represents the views of the Simnovate Patient Safety Domain Group, an international multidisciplinary expert group dedicated to the improvement of patient safety. The application and ...

  16. Enhancing the Safety Climate and Reducing Violence Against Staff in Closed Hospital Wards.

    Science.gov (United States)

    Isaak, Valerie; Vashdi, Dana; Bar-Noy, Dor; Kostisky, Hava; Hirschmann, Shmuel; Grinshpoon, Alexander

    2017-09-01

    This study examined the effectiveness of an intervention program to enhance unit safety climate and minimize employee risk of injury from patient violence. The intervention program, including a 3-day workshop, was offered to personnel on maximum security units of an Israeli psychiatric hospital. Safety climate was examined before and after the implementation of the intervention, and incidents of patient violence were investigated. Six months after the intervention, a significant improvement in employees' perceptions of management's commitment to safety as well as a marginally significant improvement in communication about safety issues were found. This study demonstrated that an intervention program to enhance safety climate was associated with a decrease in the number of aggressive incidents. The researchers concluded that this intervention program is likely to return a sense of safety to workers and reduce workplace violence.

  17. ENHANCING FOOD SAFETY AND STABILITY THROUGH IRRADIATION: A REVIEW

    Directory of Open Access Journals (Sweden)

    Manzoor Ahmad Shah

    2014-04-01

    Full Text Available Food irradiation is one of the non thermal food processing methods. It is the process of exposing food materials to the controlled amounts of ionizing radiations such as gamma rays, X-rays and accelerated electrons, to improve microbiological safety and stability. Irradiation disrupts the biological processes that lead to decay of food quality. It is an effective tool to reduce food-borne pathogens, spoilage microorganisms and parasites; to extend shelf-life and for insect disinfection. The safety and consumption of irradiated foods have been extensively studied at national levels and in international cooperations and have concluded that foods irradiated under appropriate technologies are both safe and nutritionally adequate. Specific applications of food irradiation have been approved by national legislations of more than 55 countries worldwide. This review aims to discuss the applications of irradiation in food processing with the emphasis on food safety and stability.

  18. Enhancing nuclear safety. Annual report 2014. Financial report 2014

    International Nuclear Information System (INIS)

    2015-01-01

    After some introductory texts proposed by several IRSN head managers, and a brief presentation of some key data illustrating the activity, the annual report presents the main strategic orientations, notably in the field of knowledge management, and of information and communication. After some images illustrating the past year, activities are presented. They first deal with safety: Reactor safety (operating experience feedback), From decommissioning old reactors to designing those of the future, Safety of laboratories and plants, Safety regarding risks due to infrastructure near nuclear facilities, Reactor aging, Fuel: research on corrosion and deformation, Research and assessments for improved understanding of accident situations, Earthquakes: research and assessments, About defense, Geological disposal of radioactive waste. They secondly deal with security and non-proliferation (nuclear security, nuclear non-proliferation, chemical weapon ban), thirdly with radiation protection for human and environment health (environment monitoring, radionuclide transfer in the environment, radon and polluted sites, human exposure, radiation protection in the workplace, effects of low-dose chronic exposures, Organization of radiation protection at the European level, protection in health care), and fourthly with emergency and post-accident situations (emergency and post-accident preparedness and response, Emergency response tools). The next part of the activity report addresses issues related to efficiency: Real estate program (construction projects get started), Hygiene, safety, social responsibility, Human resources, Organization chart, Board of directors, Steering committee for the nuclear defense expertise Division - CODEND, Scientific council, Ethics commission composition, Nuclear safety and radiation protection Research policy committee - COR. The financial report proposes a management report, financial statements with an appendix to annual accounts, and an auditor

  19. Efficacy and Safety of Vaccination in Pediatric Patients with Systemic Inflammatory Rheumatic Diseases: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Sandra Sousa

    2017-01-01

    Full Text Available Introduction: Children and adolescents with systemic rheumatic diseases have an increased risk of infections. Although some infections are vaccine-preventable, immunization among patients with juvenile rheumatic diseases is suboptimal, partly due to some doubts that still persist regarding its efficacy and safety in this patient population. Objectives: To review the available evidence regarding the immunological response and the safety of vaccination in children and adolescents with systemic inflammatory rheumatic diseases (SIRD. Methods: A systematic review of the current literature until December 2014 using MEDLINE, EMBASE and abstracts from the American College of Rheumatology and European League Against Rheumatism congresses (2011-2014, complemented by hand search was performed. Eligible studies were identified and efficacy (seroprotection and/or seroconversion and safety (reactions to vaccine and relapse of rheumatic disease outcomes were extracted and summarized according to the type of vaccine. Results: Twenty-eight articles concerning vaccination in pediatric patients with SIRDs were found, that included almost 2100 children and adolescents, comprising nearly all standard vaccinations of the recommended immunization schedule. Children with SIRDs generally achieved seroprotection and seroconversion; nevertheless, the antibody levels were often lower when compared with healthy children. Glucocorticoids and conventional disease-modifying anti-rheumatic drugs do not seem to significantly hamper the immune responses, whereas TNF inhibitors may reduce antibody production, particularly in response to pneumococcal conjugate, influenza, meningococcal C and hepatitis A vaccine. There were no serious adverse events, nor evidence of a relevant worsening of the underlying rheumatic disease. Concerning live attenuated vaccines, the evidence is scarce, but no episodes of overt disease were reported, even in patients under biological therapy

  20. Efficacy and Safety of Vaccination in Pediatric Patients with Systemic Inflammatory Rheumatic Diseases: a systematic review of the literature.

    Science.gov (United States)

    Sousa, Sandra; Duarte, Ana Catarina; Cordeiro, Inês; Ferreira, Joana; Gonçalves, Maria João; Meirinhos, Tiago; Rocha, Teresa Martins; Romão, Vasco C; Santos, Maria José

    2017-01-01

    Children and adolescents with systemic rheumatic diseases have an increased risk of infections. Although some infections are vaccine-preventable, immunization among patients with juvenile rheumatic diseases is suboptimal, partly due to some doubts that still persist regarding its efficacy and safety in this patient population. To review the available evidence regarding the immunological response and the safety of vaccination in children and adolescents with systemic inflammatory rheumatic diseases (SIRD). A systematic review of the current literature until December 2014 using MEDLINE, EMBASE and abstracts from the American College of Rheumatology and European League Against Rheumatism congresses (2011-2014), complemented by hand search was performed. Eligible studies were identified and efficacy (seroprotection and/or seroconversion) and safety (reactions to vaccine and relapse of rheumatic disease) outcomes were extracted and summarized according to the type of vaccine. Twenty-eight articles concerning vaccination in pediatric patients with SIRDs were found, that included almost 2100 children and adolescents, comprising nearly all standard vaccinations of the recommended immunization schedule. Children with SIRDs generally achieved seroprotection and seroconversion; nevertheless, the antibody levels were often lower when compared with healthy children. Glucocorticoids and conventional disease-modifying anti-rheumatic drugs do not seem to significantly hamper the immune responses, whereas TNF inhibitors may reduce antibody production, particularly in response to pneumococcal conjugate, influenza, meningococcal C and hepatitis A vaccine. There were no serious adverse events, nor evidence of a relevant worsening of the underlying rheumatic disease. Concerning live attenuated vaccines, the evidence is scarce, but no episodes of overt disease were reported, even in patients under biological therapy. Existing literature demonstrates that vaccines are generally well

  1. Enhanced FAA-hybrid III numerical dummy model in Madymo for aircraft occupant safety assessment

    NARCIS (Netherlands)

    Boucher, H.; Waagmeester, C.D.

    2003-01-01

    To improve survivability and to minimize the risk of injury to occupants in helicopter crash events, a complete Cabin Safety System concept including safety features and an enhanced FAA-Hybrid III dummy were developed within the HeliSafe project. A numerical tool was also created and validated to

  2. Safety of Ultrasound-Guided Botulinum Toxin Injections for Sialorrhea as Performed by Pediatric Otolaryngologists.

    Science.gov (United States)

    Shariat-Madar, Bahbak; Chun, Robert H; Sulman, Cecille G; Conley, Stephen F

    2016-05-01

    To evaluate incidence of complications and hospital readmission as a result of ultrasound-guided botulinum toxin injections to manage sialorrhea. Case series with chart review. Children's Hospital of Wisconsin. A case series with chart review was performed of all cases of ultrasound-guided injection of botulinum toxin by pediatric otolaryngologists from March 5, 2010, to September 26, 2014,. Primary outcomes included complications such as dysphagia, aspiration pneumonia, and motor paralysis. Secondary outcomes included hospitalization, intubation, and nasogastric tube placement. There were 48 patients, 111 interventions, and 306 intraglandular injections identified. Botulinum toxin type A and type B were utilized in 4 and 107 operative interventions, respectively. Type A was injected into 4 parotid and 4 submandibular glands, utilizing doses of 20 U per parotid and 30 U per submandibular gland. Type B was injected into 98 parotid and 200 submandibular glands, with average dosing of 923 U per parotid and 1170 U per submandibular gland, respectively. There were 2 instances of subjectively worsening of baseline dysphagia that self-resolved. No cases were complicated by aspiration pneumonia or motor paralysis. No patients required hospital readmission, intubation, or nasogastric tube placement. Prior published data indicated 16% complication incidence with ultrasound-guided injection of botulinum toxin. Our study found a low complication rate (0.6%) with ultrasound-guided injections of botulinum toxin to manage sialorrhea, without cases of aspiration pneumonia or motor paralysis. Of 306 intraglandular injections, there were 2 cases of worsening baseline subjective dysphagia that self-resolved. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  3. Clinical efficacy and safety of polyethylene glycol 3350 versus liquid paraffin in the treatment of pediatric functional constipation.

    Science.gov (United States)

    Rafati, Mr; Karami, H; Salehifar, E; Karimzadeh, A

    2011-01-01

    Functional constipation is prevalent in children. Recently polyethylene glycol has been introduced as an effective and safe drug to treat chronic constipation. There are only a few clinical trials on comparison of PEG and liquid paraffin in childhood constipation. The purpose of this study was to evaluate clinical efficacy and safety of PEG 3350 solution and liquid paraffin in the treatment of children with functional constipation in Sari Toba clinic during the period of 2008-2009. Children with a history of functional constipation were subjects of this study. One hundred and sixty children of 2-12 years old with functional constipation were randomized in two PEG and paraffin treatment groups. Patients received either 1.0-1.5 g/kg/day PEG 3350 or 1.0-1.5 ml/kg/day liquid paraffin for 4 months. Clinical efficacy was evaluated by stool and encopresis frequency/week and overall treatment success rate was compared in two groups. Compared with the baseline, defecation frequency/ week increased significantly and encopresis frequency meaningfully decreased in two groups during the period of the study. Patients using PEG 3350 had more success rate (mean: 95.3%±3.7) compared with the patients in paraffin group (mean: 87.2%±7.1) (p=0.087). Administration of PEG 3350 were associated with less adverse events than liquid paraffin. In conclusion in treatment of pediatric functional constipation, regarding clinical efficacy and safety, PEG 3350 were at least as effective as liquid paraffin and but less adverse drug events.

  4. Clinical efficacy and safety of polyethylene glycol 3350 versus liquid paraffin in the treatment of pediatric functional constipation

    Directory of Open Access Journals (Sweden)

    E Salehifar

    2011-05-01

    Full Text Available "nBackground and the purpose of the study: Functional constipation is prevalent in children. Recently has been introduced as an effective and safe drug to treat chronic constipation. There are only a few clinical trials on comparison of PEG and liquid paraffin in childhood constipation. The purpose of this study was to evaluate clinical efficacy and safety of PEG 3350 solution and liquid paraffin in the treatment of children with functional constipation in Sari Toba clinic during the period of 2008-2009. "nMethods: Children with a history of functional constipation were subjects of this study. One hundred and sixty children of 2-12 years old with functional constipation were randomized in two PEG and paraffin treatment groups. Patients received either 1.0-1.5 g/kg/day PEG 3350 or 1.0-1.5 ml/kg/day liquid paraffin for 4 months. Clinical efficacy was evaluated by stool and encopresis frequency/week and overall treatment success rate was compared in two groups. "nResults and major conclusion: Compared with the baseline, defecation frequency/ week increased significantly and encopresis frequency meaningfully decreased in two groups during the period of the study. Patients using PEG 3350 had more success rate (mean: 95.3%±3.7 compared with the patients in paraffin group (mean: 87.2%±7.1 (p=0.087. Administration of PEG 3350 was associated with less adverse events than liquid paraffin. In conclusion in treatment of pediatric functional constipation , regarding clinical efficacy and safety, PEG 3350 were at least as effective as liquid paraffin and but less adverse drug events.

  5. Clinical efficacy and safety of polyethylene glycol 3350 versus liquid paraffin in the treatment of pediatric functional constipation

    Science.gov (United States)

    Rafati, MR.; Karami, H.; Salehifar, E.; Karimzadeh, A.

    2011-01-01

    Background and the purpose of the study Functional constipation is prevalent in children. Recently polyethylene glycol has been introduced as an effective and safe drug to treat chronic constipation. There are only a few clinical trials on comparison of PEG and liquid paraffin in childhood constipation. The purpose of this study was to evaluate clinical efficacy and safety of PEG 3350 solution and liquid paraffin in the treatment of children with functional constipation in Sari Toba clinic during the period of 2008–2009. Methods Children with a history of functional constipation were subjects of this study. One hundred and sixty children of 2–12 years old with functional constipation were randomized in two PEG and paraffin treatment groups. Patients received either 1.0–1.5 g/kg/day PEG 3350 or 1.0–1.5 ml/kg/day liquid paraffin for 4 months. Clinical efficacy was evaluated by stool and encopresis frequency/week and overall treatment success rate was compared in two groups. Results and major conclusion Compared with the baseline, defecation frequency/ week increased significantly and encopresis frequency meaningfully decreased in two groups during the period of the study. Patients using PEG 3350 had more success rate (mean: 95.3%±3.7) compared with the patients in paraffin group (mean: 87.2%±7.1) (p=0.087). Administration of PEG 3350 were associated with less adverse events than liquid paraffin. In conclusion in treatment of pediatric functional constipation, regarding clinical efficacy and safety, PEG 3350 were at least as effective as liquid paraffin and but less adverse drug events. PMID:22615652

  6. Challenges and Enhancements to the Safety Culture of the Regulatory Body

    International Nuclear Information System (INIS)

    Niel, Jean-Christophe; Chevet, Pierre Franck; Sheron, Brian; Boyd, Michael; Carlsson, Lennart; Tiippana, Petteri; Burns, Stephen; Jamieson, Terry; Fuketa, Toyoshi; Rzentkowski, Greg; Weiss, Frank Peter; Le Guen, Bernard

    2015-06-01

    The workshop opened with presentations by both the NEA Director-General and the chair of the three committees directly involved with the safety culture of the regulatory body (SCRB). The opening session set the scene and gave an overview of the SCRB together with presentations and discussions on priorities and challenges. The main session focused on the principles of the SCRB, its implementation and the challenges and enhancements that are being raised and considered. The workshop concluded with a session that looked at findings and conclusions, the way forward and an agreed position on the SCRB. This document brings together the available presentations (slides) given at the workshop: 1 - Introduction: Challenges and Enhancements to the Safety Culture of the Regulatory Body (J-C. Niel); 2 - Thoughts on Safety Culture from a CSNI Perspective (B. Sheron); 3 - Radiological Protection Culture: CRPPH Work (M. Boyd); 4 - Challenges and Enhancements to Safety Culture of the Regulatory Body (L. Carlsson); 5 - Principles for the safety culture of the regulatory body (P. Tiippana); 6 - NRC's Internal Safety Culture: Successes, Challenges, and the Path Forward (S.G. Burns); 7 - Insights on the Canadian Nuclear Safety Commission's Safety Culture Journey (T. Jamieson); 8 - Lessons Learned from the Fukushima Dai-ichi Accident regarding Safety Culture of Regulatory Body (T. Fuketa); 9 - Challenges to Regulatory Bodies' safety culture (P-F. Chevet); 10 - Regulatory Safety Culture: International Perspective (G. Rzentkowski); 11 - Integration of Safety Research into Safety Culture Concepts (F-P. Weiss); 12 - Radiation Protection and Emergency Management Aspects: Culture drawn up by RP professionals (B. Le Guen); 13 - Closing session panel (L. Carlsson)

  7. Regional aviation safety organisations : enhancing air transport safety through regional cooperation

    NARCIS (Netherlands)

    Ratajczyk, Mikołaj Andrzej

    2014-01-01

    Aviation safety is of global concern. Yet 43% of countries worldwide lack the expertise and administrative capacity to ensure effective safety oversight of the aviation activities for which they are responsible under international law. With air traffic predicted to double in the next 15 years and

  8. Mobilizing local safety nets for enhanced adaptive capacity to ...

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

    22 avr. 2016 ... In Zimbabwe, the increased frequency of drought, flash floods, and unpredictable rainfall has added to recurrent food deficits for poor households who depend on rainfed farming on nutrient poor soils. This brief explores how the erosion of Zunde raMambo — a traditional community safety net mechanism ...

  9. Contrast-enhanced magnetic resonance venography in pediatric patients with chronic kidney disease: initial experience with ferumoxytol

    International Nuclear Information System (INIS)

    Luhar, Aarti; Khan, Sarah; Ghahremani, Shahnaz; Griggs, Rachel; Hall, Theodore R.; Finn, J.P.; Zaritsky, Joshua; Salusky, Isidro

    2016-01-01

    Ferumoxytol is an ultra-small superparamagnetic iron oxide (USPIO) particle that is FDA-approved for parenteral treatment of iron deficiency anemia in adults with chronic kidney disease. Because of the association between gadolinium-based contrast agents and nephrogenic systemic fibrosis in patients with severe chronic kidney disease, we sought to evaluate the diagnostic role of ferumoxytol-enhanced MR venography in children with chronic kidney disease. Twenty children underwent 22 high-resolution ferumoxytol-enhanced MR venography examinations at 3.0 T. High-resolution 3-D contrast-enhanced imaging was performed at a minimum of 3 time points following injection of ferumoxytol at a total dose of 4 mg/kg. Two blinded pediatric radiologists independently scored six named veins on ferumoxytol-enhanced MR venography examinations according to a three-point subjective score, where a score ≥2 was considered diagnostic. Additionally, all relevant venous structures in the included field of view were analyzed for occlusive or non-occlusive thrombosis, compression and presence of collaterals. All patients underwent ferumoxytol-enhanced MR venography successfully and without adverse event. The overall scores of the reviewing radiologists for all venous structures were 2.7-2.9. In all cases, the reviewers were confident basing their diagnoses on the ferumoxytol-enhanced MR venography findings. In 12 of 22 examinations, findings on follow-up imaging or invasive procedures were available to correlate with the findings on ferumoxytol-enhanced MR venography. There was complete concordance between the findings from follow-up imaging and invasive procedures with findings from ferumoxytol-enhanced MR venography. Ferumoxytol holds promise as a powerful alternative to gadolinium-based contrast agents for reliable, high-resolution MR venography in children with chronic kidney disease. (orig.)

  10. A study on the efficacy and safety of combining dental surgery with tonsillectomy in pediatrics

    Directory of Open Access Journals (Sweden)

    Syed F

    2018-03-01

    Full Text Available Faizaan Syed,1 Joshua C Uffman,1,2 Dmitry Tumin,1 Catherine M Flaitz,3,4 Joseph D Tobias,1,2 Vidya T Raman1,2 1Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, 2Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, 3Department of Dentistry, Nationwide Children’s Hospital, 4Division of Dentistry, The Ohio State University College of Dentistry, Columbus, OH, USA Purpose: Few data exist on combining pediatric surgical procedures under a single general anesthetic encounter (general anesthesia. We compared perioperative outcomes of combining dental surgical procedures with tonsillectomy during one anesthetic vs separate encounters. Methods: We classified elective tonsillectomy ± adenoidectomy and restorative dentistry as combined (group C or separate (group S. Outcomes included anesthesia time, recovery duration, the need for overnight hospital stay, and postoperative complications. Results: Patients aged 4±1 years underwent tonsillectomy and dental surgery in combination (n=7 or separately (n=27. No differences were noted in total anesthesia time (C: median: 150, interquartile range [IQR]: 99, 165 vs S: median: 109, IQR: 92, 132; 95% CI of difference in median: –58, +10 minutes; P=0.115 and total recovery time (C: median: 54, IQR: 40, 108 vs S: median: 72, IQR: 58, 109; 95% CI of difference in median: –16, +48 minutes; P=0.307. The need for overnight stay (C: 4 of 7, S: 20 of 27; P=0.394 did not differ between the groups. No postoperative complications were noted in either group. Conclusion: These preliminary data support the potential feasibility of combining dental procedures with tonsillectomy during a single anesthetic encounter. Such care may not only reduce costs but also limit parental work absences and increase convenience for patient families. When compared with procedures performed separately, combined procedures did not result in increased morbidity or

  11. Pharmacotherapy in the Management of Pediatric Obesity.

    Science.gov (United States)

    Kelly, Aaron S; Fox, Claudia K

    2017-08-01

    This review provides a rationale for the use of pharmacotherapy in pediatric weight management, summarizes results of some of the key pediatric clinical trials of approved and "off-label" obesity medications, introduces new options in the pediatric pipeline, and offers a glimpse into the future of pediatric obesity medicine. Despite the need for adjunctive treatments to enhance the outcomes of lifestyle modification therapy among youth with obesity, none of the obesity medications evaluated to date have been shown to meaningfully reduce BMI or cardiometabolic risk factors. Promising medications recently approved for the treatment of obesity in adults will soon be tested in pediatric trials, offering hope that new therapeutic options will soon be available. As new medications are approved to treat pediatric obesity, it will be important to evaluate the safety and efficacy of combination pharmacotherapy and investigate predictors of response. Application of precision medicine approaches to the field of pediatric obesity management will improve the long-term outlook for the tens of millions of youth afflicted with this serious and recalcitrant disease.

  12. Efficacy and safety of iorEPOCIM for chemotherapy- or radiotherapy-induced anemia in pediatric cancer patients.

    Science.gov (United States)

    Vargas, Alicia; Mendoza, Ivis; Uranga, Rolando; González, Alejandro; Martínez, Liliana; Caballero, Iraida; Piedra, Patricia; Saurez, Giselle; Verdecia, Manuel; Cabanas, Ricardo

    2010-07-01

    Recombinant human erythropoietin (RHuEPO) is an erythropoiesis stimulating agent (ESA) used to treat anemia in patients with total or relative erythropoietin deficit. In cancer patients, it is administered to optimize hemoglobin (Hb) levels, correct anemia and reduce the need for transfusions. Cuba produces a RHuEPO, registered in 1998 as iorEPOCIM, that is widely used in the national public health system, mainly to treat patients with anemia due to chronic kidney disease (CKD). Evaluate the efficacy and safety of iorEPOCIM in pediatric cancer patients with anemia following chemotherapy or radiotherapy. The working hypothesis posed an Hb increase>or=15 g/l in 70% of patients receiving iorEPOCIM for 8 weeks. A Phase IV, multicenter, open clinical trial was conducted. Participants were 157 patients aged 1-19 years with anemia and cyto-histological diagnosis of cancer in any location. Patients received either 600 U/kg iorEPOCIM intravenously, once weekly, or 150 U/kg iorEPOCIM subcutaneously, 3 times a week, for 8 weeks. All patients had blood tests every week to determine hemoglobin and hematocrit, and reticulocyte and platelet counts. Mean number of transfusions required by patients during the treatment period was compared to the mean number of transfusions received in the preceding 8 weeks. Adverse events (AE) were recorded at the 4th and 8th weeks and classified by intensity and causality. Hb levels rose>or=15 g/l in 68.8% of patients, and transfusion requirements decreased 17%. The most frequent adverse events were fever (19.3%), vomiting (10.2%) and flu-like syndrome (9.6%). Intensity of AE was predominantly mild. Only 7 AE were classified as very probably related to the product and none of those was severe. iorEPOCIM proved to be safe and effective at the doses and frequencies used in this patient population. As a result, this medication was recommended for use in all pediatric oncology and hematology services in the country.

  13. Safety and efficacy of aripiprazole for the treatment of pediatric Tourette syndrome and other chronic tic disorders

    Directory of Open Access Journals (Sweden)

    Cox JH

    2016-06-01

    Full Text Available Joanna H Cox,1 Stefano Seri,2,3 Andrea E Cavanna,2,4,5 1Heart of England NHS Foundation Trust, 2School of Life and Health Sciences, Aston Brain Centre, Aston University, 3Children’s Epilepsy Surgery Programme, The Birmingham Children’s Hospital NHS Foundation Trust, 4Department of Neuropsychiatry, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, 5Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology and UCL, London, UK Abstract: Tourette syndrome is a childhood-onset chronic tic disorder characterized by multiple motor and vocal tics and often accompanied by specific behavioral symptoms ranging from obsessionality to impulsivity. A considerable proportion of patients report significant impairment in health-related quality of life caused by the severity of their tics and behavioral symptoms and require medical intervention. The most commonly used medications are antidopaminergic agents, which have been consistently shown to be effective for tic control, but are also associated with poor tolerability because of their adverse effects. The newer antipsychotic medication aripiprazole is characterized by a unique mechanism of action (D2 partial agonism, and over the last decade has increasingly been used for the treatment of tics. We conducted a systematic literature review to assess the available evidence on the efficacy and safety of aripiprazole in pediatric patients with Tourette syndrome and other chronic tic disorders (age range: 4–18 years. Our search identified two randomized controlled trials (involving 60 and 61 participants and ten open-label studies (involving between six and 81 participants. The majority of these studies used two validated clinician-rated instruments (Yale Global Tic Severity Scale and Clinical Global Impression scale as primary outcome measures. The combined results from randomized controlled trials and open-label studies showed that aripiprazole is an

  14. Enhancing the Safety and Security of Radioactive Sources

    International Nuclear Information System (INIS)

    Hickey, J.

    2004-01-01

    The NRC initiatives to improve safety and security of sources began before 091101 and include both international and domestic activities. They supported the development and implementation of the IAEA Code of Conduct, which provides categorization of sources of concern, based on risk, improvement of regulatory programs of all member countries and improvement of safety and security of sources. International activities include the IAEA International Conference on Security of Sources (Vienna, Austria, March, 2003), the trilateral cooperation with Canada and Mexico, the assistance to individual countries to improve security and the proposed rule on export and import of radioactive material. The domestic initiatives are to issue the security orders and advisories to licensees, issue the panoramic irradiator orders (June 2003), issue the manufacturer orders (January 2004), complete the interim national source inventory, develop the national source tracking system, maintain the orphan source registration and retrieval program and upgrade the emergency preparedness

  15. Artificial intelligence enhancements to safety parameter display systems

    International Nuclear Information System (INIS)

    Hajek, B.K.; Hashemi, S.; Sharma, D.; Chandrasekaran, B.; Miller, D.W.

    1986-01-01

    Two prototype knowledge based systems have been developed at The Ohio State University to be the basis of an operator aid that can be attached to an existing nuclear power plant Safety Parameter Display System. The first system uses improved sensor validation techniques to provide input to a fault diagnosis process. The second system would use the diagnostic system output to synthesize corrective procedures to aid the control room licensed operator in plant recovery

  16. Non-technical skills training to enhance patient safety.

    Science.gov (United States)

    Gordon, Morris

    2013-06-01

      Patient safety is an increasingly recognised issue in health care. Systems-based and organisational methods of quality improvement, as well as education focusing on key clinical areas, are common, but there are few reports of educational interventions that focus on non-technical skills to address human factor sources of error. A flexible model for non-technical skills training for health care professionals has been designed based on the best available evidence, and with sound theoretical foundations.   Educational sessions to improve non-technical skills in health care have been described before. The descriptions lack the details to allow educators to replicate and innovate further.   A non-technical skills training course that can be delivered as either a half- or full-day intervention has been designed and delivered to a number of mixed groups of undergraduate medical students and doctors in postgraduate training. Participant satisfaction has been high and patient safety attitudes have improved post-intervention.   This non-technical skills educational intervention has been built on a sound evidence base, and is described so as to facilitate replication and dissemination. With the key themes laid out, clinical educators will be able to build interventions focused on numerous clinical issues that pay attention to human factor contributors to safety. © 2013 John Wiley & Sons Ltd.

  17. Enhancing nuclear safety. Annual report 2015. Financial report 2015

    International Nuclear Information System (INIS)

    Le Guludec, Dominique; Niel, Jean-Christophe; Mouton, Georges-Henri; Repussard, Jacques; Schuler, Matthieu; Marchal, Valerie; Albert, Marc-Gerard; Bigot, Marie-Pierre; Brisset, Yves; Bruna, Giovanni; Charron, Sylvie; Clavelle, Stephanie; Deschamps, Patrice; Delattre, Aleth; Demeillers, Didier; Laloi, Patrick; Lorthioir, Stephane; Monti, Pascale; Rollinger, Francois; Rouyer, Veronique; Tharaud, Christine; Jaunet, Camille; Pascal-Heuze, Charlotte

    2016-01-01

    After some introductory texts proposed by several IRSN head managers, and a brief presentation of some key data illustrating the activity, the annual report presents the main strategic orientations, notably in the field of knowledge management, and of information and communication. After some images illustrating the past year, activities are presented. They first deal with safety: safety of civil nuclear facilities, from decommissioning old reactors to designing those of the future, reactor ageing, severe accidents, fuel, criticality and neutronics, fire and containment, safety and radiation protection of defence-related facilities and activities, geological disposal of radioactive wastes. They secondly deal with security and non-proliferation (nuclear security, nuclear non-proliferation, chemical weapon ban), thirdly with radiation protection for human and environment health (environment monitoring, radionuclide transfer in the environment, radon and polluted sites, human exposure, radiation protection in the workplace, effects of chronic exposures, protection in health care), and fourthly with emergency and post-accident situations (emergency and post-accident preparedness and response). The next part of the activity report addresses issues related to efficiency: improved economic and financial management, property, computer security, quality and corporate social responsibility, human resources, organisation chart. The financial report proposes a management report, financial statements with an appendix to annual accounts, and an auditor's report

  18. Safety and effectiveness of tadalafil in pediatric patients with pulmonary arterial hypertension: a sub-group analysis based on Japan post-marketing surveillance.

    Science.gov (United States)

    Yamazaki, Hiroyoshi; Kobayashi, Noriko; Taketsuna, Masanori; Tajima, Koyuki; Suzuki, Nahoko; Murakami, Masahiro

    2017-12-01

    To evaluate the long-term safety and effectiveness of tadalafil in pediatric patients with pulmonary arterial hypertension (PAH) in real-world clinical practice. This is an observational surveillance of PAH patients receiving tadalafil in the contracted sites. A sub-group analysis was performed of 391 pediatric PAH patients (Effectiveness measurements included change in World Health Organization (WHO) functional classification of PAH, cardiac catheterization (pulmonary arterial pressure: PAP), and echocardiography (tricuspid regurgitation pressure gradient: TRPG). Survival rate was also measured. The mean patient age was 5.7 ± 5.34 years. Associated PAH (APAH) and idiopathic PAH (IPAH) accounted for 76.0% and 17.6%, respectively, of the PAH patients. Patients were followed for up to 2 years. Among 391 patients analyzed for safety, the overall incidence rate of ADRs was 16.6%. The common ADRs (≥ 1%) were headache (2.8%), hepatic function abnormal, platelet count decreased (1.3% each), and epistaxis, (1.0%). Eleven patients (2.8%) reported 16 SADRs. Three patients died secondary to SADRs. For the effectiveness analysis, the incidence of WHO functional class improvement at 3 months, 1 year, and 2 years after the initiation of tadalafil and last observation in pediatric patients were 16.5%, 19.7%, and 16.3%, respectively. Both PAP and TRPG showed a statistically significant reduction at last observation. This manuscript reveals the use of tadalafil in the real-world pediatric population with an acceptable safety profile in Japan.

  19. The Use of Neuraxial Catheters for Postoperative Analgesia in Neonates: A Multicenter Safety Analysis from the Pediatric Regional Anesthesia Network.

    Science.gov (United States)

    Long, Justin B; Joselyn, Anita S; Bhalla, Tarun; Tobias, Joseph D; De Oliveira, Gildasio S; Suresh, Santhanam

    2016-06-01

    Currently, there is limited evidence to support the safety of neuraxial catheters in neonates. Safety concerns have been cited as a major barrier to performing large randomized trials in this population. The main objective of this study is to examine the safety of neuraxial catheters in neonates across multiple institutions. Specifically, we sought to determine the incidence of overall and individual complications encountered when neuraxial catheters were used for postoperative analgesia in neonates. This was an observational study that used the Pediatric Regional Anesthesia Network database. Complications and adverse events were defined by the presence of at least 1 of the following intraoperative and/or postoperative factors: catheter malfunction (dislodgment/occlusion), infection, block abandoned (unable to place), block failure (no evidence of block), vascular (blood aspiration/hematoma), local anesthetic systemic toxicity, excessive motor block, paresthesia, persistent neurologic deficit, and other (e.g., intra-abdominal misplacement, tremors). Additional analyses were performed to identify the use of potentially toxic doses of local anesthetics. The study cohort included 307 neonates with a neuraxial catheter. There were 41 adverse events and complications recorded, resulting in an overall incidence of complications of 13.3% (95% confidence interval, 9.8%-17.4%). Among the complications, catheter malfunction, catheter contamination, and vascular puncture were common. None of the complications resulted in long-term complications and/or sequelae, resulting in an estimated incidence of any serious complications of 0.3% (95% confidence interval, 0.08%-1.8%). There were 120 of 307 patients who received intraoperative and/or postoperative infusions consistent with a potentially toxic local anesthetic dose in neonates. The incidence of potentially toxic local anesthetic infusion rates increased over time (P = 0.008). Neuraxial catheter techniques for intraoperative

  20. The safety evaluation guide for laboratories and plants a tool for enhancing safety

    International Nuclear Information System (INIS)

    Lhomme, Veronique; Daubard, Jean-Paul

    2013-01-01

    The Institute for Radioprotection and Nuclear Safety (IRSN) acts as technical support for the French government Authorities competent in nuclear safety and radiation protection for civil and defence activities. In this frame, the Institute's performs safety assessments of the safety cases submitted by operators to these Authorities for each stage in the life cycle of a nuclear facility, including dismantling operations, which is subjected to a licensing procedure. In the fuel cycle field, this concerns a large variety of facilities. Very often, depending on facilities and on safety cases, safety assessment to be performed is multidisciplinary and involves the supervisor in charge of the facility and several safety experts, particularly to cover the whole set of risks (criticality, exposure to radiation, fire, handling, containment, human and organisational factors...) encountered during facility's operations. Taking these into account, and in order to formalize the assessment process of the fuel cycle facilities, laboratories, irradiators, particle accelerators, under-decommissioning reactors and radioactive waste management, the 'Plants, Laboratories, Transports and Waste Safety' Division of IRSN has developed an internal guide, as a tool: - To present the methodological framework, and possible specificities, for the assessment according to the 'Defence in Depth Concept' (Part 1); - To provide key questions associated to the necessary contradictory technical review of the safety cases (Part 2); - To capitalise on experience on the basis of technical examples (coming from incident reports, previous safety assessments...) demonstrating the questioning (Part 3). The guide is divided in chapters, each dedicated to a type of risk (dissemination of radioactive material, external or internal exposure from ionising radiation, criticality, radiolysis mechanisms, handling operations, earthquake, human or organisational factors...) or to a type

  1. Examination of the Safety of Pediatric Vaccine Schedules in a Non-Human Primate Model: Assessments of Neurodevelopment, Learning, and Social Behavior

    Science.gov (United States)

    Curtis, Britni; Liberato, Noelle; Rulien, Megan; Morrisroe, Kelly; Kenney, Caroline; Yutuc, Vernon; Ferrier, Clayton; Marti, C. Nathan; Mandell, Dorothy; Burbacher, Thomas M.; Sackett, Gene P.

    2015-01-01

    Background In the 1990s, the mercury-based preservative thimerosal was used in most pediatric vaccines. Although there are currently only two thimerosal-containing vaccines (TCVs) recommended for pediatric use, parental perceptions that vaccines pose safety concerns are affecting vaccination rates, particularly in light of the much expanded and more complex schedule in place today. Objectives The objective of this study was to examine the safety of pediatric vaccine schedules in a non-human primate model. Methods We administered vaccines to six groups of infant male rhesus macaques (n = 12–16/group) using a standardized thimerosal dose where appropriate. Study groups included the recommended 1990s Pediatric vaccine schedule, an accelerated 1990s Primate schedule with or without the measles–mumps–rubella (MMR) vaccine, the MMR vaccine only, and the expanded 2008 schedule. We administered saline injections to age-matched control animals (n = 16). Infant development was assessed from birth to 12 months of age by examining the acquisition of neonatal reflexes, the development of object concept permanence (OCP), computerized tests of discrimination learning, and infant social behavior. Data were analyzed using analysis of variance, multilevel modeling, and survival analyses, where appropriate. Results We observed no group differences in the acquisition of OCP. During discrimination learning, animals receiving TCVs had improved performance on reversal testing, although some of these same animals showed poorer performance in subsequent learning-set testing. Analysis of social and nonsocial behaviors identified few instances of negative behaviors across the entire infancy period. Although some group differences in specific behaviors were reported at 2 months of age, by 12 months all infants, irrespective of vaccination status, had developed the typical repertoire of macaque behaviors. Conclusions This comprehensive 5-year case–control study, which closely examined

  2. Effectiveness evaluation methodology for safety processes to enhance organisational culture in hazardous installations

    International Nuclear Information System (INIS)

    Mengolini, A.; Debarberis, L.

    2008-01-01

    Safety performance indicators are widely collected and used in hazardous installations. The IAEA, OECD and other international organisations have developed approaches that strongly promote deployment of safety performance indicators. These indicators focus mainly on operational performance, but some of them also address organisational and safety culture aspects. However, operators of hazardous installations, in particular those with limited resources and time constraints, often find it difficult to collect the large number of different safety performance indicators. Moreover, they also have difficulties with giving a meaning to the numbers and trends recorded, especially to those that should reflect a positive safety culture. In this light, the aim of this article is to address the need to monitor and assess progress on implementation of a programme to enhance safety and organisational culture. It proposes a specific process-view approach to effectiveness evaluation of organisational and safety culture indicators by means of a multi-level system in which safety processes and staff involvement in defining improvement activities are central. In this way safety becomes fully embedded in staff activities. Key members of personnel become directly involved in identifying and supplying leading indicators relating to their own daily activity and become responsible and accountable for keeping the measurement system alive. Besides use of lagging indicators, particular emphasis is placed on the importance of identifying and selecting leading indicators which can be used to drive safety performance for organisational and safety culture aspects as well

  3. Effectiveness evaluation methodology for safety processes to enhance organisational culture in hazardous installations.

    Science.gov (United States)

    Mengolini, A; Debarberis, L

    2008-06-30

    Safety performance indicators are widely collected and used in hazardous installations. The IAEA, OECD and other international organisations have developed approaches that strongly promote deployment of safety performance indicators. These indicators focus mainly on operational performance, but some of them also address organisational and safety culture aspects. However, operators of hazardous installations, in particular those with limited resources and time constraints, often find it difficult to collect the large number of different safety performance indicators. Moreover, they also have difficulties with giving a meaning to the numbers and trends recorded, especially to those that should reflect a positive safety culture. In this light, the aim of this article is to address the need to monitor and assess progress on implementation of a programme to enhance safety and organisational culture. It proposes a specific process-view approach to effectiveness evaluation of organisational and safety culture indicators by means of a multi-level system in which safety processes and staff involvement in defining improvement activities are central. In this way safety becomes fully embedded in staff activities. Key members of personnel become directly involved in identifying and supplying leading indicators relating to their own daily activity and become responsible and accountable for keeping the measurement system alive. Besides use of lagging indicators, particular emphasis is placed on the importance of identifying and selecting leading indicators which can be used to drive safety performance for organisational and safety culture aspects as well.

  4. Pediatric AIDS

    International Nuclear Information System (INIS)

    Price, D.B.; Haller, J.O.; Kramer, J.; Hotson, G.C.; Loh, J.P.; Schlusselberg, D.; Inglese, C.M.; Jacobs, J.; Rose, A.L.; Menez-Bautista, R.; Fikrig, S.

    1988-01-01

    A group of 23 pediatric patients seropositive for HIV antibody were studied by computed tomography and evaluated neurodevelopmentally. Significant neurodevelopmental delays were found in over 95% of the patients studied. CT findings in six patients were normal and thirteen of 23 (57%) had prominence of the CSF spaces. Less frequent findings included calcifications in the basal ganglia and white matter. Cerebral mass lesions included one case of lymphoma and one case of hemorrhage. The CT findings in the pediatric age group differs from the adult population in that that contrast enhancing inflammatory mass lesions are uncommon. (orig.)

  5. Mobilizing local safety nets for enhanced adaptive capacity to ...

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

    2016-04-22

    Apr 22, 2016 ... This brief resulted from two projects supported by the Climate Change Adaptation in Africa program: the research project Resilience and the African Smallholder : Enhancing the Capacity of Communities to Adapt to Climate Change and the mentoring project Promoting Participatory Action Research through ...

  6. Breeder design for enhanced performance and safety characteristics

    International Nuclear Information System (INIS)

    Fischer, G.J.; Atefi, B.; Yang, J.W.; Galperin, A.; Segev, M.

    1980-01-01

    A fast breeder reactor design has been created which offers a considerably extended fuel cycle and excellent performance characteristics. An example of a core designed to operate on a ten-year fuel cycle is described in some detail. Use of metal fuel along with a moderator such as beryllium oxide dispersed throughout the core provides both design flexibility and safety advantages such as a strong Doppler feedback and limited sodium void reactivity gain. Local power variations are small for the entire cycle; control requirements are also modest, and fuel cycle costs are low

  7. Subcritical enhanced safety molten-salt reactor concept

    International Nuclear Information System (INIS)

    Alekseev, P.N.; Ignatiev, V.V.; Men'shikov, L.I.; Prusakov, V.N.; Ponomarev-Stepnoy, N.N.; Subbotin, S.A.; Krasnykh, A.K.; Rudenko, V.T.; Somov, L.N.

    1995-01-01

    The nuclear power and its fuel cycle safety requirements can be met in the main by providing nuclear power with subcritical molten salt reactors (SMSR) - 'burner' with an external neutron source. The utilized molten salt fuel is the decisive advantage of the SMSR over other burners. Fissile and fertile nuclides in the burner are solved in a liquid salt in the form of fluorides. This composition acts simultaneously as: a) fuel, b) coolant, c) medium for chemical partitioning and reprocessing. The effective way of reducing the external source power consists in the cascade neutron multiplication in the system of coupled reactors with suppressed feedback between them. (author)

  8. Development of safety enhancement technology of containment building

    International Nuclear Information System (INIS)

    Seo, Jeong Moon; Choun, Y. S.; Choi, I. K.

    2002-04-01

    This study consists of four research areas, (1) Seismic safety assessment, (2) Aging assessment of a containment building, (3) Prediction of long-term behavior and analysis of a containment building, (4) Performance verification of a containment building. In the seismic safety assessment area, responses of a containment building were monitored and the analysis method was verified. Also performed are the identification of earthquake characteristics and improvement of the seismic fragility analysis method. In the area of aging assessment of a containment building, we developed aging management code SLMS and database. Aging tests were performed for containment building materials and aging models were developed. Techniques for investigation, detection, and evaluation of aging were developed. In the area of prediction of long-term behavior and analysis of a containment building, we developed a non-linear structural analysis code NUCAS and material models. In the area of performance verification of a containment building, we analyzed the crack behavior of a containment wall and the behavior of the containment under internal pressure. We also improved the ISI methods for prestressed containment

  9. Employing ionizing radiation to enhance food safety. A review

    International Nuclear Information System (INIS)

    Grolichova, M.; Dvorak, P.; Musilova, H.

    2004-01-01

    Food irradiation is employed to ensure food safety or food sterility, extend its shelf-life and reduce the losses due to sprouting, ripening or pests. In the Czech Republic mainly spices, mixed spices and dried vegetables are exposed to ionizing radiation. The leading suppliers of irradiated foodstuffs in Europe are Belgium, France and the Netherlands. In the USA, food irradiation is more common and there are also attempts to enforce irradiation not only for food safety, but also for technological purposes. Even though irradiation is a prospective technology, its application causes physico-chemical changes that may affect nutritional adequacy and sensory characteristics of irradiated food. In this paper, the chemical changes of basic food components (proteins, saccharides, fats) are reviewed. Some chemical changes lead to the formation of radiolytic products whose risks are still subject of scientific research. It is expected that the main use of gamma irradiation will be the treatment of diets for patients suffering from different disorders of the immune system, allergic patients or for the army and space flights. Irradiation may be a critical control point in the production of some types of foodstuffs

  10. An Evaluation Method for Team Competencies to Enhance Nuclear Safety Culture

    International Nuclear Information System (INIS)

    Hang, S. M.; Seong, P. H.; Kim, A. R.

    2016-01-01

    Safety culture has received attention in safety-critical industries, including nuclear power plants (NPPs), due to various prominent accidents such as concealment of a Station Blackout (SBO) of Kori NPP unit 1 in 2012, the Sewol ferry accident in 2014, and the Chernobyl accident in 1986. Analysis reports have pointed out that one of the major contributors to the cause of the accidents is ‘the lack of safety culture’. The term, nuclear safety culture, was firstly defined after the Chernobyl accident by the IAEA in INSAG report no. 4, as follows “Safety culture is that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted their significance.” Afterwards, a wide consensus grew among researchers and nuclear-related organizations, that safety culture should be evaluated and managed in a certain manner. Consequently, each nuclear-related organization defined and developed their own safety culture definitions and assessment methods. However, none of these methods provides a way for an individual or a team to enhance the safety culture of an organization. Especially for a team, which is the smallest working unit in NPPs, team members easily overlook their required practices to improve nuclear safety culture. Therefore in this study, we suggested a method to estimate nuclear safety culture of a team, by approaching with the ‘competency’ point of view. The competency is commonly focused on individuals, and defined as, “underlying characteristics of an individual that are causally related to effective or superior performance in a job.” Similar to safety culture, the definition of competency focuses on characteristics and attitudes of individuals. Thus, we defined ‘safety culture competency’ as “underlying characteristics and outward attitudes of individuals that are causally related to a healthy and strong nuclear safety

  11. Multilayer robust control for safety enhancement of reactor operations

    International Nuclear Information System (INIS)

    Edwards, R.M.; Lee, K.Y.; Ray, A.

    1991-01-01

    A novel concept of reactor power and temperature control has been recently reported in which a conventional output feedback controller is embedded within a state feedback setting. The embedded output feedback controller at the inner layer largely compensates for plant modeling uncertainties and external disturbances, and the outer layer generates an optimal control signal via feedback of the estimated plant states. A major advantage of this embedded architecture is the robustness of the control system relative to parametric and nonparametric uncertainties and thus the opportunity for designing fault-accommodating control algorithms to improve reactor operations and plant safety. The paper illustrates the architecture of the state-feedback-assisted classical (SFAC) control, which utilizes an embedded output feedback controller designed via classical techniques. It demonstrates the difference between the performance of conventional state feedback control and SFAC by examining the sensitivity of the dominant eigenvalues of the individual closed-loop systems

  12. Development of reliability-based safety enhancement technology

    International Nuclear Information System (INIS)

    Kim, Kil Yoo; Han, Sang Hoon; Jang, Seung Cherl

    2002-04-01

    This project aims to develop critical technologies and the necessary reliability DB for maximizing the economics in the NPP operation with keeping the safety using the information of the risk (or reliability). For the research goal, firstly the four critical technologies(Risk Informed Tech. Spec. Optimization, Risk Informed Inservice Testing, On-line Maintenance, Maintenance Rule) for RIR and A have been developed. Secondly, KIND (Korea Information System for Nuclear Reliability Data) has been developed. Using KIND, YGN 3,4 and UCN 3,4 component reliability DB have been established. A reactor trip history DB for all NPP in Korea also has been developed and analyzed. Finally, a detailed reliability analysis of RPS/ESFAS for KNSP has been performed. With the result of the analysis, the sensitivity analysis also has been performed to optimize the AOT/STI of tech. spec. A statistical analysis procedure and computer code have been developed for the set point drift analysis

  13. Training system enhancement for nuclear safety at PAKS NPP

    International Nuclear Information System (INIS)

    KIss, I.

    2000-01-01

    Paks Nuclear Power Plant is the only commercial nuclear facility in Hungary, which has been operational since 1982. The over 15 years operation of the plant can from all aspects be considered as a success, to which the well qualified, competent staff significantly contributes. Like other N-plants, Paks NPP is also exposed to major challenges due to plant ageing and changes in circumstances that affect the operation. The management focusing on maintaining nuclear safety launched an overall programme to upgrade quality of personnel training and to improve its infrastructure. Though this programme has successfully finished with visible proofs, further actions to develop a reconsidered human resource policy is needed so that the plant would successfully stand against the challenges of the 21. century. (author)

  14. Safety and Efficacy of the Off-Label Use of Milrinone in Pediatric Patients with Heart Diseases

    Science.gov (United States)

    Lee, Joowon; Kwon, Hye Won; Kwon, Bo Sang; Bae, Eun Jung; Noh, Chung Il; Lim, Hong Gook; Kim, Woong Han; Lee, Jeong Ryul; Kim, Yong Jin

    2014-01-01

    Background and Objectives Milrinone is often used in children to treat acute heart failure and prevent low cardiac output syndrome after cardiac surgery. Due to the lack of studies on the long-term milrinone use in children, the objective of this study was to assess the safety and efficacy of the current patterns of milrinone use for ≥3 days in infants and children with heart diseases. Subjects and Methods We retrospectively reviewed the medical records of patients aged milrinone for ≥3 days from January 2005 to December 2012. Patients' characteristics including age, sex, height, weight, and body surface area were recorded. The following parameters were analyzed to identify the clinical application of milrinone: initial infusion rate, maintenance continuous infusion rate, total duration of milrinone therapy, and concomitantly infused inotropes. The safety of milrinone was determined based on the occurrence of adverse events such as hypotension, arrhythmia, chest pain, headache, hypokalemia, and thrombocytopenia. Results We assessed 730 admissions (684 patients) during this period. Ventricular septal defects were the most common diagnosis (42.4%) in these patients. Milrinone was primarily used after cardiac surgery in 715 admissions (97.9%). The duration of milrinone treatment varied from 3 to 64.4 days (≥7 days in 149 admissions). Ejection fraction and fractional shortening of the left ventricle improved in patients receiving milrinone after cardiac surgery. Dose reduction of milrinone due to hypotension occurred in only 4 admissions (0.5%). Although diverse arrhythmias occurred in 75 admissions (10.3%), modification of milrinone infusion to manage arrhythmia occurred in only 3 admissions (0.4%). Multivariate analysis indicated that the development of arrhythmia was not influenced by the pattern of milrinone use. Conclusion Milrinone was generally administered for ≥3 days in children with heart diseases. The use of milrinone for ≥3 days was effective in

  15. Nuclear static eliminators halt airborne contamination and enhance personnel safety

    International Nuclear Information System (INIS)

    Edelmann, G.F.; Regan, J.T.

    1985-01-01

    In January 1984, Nelco Products, Inc. opened a new plant in Fullerton, CA to produce fiberglass/epoxy sheet stock which is used to manufacture single-sided, double-sided and multi-layer printed circuit boards (PCB) for electronic and telecommunications apparatus. The process for making the PCB core material begins with woven fiberglass fabric which passes through a series of metal take-up and tensioning rollers, and is then immersed in and impregnated with an equivalent weight of epoxy resin. Shortly after startup, the plant encountered quality control and safety problems due to electrostatic charges that commonly occur when processing non-conductors such as fiberglass plastics and paper given serious consideration until the plant had been operating for about six months and continued to have quality and safety problems due to static charges. The engineers decided to try a bar-type nuclear static eliminator containing polonium 210 (Po-210) whose emissions create both negative and positive air ions. The nuclear-powered device is available only on an annual renewable lease, because the normal useful life is one year, and the US Nuclear Regulatory Commission requires a leak test each 12 months. A fresh bar is shipped to the lessee at the end of the 12-month period, and the old one is returned to the lessor. The nuclear-powered static eliminators have improved the quality of the PCB core material since the fiberglass cloth is practically free of any dirt or dust before it enters the resin-impregnating bath. Furthermore, the operators no longer complain about electrical shocks

  16. [Innovative training for enhancing patient safety. Safety culture and integrated concepts].

    Science.gov (United States)

    Rall, M; Schaedle, B; Zieger, J; Naef, W; Weinlich, M

    2002-11-01

    Patient safety is determined by the performance safety of the medical team. Errors in medicine are amongst the leading causes of death of hospitalized patients. These numbers call for action. Backgrounds, methods and new forms of training are introduced in this article. Concepts from safety research are transformed to the field of emergency medical treatment. Strategies from realistic patient simulator training sessions and innovative training concepts are discussed. The reasons for the high numbers of errors in medicine are not due to a lack of medical knowledge, but due to human factors and organisational circumstances. A first step towards an improved patient safety is to accept this. We always need to be prepared that errors will occur. A next step would be to separate "error" from guilt (culture of blame) allowing for a real analysis of accidents and establishment of meaningful incident reporting systems. Concepts with a good success record from aviation like "crew resource management" (CRM) training have been adapted my medicine and are ready to use. These concepts require theoretical education as well as practical training. Innovative team training sessions using realistic patient simulator systems with video taping (for self reflexion) and interactive debriefing following the sessions are very promising. As the need to reduce error rates in medicine is very high and the reasons, methods and training concepts are known, we are urged to implement these new training concepts widely and consequently. To err is human - not to counteract it is not.

  17. Enhancing communication skills for pediatric visits through on-line training using video demonstrations

    Directory of Open Access Journals (Sweden)

    Wissow Larry

    2008-02-01

    Full Text Available Abstract Background Training in communication skills for health professionals is important, but there are substantial barriers to individual in-person training for practicing clinicians. We evaluated the feasibility and desirability of on-line training and sought suggestions for future courses. Methods Based on successful in-person curricula for communication skills and our previous on-line curricula, we created an on-line course consisting of 28 modules (4.75 hours CME credit about communication skills during pediatric visits that included a mental health concern; each module included a brief case, a multiple choice question, an explanation, and a 1–2 minute video demonstrating key skills. Specific communication skills included: greeting, setting an agenda, discussing diagnosis and treatment, and managing negative interactions. The course was announced by emails in spring, 2007; the course was available on-line for 60 days; we aimed to enroll 50 clinicians. Outcomes were analyzed for those who evaluated the course within 75 days of its initial availability. Results Overall, 61 clinicians registered, of whom most were nurses (N = 24, physicians (N = 22, or psychologists or social workers (N = 12. Of the 36 (59% clinicians who evaluated the course, over 85% agreed that all course objectives had been met; over 90% reported greater confidence in greetings and agenda-setting; and over 80% reported greater confidence in discussing diagnosis and treatment and managing negative interactions. Nearly all, 97% would recommend the course to other clinicians and trainees. Suggestions for improvement included a library of additional video vignettes and written materials to accompany the on-line training. Conclusion On-line training in communication skills for pediatric mental health visits is feasible, desirable and associated with increased confidence in key skills. Positive feedback from clinicians suggests that a comparison of on-line versus in

  18. Perception Towards the Use of Smartphone Application (Apps to Enhance Medication Adherence Among Saudi Pediatrics

    Directory of Open Access Journals (Sweden)

    Renad Alsalamah

    2018-03-01

    Full Text Available Objectives: The aim of this study was to measure the importance of smartphone applications (Apps in medication adherence in children to help parents and caregivers in giving medication to children to maintain a good health and quality of life, and to improve current clinical practices in adherence to medications among Saudi pediatrics. Methodology: Cross sectional survey to Saudi Arabia population was conducted from March to April 2017(n=405. Data were collected, tabulated and analyzed using Survey Monkey. We present design requirements for building medication reminders that support the routine aspect of medication-taking by linking children’s concerns, (such as games on taking medications at time. Results: Of the 405 survey participants, the majority of participants 72.5% were not aware by applications of smart device that make easier to take medicines regularly. Eighty percent of participants preferred a mobile app to help their children take the medicine easily and regularly, and 39.8% of them thought that the child will interact with this game, the majority of them 88.6% don’t have any obstacle hinders the use of these updated applications. Fifty percent of them will encourage young patients, to use such applications (App to help them in their medication adherence. Conclusion: Nonadherence to medication is still represents a fundamental health care challenge. The presence of an application makes it easier for parents to give medication to their sick children. Most children love playing games, there is a high probability of their attachment to this application (App and it will promote children’s medication adherence. Key words: Patient adherence, Pediatric, Smartphone, Applications, Apps.

  19. Using a Multimedia Presentation to Enhance Informed Consent in a Pediatric Emergency Department.

    Science.gov (United States)

    Spencer, Sandra P; Stoner, Michael J; Kelleher, Kelly; Cohen, Daniel M

    2015-08-01

    Informed consent is an ethical process for ensuring patient autonomy. Multimedia presentations (MMPs) often aid the informed consent process for research studies. Thus, it follows that MMPs would improve informed consent in clinical settings. The aim of this study was to determine if an MMP for the informed consent process for ketamine sedation improves parental satisfaction and comprehension as compared with standard practice. This 2-phase study compared 2 methods of informed consent for ketamine sedation of pediatric patients. Phase 1 was a randomized, prospective study that compared the standard verbal consent to an MMP. Phase 2 implemented the MMP into daily work flow to validate the previous year's results. Parents completed a survey evaluating their satisfaction of the informed consent process and assessing their knowledge of ketamine sedation. Primary outcome measures were parental overall satisfaction with the informed consent process and knowledge of ketamine sedation. One hundred eighty-four families from a free-standing, urban, tertiary pediatric emergency department with over 85,000 annual visits were enrolled. Different demographics were not associated with a preference for the MMP or improved scores on the content quiz. Intervention families were more likely "to feel involved in the decision to use ketamine" and to understand that "they had the right to refuse the ketamine" as compared with control families. The intervention group scored significantly higher overall on the content section than the control group. Implementation and intervention families responded similarly to all survey sections. Multimedia presentation improves parental understanding of ketamine sedation, whereas parental satisfaction with the informed consent process remains unchanged. Use of MMP in the emergency department for informed consent shows potential for both patients and providers.

  20. Segmentation Scheme for Safety Enhancement of Engineered Safety Features Component Control System

    International Nuclear Information System (INIS)

    Lee, Sangseok; Sohn, Kwangyoung; Lee, Junku; Park, Geunok

    2013-01-01

    Common Caused Failure (CCF) or undetectable failure would adversely impact safety functions of ESF-CCS in the existing nuclear power plants. We propose the segmentation scheme to solve these problems. Main function assignment to segments in the proposed segmentation scheme is based on functional dependency and critical function success path by using the dependency depth matrix. The segment has functional independence and physical isolation. The segmentation structure is that prohibit failure propagation to others from undetectable failures. Therefore, the segmentation system structure has robustness to undetectable failures. The segmentation system structure has functional diversity. The specific function in the segment defected by CCF, the specific function could be maintained by diverse control function that assigned to other segments. Device level control signals and system level control signals are separated and also control signal and status signals are separated due to signal transmission paths are allocated independently based on signal type. In this kind of design, single device failure or failures on signal path in the channel couldn't result in the loss of all segmented functions simultaneously. Thus the proposed segmentation function is the design scheme that improves availability of safety functions. In conventional ESF-CCS, the single controller generates the signal to control the multiple safety functions, and the reliability is achieved by multiplication within the channel. This design has a drawback causing the loss of multiple functions due to the CCF (Common Cause Failure) and single failure Heterogeneous controller guarantees the diversity ensuring the execution of safety functions against the CCF and single failure, but requiring a lot of resources like manpower and cost. The segmentation technology based on the compartmentalization and functional diversification decreases the CCF and single failure nonetheless the identical types of controllers

  1. Segmentation Scheme for Safety Enhancement of Engineered Safety Features Component Control System

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sangseok; Sohn, Kwangyoung [Korea Reliability Technology and System, Daejeon (Korea, Republic of); Lee, Junku; Park, Geunok [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2013-05-15

    Common Caused Failure (CCF) or undetectable failure would adversely impact safety functions of ESF-CCS in the existing nuclear power plants. We propose the segmentation scheme to solve these problems. Main function assignment to segments in the proposed segmentation scheme is based on functional dependency and critical function success path by using the dependency depth matrix. The segment has functional independence and physical isolation. The segmentation structure is that prohibit failure propagation to others from undetectable failures. Therefore, the segmentation system structure has robustness to undetectable failures. The segmentation system structure has functional diversity. The specific function in the segment defected by CCF, the specific function could be maintained by diverse control function that assigned to other segments. Device level control signals and system level control signals are separated and also control signal and status signals are separated due to signal transmission paths are allocated independently based on signal type. In this kind of design, single device failure or failures on signal path in the channel couldn't result in the loss of all segmented functions simultaneously. Thus the proposed segmentation function is the design scheme that improves availability of safety functions. In conventional ESF-CCS, the single controller generates the signal to control the multiple safety functions, and the reliability is achieved by multiplication within the channel. This design has a drawback causing the loss of multiple functions due to the CCF (Common Cause Failure) and single failure Heterogeneous controller guarantees the diversity ensuring the execution of safety functions against the CCF and single failure, but requiring a lot of resources like manpower and cost. The segmentation technology based on the compartmentalization and functional diversification decreases the CCF and single failure nonetheless the identical types of

  2. Safety and efficacy of gadoteric acid in pediatric magnetic resonance imaging: overview of clinical trials and post-marketing studies

    Energy Technology Data Exchange (ETDEWEB)

    Balassy, Csilla [Medical University of Vienna, Vienna General Hospital, Department of Radiology, Division of General and Pediatric Radiology, Vienna (Austria); Roberts, Donna [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Miller, Stephen F. [LeBonheur Children' s Hospital, Department of Radiology, Memphis, TN (United States)

    2015-11-15

    Gadoteric acid is a paramagnetic gadolinium macrocyclic contrast agent approved for use in MRI of cerebral and spinal lesions and for body imaging. To investigate the safety and efficacy of gadoteric acid in children by extensively reviewing clinical and post-marketing observational studies. Data were collected from 3,810 children (ages 3 days to 17 years) investigated in seven clinical trials of central nervous system (CNS) imaging (n = 141) and six post-marketing observational studies of CNS, musculoskeletal and whole-body MR imaging (n = 3,669). Of these, 3,569 children were 2-17 years of age and 241 were younger than 2 years. Gadoteric acid was generally administered at a dose of 0.1 mmol/kg. We evaluated image quality, lesion detection and border delineation, and the safety of gadoteric acid. We also reviewed post-marketing pharmacovigilance experience. Consistent with findings in adults, gadoteric acid was effective in children for improving image quality compared with T1-W unenhanced sequences, providing diagnostic improvement, and often influencing the therapeutic approach, resulting in treatment modifications. In studies assessing neurological tumors, gadoteric acid improved border delineation, internal morphology and contrast enhancement compared to unenhanced MR imaging. Gadoteric acid has a well-established safety profile. Among all studies, a total of 10 children experienced 20 adverse events, 7 of which were thought to be related to gadoteric acid. No serious adverse events were reported in any study. Post-marketing pharmacovigilance experience did not find any specific safety concern. Gadoteric acid was associated with improved lesion detection and delineation and is an effective and well-tolerated contrast agent for use in children. (orig.)

  3. Safety and efficacy of gadoteric acid in pediatric magnetic resonance imaging: overview of clinical trials and post-marketing studies.

    Science.gov (United States)

    Balassy, Csilla; Roberts, Donna; Miller, Stephen F

    2015-11-01

    Gadoteric acid is a paramagnetic gadolinium macrocyclic contrast agent approved for use in MRI of cerebral and spinal lesions and for body imaging. To investigate the safety and efficacy of gadoteric acid in children by extensively reviewing clinical and post-marketing observational studies. Data were collected from 3,810 children (ages 3 days to 17 years) investigated in seven clinical trials of central nervous system (CNS) imaging (n = 141) and six post-marketing observational studies of CNS, musculoskeletal and whole-body MR imaging (n = 3,669). Of these, 3,569 children were 2-17 years of age and 241 were younger than 2 years. Gadoteric acid was generally administered at a dose of 0.1 mmol/kg. We evaluated image quality, lesion detection and border delineation, and the safety of gadoteric acid. We also reviewed post-marketing pharmacovigilance experience. Consistent with findings in adults, gadoteric acid was effective in children for improving image quality compared with T1-W unenhanced sequences, providing diagnostic improvement, and often influencing the therapeutic approach, resulting in treatment modifications. In studies assessing neurological tumors, gadoteric acid improved border delineation, internal morphology and contrast enhancement compared to unenhanced MR imaging. Gadoteric acid has a well-established safety profile. Among all studies, a total of 10 children experienced 20 adverse events, 7 of which were thought to be related to gadoteric acid. No serious adverse events were reported in any study. Post-marketing pharmacovigilance experience did not find any specific safety concern. Gadoteric acid was associated with improved lesion detection and delineation and is an effective and well-tolerated contrast agent for use in children.

  4. Safety and efficacy of gadoteric acid in pediatric magnetic resonance imaging: overview of clinical trials and post-marketing studies

    International Nuclear Information System (INIS)

    Balassy, Csilla; Roberts, Donna; Miller, Stephen F.

    2015-01-01

    Gadoteric acid is a paramagnetic gadolinium macrocyclic contrast agent approved for use in MRI of cerebral and spinal lesions and for body imaging. To investigate the safety and efficacy of gadoteric acid in children by extensively reviewing clinical and post-marketing observational studies. Data were collected from 3,810 children (ages 3 days to 17 years) investigated in seven clinical trials of central nervous system (CNS) imaging (n = 141) and six post-marketing observational studies of CNS, musculoskeletal and whole-body MR imaging (n = 3,669). Of these, 3,569 children were 2-17 years of age and 241 were younger than 2 years. Gadoteric acid was generally administered at a dose of 0.1 mmol/kg. We evaluated image quality, lesion detection and border delineation, and the safety of gadoteric acid. We also reviewed post-marketing pharmacovigilance experience. Consistent with findings in adults, gadoteric acid was effective in children for improving image quality compared with T1-W unenhanced sequences, providing diagnostic improvement, and often influencing the therapeutic approach, resulting in treatment modifications. In studies assessing neurological tumors, gadoteric acid improved border delineation, internal morphology and contrast enhancement compared to unenhanced MR imaging. Gadoteric acid has a well-established safety profile. Among all studies, a total of 10 children experienced 20 adverse events, 7 of which were thought to be related to gadoteric acid. No serious adverse events were reported in any study. Post-marketing pharmacovigilance experience did not find any specific safety concern. Gadoteric acid was associated with improved lesion detection and delineation and is an effective and well-tolerated contrast agent for use in children. (orig.)

  5. Pressurizer safety valve serviceability enhancement by spring compression stability

    Energy Technology Data Exchange (ETDEWEB)

    Ratiu, M.D.; Moisidis, N.T. [California Consulting Engineering and Technology (CALCET), San Leandro, California (United States)

    2007-07-01

    The proactive maintenance of the spring-loaded-self-actuated Pressurizer Safety Valve (PSV) has caused frequent concerns pertaining the spring self actuated reliability due to set point drift, spurious openings, and seat leakage. The exhaustive testing performed on a Crosby PSV model 6M6 has revealed that the principal cause of these malfunctions is the spring compression elastic instability during service. The spring lateral deformations measurements performed validated the analytical shapes for spring compression: symmetrical bending - for coaxial supported ends - restraining any support displacement, and asymmetrical bending induced by the potential misalignment of the supported top end. The source of the spring compression instability appears on the tested Crosby PSV induced by the top end lateral displacement during long term operation. The testing with restrained displacement at the spring top has shown consistent set-point reproducibility, less than +/- 1 per cent. To eliminate the asymmetrical spring buckling, a design review of the PSV is proposed including the guided fixture at the top and the decrease of spring coil slenderness ratio H/D, corresponding to the general analytical elastic stability for the asymmetrical compression. (authors)

  6. Pressurizer safety valve serviceability enhancement by spring compression stability

    International Nuclear Information System (INIS)

    Ratiu, M.D.; Moisidis, N.T.

    2007-01-01

    The proactive maintenance of the spring-loaded-self-actuated Pressurizer Safety Valve (PSV) has caused frequent concerns pertaining the spring self actuated reliability due to set point drift, spurious openings, and seat leakage. The exhaustive testing performed on a Crosby PSV model 6M6 has revealed that the principal cause of these malfunctions is the spring compression elastic instability during service. The spring lateral deformations measurements performed validated the analytical shapes for spring compression: symmetrical bending - for coaxial supported ends - restraining any support displacement, and asymmetrical bending induced by the potential misalignment of the supported top end. The source of the spring compression instability appears on the tested Crosby PSV induced by the top end lateral displacement during long term operation. The testing with restrained displacement at the spring top has shown consistent set-point reproducibility, less than +/- 1 per cent. To eliminate the asymmetrical spring buckling, a design review of the PSV is proposed including the guided fixture at the top and the decrease of spring coil slenderness ratio H/D, corresponding to the general analytical elastic stability for the asymmetrical compression. (authors)

  7. IAEA Sees Safety Commitment at Spain’s Almaraz Nuclear Power Plant, Areas for Enhancement

    International Nuclear Information System (INIS)

    2018-01-01

    An International Atomic Energy Agency (IAEA) team of experts said the operator of Spain’s Almaraz Nuclear Power Plant demonstrated a commitment to the long-term safety of the plant and noted several good practices to share with the nuclear industry globally. The team also identified areas for further enhancement. The Operational Safety Review Team (OSART) today concluded an 18-day mission to Almaraz, whose two 1,050-MWe pressurized-water reactors started commercial operation in 1983 and 1984, respectively. Centrales Nucleares Almaraz-Trillo (CNAT) operates the plant, located about 200 km southwest of Madrid. OSART missions aim to improve operational safety by objectively assessing safety performance using the IAEA’s safety standards and proposing recommendations for improvement where appropriate. Nuclear power generates more than 21 per cent of electricity in Spain, whose seven operating power reactors all began operation in the 1980s.The mission made a number of recommendations to improve operational safety, including: • The plant should implement further actions related to management, staff and contractors to enforce standards and expectations related to industrial safety. • The plant should take measures to reinforce and implement standards to enhance the performance of reactivity manipulations in a deliberate and carefully-controlled manner. • The plant should improve the support, training and documented guidance for Severe Accident Management Guideline users in order to mitigate complex severe accident scenarios. The team provided a draft report of the mission to the plant’s management. The plant management and the Nuclear Safety Council (CSN), which is responsible for nuclear safety oversight in Spain, will have the opportunity to make factual comments on the draft. These will be reviewed by the IAEA and the final report will be submitted to the Government of Spain within three months. The plant management said it would address the areas

  8. U.S. assistance enhancing safety culture in countries operating Soviet-designed reactors

    International Nuclear Information System (INIS)

    Guppy, J.G.; Horak, W.C.; Reisman, A.W.

    1995-01-01

    The United States Department of Energy (USDOE) is managing the International Nuclear Safety Program (INSP), which is aimed at providing assistance to enhance safety at commercial nuclear power plants (NPPS) in Russia and Ukraine, as well as Central European countries (CEC). The funding for this program has been provided by the US Agency for International Development (AID). Brookhaven National Laboratory has been assisting DOE in certain portions of this program. The enhancement of safety culture is one of the most important goals of the joint International Nuclear Safety Program. In terms of the INSP, safety culture is comprised of two major components; (1) an environment that is a function of regulations, management sensitivity and structure; and (2) an individual commitment to safety in the day to day execution of activities in terms of thought and accountability. The long term impact of the INSP activities can only be measured by the effectiveness of strengthening safety culture within our partner counties. The strengthening of this culture will manifest in reduced risk of a nuclear accident long after other evidence of the INSP activities has disappeared. One area within the INSP, which has already led to a number of successful specific projects, is under the plant safety upgrade activities. Here, the US and the partner countries jointly identify specific target areas for the INSP efforts. Each identified area has a major component involving safety culture enhancement. With any direct involvement in the particular assistance activities, areas are identified to include a need for training. As technical experts and management from the partner country are assisted in addressing the identified needs, the training programs are provided which will not only address the specific need at hand, but will also teach skills which can be applied to different, but related needs that may exist or develop

  9. Clinical Applications of Contrast-Enhanced Ultrasound in the Pediatric Work-Up of Focal Liver Lesions and Blunt Abdominal Trauma

    DEFF Research Database (Denmark)

    Laugesen, Nicolaj Grønbæk; Nolsoe, Christian Pallson; Rosenberg, Jacob

    2017-01-01

    of CEUS is indeed promising. However, no ultrasound contrast agent manufactured today is registered for pediatric use in Europe. The contrast agent SonoVue(®) has recently been approved by the FDA under the name of Lumason(®) to be used in hepatic investigations in adults and children. This article...... help reduce radiation exposure and use of iodinated contrast agents in pediatrics, thereby potentially reducing complications in routine imaging.......In pediatrics ultrasound has long been viewed more favorably than imaging that exposes patients to radiation and iodinated contrast or requires sedation. It is child-friendly and diagnostic capabilities have been improved with the advent of contrast-enhanced ultrasound (CEUS). The application...

  10. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... imaging techniques. top of page Additional Information and Resources The Alliance for Radiation Safety in Pediatric Imaging's " ... To locate a medical imaging or radiation oncology provider in your community, you can search the ACR- ...

  11. Enhancing Comparative Effectiveness Research With Automated Pediatric Pneumonia Detection in a Multi-Institutional Clinical Repository: A PHIS+ Pilot Study.

    Science.gov (United States)

    Meystre, Stephane; Gouripeddi, Ramkiran; Tieder, Joel; Simmons, Jeffrey; Srivastava, Rajendu; Shah, Samir

    2017-05-15

    Community-acquired pneumonia is a leading cause of pediatric morbidity. Administrative data are often used to conduct comparative effectiveness research (CER) with sufficient sample sizes to enhance detection of important outcomes. However, such studies are prone to misclassification errors because of the variable accuracy of discharge diagnosis codes. The aim of this study was to develop an automated, scalable, and accurate method to determine the presence or absence of pneumonia in children using chest imaging reports. The multi-institutional PHIS+ clinical repository was developed to support pediatric CER by expanding an administrative database of children's hospitals with detailed clinical data. To develop a scalable approach to find patients with bacterial pneumonia more accurately, we developed a Natural Language Processing (NLP) application to extract relevant information from chest diagnostic imaging reports. Domain experts established a reference standard by manually annotating 282 reports to train and then test the NLP application. Findings of pleural effusion, pulmonary infiltrate, and pneumonia were automatically extracted from the reports and then used to automatically classify whether a report was consistent with bacterial pneumonia. Compared with the annotated diagnostic imaging reports reference standard, the most accurate implementation of machine learning algorithms in our NLP application allowed extracting relevant findings with a sensitivity of .939 and a positive predictive value of .925. It allowed classifying reports with a sensitivity of .71, a positive predictive value of .86, and a specificity of .962. When compared with each of the domain experts manually annotating these reports, the NLP application allowed for significantly higher sensitivity (.71 vs .527) and similar positive predictive value and specificity . NLP-based pneumonia information extraction of pediatric diagnostic imaging reports performed better than domain experts in this

  12. Engineering Solutions to Enhance Traffic Safety Performance on Two-Lane Highways

    Directory of Open Access Journals (Sweden)

    Lina Wu

    2015-01-01

    Full Text Available Improving two-lane highway traffic safety conditions is of practical importance to the traffic system, which has attracted significant research attention within the last decade. Many cost-effective and proactive solutions such as low-cost treatments and roadway safety monitoring programs have been developed to enhance traffic safety performance under prevailing conditions. This study presents research perspectives achieved from the Highway Safety Enhancement Project (HSEP that assessed safety performance on two-lane highways in Beijing, China. Potential causal factors are identified based on proposed evaluation criteria, and primary countermeasures are developed against inferior driving conditions such as sharp curves, heavy gradients, continuous downgrades, poor sight distance, and poor clear zones. Six cost-effective engineering solutions were specifically implemented to improve two-lane highway safety conditions, including (1 traffic sign replacement, (2 repainting pavement markings, (3 roadside barrier installation, (4 intersection channelization, (5 drainage optimization, and (6 sight distance improvement. The effectiveness of these solutions was examined and evaluated based on Empirical Bayes (EB models. The results indicate that the proposed engineering solutions effectively improved traffic safety performance by significantly reducing crash occurrence risks and crash severities.

  13. Automated Processing of Dynamic Contrast-Enhanced MRI: Correlation of Advanced Pharmacokinetic Metrics with Tumor Grade in Pediatric Brain Tumors.

    Science.gov (United States)

    Vajapeyam, S; Stamoulis, C; Ricci, K; Kieran, M; Poussaint, T Young

    2017-01-01

    Pharmacokinetic parameters from dynamic contrast-enhanced MR imaging have proved useful for differentiating brain tumor grades in adults. In this study, we retrospectively reviewed dynamic contrast-enhanced perfusion data from children with newly diagnosed brain tumors and analyzed the pharmacokinetic parameters correlating with tumor grade. Dynamic contrast-enhanced MR imaging data from 38 patients were analyzed by using commercially available software. Subjects were categorized into 2 groups based on pathologic analyses consisting of low-grade (World Health Organization I and II) and high-grade (World Health Organization III and IV) tumors. Pharmacokinetic parameters were compared between the 2 groups by using linear regression models. For parameters that were statistically distinct between the 2 groups, sensitivity and specificity were also estimated. Eighteen tumors were classified as low-grade, and 20, as high-grade. Transfer constant from the blood plasma into the extracellular extravascular space (K trans ), rate constant from extracellular extravascular space back into blood plasma (K ep ), and extracellular extravascular volume fraction (V e ) were all significantly correlated with tumor grade; high-grade tumors showed higher K trans , higher K ep , and lower V e . Although all 3 parameters had high specificity (range, 82%-100%), K ep had the highest specificity for both grades. Optimal sensitivity was achieved for V e , with a combined sensitivity of 76% (compared with 71% for K trans and K ep ). Pharmacokinetic parameters derived from dynamic contrast-enhanced MR imaging can effectively discriminate low- and high-grade pediatric brain tumors. © 2017 by American Journal of Neuroradiology.

  14. Music therapy in pediatric palliative care: family-centered care to enhance quality of life.

    Science.gov (United States)

    Lindenfelser, Kathryn J; Hense, Cherry; McFerran, Katrina

    2012-05-01

    Research into the value of music therapy in pediatric palliative care (PPC) has identified quality of life as one area of improvement for families caring for a child in the terminal stages of a life-threatening illness. This small-scale investigation collected data in a multisite, international study including Minnesota, USA, and Melbourne, Australia. An exploratory mixed method design used the qualitative data collected through interviews with parents to interpret results from the PedsQL Family Impact Module of overall parental quality of life. Parents described music therapy as resulting in physical improvements of their child by providing comfort and stimulation. They also valued the positive experiences shared by the family in music therapy sessions that were strength oriented and family centered. This highlighted the physical and communication scales within the PedsQL Family Impact Module, where minimal improvements were achieved in contrast to some strong results suggesting diminished quality of life in cognitive and daily activity domains. Despite the significant challenges faced by parents during this difficult time, parents described many positive experiences in music therapy, and the overall score for half of the parents in the study did not diminish. The value of music therapy as a service that addresses the family-centered agenda of PPC is endorsed by this study.

  15. Pediatric Specialists

    Science.gov (United States)

    ... Healthy Children > Family Life > Medical Home > Pediatric Specialists Pediatric Specialists Article Body ​Your pediatrician may refer your child to a pediatric specialist for further evaluation and treatment. Pediatric specialists ...

  16. NASA Engineering and Safety Center (NESC) Enhanced Melamine (ML) Foam Acoustic Test (NEMFAT)

    Science.gov (United States)

    McNelis, Anne M.; Hughes, William O.; McNelis, Mark E.

    2014-01-01

    The NASA Engineering and Safety Center (NESC) funded a proposal to achieve initial basic acoustic characterization of ML (melamine) foam, which could serve as a starting point for a future, more comprehensive acoustic test program for ML foam. A project plan was developed and implemented to obtain acoustic test data for both normal and enhanced ML foam. This project became known as the NESC Enhanced Melamine Foam Acoustic Test (NEMFAT). This document contains the outcome of the NEMFAT project.

  17. Implementation of an Enhanced Measurement Control Program for handling nuclear safety samples at WSRC

    International Nuclear Information System (INIS)

    Boler-Melton, C.; Holland, M.K.

    1991-01-01

    In the separation and purification of nuclear material, nuclear criticality safety (NCS) is of primary concern. The primary nuclear criticality safety controls utilized by the Savannah River Site (SRS) Separations Facilities involve administrative and process equipment controls. Additional assurance of NCS is obtained by identifying key process hold points where sampling is used to independently verify the effectiveness of production control. Nuclear safety measurements of samples from these key process locations provide a high degree of assurance that processing conditions are within administrative and procedural nuclear safety controls. An enhanced procedure management system aimed at making improvements in the quality, safety, and conduct of operation was implemented for Nuclear Safety Sample (NSS) receipt, analysis, and reporting. All procedures with nuclear safety implications were reviewed for accuracy and adequate detail to perform the analytical measurements safely, efficiently, and with the utmost quality. Laboratory personnel worked in a ''Deliberate Operating'' mode (a systematic process requiring continuous expert oversight during all phases of training, testing, and implementation) to initiate the upgrades. Thus, the effort to revise and review nuclear safety sample procedures involved a team comprised of a supervisor, chemist, and two technicians for each procedure. Each NSS procedure was upgraded to a ''Use Every Time'' (UET) procedure with sign-off steps to ensure compliance with each step for every nuclear safety sample analyzed. The upgrade program met and exceeded both the long and short term customer needs by improving measurement reliability, providing objective evidence of rigid adherence to program principles and requirements, and enhancing the system for independent verification of representative sampling from designated NCS points

  18. Mentorship for newly appointed physicians: a strategy for enhancing patient safety?

    Science.gov (United States)

    Harrison, Reema; McClean, Serwaa; Lawton, Rebecca; Wright, John; Kay, Clive

    2014-09-01

    Mentorship is an increasingly popular innovation from business and industry that is being applied in health-care contexts. This paper explores the concept of mentorship for newly appointed physicians in their first substantive senior post, and specifically its utilization to enhance patient safety. Semi-structured face to face and telephone interviews with Medical Directors (n = 5), Deputy Medical Directors (n = 4), and Clinical Directors (n = 6) from 9 acute NHS Trusts in the Yorkshire and Humber region in the north of England. A focused thematic analysis was used. A number of beneficial outcomes were associated with mentorship for newly appointed physicians including greater personal and professional support, organizational commitment, and general well-being. Providing newly appointed senior physicians with support through mentorship was considered to enhance the safety of patient care. Mentorship may prevent or reduce active failures, be used to identify threats in the local working environment, and in the longer term, address latent threats to safety within the organization by encouraging a healthier safety culture. Offering mentorship to all newly appointed physicians in their first substantive post in health care may be a useful strategy to support the development of their clinical, professional, and personal skills in this transitional period that may also enhance the safety of patient care.

  19. Preliminary Evaluation of an Aviation Safety Thesaurus' Utility for Enhancing Automated Processing of Incident Reports

    Science.gov (United States)

    Barrientos, Francesca; Castle, Joseph; McIntosh, Dawn; Srivastava, Ashok

    2007-01-01

    This document presents a preliminary evaluation the utility of the FAA Safety Analytics Thesaurus (SAT) utility in enhancing automated document processing applications under development at NASA Ames Research Center (ARC). Current development efforts at ARC are described, including overviews of the statistical machine learning techniques that have been investigated. An analysis of opportunities for applying thesaurus knowledge to improving algorithm performance is then presented.

  20. Outline of the Fukushima Daiichi Accident. Lessons Learned and Safety Enhancements

    Directory of Open Access Journals (Sweden)

    Hirano Masashi

    2017-01-01

    This paper briefly presents the outline of the Fukushima Daiichi accident and summarizes the major lessons learned having been drawn and safety enhancements having been done in Japan for the purpose of giving inputs to the discussions to be taken place in the Special Invited Session “Fukushima, 5 years after”.

  1. New generation main control room of enhanced safety NPP with MKER reactor

    International Nuclear Information System (INIS)

    Golovanev, V.E.; Gorelov, A.I.; Proshin, V.A.

    1994-01-01

    Russia is planning to begin the gradual substitution RMBK NPP units, whose resources were worked out itself, to NPP units with a 800 MW multiloop boiling water power reactor (MKER-800) enhanced safety at next ten-year period. Main drawbacks of RBMK Reactor were completely removed in design of MKER-800 reactor. Moreover some special decisions were made to give MKER-800 self-safety properties. The proposed design of the MKER-800 enhanced safety reactor is not only fully free from the drawbacks of the RBMK reactors, but also show a number of advantages of channel-type reactors. This Paper presents some preliminary proposals of MCR Design, that developed Research and Development Institute of Power Energy (RDIPE). 6 refs, 2 figs

  2. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... information about radiation dose. There always is a risk of complications from general anesthesia or sedation. Every measure will be taken to ... in X-Ray and CT Exams Contrast Materials Anesthesia Safety Children and Radiation Safety ... (Pediatric) CT (Computed Tomography) Videos related to Children's (Pediatric) ...

  3. INPO Perspectives and Activities to Enhance Supplier Human Performance and Safety Culture

    International Nuclear Information System (INIS)

    Duncan, R. J.

    2016-01-01

    Within their own organizations, utilities have made significant improvements in human performance and safety culture, supported by a strong community of practice through INPO and WANO. In recent years, utilities have been making increasing use of suppliers for design, construction, inspection and maintenance services in support of their NPPs. Many of these suppliers do not have the benefit of being members of a community of practice when it comes to human performance and safety culture. To help the supplier community make improvements similar to what the utilities have achieved, INPO has recently expanded its Supplier Participant program to address the issue of human performance and safety culture in the supplier community. The intent of this paper will be to share the INPO’s perspectives and activities in helping suppliers of services and products to NPPs enhance their human performance and safety culture. (author)

  4. RAF/9/049: Enhancing and Sustaining the National Regulatory Bodies for safety

    International Nuclear Information System (INIS)

    Keter, C.J.

    2017-01-01

    The main objective of this project is to enhance regulatory infrastructure, sustainability and cooperation among national regulatory bodies. This will support strengthening of the existing regulatory framework and capacity building in the region. Self-Assessment using the Self-Assessment Regulatory Infrastructure for Safety (SARIS) was completed on 26th May 2016. Changes made to the legislation is ongoing. The Nuclear Regulatory Bill 2017 is at an advanced stage and about to be tabled to Cabinet. The project objectives shall be addressed under a new project, RAF/9/058 – Improving the Regulatory Framework for the Control of Radiation Sources in Member States. Two major tasks for Kenya to focus include Review of regulations on waste safety, radiation sources and on safety of NPP and advising on drafting of radiation safety guides

  5. Enhanced tracheostomy wound healing using maltodextrin and silver alginate compounds in pediatrics: a pilot study.

    Science.gov (United States)

    Hartzell, Larry D; Havens, Tara N; Odom, Brian H; Stillman, Tanya G; Boswell, Jessica L; Bower, Charles M; Richter, Gresham T

    2014-12-01

    Tracheostomy wounds are commonly encountered in children but rarely reported. Relatively few treatments are available or have been investigated to manage this problem. Healing times for pediatric tracheostomy wounds are often unpredictable and protracted. Recent use of maltodextrin gel (MD) and a silver alginate sponge (AG) at our institution has demonstrated expedited healing and interest in this novel treatment for tracheostomy wounds. We conducted an 11-month retrospective review of children with wound complications following tracheostomy placement at a tertiary care facility. Wounds were evaluated and rated based upon the National Pressure Ulcer Advisory Panel staging system. Subjects identified with stage 2 or greater tracheostomy-related ulcers treated with MD and/or AG were included. Subject characteristics and wound healing rates were tabulated in a database that included age, wound site, initial and final wound stage, type of treatment, length of treatment, and complications. Tracheostomy wounds treated as an out-patient were excluded from the study. Eighteen subjects, which included both in-patients and out-patients, were treated with AG and/or MD during the study period for tracheostomy-related wounds. Of the 26 subjects with tracheostomies performed during the study period, 10 (38.5%) were treated for postoperative wounds. A total of 11 subjects completed their in-patient wound treatment and were thus included in the study. Average subject age was 5.3 y (range 0.25-15.6 y). Wound locations were as follows: infrastomal region (n = 8), stoma (n = 2), and lateral neck (n = 1). Six subjects had stage 2 wounds, 4 had stage 3 wounds, and 1 had a stage 4 ulcer. All wounds achieved complete epithelialization following treatment with MD and/or AG. The average length of treatment was 12.8 d (range 6-28 d). No adverse effects were identified. Postoperative tracheostomy wounds are common. The use of MD and AG provides an effective and safe treatment for

  6. Improving nuclear safety at international research reactors: The Integrated Research Reactor Safety Enhancement Program (IRRSEP)

    International Nuclear Information System (INIS)

    Huizenga, David; Newton, Douglas; Connery, Joyce

    2002-01-01

    Nuclear energy continues to play a major role in the world's energy economy. Research and test reactors are an important component of a nation's nuclear power infrastructure as they provide training, experiments and operating experience vital to developing and sustaining the industry. Indeed, nations with aspirations for nuclear power development usually begin their programs with a research reactor program. Research reactors also are vital to international science and technology development. It is important to keep them safe from both accident and sabotage, not only because of our obligation to prevent human and environmental consequence but also to prevent corresponding damage to science and industry. For example, an incident at a research reactor could cause a political and public backlash that would do irreparable harm to national nuclear programs. Following the accidents at Three Mile Island and Chernobyl, considerable efforts and resources were committed to improving the safety posture of the world's nuclear power plants. Unsafe operation of research reactors will have an amplifying effect throughout a country or region's entire nuclear programs due to political, economic and nuclear infrastructure consequences. (author)

  7. A novel approach to leveraging electronic health record data to enhance pediatric surgical quality improvement bundle process compliance.

    Science.gov (United States)

    Fisher, Jason C; Godfried, David H; Lighter-Fisher, Jennifer; Pratko, Joseph; Sheldon, Mary Ellen; Diago, Thelma; Kuenzler, Keith A; Tomita, Sandra S; Ginsburg, Howard B

    2016-06-01

    Quality improvement (QI) bundles have been widely adopted to reduce surgical site infections (SSI). Improvement science suggests when organizations achieve high-reliability to QI processes, outcomes dramatically improve. However, measuring QI process compliance is poorly supported by electronic health record (EHR) systems. We developed a custom EHR tool to facilitate capture of process data for SSI prevention with the aim of increasing bundle compliance and reducing adverse events. Ten SSI prevention bundle processes were linked to EHR data elements that were then aggregated into a snapshot display superimposed on weekly case-log reports. The data aggregation and user interface facilitated efficient review of all SSI bundle elements, providing an exact bundle compliance rate without random sampling or chart review. Nine months after implementation of our custom EHR tool, we observed centerline shifts in median SSI bundle compliance (46% to 72%). Additionally, as predicted by high reliability principles, we began to see a trend toward improvement in SSI rates (1.68 to 0.87 per 100 operations), but a discrete centerline shift was not detected. Simple informatics solutions can facilitate extraction of QI process data from the EHR without relying on adjunctive systems. Analyses of these data may drive reductions in adverse events. Pediatric surgical departments should consider leveraging the EHR to enhance bundle compliance as they implement QI strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Detection of PCT and urinary β2 -MG enhances the accuracy for localization diagnosing pediatric urinary tract infection.

    Science.gov (United States)

    Fang, Jian; Luan, Jiangwei; Zhu, Gaohong; Qi, Chang; Wang, Dandan

    2017-09-01

    The purpose of this article was to investigate whether the combination of urinary beta 2 microglobulin (urinary β 2 -MG) and procalcitonin (PCT) diagnosis could enhance the localization diagnostic precision of pediatric urinary tract infection comparing with single diagnosis. A study was conducted in the Nephrology Department of Wuhan women and children's health care centre. This study incorporated 85 participants, including 35 children who were diagnosed as upper urinary tract infection (UUTI) with the symptom of fever and 50 children who conducted lower urinary tract infection (LUTI). Levels of PCT and urinary β 2 -MG in both UUTI and LUTI patients were measured and compared. The level of PCT and β 2 -MG were both significantly higher in UUTI group compared with in LUTI group. AUC of urinary β 2 -MG ROC (sensitivity of 71.4%, specificity of 90.0%) was significantly smaller than that of PCT ROC (sensitivity of 77.1%, specificity of 96.0%) in the single diagnosis. Although in the combined diagnosis, the sensitivity and specificity increased to 88.6% and 98%, respectively. Both PCT and β 2 -MG could be used to localize the UTI. Introducing urinary β 2 -MG into PCT diagnosis could increase the sensitivity and specificity of UTI lesion diagnosis in clinical practice. © 2016 The Authors Journal of Clinical Laboratory Analysis Published by Wiley Periodicals, Inc.

  9. Enhancing the safety of elderly victims after the close of an APS investigation.

    Science.gov (United States)

    Jackson, Shelly L; Hafemeister, Thomas L

    2013-04-01

    The purpose of this study was to test whether particular actions on the part of adult protective services (APS), the elderly victim, and/or society's response to abusive individuals, are associated with the continuation of abuse after the close of an APS investigation and thereby compromise victim safety. Interviews were conducted with 71 APS caseworkers, 55 of the elderly victims of substantiated abuse, and 35 third-party persons. A small proportion of elderly victims continue to experience abuse after the close of an APS investigation. Elderly victims were more likely to experience continued abuse when they chose to have ongoing contact with their abusers, vis-à-vis cohabitation or otherwise, and when their abusers experienced no consequences. Although continuation of abuse did not differ by the type of maltreatment involved, reasons for the cessation of abuse, and other safety indicators, did. To enhance victim safety, greater monitoring may be warranted in cases wherein elderly victims continue to have contact with their abuser and when abusive individuals experience no consequences. To further enhance victim safety, abusive individuals must be incorporated into an overall strategic response to elder abuse. A potential avenue for facilitating victim safety while maintaining victim autonomy is to understand their motivations for desiring continued contact with their abuser and developing interventions based upon such knowledge.

  10. An Approach to Enhancement of the Safety Culture of Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2014-05-15

    The culture of an organization is very complex to study and evaluate, but it is possible to examine the specific norms that figure out the culture for the safety of a system. This paper describes an initiation plan to study the safety culture issue in Korean NPPs. Recently there happened successively events that turned out to be socially prominent in Korea. Many issues on the safety culture aspect of NPPs have been raised including the types of errors such as violations, an intended concealment of safety-related information, counterfeit items, forgery process in procurement, and so on. Those were investigated in detail for the root causes of these issues as human and organizational errors and for the countermeasures to prevent those events. They are integrated into a correspondent long-term plan including the establishment of a fundamental infrastructure of safety culture management for operating NPPs in Korea. A monitoring system with analysis functions utilizing system dynamics simulation and data mining is proposed to be incorporated into a safety culture management system. Additionally, a set of training and support programs are to be developed for the enhancement of some selected competence of the operating personnel in Korean NPPs. The safe operation of NPPs requires the typical safety culture characteristics of the high reliability organization (HRO). The culture of an organization is very complex to study and evaluate, but it is possible to examine the specific norms that figure out the culture for the safety of a system. This paper describes an integrated systems approach as an initiating plan to study the safety culture issue in Korean NPPs.

  11. An Approach to Enhancement of the Safety Culture of Nuclear Power Plants

    International Nuclear Information System (INIS)

    Lee, Yong Hee

    2014-01-01

    The culture of an organization is very complex to study and evaluate, but it is possible to examine the specific norms that figure out the culture for the safety of a system. This paper describes an initiation plan to study the safety culture issue in Korean NPPs. Recently there happened successively events that turned out to be socially prominent in Korea. Many issues on the safety culture aspect of NPPs have been raised including the types of errors such as violations, an intended concealment of safety-related information, counterfeit items, forgery process in procurement, and so on. Those were investigated in detail for the root causes of these issues as human and organizational errors and for the countermeasures to prevent those events. They are integrated into a correspondent long-term plan including the establishment of a fundamental infrastructure of safety culture management for operating NPPs in Korea. A monitoring system with analysis functions utilizing system dynamics simulation and data mining is proposed to be incorporated into a safety culture management system. Additionally, a set of training and support programs are to be developed for the enhancement of some selected competence of the operating personnel in Korean NPPs. The safe operation of NPPs requires the typical safety culture characteristics of the high reliability organization (HRO). The culture of an organization is very complex to study and evaluate, but it is possible to examine the specific norms that figure out the culture for the safety of a system. This paper describes an integrated systems approach as an initiating plan to study the safety culture issue in Korean NPPs

  12. Reduction of adult fingers visualized on pediatric intensive care unit (PICU) chest radiographs after radiation technologist and PICU staff radiation safety education

    International Nuclear Information System (INIS)

    Tynan, J.R.; Duncan, M.D.; Burbridge, B.E.

    2009-01-01

    A recent publication from our centre revealed a disturbing finding of a significant incidence of adult fingers seen on the pediatric intensive care unit (PICU) chest radiographs. This is inappropriate occupational exposure to diagnostic radiation. We hypothesized that the incidence of adult fingers on PICU chest radiographs would decline after radiation safety educational seminars were given to the medical radiation technologists and PICU staff. The present study's objectives were addressed by using a pretest-posttest design. Two cross-sectional PICU chest radiograph samples, taken before and after the administration of radiation safety education for our medical radiation technologists and PICU staff, were compared by using a χ 2 test. There was a 61.2% and 76.9% reduction in extraneous adult fingers, directly exposed to the x-ray beam and those seen in the coned regions of the film, respectively, on PICU chest radiographs (66.7% reduction overall). This reduction was statistically significant (χ2 = 20.613, P < .001). Limiting unnecessary occupational radiation exposure is a critical issue in radiology. There was a statistically and clinically significant association between radiation safety education and the decreased number of adult fingers seen on PICU chest radiographs. This study provides preliminary evidence in favour of the benefit of radiation safety seminars. (author)

  13. Effects of mental demands during dispensing on perceived medication safety and employee well-being: a study of workload in pediatric hospital pharmacies.

    Science.gov (United States)

    Holden, Richard J; Patel, Neal R; Scanlon, Matthew C; Shalaby, Theresa M; Arnold, Judi M; Karsh, Ben-Tzion

    2010-12-01

    Pharmacy workload is a modifiable work system factor believed to affect both medication safety outcomes and employee outcomes, such as job satisfaction. This study sought to measure the effect of workload on safety and employee outcomes in 2 pediatric hospitals and to do so using a novel approach to pharmacy workload measurement. Rather than measuring prescription volume or other similar indicators, this study measured the type and intensity of mental demands experienced during the medication dispensing tasks. The effects of external (interruptions, divided attention, and rushing) and internal (concentration and effort) task demands on perceived medication error likelihood, adverse drug event likelihood, job dissatisfaction, and burnout were statistically estimated using multiple linear and logistic regression. Pharmacists and pharmacy technicians reported high levels of external and internal mental demands during dispensing. The study supported the hypothesis that external demands (interruptions, divided attention, and rushing) negatively impacted medication safety and employee well-being outcomes. However, as hypothesized, increasing levels of internal demands (concentration and effort) were not associated with greater perceived likelihood of error, adverse drug events, or burnout and even had a positive effect on job satisfaction. Replicating a prior study in nursing, this study shows that new conceptualizations and measures of workload can generate important new findings about both detrimental and beneficial effects of workload on patient safety and employee well-being. This study discusses what those findings imply for policy, management, and design concerning automation, cognition, and staffing. Copyright © 2010 Elsevier Inc. All rights reserved.

  14. Effects of mental demands during dispensing on perceived medication safety and employee well being: A study of workload in pediatric hospital pharmacies

    Science.gov (United States)

    Holden, Richard J.; Patel, Neal R.; Scanlon, Matthew C.; Shalaby, Theresa M.; Arnold, Judi M.; Karsh, Ben-Tzion

    2009-01-01

    Background Pharmacy workload is a modifiable work system factor believed to affect both medication safety outcomes and employee outcomes such as job satisfaction. Objectives This study sought to measure the effect of workload on safety and employee outcomes in two pediatric hospitals and to do so using a novel approach to pharmacy workload measurement. Methods Rather than measuring prescription volume or other similar indicators, this study measured the type and intensity of mental demands experienced during the medication dispensing tasks. The effects of external (interruptions, divided attention, rushing) and internal (concentration, effort) task demands on perceived medication error likelihood, adverse drug event likelihood, job dissatisfaction, and burnout were statistically estimated using multiple linear and logistic regression. Results Pharmacists and pharmacy technicians reported high levels of external and internal mental demands during dispensing. The study supported the hypothesis that external demands (interruptions, divided attention, rushing) negatively impacted medication safety and employee well being outcomes. However, as hypothesized, increasing levels of internal demands (concentration and effort) were not associated with greater perceived likelihood of error, adverse drug events, or burnout, and even had a positive effect on job satisfaction. Conclusion Replicating a prior study in nursing, this study shows that new conceptualizations and measures of workload can generate important new findings about both detrimental and beneficial effects of workload on patient safety and employee well being. This study discusses what those findings imply for policy, management, and design concerning automation, cognition, and staffing. PMID:21111387

  15. Safety and adverse effects during 24 hours after contrast-enhanced MRI with gadobenate dimeglumine (MultiHance {sup registered}) in children

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Guenther; Schuerholz, Hellmut; Buecker, Arno; Fries, Peter [Homburg University Hospital, Homburg, Saar (Germany); Kirchin, Miles A. [Bracco Imaging SpA, Milan (Italy)

    2013-02-15

    Gadolinium-based MR contrast agents have long been considered safe for routine diagnostic imaging. However, the advent of nephrogenic systemic fibrosis (NSF) among certain patients with severe renal insufficiency has brought the issue of safety into question. Nowhere is safety of greater concern than among children who frequently require multiple contrast-enhanced MRI examinations over an extended period of time. To retrospectively evaluate the safety of gadobenate dimeglumine for contrast-enhanced (CE) MRI across a range of indications. Two hundred pediatric inpatients (age: 4 days to 15 years) underwent CE MRI as part of clinical routine. The children received a gadobenate dimeglumine dose of either 0.05 mmol/kg body weight (liver, abdominal imaging, musculoskeletal imaging, brain and other rare indications) or 0.1 mmol/kg bodyweight (cardiovascular imaging, MR-urography). Young (< 8 years) children with congenital heart disease were intubated and underwent MRA evaluation with controlled ventilation. Monitoring for adverse events was performed for at least 24 h after each gadobenate dimeglumine injection. Depending on clinical necessity, laboratory measurements and, in some cases, vital sign and ECG determinations were made before and after contrast injection. Safety was evaluated by age group, indication and dose administered. No clinically adverse events were reported among children who had one MRI scan only or among children who had several examinations. There were no changes in creatinine or bilirubin levels even in very young children. No adverse events were recorded during the first 24 h following administration of gadobenate dimeglumine in 200 children. (orig.)

  16. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info About Us News Physician ... such low-dose exposure. For more information about safety in pediatric radiology procedures, visit the Image Gently ...

  17. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us ... such low-dose exposure. For more information about safety in pediatric radiology procedures, visit the Image Gently ...

  18. The pharmacokinetics and safety of twice daily i.v. BU during conditioning in pediatric allo-SCT recipients.

    Science.gov (United States)

    Le Gall, J B; Milone, M C; Waxman, I M; Shaw, L M; Harrison, L; Duffy, D; van de Ven, C; Militano, O; Geyer, M B; Morris, E; Bhatia, M; Satwani, P; George, D; Garvin, J H; Bradley, M B; Schwartz, J; Baxter-Lowe, L A; Cairo, M S

    2013-01-01

    Intravenous BU divided four times daily (q6 h) has been shown to be safe and effective in pediatric allo-SCT recipients. Though less frequent dosing is desirable, pharmacokinetic (PK) data on twice daily (q12 h) i.v. BU administration in pediatric allo-SCT recipients is limited. We prospectively examined the PK results in a cohort of pediatric allo-SCT recipients receiving i.v. BU q12 h as part of conditioning before allo-SCT. BU levels were obtained after the first dose of conditioning. PK parameter analysis (n=49) yielded the following 95% confidence intervals (CI₉₅): weight-normalized volume of distribution: 0.65-0.73 L/kg; t(1/2): 122-147 min; weight-normalized clearance (CL(n)): 3.4-4.3 mL/min/kg; and area under the curve: 1835-2180 mmol × min/L. From these results, a steady state concentration was calculated with CI₉₅ between 628-746 ng/mL. Comparison between recipients ≤4 vs >4 years old revealed significant differences in t(1/2) (mean: 115 vs 146 min, P=0.008) and CL(n) (mean: 4.4 vs 3.5 mL/min/kg, P=0.038). Intravenous BU q12 h had a comparable PK to i.v. BU q6 h PK seen in the literature, and in pediatric allo-SCT recipients, is a feasible, attractive alternative to i.v. q6h dosing.

  19. The Ex Hoc Infrastructure - Enhancing Traffic Safety through LIfe WArning Systems

    DEFF Research Database (Denmark)

    Hansen, Klaus Marius; Kristensen, Lars Michael; Eskildsen, Toke

    2004-01-01

    New pervasive computing technologies for sensing and communication open up novel possibilities for enhancing traffic safety. We are currently designing and implementing the Ex Hoc infrastructure framework for communication among mobile and stationary units including vehicles. The infrastructure...... will connect sensing devices on vehicles with sensing devices on other vehicles and with stationary communication units placed alongside roads. The current application of Ex Hoc is to enable the collection and dissemination of information on road condition through LIfe Warning Systems (LIWAS) units....

  20. Reducing variety enhances effectiveness of family-based treatment for pediatric obesity.

    Science.gov (United States)

    Epstein, Leonard H; Kilanowski, Colleen; Paluch, Rocco A; Raynor, Hollie; Daniel, Tinuke Oluyomi

    2015-04-01

    Basic research has shown that increasing variety increases energy intake, and repeated consumption of the same food increases habituation to those foods and reduces consumption. Twenty-four families with overweight/obese 8-12 year-old children and overweight/obese parents were randomly assigned to 6months of usual family based treatment (FBT) or FBT plus reduced variety of high energy-dense foods (FBT+Variety). Intention to treat mixed model ANOVA showed between group differences in child percent overweight (FBT+Variety-15.4% vs. FBT-8.9%, p=0.017) and parent BMI (FBT+Variety-3.7kg/m(2) vs. FBT-2.3kg/m(2); p=0.017). Positive relationships were observed between child zBMI and parent BMI changes (r=0.51, p=0.018), and between reductions in food variety of high energy-dense foods and reductions in child zBMI (r=0.54, p=0.02) and parent BMI (r=0.45, p=0.08). These pilot data suggest that reducing the variety of high energy dense foods and repeating meals within the context of FBT resulted in improved child and parent weight changes at six months. This represents easy to implement changes that reduce choice and may reduce response burden on families. Reducing variety may be a complement to standard FBT that enhances weight loss. Long term studies are needed to assess maintenance of these changes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Immunological low-dose radiation modulates the pediatric medulloblastoma antigens and enhances antibody-dependent cellular cytotoxicity.

    Science.gov (United States)

    Das, Arabinda; McDonald, Daniel; Lowe, Stephen; Bredlau, Amy-Lee; Vanek, Kenneth; Patel, Sunil J; Cheshier, Samuel; Eskandari, Ramin

    2017-03-01

    Immunotherapy can be an effective treatment for pediatric medulloblastoma (MB) patients. However, major subpopulations do not respond to immunotherapy, due to the lack of antigenic mutations or the immune-evasive properties of MB cells. Clinical observations suggest that radiation therapy (RT) may expand the therapeutic reach of immunotherapy. The aim of the present investigation is to study the effect of low-dose X-ray radiation (LDXR, 1 Gy) on the functional immunological responses of MB cells (DAOY, D283, and D341). Induction of MB cell death was examined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Production of reactive oxygen species (ROS) was measured by fluorescent probes. Changes in the expression of  human leukocyte antigen (HLA) molecules and caspase-3 activities during treatment were analyzed using Western blotting and caspase-3 assay. Western blot analysis demonstrated that LDXR upregulated the expression of HLA class I and HLA II molecules by more than 20% compared with control and high-dose (12 Gy) groups in vitro. Several of these HLA subtypes, such as MAGE C1, CD137, and ICAM-1, have demonstrated upregulation. In addition, LDXR increases ROS production in association with phosphorylation of NF-κB and cell surface expression of mAb target molecules (HER2 and VEGF). These data suggest that a combined LDXR and mAb therapy can create a synergistic effect in vitro. These results suggest that LDXR modulates HLA molecules, leading to alterations in T-cell/tumor-cell interaction and enhancement of T-cell-mediated MB cell death. Also, low-dose radiotherapy combined with monoclonal antibody therapy may one day augment the standard treatment for MB, but more investigation is needed to prove its utility as a new therapeutic combination for MB patients.

  2. Pediatric Sinusitis

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Pediatric Sinusitis Pediatric Sinusitis Patient Health Information News media interested in ... sinuses are present at birth. Unlike in adults, pediatric sinusitis is difficult to diagnose because symptoms of ...

  3. Pediatric Asthma

    Science.gov (United States)

    ... Science Education & Training Home Conditions Asthma (Pediatric) Asthma (Pediatric) Make an Appointment Refer a Patient Ask a ... meet the rising demand for asthma care. Our pediatric asthma team brings together physicians, nurses, dietitians, physical ...

  4. Decreasing Turnaround Time and Increasing Patient Satisfaction in a Safety Net Hospital-Based Pediatrics Clinic Using Lean Six Sigma Methodologies.

    Science.gov (United States)

    Jayasinha, Yasangi

    2016-01-01

    Increasingly, health care quality indicators are focusing on patient-centeredness as an indicator of performance. The National Quality Forum lists assessment of patient experience, often conducted using patient surveys, as a top priority. We developed a patient-reported time stamp data collection tool that was used to collect cycle times in a safety net hospital-based outpatient pediatrics clinic. Data were collected using patient-reported survey to obtain cycle times in Pediatric clinic, as well as qualitative and quantitative patient satisfaction data. Several rapid-cycle improvements were performed using Lean Six Sigma methodologies to reduce cycle time by eliminating waste and revise unnecessary processes to improve operational effectiveness and patient and staff satisfaction. A total of 94 surveys were collected and revealed average cycle time of 113 minutes. Our measured patient satisfaction rating was 87%. Discharge and check-in processes were identified as the least efficient and were targeted for intervention. Following implementation, the overall cycle time was decreased from 113 to 90 minutes. Patient satisfaction ratings increased from 87% to 95%. We demonstrate that using Lean Six Sigma tools can be invaluable to clinical restructuring and redesign and results in measurable, improved outcomes in care delivery.

  5. 4th ASEM Seminar on Knowledge Management to Enhance Nuclear Safety

    International Nuclear Information System (INIS)

    Castello, F.; Reyes, A. de los; Sobari, M. P. Mohd; Istiyanto, J. E.; Faross, P.; Delarosa, A.

    2016-01-01

    Full text: The 4th Asia-Europe Meeting (ASEM) Seminar on Nuclear Safety was convened in Madrid, Spain on 29th–30th October 2015, hosted by the Spanish Nuclear Safety Council. The seminar’s theme was “Knowledge management to enhance nuclear safety”, which aimed to continue discussing on nuclear safety to foster Asia-Europe capacity-building and cooperation in nuclear safety. The seminar was attended by representatives from national governments, nuclear regulators, energy companies, radiation protection and nuclear safety authorities, research institutes and universities. According to such model, proposed by the IAEA, the national capacity building requires an integrated approach based on four pillars: human resources development, education and training, knowledge management and knowledge networking. In this context, Nuclear Knowledge Management (KM) has become a high priority in many countries and international organizations and it has been taken into account to develop and implement specific strategies in ensuring safe and sustainable operation of nuclear facilities. At national level, a sustainable approach should include the necessary Nuclear Knowledge Management actions to ensure that every actor having a significant role in the national nuclear programmes infrastructure acquires, preserves and improves its corporate and individual knowledge. (author

  6. Pediatric dental sedation: challenges and opportunities

    Directory of Open Access Journals (Sweden)

    Nelson TM

    2015-08-01

    Full Text Available Travis M Nelson, Zheng Xu Department of Pediatric Dentistry, University of Washington, Seattle, WA, USA Abstract: High levels of dental caries, challenging child behavior, and parent expectations support a need for sedation in pediatric dentistry. This paper reviews modern developments in pediatric sedation with a focus on implementing techniques to enhance success and patient safety. In recent years, sedation for dental procedures has been implicated in a disproportionate number of cases that resulted in death or permanent neurologic damage. The youngest children and those with more complicated medical backgrounds appear to be at greatest risk. To reduce complications, practitioners and regulatory bodies have supported a renewed focus on health care quality and safety. Implementation of high fidelity simulation training and improvements in patient monitoring, including end-tidal carbon dioxide, are becoming recognized as a new standard for sedated patients in dental offices and health care facilities. Safe and appropriate case selection and appropriate dosing for overweight children is also paramount. Oral sedation has been the mainstay of pediatric dental sedation; however, today practitioners are administering modern drugs in new ways with high levels of success. Employing contemporary transmucosal administration devices increases patient acceptance and sedation predictability. While recently there have been many positive developments in sedation technology, it is now thought that medications used in sedation and anesthesia may have adverse effects on the developing brain. The evidence for this is not definitive, but we suggest that practitioners recognize this developing area and counsel patients accordingly. Finally, there is a clear trend of increased use of ambulatory anesthesia services for pediatric dentistry. Today, parents and practitioners have become accustomed to children receiving general anesthesia in the outpatient setting. As a

  7. Safety

    International Nuclear Information System (INIS)

    1998-01-01

    A brief account of activities carried out by the Nuclear power plants Jaslovske Bohunice in 1997 is presented. These activities are reported under the headings: (1) Nuclear safety; (2) Industrial and health safety; (3) Radiation safety; and Fire protection

  8. Short-term initiatives for enhancing cyber-safety within South African schools

    Directory of Open Access Journals (Sweden)

    Elmarie Kritzinger

    2016-07-01

    Full Text Available The rate of technological development across the globe is dramatic. The decreasing cost and increasing availability of ICT devices means that its users are no longer exclusively industry or government employees – they are now also home users. Home users integrate ICT in their daily lives for education, socialising and information gathering. However, using ICT is associated with risks and threats, such as identity theft and phishing scams. Most home users of ICT do not have the necessary information technology and Internet skills to protect themselves and their information. School learners, in particular, are not sufficiently educated on how to use technological devices safely, especially in developing countries such as South Africa. The national school curriculum in South Africa currently does not make provision for cyber-safety education, and the availability of supporting material and training for ICT teachers in South Africa is limited, resulting in a lack of knowledge and skills regarding cyber-safety. The research in hand focuses on the situation concerning cyber-safety awareness in schools and has adopted a short-term approach towards cyber-safety among teachers and school learners in South Africa until a formal long-term national approach has been implemented. This study takes a quantitative approach to investigating the current options of teachers to enhance cyber-safety among learners in their schools. The research proposes that short-term initiatives (i.e. posters can increase learners’ awareness of cyber-safety until formal cyber-safety awareness methods have been introduced.

  9. Trending of low level events and near misses to enhance safety performance in nuclear power plants

    International Nuclear Information System (INIS)

    2005-11-01

    The IAEA Safety Fundamentals publication, Safety of Nuclear Installations, Safety Series No. 110, states the need for operating organizations to establish a programme for the collection and analysis of operating experience in nuclear power plants. Such a programme ensures that operating experience is analysed, events important to safety are reviewed in depth, and lessons learned are disseminated to the staff of the organization and to relevant national and international organizations. As a result of the effort to enhance safety in operating organizations, incidents are progressively decreasing in number and significance. This means that in accordance with international reporting requirements the amount of collected data becomes less sufficient to draw meaningful statistical conclusions. This is where the collection and trend analysis of low level events and near misses can prove to be very useful. These trends can show which of the safety barriers are weak or failing more frequently. Evaluation and trending of low level events and near misses will help to prevent major incidents because latent weaknesses have been identified and corrective actions taken to prevent recurrence. This leads to improved safety and production. Low level events and near misses, which may reach several thousand per reactor operating year, need to be treated by the organizations as learning opportunities. A system for capturing these low level events and near misses truly needs to be an organization-wide system in which all levels of the organization, including contractors, participate. It is desirable that the overall operational experience feedback (OEF) process should integrate the lessons learned and the associated data from significant events with those of lower level events and near misses. To be able to effectively implement a process dealing with low level events and near misses, it is necessary that the organization have a well established OEF process for significant events

  10. Low-tube-voltage selection for non-contrast-enhanced CT: Comparison of the radiation dose in pediatric and adult phantoms.

    Science.gov (United States)

    Shimonobo, Toshiaki; Funama, Yoshinori; Utsunomiya, Daisuke; Nakaura, Takeshi; Oda, Seitaro; Kiguchi, Masao; Masuda, Takanori; Sakabe, Daisuke; Yamashita, Yasuyuki; Awai, Kazuo

    2016-01-01

    We used pediatric and adult anthropomorphic phantoms to compare the radiation dose of low- and standard tube voltage chest and abdominal non-contrast-enhanced computed tomography (CT) scans. We also discuss the optimal low tube voltage for non-contrast-enhanced CT. Using a female adult- and three differently-sized pediatric anthropomorphic phantoms we acquired chest and abdominal non-contrast-enhanced scans on a 320-multidetector CT volume scanner. The tube voltage was set at 80-, 100-, and 120 kVp. The tube current was automatically assigned on the CT scanner in response to the set image noise level. On each phantom and at each tube voltage we measured the surface and center dose using high-sensitivity metal-oxide-semiconductor field-effect transistor detectors. The mean surface dose of chest and abdominal CT scans in 5-year olds was 4.4 and 5.3 mGy at 80 kVp, 4.5 and 5.4 mGy at 100 kV, and 4.0 and 5.0 mGy at 120 kVp, respectively. These values were similar in our 3-pediatric phantoms (p > 0.05). The mean surface dose in the adult phantom increased from 14.7 to 19.4 mGy for chest- and from 18.7 to 24.8 mGy for abdominal CT as the tube voltage decreased from 120 to 80 kVp (p voltage and the low tube voltage technique can be used for non-contrast-enhanced chest- and abdominal scanning. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  11. Report of a consultants meeting on backfittings and safety enhancement measures in NPPs with WWER 440/213 reactors. Extrabudgetary programme on the safety of WWER NPPS

    International Nuclear Information System (INIS)

    1994-01-01

    The purpose of this Consultants' Meeting held by the IAEA in Vienna from 11-15 April 1994 within the framework of the Extrabudgetary Programme on WWER Safety was to review and analyze safety issues revealed during operation and through analyses of NPPs with WWER 440/213 reactors. The initial list of safety issues based on the available reports from various studies had been prepared by the IAEA secretariat before the meeting, together with indications of safety enhancement measures proposed in various NPP units. During the meeting, the underlying safety concerns and actual technical status of the plants were discussed and the ranking of the safety issues was considered. 58 refs, 1 tab

  12. Exploiting Science: Enhancing the Safety Training of Pilots to Reduce the Risk of Bird Strikes

    Science.gov (United States)

    Mendonca, Flavio A. C.

    Analysis of bird strikes to aviation in the U.S. from 1990 to 2015 indicate that the successful mitigation efforts at airports, which must be sustained, have reduced incidents with damage and a negative effect-on-flight since 2000. However, such efforts have done little to reduce strikes outside the airport jurisdiction, such as occurred with US Airways Flight 1549 in 2009. There are basically three strategies to mitigate the risk of bird strikes: standards set by aviation authorities, technology, and actions by crewmembers. Pilots play an important role as stakeholders in the prevention of bird strikes, especially outside the airport environment. Thus, safety efforts require enhanced risk management and aeronautical decision-making training for flight crews. The purpose of this study was to determine if a safety training protocol could effectively enhance CFR Part 141 general aviation pilots' knowledge and skills to reduce the risk of bird strikes to aviation. Participants were recruited from the Purdue University professional flight program and from Purdue Aviation. The researcher of this study used a pretest posttest experimental design. Additionally, qualitative data were collected through open-ended questions in the pretest, posttest, and a follow-up survey questionnaire. The participants' pretest and posttest scores were analyzed using parametric and nonparametric tests. Results indicated a significant increase in the posttest scores of the experimental group. An investigation of qualitative data showed that the topic "safety management of bird hazards by pilots" is barely covered during the ground and flight training of pilots. Furthermore, qualitative data suggest a misperception of the safety culture tenets and a poor familiarity with the safety risk management process regarding bird hazards. Finally, the researcher presented recommendations for practice and future research.

  13. Pharmacokinetics and Safety of Travoprost 0.004% Ophthalmic Solution Preserved with Polyquad in Pediatric Patients with Glaucoma.

    Science.gov (United States)

    Stahl, Erin; Bremond-Gignac, Dominique; Landry, Theresa; Curtis, Mike; Gedif, Kinfemichael; Al Shahwan, Sami; Dixon, El Roy

    2017-06-01

    To evaluate the systemic pharmacokinetics (PKs) of travoprost 0.004% preserved with Polyquad ® (TRAVATAN ® ) in pediatric patients with glaucoma or ocular hypertension. This was a phase 1, open-label, multicenter clinical study of patients aged ≥2 months to <18 years. Patients received daily administration of travoprost 0.004% preserved with Polyquad in both eyes for 7 days. Plasma samples were collected 30 min before the final dose and at 10, 20, 40, and 80 min postdose. The main outcome measure was maximum concentration of travoprost free acid in plasma (C max ). Included in the PK analysis were 24 patients (average age 9.6 ± 4.9 years). At least 1 sample with quantifiable levels of travoprost free acid was collected for 11 patients. The mean C max was 0.0471 ± 0.0105 ng/mL for patients aged 2 months to <3 years; 0.0258 ± 0.0128 ng/mL for ages 3 to <12 years; and 0.0109 ± 0.0005 ng/mL for ages 12 to <18 years. Travoprost was undetectable in samples collected predose from pediatric patients. Treatment-related adverse events (AEs) included hyperemia, eye pain, and eye pruritus (n = 1 each). There were no discontinuations or drug-related serious AEs. Travoprost free acid concentration in plasma was low in pediatric patients, detectable in only 11 of 24 patients. There was no accumulation of travoprost over the course of treatment. No clear relationship was observed between age/body surface area and C max . No increased risk was identified for the use of travoprost 0.004% preserved with Polyquad in patients <18 years of age.

  14. ENSI’s synopsis concerning the enhancement of safety margins; Zusammenfassung des ENSI zur Erhöhung der Sicherheitsmargen

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    This press release issued by the Swiss Federal Nuclear Safety Inspectorate ENSI discusses the results of its probabilistic safety analysis on the safety margins for Swiss nuclear power stations that was made after the Fukushima nuclear accident. External incidents such as earthquakes and flooding and their impact on the power stations are analysed by the ERSIM project concerning the enhancement of safety margins. Three shut-down scenarios are discussed. The safety margins with respect to earthquakes and flooding for all four nuclear power station sites are discussed in detail.

  15. Feasibility, tolerability and safety of pediatric hyperpolarized "1"2"9Xe magnetic resonance imaging in healthy volunteers and children with cystic fibrosis

    International Nuclear Information System (INIS)

    Walkup, Laura L.; Watters, Erin; Ruppert, Kai; Thomen, Robert P.; Woods, Jason C.; Akinyi, Teckla G.; Cleveland, Zackary I.; Clancy, John P.

    2016-01-01

    Hyperpolarized "1"2"9Xe is a promising contrast agent for MRI of pediatric lung function, but its safety and tolerability in children have not been rigorously assessed. To assess the feasibility, safety and tolerability of hyperpolarized "1"2"9Xe gas as an inhaled contrast agent for pediatric pulmonary MRI in healthy control subjects and in children with cystic fibrosis. Seventeen healthy control subjects (ages 6-15 years, 11 boys) and 11 children with cystic fibrosis (ages 8-16 years, 4 boys) underwent "1"2"9Xe MRI, receiving up to three doses of "1"2"9Xe gas prepared by either a commercially available or a homebuilt "1"2"9Xe polarizer. Subject heart rate and SpO_2 were monitored for 2 min post inhalation and compared to resting baseline values. Adverse events were reported via follow-up phone call at days 1 and 30 (range ±7 days) post-MRI. All children tolerated multiple doses of "1"2"9Xe, and no children withdrew from the study. Relative to baseline, most children who received a full dose of gas for imaging (10 of 12 controls and 8 of 11 children with cystic fibrosis) experienced a nadir in SpO_2 (mean -6.0 ± standard deviation 7.2%, P≤0.001); however within 2 min post inhalation SpO_2 values showed no significant difference from baseline (P=0.11). There was a slight elevation in heart rate (mean +6.6 ± 13.9 beats per minute [bpm], P=0.021), which returned from baseline within 2 min post inhalation (P=0.35). Brief side effects related to the anesthetic properties of xenon were mild and quickly resolved without intervention. No serious or severe adverse events were observed; in total, four minor adverse events (14.3%) were reported following "1"2"9Xe MRI, but all were deemed unrelated to the study. The feasibility, safety and tolerability of "1"2"9Xe MRI has been assessed in a small group of children as young as 6 years. SpO_2 changes were consistent with the expected physiological effects of a short anoxic breath-hold, and other mild side effects were

  16. Feasibility, tolerability and safety of pediatric hyperpolarized {sup 129}Xe magnetic resonance imaging in healthy volunteers and children with cystic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Walkup, Laura L.; Watters, Erin; Ruppert, Kai [Cincinnati Children' s Hospital Medical Center, Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati, OH (United States); Thomen, Robert P.; Woods, Jason C. [Cincinnati Children' s Hospital Medical Center, Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati, OH (United States); Washington University in St. Louis, Department of Physics, St. Louis, MO (United States); Akinyi, Teckla G.; Cleveland, Zackary I. [Cincinnati Children' s Hospital Medical Center, Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati, OH (United States); University of Cincinnati, Biomedical Engineering Program, Cincinnati, OH (United States); Clancy, John P. [Cincinnati Children' s Hospital Medical Center, Division of Pulmonary Medicine, Cincinnati, OH (United States)

    2016-11-15

    Hyperpolarized {sup 129}Xe is a promising contrast agent for MRI of pediatric lung function, but its safety and tolerability in children have not been rigorously assessed. To assess the feasibility, safety and tolerability of hyperpolarized {sup 129}Xe gas as an inhaled contrast agent for pediatric pulmonary MRI in healthy control subjects and in children with cystic fibrosis. Seventeen healthy control subjects (ages 6-15 years, 11 boys) and 11 children with cystic fibrosis (ages 8-16 years, 4 boys) underwent {sup 129}Xe MRI, receiving up to three doses of {sup 129}Xe gas prepared by either a commercially available or a homebuilt {sup 129}Xe polarizer. Subject heart rate and SpO{sub 2} were monitored for 2 min post inhalation and compared to resting baseline values. Adverse events were reported via follow-up phone call at days 1 and 30 (range ±7 days) post-MRI. All children tolerated multiple doses of {sup 129}Xe, and no children withdrew from the study. Relative to baseline, most children who received a full dose of gas for imaging (10 of 12 controls and 8 of 11 children with cystic fibrosis) experienced a nadir in SpO{sub 2} (mean -6.0 ± standard deviation 7.2%, P≤0.001); however within 2 min post inhalation SpO{sub 2} values showed no significant difference from baseline (P=0.11). There was a slight elevation in heart rate (mean +6.6 ± 13.9 beats per minute [bpm], P=0.021), which returned from baseline within 2 min post inhalation (P=0.35). Brief side effects related to the anesthetic properties of xenon were mild and quickly resolved without intervention. No serious or severe adverse events were observed; in total, four minor adverse events (14.3%) were reported following {sup 129}Xe MRI, but all were deemed unrelated to the study. The feasibility, safety and tolerability of {sup 129}Xe MRI has been assessed in a small group of children as young as 6 years. SpO{sub 2} changes were consistent with the expected physiological effects of a short anoxic breath

  17. Priority ranking of safety-related systems for structural enhancement assessment at Savannah River Site

    International Nuclear Information System (INIS)

    Kao, G.C.; Daugherty, W.L.; Barnes, D.M.

    1992-09-01

    In order to extend the service life of safety related structures and systems in a logical manner, a Structural Enhancement Program was initiated to evaluate the structural integrity of eight (8) systems, namely: Cooling Water System, Emergency Cooling System, Moderator Recovery System supplementary Safety System, Water Removal System, Service Raw Water System, Service Clarified Water System, and River Water System. Since the level of importance of each system to reactor operations varies from one system to another, the scope of structural integrity evaluation for each system should be prioritized accordingly. This paper presents the assessment of system priority for structural evaluation based on a ranking methodology and specifies the level of structural evaluation consistent with the established priority. The effort was undertaken by a five-member panel representing four (4) major disciplines, including. structures, reactor engineering/operations, risk management and materials. The above systems were divided into a total of thirty-five (35) subsystem. These subsystems were then ranked with six (6) attributes, namely: Safety Classification, Degradation Mechanisms, Difficulty of Replacement, Failure Mode, Radiation Dose to Workers and Consequence of Failure. Each attribute was assigned a set of consequences or events with corresponding weighting scores. The results of the ranking process yielded two groups of subsystems, categorized as Priority I and II subsystems. The level of structural assessment was then formulated accordingly. The prioritized approach will allow more efficient allocation of resources, so that the Structural Enhancement Program can be implemented in a cost-effective and efficient manner

  18. Handling and safety enhancement of race cars using active aerodynamic systems

    Science.gov (United States)

    Diba, Fereydoon; Barari, Ahmad; Esmailzadeh, Ebrahim

    2014-09-01

    A methodology is presented in this work that employs the active inverted wings to enhance the road holding by increasing the downward force on the tyres. In the proposed active system, the angles of attack of the vehicle's wings are adjusted by using a real-time controller to increase the road holding and hence improve the vehicle handling. The handling of the race car and safety of the driver are two important concerns in the design of race cars. The handling of a vehicle depends on the dynamic capabilities of the vehicle and also the pneumatic tyres' limitations. The vehicle side-slip angle, as a measure of the vehicle dynamic safety, should be narrowed into an acceptable range. This paper demonstrates that active inverted wings can provide noteworthy dynamic capabilities and enhance the safety features of race cars. Detailed analytical study and formulations of the race car nonlinear model with the airfoils are presented. Computer simulations are carried out to evaluate the performance of the proposed active aerodynamic system.

  19. Efforts toward enhancing seismic safety at Kashiwazaki Kariwa Nuclear Power Station

    International Nuclear Information System (INIS)

    Yamashita, Kazuhiko

    2009-01-01

    It has been two years since the Niigata-ken Chuetsu-oki Earthquake (NCOE) occurred in 2007. The earthquake brought a major disaster for Kashiwazaki, Kariwa, and the neighboring areas. First of all, we would like to give condolences to people in the devastated area and to pray for the immediate recovery. Our Kashiwazaki Kariwa Nuclear Power Station located in the same area was naturally caught up in the earthquake. The station was hit by a big tremor more than its intensity assumed to be valid at the station design stage. In spite of unexpected tremor, preventive functions for the station safety worked as expected as it designed. Critical facilities designed as high seismic class were not damaged, though considerable damages were seen in outside-facilities designed as low seismic class. We currently make efforts to inspect and recover damages. While we carefully carry out inspection and assessment to make sure the station integrity, we are also going forward restoration as well as construction for seismic safety enhancement in turn. This report introduces details of the following accounts, these are an outline of guidelines for seismic design evaluation that was revised in 2006, a situation at Kashiwazaki Kariwa Nuclear Power Station in the aftermath of the earthquake, and efforts toward enhancing seismic safety that the Tokyo Electric Power Company (TEPCO) has made since the seismic disaster, and our approach to evaluation of facility integrity. (author)

  20. Topical imiquimod treatment of cutaneous vascular disorders in pediatric patients: clinical evaluation on the efficacy and safety

    Institute of Scientific and Technical Information of China (English)

    Xiao-hong MAO; Jian-you WANG; Jian-liang YAN

    2012-01-01

    Objective:To evaluate the clinical effect of topical imiquimod treatment on cutaneous vascular disorders in pediatric patients.Methods:A retrospective investigation was conducted in 25 pediatric patients with cutaneous vascular disorders,including 19 infantile hemangiomas (IHs) (12 superficial/7 mixed type),5 nevus flammeus (NF),and 1 pyogenic granuloma (PG).Imiquimod 5% cream was applied every other day for 4 to 16 weeks (average 9.6weeks).Results:Of the 19 IHs treated,an overall efficacy of 52.6% was achieved,with a clinical resolution rate of 15.8%,excellent rate of 26.3%,and moderate rate of 10.5%.The superficial type responded the best at 66.7%,while the mixed type showed only 28.6% effectiveness,which was predominantly from their superficial parts.No obvious response was noted in the 5 patients with NF.Side effects were observed in 78.9% of the patients,mostly mild to moderate local irritations and occasionally severe reactions such as thick crusting and ulceration.Systemic side events were observed in 4 IH patients including fever and digestive tract reactions.No recurrence was observed during the follow-up examination.Conclusions:Topical imiquimod could be an alternative option for the treatment of uncomplicated superficial IHs with satisfactory tolerability.

  1. A Secure ECC-based RFID Mutual Authentication Protocol to Enhance Patient Medication Safety.

    Science.gov (United States)

    Jin, Chunhua; Xu, Chunxiang; Zhang, Xiaojun; Li, Fagen

    2016-01-01

    Patient medication safety is an important issue in patient medication systems. In order to prevent medication errors, integrating Radio Frequency Identification (RFID) technology into automated patient medication systems is required in hospitals. Based on RFID technology, such systems can provide medical evidence for patients' prescriptions and medicine doses, etc. Due to the mutual authentication between the medication server and the tag, RFID authentication scheme is the best choice for automated patient medication systems. In this paper, we present a RFID mutual authentication scheme based on elliptic curve cryptography (ECC) to enhance patient medication safety. Our scheme can achieve security requirements and overcome various attacks existing in other schemes. In addition, our scheme has better performance in terms of computational cost and communication overhead. Therefore, the proposed scheme is well suitable for patient medication systems.

  2. Enhancing the Safety, Security and Resilience of ICT and Scada Systems Using Action Research

    Science.gov (United States)

    Johnsen, Stig; Skramstad, Torbjorn; Hagen, Janne

    This paper discusses the results of a questionnaire-based survey used to assess the safety, security and resilience of information and communications technology (ICT) and supervisory control and data acquisition (SCADA) systems used in the Norwegian oil and gas industry. The survey identifies several challenges, including the involvement of professionals with different backgrounds and expertise, lack of common risk perceptions, inadequate testing and integration of ICT and SCADA systems, poor information sharing related to undesirable incidents and lack of resilience in the design of technical systems. Action research is proposed as a process for addressing these challenges in a systematic manner and helping enhance the safety, security and resilience of ICT and SCADA systems used in oil and gas operations.

  3. 47{sup th} Annual meeting on nuclear technology (AMNT 2016). Key topic / Enhanced safety and operation excellence

    Energy Technology Data Exchange (ETDEWEB)

    Traichel, Anke [NUKEM Technologies Engineering Services GmbH, Alzenau (Germany). Dept. of Safety Engineering and Assessment / Proposals Engineering

    2017-04-15

    Summary report on the Key Topic ''Enhanced Safety and Operation Excellence'' Technical Session ''Safety, IT, Hazards and PSA'' of the 47th Annual Meeting on Nuclear Technology (AMNT 2016) held in Hamburg, 10 to 12 May 2016.

  4. A new design concept for offshore nuclear power plants with enhanced safety features

    International Nuclear Information System (INIS)

    Lee, Kihwan; Lee, Kang-Heon; Lee, Jeong Ik; Jeong, Yong Hoon; Lee, Phill-Seung

    2013-01-01

    Highlights: ► A new design concept for offshore nuclear power plants is proposed. ► The total general arrangement for the concept is suggested. ► A new emergency passive containment cooling system (EPCCS) is proposed. ► A new emergency passive reactor-vessel cooling system (EPRVCS) is proposed. ► Safety features against earthquakes, tsunamis, and storms are discussed. - Abstract: In this paper, we present a new concept for offshore nuclear power plants (ONPP) with enhanced safety features. The design concept of a nuclear power plant (NPP) mounted on gravity-based structures (GBSs), which are widely used offshore structures, is proposed first. To demonstrate the feasibility of the concept, a large-scale land-based nuclear power plant model APR1400, which is the most recent NPP model in the Republic of Korea, is mounted on a GBS while minimizing modification to the original features of APR1400. A new total general arrangement (GA) and basic design principles are proposed and can be directly applied to any existing land based large scale NPPs. The proposed concept will enhance the safety of a NPP due to several aspects. A new emergency passive containment cooling system (EPCCS) and emergency passive reactor-vessel cooling system (EPRVCS) are proposed; their features of using seawater as coolant and safety features against earthquakes, Tsunamis, storms, and marine collisions are also described. We believe that the proposed offshore nuclear power plant is more robust than conventional land-based nuclear power plants and it has strong potential to provide great opportunities in nuclear power industries by decoupling the site of construction and that of installation.

  5. Long-term efficacy and safety of prophylaxis with recombinant factor VIII in Chinese pediatric patients with hemophilia A: a multi-center, retrospective, non-interventional, phase IV (ReCARE) study.

    Science.gov (United States)

    Li, Changgang; Zhang, Xinsheng; Zhao, Yongqiang; Wu, Runhui; Hu, Qun; Xu, Weiqun; Sun, Jing; Yang, Renchi; Li, Xiaojing; Zhou, Rongfu; Lian, Shinmei; Gu, Jian; Wu, Junde; Hou, Qingsong

    2017-07-01

    The first recombinant factor VIII (rFVIII) product was launched in China in 2007. However, until now, no study has been conducted to describe the efficacy and safety of prophylaxis with rFVIII in Chinese pediatric patients with hemophilia A (HA). To summarize the efficacy and safety data on prophylaxis with rFVIII in Chinese pediatric patients with HA. ReCARE (Retrospective study in Chinese pediatric hemophilia A patients with rFVIII contained regular prophylaxis) was a retrospective study conducted in 12 hemophilia treatment centers (HTCs) across China. The primary endpoints included reduction in annualized bleeding rate (ABR); the secondary endpoints included evaluation of joint function (number and sites of target joints) using Gilbert score and Hemophilia Joint Health Score (HJHS), quality of life (QoL) and factors affecting treatment choices. Safety assessment of rFVIII was also conducted. We analyzed a total of 183 male pediatric patients (mean age, 7.1 ± 4.23 years) who received prophylaxis between 1 November 2007 and 31 May 2013. Compared with baseline, prophylaxis with rFVIII significantly reduced overall annualized joint bleed rate (AJBR) (p < .001) and ABR (p < .001). Inhibitor formation was reported in 5 (2.7%) patients and hemarthrosis was reported in 1 patient. The mean number of target joints was positively related to age (p < .001) and weight (p = .003) at baseline. Responses from survey questionnaires reported that effective bleeding control, joint protection, improvement in quality of life, favorable medical insurance policies, and economic capability were reasons for choosing prophylaxis. Prophylaxis with rFVIII reduced bleeding and number of target joints, even with a low-dose regimen, in Chinese pediatric patients with HA. Other than the efficacy and safety, factors such as poor disease control, improved economic stability and stable financial support made prophylaxis as an attractive treatment option. ClinicalTrials.gov ID

  6. 48{sup th} Annual meeting on nuclear technology (AMNT 2017). Key topic / Enhanced safety and operation excellence. Technical session: Operation and safety of nuclear installations, fuel

    Energy Technology Data Exchange (ETDEWEB)

    Hollands, Thorsten [Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS) gGmbH, Garching (Germany). Bereich Reaktorsicherheitsforschung

    2017-12-15

    The sessions Fuel and Materials and Containment and SFP, as part of the Technical Sessions Operation and Safety of Nuclear Installations, Fuel implemented in the Key Topic Enhanced Safety and Operation Excellence were chaired by Dr. Thorsten Hollands (Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS) gGmbH) and Dr. Erwin Fischer (PreussenElektra GmbH) who was the keynote coordinator for the Technical Sessions. Both sessions consist of a keynote lecture followed by technical presentations.

  7. Safety and tolerability of aripiprazole for irritability in pediatric patients with autistic disorder: a 52-week, open-label, multicenter study.

    Science.gov (United States)

    Marcus, Ronald N; Owen, Randall; Manos, George; Mankoski, Raymond; Kamen, Lisa; McQuade, Robert D; Carson, William H; Findling, Robert L

    2011-09-01

    Evaluate the long-term safety and tolerability of aripiprazole in the treatment of irritability in pediatric subjects (6-17 years) with autistic disorder. A 52-week, open-label, flexibly dosed (2-15 mg/d) study of the safety and tolerability of aripiprazole in outpatients with a DSM-IV-TR diagnosis of autistic disorder who either had completed 1 of 2 antecedent, 8-week randomized trials or were enrolled de novo (ie, not treated in the randomized trials). Safety and tolerability measures included incidences of adverse events, extrapyramidal symptoms, weight, metabolic measures, vital signs, and other clinical assessments. Subjects were enrolled between September 2006 and June 2009. Three hundred thirty subjects entered the treatment phase: 86 de novo, 174 prior aripiprazole, and 70 prior placebo. A total of 199 (60.3%) subjects completed 52 weeks of treatment. Adverse events were experienced by 286/330 subjects (86.7%). Common adverse events included weight increase, vomiting, nasopharyngitis, increased appetite, pyrexia, upper respiratory tract infection, and insomnia. Discontinuations due to adverse events occurred in 35/330 randomized subjects (10.6%)-most commonly aggression and weight increase. One patient discontinued from the study due to a laboratory-related adverse event (moderately increased alanine transaminase and aspartate transaminase). Nine subjects experienced serious adverse events-most frequently aggression. Extrapyramidal symptoms-related adverse events occurred in 48/330 subjects (14.5%)-most commonly tremor (3.0%), psychomotor hyperactivity (2.7%), akathisia (2.4%), and dyskinesia (not tardive, 2.4%). At > 9 months' aripiprazole exposure (n = 220), mean change in body weight z score was 0.33 and body mass index z score was 0.31. The percentages of subjects with clinically significant fasting metabolic abnormalities at > 9 months were 2% for glucose, 5% for total cholesterol, 7% for low-density lipoprotein cholesterol, 30% for high

  8. Approach to design of future FBRs with enhanced safety and economy

    International Nuclear Information System (INIS)

    Raghupathy, S.; Balasubramaniyan, V.; Puthiyavinayagam, P.; Selvaraj, P.; Chellapandi, P.; Chetal, S.C.; Raj, Baldev

    2009-01-01

    After the techno economic demonstration of FBR technology through PFBR, it is essential to achieve high economic competitiveness with enhanced safety on par with other power generation options. Towards this, design studies were made with the objectives of identifying means to achieve enhanced safety, design features for improving economy, conceptualise the plant layout, ways to reduce construction time and to achieve higher capacity factor. This paper describes the outcome of the above studies and the approach to the design of future FBRs with enhanced safety and economy. High economic competitiveness and public acceptance are essential for commercial deployment of fast reactors. India has a well-laid out three phase nuclear power programme with Pressurised Heavy Water Reactors (PHWRs) utilizing natural uranium as fuel in the first phase and fast breeder reactors (FBRs) using plutonium and thorium in the second and third phases. Deploying FBRs on a commercial scale is vital for India in order to utilize the vast thorium reserves and to meet the long term energy needs of the country. As a first step, a 40 MWt, 13.5 MWe Fast Breeder Test Reactor (FBTR) was constructed and has been in operation since 1985. Operation of FBTR has given valuable operating experience with critical systems of FBRs including sodium systems and has given confidence to undertake the design of 500 MWe Prototype Fast Breeder Reactor (PFBR). Construction of PFBR is currently under progress and is expected to be completed by 2010. It is planned to construct four more oxide fuelled FBRs of 500 MWe capacity by 2020 and metal fuelled FBRs of 1000 MWe thereafter. Enhanced safety is proposed to be achieved through improvements in shut down systems, adopting in-vessel primary sodium purification concept, improving the reliability of decay heat removal system, shifting component decontamination activities to a separate building located outside the reactor containment building, providing additional

  9. Operational experience review and methods to enhance safety and reliability in the NPP-Leibstadt (KKL)

    Energy Technology Data Exchange (ETDEWEB)

    Haeusermann, R [Kernkraftwerk Leibstadt AG, Leibstadt (Switzerland)

    1997-10-01

    In the nuclear community it became clear that an integrated feedback system of operating experience must also include the unsuccessful results. The deviations, expected to achieved performance are analysed to the failure mode and its effect. KKL has lowered the number of safety significant events since commercial operation started. The thoroughness of the review/analysis of the events has increased with high priority set to human factor induced events in operation and maintenance. Since the participation of the author in the ASSET-Mission in Smolensk in 1993, KKL introduced the ASSET-Root-Cause method and has supplemented it by the HPES (Human Performance Enhancement System). 4 refs, 6 figs.

  10. Operational experience review and methods to enhance safety and reliability in the NPP-Leibstadt (KKL)

    International Nuclear Information System (INIS)

    Haeusermann, R.

    1997-01-01

    In the nuclear community it became clear that an integrated feedback system of operating experience must also include the unsuccessful results. The deviations, expected to achieved performance are analysed to the failure mode and its effect. KKL has lowered the number of safety significant events since commercial operation started. The thoroughness of the review/analysis of the events has increased with high priority set to human factor induced events in operation and maintenance. Since the participation of the author in the ASSET-Mission in Smolensk in 1993, KKL introduced the ASSET-Root-Cause method and has supplemented it by the HPES (Human Performance Enhancement System). 4 refs, 6 figs

  11. The Safety of Using High Frequency, Low Intensity Ultrasound to Enhance Thrombolysis

    International Nuclear Information System (INIS)

    Soltani, Azita

    2006-01-01

    The EKOS Ultrasound Infusion Systems (EKOS Corporation, Bothell, WA) use high frequency, low intensity ultrasound to accelerate thrombolysis by enhancing clot permeability and lytic drug penetration into thrombus. These systems are designed to provide efficacious catheter-directed treatment for the management of stroke, peripheral arterial occlusion and deep vein thrombosis. The in vitro and in vivo results of investigating the stability of therapeutic and diagnostic compounds used in combination with EKOS devices, the potential for adverse biological effects and the clot fragmentation confirmed the safety of EKOS ultrasound infusion systems in thrombolysis treatment

  12. Safety enhancement concept for NPP of new generation with VVER reactors

    International Nuclear Information System (INIS)

    Bezlepkin, V.; Kukhtevich, I.; Semashko, S.; Svetlov, S.; Solodovnikov, A.

    2004-01-01

    With the present day conditions, in order to successfully promote new NPP designs in the electric power markets, it is necessary to ensure enhanced technical/economic performances provided that international safety requirements are properly adhered to. When compared with high-powered nuclear power plants, NPP VVER-640 design (medium powered) possesses a number of advantages for the regions with undeveloped energy systems. Reduced specific energy intensity of the core adopted in this type of reactor allows to ensure the emergency cooldown of the reactor plant by passive means and to minimize the 'human factor' risk and external effects and provide sound substantiations as to how to retain corium inside RPV in case of severe accidents. At the same time, high-powered NPPs seem to be promising for regions with developed energy systems. Among such designs, NPP VVER-1000 and VVER-1500 designs are the most desirable. Configuration of new generation NPP with VVER-1500 is to be selected based on the gained experience in designing NPPs of previous generations considering the latest safety requirements and situation in the domestic and global energy markets for the time being and in the short run. Recent IAEA publications and latest EUR requirements insist that the following key safety indices should be established for new NPP designs: - aggregated frequency of core melting is 10 -6 (1/year); - frequency of maximum accident release is 10 -7 (1/year). To meet the aforementioned criteria, it is necessary to implement some safety assurance principles recommended by IAEA (in-depth defence, single failure, redundancy, diversity, etc.), application of deterministic and probabilistic methods for selection of safety assurance activities and means and use of reasonable combination of active and passive systems. Application of VVER-640 concept to high-powered NPPs seems to be a formidable task due to a number of reasons, namely, it is quite difficult to carry out cooldown process

  13. Evaluating application of the National Healthcare Safety Network central line-associated bloodstream infection surveillance definition: a survey of pediatric intensive care and hematology/oncology units.

    Science.gov (United States)

    Gaur, Aditya H; Miller, Marlene R; Gao, Cuilan; Rosenberg, Carol; Morrell, Gloria C; Coffin, Susan E; Huskins, W Charles

    2013-07-01

    To evaluate the application of the National Healthcare Safety Network (NHSN) central line-associated bloodstream infection (CLABSI) definition in pediatric intensive care units (PICUs) and pediatric hematology/oncology units (PHOUs) participating in a multicenter quality improvement collaborative to reduce CLABSIs; to identify sources of variability in the application of the definition. Online survey using 18 standardized case scenarios. Each described a positive blood culture in a patient and required a yes- or-no answer to the question "Is this a CLABSI?" NHSN staff responses were the reference standard. Sixty-five US PICUs and PHOUs. Staff who routinely adjudicate CLABSIs using NHSN definitions. Sixty responses were received from 58 (89%) of 65 institutions; 78% of respondents were infection preventionists, infection control officers, or infectious disease physicians. Responses matched those of NHSN staff for 78% of questions. The mean (SE) percentage of concurring answers did not differ for scenarios evaluating application of 1 of the 3 criteria ("known pathogen," 78% [1.7%]; "skin contaminant, >1 year of age," 76% [SE, 2.5%]; "skin contaminant, ≤1 year of age," 81% [3.8%]; [Formula: see text]). The mean percentage of concurring answers was lower for scenarios requiring respondents to determine whether a CLABSI was present or incubating on admission (64% [4.6%]; [Formula: see text]) or to distinguish between primary and secondary bacteremia (65% [2.5%]; [Formula: see text]). The accuracy of application of the CLABSI definition was suboptimal. Efforts to reduce variability in identifying CLABSIs that are present or incubating on admission and in distinguishing primary from secondary bloodstream infection are needed.

  14. Iron chelation with deferasirox in adult and pediatric patients with thalassemia major: efficacy and safety during 5 years' follow-up.

    Science.gov (United States)

    Cappellini, M Domenica; Bejaoui, Mohamed; Agaoglu, Leyla; Canatan, Duran; Capra, Marcello; Cohen, Alan; Drelichman, Guillermo; Economou, Marina; Fattoum, Slaheddine; Kattamis, Antonis; Kilinc, Yurdanur; Perrotta, Silverio; Piga, Antonio; Porter, John B; Griffel, Louis; Dong, Victor; Clark, Joan; Aydinok, Yesim

    2011-07-28

    Patients with β-thalassemia require lifelong iron chelation therapy from early childhood to prevent complications associated with transfusional iron overload. To evaluate long-term efficacy and safety of once-daily oral iron chelation with deferasirox, patients aged ≥ 2 years who completed a 1-year, phase 3, randomized trial entered a 4-year extension study, either continuing on deferasirox (deferasirox cohort) or switching from deferoxamine to deferasirox (crossover cohort). Of 555 patients who received ≥ 1 deferasirox dose, 66.8% completed the study; 43 patients (7.7%) discontinued because of adverse events. In patients with ≥ 4 years' deferasirox exposure who had liver biopsy, mean liver iron concentration significantly decreased by 7.8 ± 11.2 mg Fe/g dry weight (dw; n = 103; P < .001) and 3.1 ± 7.9 mg Fe/g dw (n = 68; P < .001) in the deferasirox and crossover cohorts, respectively. Median serum ferritin significantly decreased by 706 ng/mL (n = 196; P < .001) and 371 ng/mL (n = 147; P < .001), respectively, after ≥ 4 years' exposure. Investigator-assessed, drug-related adverse events, including increased blood creatinine (11.2%), abdominal pain (9.0%), and nausea (7.4%), were generally mild to moderate, transient, and reduced in frequency over time. No adverse effect was observed on pediatric growth or adolescent sexual development. This first prospective study of long-term deferasirox use in pediatric and adult patients with β-thalassemia suggests treatment for ≤ 5 years is generally well tolerated and effectively reduces iron burden. This trial was registered at www.clinicaltrials.gov as #NCT00171210.

  15. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... your child. top of page Additional Information and Resources The Alliance for Radiation Safety in Pediatric Imaging's " ... To locate a medical imaging or radiation oncology provider in your community, you can search the ACR- ...

  16. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... CT scans that are not clearly needed. Another strategy is to consider other tests, such as MRI ... for Radiation Safety in Pediatric Imaging's "Image Gently" Campaign top of page This page was reviewed on ...

  17. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info About Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) ...

  18. [Tolerance, safety and efficacy of the one-day preparation of PEG3350 + bisacodyl compared to 2 days of PEG3350 + bisacodyl in pediatric patients].

    Science.gov (United States)

    Portillo Canizalez, Ligia Marcela; Blanco Rodriguez, Gerardo; Teyssier Morales, Gustavo; Penchyna Grub, Jaime; Trauernicht Mendieta, Sean; Zurita-Cruz, Jessie Nallely

    Multiple intestinal preparations have been used in children undergoing colonoscopy, with variable limitation due to acceptance, tolerance, and proper cleaning. The objective of this study was to compare the tolerability, safety and efficacy of the colonoscopy preparation with 1 day with PEG 3350 (poliethylenglycol) (4g/kg/day) + bisacodyl compared to 2 days of preparation with PEG 3350 (2g/kg/day) + bisacodyl in pediatric patients. A clinical, randomized, and blind trial was performed. Patients aged 2 to 18 years scheduled for colonoscopy were included. Patients were randomized into two groups: 1 day of preparation with PEG 3350 4g/kg/day + bisacodyl and 2 days of preparation with PEG 3350 2g/kg/day + bisacodyl. Through a questionnaire, physical examination and endoscopic evaluation (Boston scale), the tolerance, safety and efficacy of the 2 preparations to be evaluated were determined. Student's t test was performed for quantitative variables and χ 2 for qualitative variables. There were no significant differences in compliance rates, adverse effects, and extent of colonoscopic evaluation. Tolerance and safety between the intestinal preparation for 1-day colonoscopy with PEG 3350 (4g/kg/day) + bisacodyl and the 2-day preparation with PEG 3350 (2g/kg/day) + bisacodyl were similar. The quality of cleanliness was good in both groups, being partially more effective in the 1-day group with PEG 3350 (4g/kg/day). Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  19. Safety Enhancements for PHWRs Based on Macroscopic Losses of the Fukushima Accident

    Directory of Open Access Journals (Sweden)

    Sang Ho Kim

    2015-01-01

    Full Text Available The role of nuclear energy is to supply electric power on a stable basis to meet increasing demands, reduce carbon dioxide emissions, and maintain stable electric power costs while ensuring safety. The Fukushima accident taught us many lessons for creating safer nuclear power plants. Considering the design of systems, the areas of weakness at the Fukushima nuclear power plants can be divided into three categories: plant protection, electricity supply, and cooling of the nuclear fuel. In this paper, focusing on these three areas, the lessons learned are proposed and applied for pressurized heavy water reactors. Firstly, hard protection against external risks ensures the integrity of components and systems such that they can perform their original functions. Secondly, additional emergency power supply systems for electrical redundancy and diversity can improve the response capabilities for an accident by increasing the availability of active components. Thirdly, cooling for removing decay heat can be augmented by adopting diverse safety systems derived from other types of reactors. This study is expected to contribute to the safety enhancement of pressurized heavy water reactors by applying design changes based on the lessons learned from the Fukushima accident.

  20. Gypsum plasterboards enhanced with phase change materials: A fire safety assessment using experimental and computational techniques

    Directory of Open Access Journals (Sweden)

    Kolaitis Dionysios I.

    2013-11-01

    Full Text Available Phase Change Materials (PCM can be used for thermal energy storage, aiming to enhance building energy efficiency. Recently, gypsum plasterboards with incorporated paraffin-based PCM blends have become commercially available. In the high temperature environment developed during a fire, the paraffins, which exhibit relatively low boiling points, may evaporate and, escaping through the gypsum plasterboard's porous structure, emerge to the fire region, where they may ignite, thus adversely affecting the fire resistance characteristics of the building. Aiming to assess the fire safety behaviour of such building materials, an extensive experimental and computational analysis is performed. The fire behaviour and the main thermo-physical physical properties of PCM-enhanced gypsum plasterboards are investigated, using a variety of standard tests and devices (Scanning Electron Microscopy, Thermo Gravimetric Analysis, Cone Calorimeter. The obtained results are used to develop a dedicated numerical model, which is implemented in a CFD code. CFD simulations are validated using measurements obtained in a cone calorimeter. In addition, the CFD code is used to simulate an ISO 9705 room exposed to fire conditions, demonstrating that PCM addition may indeed adversely affect the fire safety of a gypsum plasterboard clad building.

  1. Ongoing enhancements in the German nuclear regulatory framework with respect to fire safety

    Energy Technology Data Exchange (ETDEWEB)

    Elsche, Bjoern [e.on Kernkraft, Hannover (Germany); Roewekamp, Marina [Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS) gGmbH, Koeln (Germany); Neugebauer, Wilfried [AREVA NP, Erlangen (Germany); Gersinska, Rainer [Bundesamt fuer Strahlenschutz (BfS), Salzgitter (Germany). KTA-Geschaeftsstelle

    2015-12-15

    In the recent past, the regulatory framework for nuclear power plants (NPP) in Germany has been updated and enhanced comprising on the one hand comprehensive high level regulatory documents such as the 'Safety Requirements for Nuclear Power Plants' and, on the other hand, revised state-of-the-art nuclear safety standards and rules being incorporated in a corresponding legal structure. A major enhancement concerns the nuclear fire and explosion protection standards being already available as so-called green print for final comments which are expected to be officially published end of 2015. The update became necessary after approx. ten years for better addressing some lessons learnt form the operating experience, the consideration of post- Fukushima insights, such as more systematically addressing event combinations with fires and taking into account deviations from non-nuclear standards for escape and rescue routes. Moreover, fire protections remains an important issue for nuclear power plants in Germany during the longer term post-commercial safe shutdown period before decommissioning during which the spent fuel elements remain either in the containment or in the spent fuel pool for further years requiring suitable fire protection means being in place.

  2. [Complications in pediatric anesthesia].

    Science.gov (United States)

    Becke, K

    2014-07-01

    As in adult anesthesia, morbidity and mortality could be significantly reduced in pediatric anesthesia in recent decades. This fact cannot conceal the fact that the incidence of anesthetic complications in children is still much more common than in adults and sometimes with a severe outcome. Newborns and infants in particular but also children with emergency interventions and severe comorbidities are at increased risk of potential complications. Typical complications in pediatric anesthesia are respiratory problems, medication errors, difficulties with the intravenous puncture and pulmonal aspiration. In the postoperative setting, nausea and vomiting, pain, and emergence delirium can be mentioned as typical complications. In addition to the systematic prevention of complications in pediatric anesthesia, it is important to quickly recognize disturbances of homeostasis and treat them promptly and appropriately. In addition to the expertise of the performing anesthesia team, the institutional structure in particular can improve quality and safety in pediatric anesthesia.

  3. SAFETY

    CERN Multimedia

    Niels Dupont

    2013-01-01

    CERN Safety rules and Radiation Protection at CMS The CERN Safety rules are defined by the Occupational Health & Safety and Environmental Protection Unit (HSE Unit), CERN’s institutional authority and central Safety organ attached to the Director General. In particular the Radiation Protection group (DGS-RP1) ensures that personnel on the CERN sites and the public are protected from potentially harmful effects of ionising radiation linked to CERN activities. The RP Group fulfils its mandate in collaboration with the CERN departments owning or operating sources of ionising radiation and having the responsibility for Radiation Safety of these sources. The specific responsibilities concerning "Radiation Safety" and "Radiation Protection" are delegated as follows: Radiation Safety is the responsibility of every CERN Department owning radiation sources or using radiation sources put at its disposition. These Departments are in charge of implementing the requi...

  4. A Phase 3, multicenter, open-label, switchover trial to assess the safety and efficacy of taliglucerase alfa, a plant cell-expressed recombinant human glucocerebrosidase, in adult and pediatric patients with Gaucher disease previously treated with imiglucerase.

    Science.gov (United States)

    Pastores, Gregory M; Petakov, Milan; Giraldo, Pilar; Rosenbaum, Hanna; Szer, Jeffrey; Deegan, Patrick B; Amato, Dominick J; Mengel, Eugen; Tan, Ee Shien; Chertkoff, Raul; Brill-Almon, Einat; Zimran, Ari

    2014-12-01

    Taliglucerase alfa is a β-glucosidase enzyme replacement therapy (ERT) approved in the US and other countries for the treatment of Gaucher disease (GD) in adults and is approved in pediatric and adult patients in Australia and Canada. It is the first approved plant cell-expressed recombinant human protein. A Phase 3, multicenter, open-label, 9-month study assessed safety and efficacy of switching to taliglucerase alfa in adult and pediatric patients with GD treated with imiglucerase for at least the previous 2years. Patients with stable disease were offered taliglucerase alfa treatment using the same dose (9-60U/kg body weight) and regimen of administration (every 2weeks) as imiglucerase. This report summarizes results from 26 adult and 5 pediatric patients who participated in the trial. Disease parameters (spleen and liver volumes, hemoglobin concentration, platelet count, and biomarker levels) remained stable through 9months of treatment in adults and children following the switch from imiglucerase. All treatment-related adverse events were mild or moderate in severity and transient in nature. Exploratory parameters of linear growth and development showed positive outcomes in pediatric patients. These findings provide evidence of the efficacy and safety profile of taliglucerase alfa as an ERT for GD in patients previously treated with imiglucerase. This trial was registered at www.clinicaltrials.gov as # NCT00712348. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Enhancement of color and clarity in topaz and diamonds by nuclear radiation, safety and security concerns

    International Nuclear Information System (INIS)

    Shamshad Ahmed

    2009-01-01

    Inducement of color and clarity in gemstone Topaz, otherwise devoid of these attributes, has been achieved by synergistic utilization of neutron irradiation, electron beam irradiation and heat. The transformation of the colorless, cheaply available topaz into desirable deep blue topaz is a significant value addition, not achievable by other contending techniques .Likewise colorless and unclear diamonds, available in trade at throw away price, have been transformed by neutron irradiation into colored diamonds, known as fancy diamonds. The enhanced gems may possess stable or unstable colors depending on the nature of the color centers produced. In the case of blue topaz and fancy diamonds the colors produced were stable and heating at elevated temperatures can only lead to fading of colors. The enhancement of gems by neutron irradiation is commercially viable provided appropriate equipment and tools are used .In the paper are described the processes of the enhancement of topaz and diamonds along with the instrumentation involved. However, in view of the radioactivity generated as a result of the exposure of gems to the neutrons, and the likelihood of undue exposure of the users, operators etc to the radioactive gems, safety aspects command serious attention. In the paper, the strategies to avoid or to mitigate the radioactivity generated have been discussed. Also documented are the methodologies and the controls to ensure that the radioactive gems are not released before ensuring that the radioactivity, if any, in the irradiated materials is not above the permissible levels in conformity with the international standards. Safety, security and safeguard of these materials are thus appropriately addressed. (Authors)

  6. Safety

    International Nuclear Information System (INIS)

    2001-01-01

    This annual report of the Senior Inspector for the Nuclear Safety, analyses the nuclear safety at EDF for the year 1999 and proposes twelve subjects of consideration to progress. Five technical documents are also provided and discussed concerning the nuclear power plants maintenance and safety (thermal fatigue, vibration fatigue, assisted control and instrumentation of the N4 bearing, 1300 MW reactors containment and time of life of power plants). (A.L.B.)

  7. Safety and Efficacy of the Off-Label Use of Milrinone in Pediatric Patients with Heart Diseases

    OpenAIRE

    Lee, Joowon; Kim, Gi Beom; Kwon, Hye Won; Kwon, Bo Sang; Bae, Eun Jung; Noh, Chung Il; Lim, Hong Gook; Kim, Woong Han; Lee, Jeong Ryul; Kim, Yong Jin

    2014-01-01

    Background and Objectives Milrinone is often used in children to treat acute heart failure and prevent low cardiac output syndrome after cardiac surgery. Due to the lack of studies on the long-term milrinone use in children, the objective of this study was to assess the safety and efficacy of the current patterns of milrinone use for ≥3 days in infants and children with heart diseases. Subjects and Methods We retrospectively reviewed the medical records of patients aged

  8. Oxidized Metal Powders for Mechanical Shock and Crush Safety Enhancers; TOPICAL

    International Nuclear Information System (INIS)

    GARINO, TERRY J.

    2002-01-01

    The use of oxidized metal powders in mechanical shock or crush safety enhancers in nuclear weapons has been investigated. The functioning of these devices is based on the remarkable electrical behavior of compacts of certain oxidized metal powders when subjected to compressive stress. For example, the low voltage resistivity of a compact of oxidized tantalum powder was found to decrease by over six orders of magnitude during compaction between 1 MPa, where the thin, insulating oxide coatings on the particles are intact, to 10 MPa, where the oxide coatings have broken down along a chain of particles spanning the electrodes. In this work, the behavior of tantalum and aluminum powders was investigated. The low voltage resistivity during compaction of powders oxidized under various conditions was measured and compared. In addition, the resistivity at higher voltages and the dielectric breakdown strength during compaction were also measured. A key finding was that significant changes in the electrical properties persist after the removal of the stress so that a mechanical shock enhancer is feasible. This was verified by preliminary shock experiments. Finally, conceptual designs for both types of enhancers are presented

  9. Outline of the Fukushima Daiichi Accident. Lessons Learned and Safety Enhancements

    Science.gov (United States)

    Hirano, Masashi

    2017-09-01

    Abstract. On March 11, 2011, an earthquake and subsequent tsunamis off the Pacific coastline of Japan's Tohoku region caused widespread devastation in Japan. As of June 10, 2016, it is reported that a total of 15,894 people lost their lives and 2,558 people are still unaccounted for. In Fukushima Prefecture, approximately 100,000 people are still obliged to live away from their homes due to the earthquake and tsunami as well as the Fukushima Daiichi accident. On the day, the earthquake and tsunami caused severe damages to the Tokyo Electric Power Company (TEPCO)'s Fukushima Daiichi Nuclear Power Station (NPS). All the units in operation, namely Units 1 to 3, were automatically shut down on seismic reactor protection system trips but the earthquake led to the loss of all off-site electrical power supplies to that site. The subsequent tsunami inundated the site up to 4 to 5 m above its ground level and caused, in the end, the loss of core cooling function in Units 1 to 3, resulting in severe core damages and containment vessel failures in these three units. Hydrogen was released from the containment vessels, leading to explosions in the reactor buildings of Units 1, 3 and 4. Radioactive materials were released to the atmosphere and were deposited on the land and in the ocean. One of the most important lessons learned is an importance to prevent such large scale common cause failures due to extreme natural events. This leads to a conclusion that application of the defense-in-depth philosophy be enhanced because the defense-in-depth philosophy has been and continues to be an effective way to account for uncertainties associated with risks. From the human and organizational viewpoints, the final report from the Investigation Committee of the Government pointed out so-called "safety myth" that existed among nuclear operators including TEPCO as well as the government, that serious severe accidents could never occur in nuclear power plants in Japan. After the accident, the

  10. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine ...

  11. Pediatric Stroke

    Science.gov (United States)

    ... and Patient Resources Home » Patients & Families » About Stroke » Pediatric Stroke » Introduction Introduction What is a Stroke? Ischemic Stroke Intracerebral Hemorrhage Subarachnoid Hemorrhage Pediatric Stroke Introduction Types of Stroke Diagnosis and Treatment ...

  12. Myocarditis - pediatric

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007307.htm Myocarditis - pediatric To use the sharing features on this page, please enable JavaScript. Pediatric myocarditis is inflammation of the heart muscle in ...

  13. Effect of just-in-time simulation training on tracheal intubation procedure safety in the pediatric intensive care unit.

    Science.gov (United States)

    Nishisaki, Akira; Donoghue, Aaron J; Colborn, Shawn; Watson, Christine; Meyer, Andrew; Brown, Calvin A; Helfaer, Mark A; Walls, Ron M; Nadkarni, Vinay M

    2010-07-01

    Tracheal intubation-associated events (TIAEs) are common (20%) and life threatening (4%) in pediatric intensive care units. Physician trainees are required to learn tracheal intubation during intensive care unit rotations. The authors hypothesized that "just-in-time" simulation-based intubation refresher training would improve resident participation, success, and decrease TIAEs. For 14 months, one of two on-call residents, nurses, and respiratory therapists received 20-min multidisciplinary simulation-based tracheal intubation training and 10-min resident skill refresher training at the beginning of their on-call period in addition to routine residency education. The rate of first attempt and overall success between refresher-trained and concurrent non-refresher-trained residents (controls) during the intervention phase was compared. The incidence of TIAEs between preintervention and intervention phase was also compared. Four hundred one consecutive primary orotracheal intubations were evaluated: 220 preintervention and 181 intervention. During intervention phase, neither first-attempt success nor overall success rate differed between refresher-trained residents versus concurrent non-refresher-trained residents: 20 of 40 (50%) versus 15 of 24 (62.5%), P = 0.44 and 23 of 40 (57.5%) versus 18 of 24 (75.0%), P = 0.19, respectively. The resident's first attempt and overall success rate did not differ between preintervention and intervention phases. The incidence of TIAE during preintervention and intervention phases was similar: 22.0% preintervention versus 19.9% intervention, P = 0.62, whereas resident participation increased from 20.9% preintervention to 35.4% intervention, P = 0.002. Resident participation continued to be associated with TIAE even after adjusting for the phase and difficult airway condition: odds ratio 2.22 (95% CI 1.28-3.87, P = 0.005). Brief just-in-time multidisciplinary simulation-based intubation refresher training did not improve the resident

  14. Thermal safety of ultrasound-enhanced ocular drug delivery: A modeling study

    International Nuclear Information System (INIS)

    Nabili, Marjan; Geist, Craig; Zderic, Vesna

    2015-01-01

    Purpose: Delivery of sufficient amounts of therapeutic drugs into the eye for treatment of various ocular diseases is often a challenging task. Ultrasound was shown to be effective in enhancing ocular drug delivery in the authors’ previous in vitro and in vivo studies. Methods: The study reported here was designed to investigate the safety of ultrasound application and its potential thermal effects in the eye using PZFlex modeling software. The safety limit in this study was set as a temperature increase of no more than 1.5 °C based on regulatory recommendations and previous experimental safety studies. Acoustic and thermal specifications of different human eye tissues were obtained from the published literature. The tissues of particular interest in this modeling safety study were cornea, lens, and the location of optic nerve in the posterior eye. Ultrasound application was modeled at frequencies of 400 kHz–1 MHz, intensities of 0.3–1 W/cm 2 , and exposure duration of 5 min, which were the parameters used in the authors’ previous drug delivery experiments. The baseline eye temperature was 37 °C. Results: The authors’ results showed that the maximal tissue temperatures after 5 min of ultrasound application were 38, 39, 39.5, and 40 °C in the cornea, 39.5, 40, 42, and 43 °C in the center of the lens, and 37.5, 38.5, and 39 °C in the back of the eye (at the optic nerve location) at frequencies of 400, 600, 800 kHz, and 1 MHz, respectively. Conclusions: The ocular temperatures reached at higher frequencies were considered unsafe based on current recommendations. At a frequency of 400 kHz and intensity of 0.8 W/cm 2 (parameters shown in the authors’ previous in vivo studies to be optimal for ocular drug delivery), the temperature increase was small enough to be considered safe inside different ocular tissues. However, the impact of orbital bone and tissue perfusion should be included in future modeling efforts to determine the safety of this

  15. Thermal safety of ultrasound-enhanced ocular drug delivery: A modeling study

    Energy Technology Data Exchange (ETDEWEB)

    Nabili, Marjan, E-mail: mnabili@gwmail.gwu.edu [Department of Electrical and Computer Engineering, The George Washington University, 800 22nd Street NW, Room 5000, Washington, DC 20052 (United States); Geist, Craig, E-mail: cgeist@mfa.gwu.edu, E-mail: zderic@gwu.edu [Department of Ophthalmology, The George Washington University, 2150 Pennsylvania Avenue NW, Floor 2A, Washington, DC 20037 (United States); Zderic, Vesna, E-mail: cgeist@mfa.gwu.edu, E-mail: zderic@gwu.edu [Department of Biomedical Engineering, The George Washington University, 800 22nd Street NW, Room 6670, Washington, DC 20052 (United States)

    2015-10-15

    Purpose: Delivery of sufficient amounts of therapeutic drugs into the eye for treatment of various ocular diseases is often a challenging task. Ultrasound was shown to be effective in enhancing ocular drug delivery in the authors’ previous in vitro and in vivo studies. Methods: The study reported here was designed to investigate the safety of ultrasound application and its potential thermal effects in the eye using PZFlex modeling software. The safety limit in this study was set as a temperature increase of no more than 1.5 °C based on regulatory recommendations and previous experimental safety studies. Acoustic and thermal specifications of different human eye tissues were obtained from the published literature. The tissues of particular interest in this modeling safety study were cornea, lens, and the location of optic nerve in the posterior eye. Ultrasound application was modeled at frequencies of 400 kHz–1 MHz, intensities of 0.3–1 W/cm{sup 2}, and exposure duration of 5 min, which were the parameters used in the authors’ previous drug delivery experiments. The baseline eye temperature was 37 °C. Results: The authors’ results showed that the maximal tissue temperatures after 5 min of ultrasound application were 38, 39, 39.5, and 40 °C in the cornea, 39.5, 40, 42, and 43 °C in the center of the lens, and 37.5, 38.5, and 39 °C in the back of the eye (at the optic nerve location) at frequencies of 400, 600, 800 kHz, and 1 MHz, respectively. Conclusions: The ocular temperatures reached at higher frequencies were considered unsafe based on current recommendations. At a frequency of 400 kHz and intensity of 0.8 W/cm{sup 2} (parameters shown in the authors’ previous in vivo studies to be optimal for ocular drug delivery), the temperature increase was small enough to be considered safe inside different ocular tissues. However, the impact of orbital bone and tissue perfusion should be included in future modeling efforts to determine the safety

  16. Innovating to enhance clinical data management using non-commercial and open source solutions across a multi-center network supporting inpatient pediatric care and research in Kenya.

    Science.gov (United States)

    Tuti, Timothy; Bitok, Michael; Paton, Chris; Makone, Boniface; Malla, Lucas; Muinga, Naomi; Gathara, David; English, Mike

    2016-01-01

    To share approaches and innovations adopted to deliver a relatively inexpensive clinical data management (CDM) framework within a low-income setting that aims to deliver quality pediatric data useful for supporting research, strengthening the information culture and informing improvement efforts in local clinical practice. The authors implemented a CDM framework to support a Clinical Information Network (CIN) using Research Electronic Data Capture (REDCap), a noncommercial software solution designed for rapid development and deployment of electronic data capture tools. It was used for collection of standardized data from case records of multiple hospitals' pediatric wards. R, an open-source statistical language, was used for data quality enhancement, analysis, and report generation for the hospitals. In the first year of CIN, the authors have developed innovative solutions to support the implementation of a secure, rapid pediatric data collection system spanning 14 hospital sites with stringent data quality checks. Data have been collated on over 37 000 admission episodes, with considerable improvement in clinical documentation of admissions observed. Using meta-programming techniques in R, coupled with branching logic, randomization, data lookup, and Application Programming Interface (API) features offered by REDCap, CDM tasks were configured and automated to ensure quality data was delivered for clinical improvement and research use. A low-cost clinically focused but geographically dispersed quality CDM (Clinical Data Management) in a long-term, multi-site, and real world context can be achieved and sustained and challenges can be overcome through thoughtful design and implementation of open-source tools for handling data and supporting research. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  17. Safety of primed repetitive transcranial magnetic stimulation and modified constraint-induced movement therapy in a randomized controlled trial in pediatric hemiparesis.

    Science.gov (United States)

    Gillick, Bernadette T; Krach, Linda E; Feyma, Tim; Rich, Tonya L; Moberg, Kelli; Menk, Jeremiah; Cassidy, Jessica; Kimberley, Teresa; Carey, James R

    2015-04-01

    To investigate the safety of combining a 6-Hz primed low-frequency repetitive transcranial magnetic stimulation (rTMS) intervention in the contralesional hemisphere with a modified constraint-induced movement therapy (mCIMT) program in children with congenital hemiparesis. Phase 1 randomized, double-blinded, placebo-controlled pretest/posttest trial. University academic facility and pediatric specialty hospital. Subjects (N = 19; age range, 8-17 y) with congenital hemiparesis caused by ischemic stroke or periventricular leukomalacia. No subject withdrew because of adverse events. All subjects included completed the study. Subjects were randomized to 1 of 2 groups: either real rTMS plus mCIMT (n = 10) or sham rTMS plus mCIMT (n = 9). Adverse events, physician assessment, ipsilateral hand function, stereognosis, cognitive function, subject report of symptoms assessment, and subject questionnaire. No major adverse events occurred. Minor adverse events were found in both groups. The most common events were headaches (real: 50%, sham: 89%; P = .14) and cast irritation (real: 30%, sham: 44%; P = .65). No differences between groups in secondary cognitive and unaffected hand motor measures were found. Primed rTMS can be used safely with mCIMT in congenital hemiparesis. We provide new information on the use of rTMS in combination with mCIMT in children. These findings could be useful in research and future clinical applications in advancing function in congenital hemiparesis. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. The need to optimize inservice testing and inspection to enhance safety

    International Nuclear Information System (INIS)

    Perry, J.A.

    1996-01-01

    Welcome to the Fourth U.S. Nuclear Regulatory Commission and American Society of Mechanical Engineers (USNRC/ASME) Symposium on Valve and Pump Testing in Nuclear Power Plants. This symposium provides a forum to exchange information on technical and regulatory issues associated with the testing of valves and pumps used in nuclear power plants. Progress made since the last symposium will be discussed along with various methods for in service testing of valves and pumps. Active participation by industry representatives, regulators and consultants will entail discussion of a broad array of ideas and points of view regarding how to improve the in service testing of valves and pumps at nuclear power plants. One of the challenges faced is the need to optimize the in service testing and inspection to enhance safety, operability and reliability. The author addresses this challenge from an ASME Nuclear Codes and Standards point of view

  19. The need to optimize inservice testing and inspection to enhance safety

    Energy Technology Data Exchange (ETDEWEB)

    Perry, J.A.

    1996-12-01

    Welcome to the Fourth U.S. Nuclear Regulatory Commission and American Society of Mechanical Engineers (USNRC/ASME) Symposium on Valve and Pump Testing in Nuclear Power Plants. This symposium provides a forum to exchange information on technical and regulatory issues associated with the testing of valves and pumps used in nuclear power plants. Progress made since the last symposium will be discussed along with various methods for in service testing of valves and pumps. Active participation by industry representatives, regulators and consultants will entail discussion of a broad array of ideas and points of view regarding how to improve the in service testing of valves and pumps at nuclear power plants. One of the challenges faced is the need to optimize the in service testing and inspection to enhance safety, operability and reliability. The author addresses this challenge from an ASME Nuclear Codes and Standards point of view.

  20. Training method for enhancement of safety attitude in nuclear power plant based on crew resource management

    International Nuclear Information System (INIS)

    Ishibashi, Akira; Karikawa, Daisuke; Takahashi, Makoto; Wakabayashi, Toshio; Kitamura, Masaharu

    2010-01-01

    A conventional training program for nuclear power plant operators has been developed with emphasis on improvement of knowledge and skills of individual operators. Although it has certainly contributed to safety operation of nuclear power plants, some recent incidents have indicated the necessity of an improved training program aiming at improvement of the performance of operators working as a team. In the aviation area, crew resource management (CRM) training has shown the effect of resolving team management issues of flight crews, aircraft maintenance crews, and so on. In the present research, we attempted to introduce the CRM concept into operator training in nuclear power plants as training for conceptual skill enhancement. In this paper, a training method specially customized for nuclear power plant operators based on CRM is proposed. The proposed method has been practically utilized in the management training course of Japan Nuclear Technology Institute. The validity of the proposed method has been evaluated by means of a questionnaire survey. (author)

  1. An efficient RFID authentication protocol to enhance patient medication safety using elliptic curve cryptography.

    Science.gov (United States)

    Zhang, Zezhong; Qi, Qingqing

    2014-05-01

    Medication errors are very dangerous even fatal since it could cause serious even fatal harm to patients. In order to reduce medication errors, automated patient medication systems using the Radio Frequency Identification (RFID) technology have been used in many hospitals. The data transmitted in those medication systems is very important and sensitive. In the past decade, many security protocols have been proposed to ensure its secure transition attracted wide attention. Due to providing mutual authentication between the medication server and the tag, the RFID authentication protocol is considered as the most important security protocols in those systems. In this paper, we propose a RFID authentication protocol to enhance patient medication safety using elliptic curve cryptography (ECC). The analysis shows the proposed protocol could overcome security weaknesses in previous protocols and has better performance. Therefore, the proposed protocol is very suitable for automated patient medication systems.

  2. Efficacy and Safety of Combined Oral and Enema Therapy Using Polyethylene Glycol 3350-Electrolyte for Disimpaction in Pediatric Constipation

    OpenAIRE

    Yoo, Taeyeon; Bae, Sun Hwan

    2017-01-01

    Purpose We evaluated the efficacy and safety of combined oral and enema therapy using polyethylene glycol (PEG) 3350 with electrolyte solution for disimpaction in hospitalized children. Methods We retrospectively studied 28 children having functional constipation who received inpatient treatment between 2008 and 2016. The amount of oral PEG 3350 electrolyte solution administered was 50–70 mL/kg/d (PEG 3350, 3–4.1 g/kg/d), and an enema solution was administered 1–2 times a day as a single dose...

  3. Enhancement of the safety of live influenza vaccine by attenuating mutations from cold-adapted hemagglutinin

    International Nuclear Information System (INIS)

    Lee, Yoon Jae; Jang, Yo Han; Kim, Paul; Lee, Yun Ha; Lee, Young Jae; Byun, Young Ho; Lee, Kwang-Hee; Kim, Kyusik; Seong, Baik Lin

    2016-01-01

    In our previous study, X-31ca-based H5N1 LAIVs, in particular, became more virulent in mice than the X-31ca MDV, possibly by the introduction of the surface antigens of highly pathogenic H5N1 influenza virus, implying that additional attenuation is needed in this cases to increase the safety level of the vaccine. In this report we suggest an approach to further increase the safety of LAIV through additional cold-adapted mutations in the hemagglutinin. The cold-adaptation of X-31 virus resulted in four amino acid mutations in the HA. We generated a panel of 7:1 reassortant viruses each carrying the hemagglutinins with individual single amino acid mutations. We examined their phenotypes and found a major attenuating mutation, N81K. This attenuation marker conferred additional temperature-sensitive and attenuation phenotype to the LAIV. Our data indicate that the cold-adapted mutation in the HA confers additional attenuation to the LAIV strain, without compromising its productivity and immune response. - Highlights: • Cold-adaptation process induced four amino acid mutations in the HA of X-31 virus. • The four mutations in the HA also contributed to attenuation of the X-31ca virus • N81K mutation was the most significant marker for the attenuation of X-31ca virus. • Introduction of N81K mutation into H3N2 LAIV further attenuated the vaccine. • This approach provides a useful guideline for enhancing the safety of the LAIVs.

  4. Enhancement of the safety of live influenza vaccine by attenuating mutations from cold-adapted hemagglutinin

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yoon Jae [Graduate Program in Biomaterials Science and Engineering, College of Life Science and Biotechnology, Yonsei University, Seoul (Korea, Republic of); Laboratory of Molecular Medicine, Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul (Korea, Republic of); Vaccine Translational Research Center, Yonsei University, Seoul (Korea, Republic of); Jang, Yo Han [Laboratory of Molecular Medicine, Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul (Korea, Republic of); Kim, Paul; Lee, Yun Ha; Lee, Young Jae [Laboratory of Molecular Medicine, Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul (Korea, Republic of); Vaccine Translational Research Center, Yonsei University, Seoul (Korea, Republic of); Byun, Young Ho; Lee, Kwang-Hee; Kim, Kyusik [Laboratory of Molecular Medicine, Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul (Korea, Republic of); Seong, Baik Lin, E-mail: blseong@yonsei.ac.kr [Graduate Program in Biomaterials Science and Engineering, College of Life Science and Biotechnology, Yonsei University, Seoul (Korea, Republic of); Laboratory of Molecular Medicine, Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul (Korea, Republic of); Vaccine Translational Research Center, Yonsei University, Seoul (Korea, Republic of)

    2016-04-15

    In our previous study, X-31ca-based H5N1 LAIVs, in particular, became more virulent in mice than the X-31ca MDV, possibly by the introduction of the surface antigens of highly pathogenic H5N1 influenza virus, implying that additional attenuation is needed in this cases to increase the safety level of the vaccine. In this report we suggest an approach to further increase the safety of LAIV through additional cold-adapted mutations in the hemagglutinin. The cold-adaptation of X-31 virus resulted in four amino acid mutations in the HA. We generated a panel of 7:1 reassortant viruses each carrying the hemagglutinins with individual single amino acid mutations. We examined their phenotypes and found a major attenuating mutation, N81K. This attenuation marker conferred additional temperature-sensitive and attenuation phenotype to the LAIV. Our data indicate that the cold-adapted mutation in the HA confers additional attenuation to the LAIV strain, without compromising its productivity and immune response. - Highlights: • Cold-adaptation process induced four amino acid mutations in the HA of X-31 virus. • The four mutations in the HA also contributed to attenuation of the X-31ca virus • N81K mutation was the most significant marker for the attenuation of X-31ca virus. • Introduction of N81K mutation into H3N2 LAIV further attenuated the vaccine. • This approach provides a useful guideline for enhancing the safety of the LAIVs.

  5. Drug Repositioning of Proton Pump Inhibitors for Enhanced Efficacy and Safety of Cancer Chemotherapy

    Directory of Open Access Journals (Sweden)

    Kenji Ikemura

    2017-12-01

    Full Text Available Proton pump inhibitors (PPIs, H+/K+-ATPase inhibitors, are the most commonly prescribed drugs for the treatment of gastroesophageal reflux and peptic ulcer diseases; they are highly safe and tolerable. Since PPIs are frequently used in cancer patients, studies investigating interactions between PPIs and anticancer agents are of particular importance to achieving effective and safe cancer chemotherapy. Several studies have revealed that PPIs inhibit not only the H+/K+-ATPase in gastric parietal cells, but also the vacuolar H+-ATPase (V-ATPase overexpressed in tumor cells, as well as the renal basolateral organic cation transporter 2 (OCT2 associated with pharmacokinetics and/or renal accumulation of various drugs, including anticancer agents. In this mini-review, we summarize the current knowledge regarding the impact of PPIs on the efficacy and safety of cancer chemotherapeutics via inhibition of targets other than the H+/K+-ATPase. Co-administration of clinical doses of PPIs protected kidney function in patients receiving cisplatin and fluorouracil, presumably by decreasing accumulation of cisplatin in the kidney via OCT2 inhibition. In addition, co-administration or pretreatment with PPIs could inhibit H+ transport via the V-ATPase in tumor cells, resulting in lower extracellular acidification and intracellular acidic vesicles to enhance the sensitivity of the tumor cells to the anticancer agents. In the present mini-review, we suggest that PPIs enhance the efficacy and safety of anticancer agents via off-target inhibition (e.g., of OCT2 and V-ATPase, rather than on-target inhibition of the H+/K+-ATPase. The present findings should provide important information to establish novel supportive therapy with PPIs during cancer chemotherapy.

  6. Do systematic reviews on pediatric topics need special methodological considerations?

    Science.gov (United States)

    Farid-Kapadia, Mufiza; Askie, Lisa; Hartling, Lisa; Contopoulos-Ioannidis, Despina; Bhutta, Zulfiqar A; Soll, Roger; Moher, David; Offringa, Martin

    2017-03-06

    Systematic reviews are key tools to enable decision making by healthcare providers and policymakers. Despite the availability of the evidence based Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA-2009 and PRISMA-P 2015) statements that were developed to improve the transparency and quality of reporting of systematic reviews, uncertainty on how to deal with pediatric-specific methodological challenges of systematic reviews impairs decision-making in child health. In this paper, we identify methodological challenges specific to the design, conduct and reporting of pediatric systematic reviews, and propose a process to address these challenges. One fundamental decision at the outset of a systematic review is whether to focus on a pediatric population only, or to include both adult and pediatric populations. Both from the policy and patient care point of view, the appropriateness of interventions and comparators administered to pre-defined pediatric age subgroup is critical. Decisions need to be based on the biological plausibility of differences in treatment effects across the developmental trajectory in children. Synthesis of evidence from different trials is often impaired by the use of outcomes and measurement instruments that differ between trials and are neither relevant nor validated in the pediatric population. Other issues specific to pediatric systematic reviews include lack of pediatric-sensitive search strategies and inconsistent choices of pediatric age subgroups in meta-analyses. In addition to these methodological issues generic to all pediatric systematic reviews, special considerations are required for reviews of health care interventions' safety and efficacy in neonatology, global health, comparative effectiveness interventions and individual participant data meta-analyses. To date, there is no standard approach available to overcome this problem. We propose to develop a consensus-based checklist of essential items which

  7. A knee-mounted biomechanical energy harvester with enhanced efficiency and safety

    Science.gov (United States)

    Chen, Chao; Chau, Li Yin; Liao, Wei-Hsin

    2017-06-01

    Energy harvesting is becoming a major limiting issue for many portable devices. When undertaking any activity, the human body generates a significant amount of biomechanical energy, which can be collected by means of a portable energy harvester. This energy provides a method of powering portable devices such as prosthetic limbs. In this paper, a knee-mounted energy harvester with enhanced efficiency and safety is proposed and developed to convert mechanical energy into electricity during human motion. This device can change the bi-directional knee input into uni-directional rotation for an electromagnetic generator using a specially designed transmission system. Without the constraint of induced impact on the human body, this device can harvest biomechanical energy from both knee flexion and extension, improving the harvesting efficiency over previous single-direction energy harvesters. It can also provide protection from device malfunction, and increase the safety of current biomechanical energy harvesters. A highly compact and light prototype is developed taking into account human kinematics. The biomechanical energy harvesting system is also modeled and analyzed. The prototype is tested under different conditions including walking, running and climbing stairs, to evaluate the energy harvesting performance and effect on the human gait. The experimental results show that the prototype can harvest an average power of 3.6 W at 1.5 m s-1 walking speed, which is promising for portable electronic devices.

  8. Enhanced CANDU 6 design assist probabilistic safety assessment results and insights

    International Nuclear Information System (INIS)

    Torabi, T.; Bettig, R.; Iliescu, P.; Robinson, J.; Santamaura, P.; Skorupska, B.; Tyagi, A.K.; Vencel, I.

    2013-01-01

    The Enhanced CANDU 6(EC6) is a 700 MWe reactor, which has evolved from the well-established CANDU line of reactors, which are heavy-water moderated, and heavy-water cooled horizontal pressure tube reactors, using natural uranium fuel. The EC6 design retains the generic CANDU design features, while incorporating innovations and state-of-the-art technologies to ensure competitiveness with other design with respect to operation, performance and economics. A design assist probabilistic safety assessment (PSA) was conducted during the design change phase of the project. The purpose of the assessment was to assess internal events during at-power operation and identify the design improvements and additional features needed to comply with the latest regulatory requirements in Canada and compete with other reactor designs, internationally. The PSA results show that the EC6 plant response to the postulated initiating events is well balanced, and the design meets its safety objectives. This paper summarizes the results and insights gained during the development of the PSA models for at-power internal events. (author)

  9. Thermal-Responsive Polymers for Enhancing Safety of Electrochemical Storage Devices.

    Science.gov (United States)

    Yang, Hui; Leow, Wan Ru; Chen, Xiaodong

    2018-03-01

    Thermal runway constitutes the most pressing safety issue in lithium-ion batteries and supercapacitors of large-scale and high-power density due to risks of fire or explosion. However, traditional strategies for averting thermal runaway do not enable the charging-discharging rate to change according to temperature or the original performance to resume when the device is cooled to room temperature. To efficiently control thermal runaway, thermal-responsive polymers provide a feasible and reversible strategy due to their ability to sense and subsequently act according to a predetermined sequence when triggered by heat. Herein, recent research progress on the use of thermal-responsive polymers to enhance the thermal safety of electrochemical storage devices is reviewed. First, a brief discussion is provided on the methods of preventing thermal runaway in electrochemical storage devices. Subsequently, a short review is provided on the different types of thermal-responsive polymers that can efficiently avoid thermal runaway, such as phase change polymers, polymers with sol-gel transitions, and polymers with positive temperature coefficients. The results represent the important development of thermal-responsive polymers toward the prevention of thermal runaway in next-generation smart electrochemical storage devices. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. Development of a Nursing Handoff Tool: A Web-Based Application to Enhance Patient Safety

    Science.gov (United States)

    Goldsmith, Denise; Boomhower, Marc; Lancaster, Diane R.; Antonelli, Mary; Kenyon, Mary Anne Murphy; Benoit, Angela; Chang, Frank; Dykes, Patricia C.

    2010-01-01

    Dynamic and complex clinical environments present many challenges for effective communication among health care providers. The omission of accurate, timely, easily accessible vital information by health care providers significantly increases risk of patient harm and can have devastating consequences for patient care. An effective nursing handoff supports the standardized transfer of accurate, timely, critical patient information, as well as continuity of care and treatment, resulting in enhanced patient safety. The Brigham and Women’s/Faulkner Hospital Healthcare Information Technology Innovation Program (HIP) is supporting the development of a web based nursing handoff tool (NHT). The goal of this project is to develop a “proof of concept” handoff application to be evaluated by nurses on the inpatient intermediate care units. The handoff tool would enable nurses to use existing knowledge of evidence-based handoff methodology in their everyday practice to improve patient care and safety. In this paper, we discuss the results of nursing focus groups designed to identify the current state of handoff practice as well as the functional and data element requirements of a web based Nursing Handoff Tool (NHT). PMID:21346980

  11. Criticality safety evaluation for the Advanced Test Reactor enhanced low enriched uranium fuel elements

    International Nuclear Information System (INIS)

    Montierth, Leland M.

    2016-01-01

    The Global Threat Reduction Initiative (GTRI) convert program is developing a high uranium density fuel based on a low enriched uranium (LEU) uranium-molybdenum alloy. Testing of prototypic GTRI fuel elements is necessary to demonstrate integrated fuel performance behavior and scale-up of fabrication techniques. GTRI Enhanced LEU Fuel (ELF) elements based on the ATR-Standard Size elements (all plates fueled) are to be fabricated for testing in the Advanced Test Reactor (ATR). While a specific ELF element design will eventually be provided for detailed analyses and in-core testing, this criticality safety evaluation (CSE) is intended to evaluate a hypothetical ELF element design for criticality safety purposes. Existing criticality analyses have analyzed Standard (HEU) ATR elements from which controls have been derived. This CSE documents analysis that determines the reactivity of the hypothetical ELF fuel elements relative to HEU ATR elements and whether the existing HEU ATR element controls bound the ELF element. The initial calculations presented in this CSE analyzed the original ELF design, now referred to as Mod 0.1. In addition, as part of a fuel meat thickness optimization effort for reactor performance, other designs have been evaluated. As of early 2014 the most current conceptual designs are Mk1A and Mk1B, that were previously referred to as conceptual designs Mod 0.10 and Mod 0.11, respectively. Revision 1 evaluates the reactivity of the ATR HEU Mark IV elements for a comparison with the Mark VII elements.

  12. Male enhancement Nutraceuticals in the Middle East market: Claim, pharmaceutical quality and safety assessments.

    Science.gov (United States)

    ElAgouri, Ghada; ElAmrawy, Fatema; ElYazbi, Ahmed; Eshra, Ahmed; Nounou, Mohamed I

    2015-08-15

    The global market is invaded by male enhancement nutraceuticals claimed to be of natural origin sold with a major therapeutic claim. Most of these products have been reported by international systems like the Food and Drug Administration (FDA). We hypothesize that these products could represent a major threat to the health of the consumers. In this paper, pharmaceutical evaluation of some of these nutraceutical products sold in Egypt under the therapeutic claim of treating erectile dysfunction, are discussed along with pharmacological evaluation to investigate their safety and efficacy parameters. Samples were analyzed utterly using conventional methods, i.e.: HPLC, HPTLC, NIR, content uniformity and weight variation and friability. The SeDeM system was used for quality assessment. On the basis of the results of this research, the sampled products are adulterated and totally heterogeneous in their adulterant drug content and pharmaceutical quality. These products represent a major safety threat for the consumers in Egypt and the Middle East, especially; the target audience is mostly affected with heart and blood pressure problems seeking natural and safe alternatives to the well-established Phosphodiesterase 5 Inhibitors (PDE-5Is). Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Criticality safety evaluation for the Advanced Test Reactor enhanced low enriched uranium fuel elements

    Energy Technology Data Exchange (ETDEWEB)

    Montierth, Leland M. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-07-19

    The Global Threat Reduction Initiative (GTRI) convert program is developing a high uranium density fuel based on a low enriched uranium (LEU) uranium-molybdenum alloy. Testing of prototypic GTRI fuel elements is necessary to demonstrate integrated fuel performance behavior and scale-up of fabrication techniques. GTRI Enhanced LEU Fuel (ELF) elements based on the ATR-Standard Size elements (all plates fueled) are to be fabricated for testing in the Advanced Test Reactor (ATR). While a specific ELF element design will eventually be provided for detailed analyses and in-core testing, this criticality safety evaluation (CSE) is intended to evaluate a hypothetical ELF element design for criticality safety purposes. Existing criticality analyses have analyzed Standard (HEU) ATR elements from which controls have been derived. This CSE documents analysis that determines the reactivity of the hypothetical ELF fuel elements relative to HEU ATR elements and whether the existing HEU ATR element controls bound the ELF element. The initial calculations presented in this CSE analyzed the original ELF design, now referred to as Mod 0.1. In addition, as part of a fuel meat thickness optimization effort for reactor performance, other designs have been evaluated. As of early 2014 the most current conceptual designs are Mk1A and Mk1B, that were previously referred to as conceptual designs Mod 0.10 and Mod 0.11, respectively. Revision 1 evaluates the reactivity of the ATR HEU Mark IV elements for a comparison with the Mark VII elements.

  14. Developing a smartphone based warning system application to enhance the safety at work zones : final report.

    Science.gov (United States)

    2016-05-01

    Collisions in the work zone have always been a contributing factor to compromising safety on urban roadways. The National Highway Traffic Safety Administration (NHTSA) and the State Transportation Authorities have implemented many safety countermeasu...

  15. Chronicle of pediatric radiology

    International Nuclear Information System (INIS)

    Benz-Bohm, Gabriele; Richter, Ernst

    2012-01-01

    The chronicle of pediatric radiology covers the following issues: Development of pediatric radiology in Germany (BRD, DDR, pediatric radiological accommodations); development of pediatric radiology in the Netherlands (chronology and pediatric radiological accommodations); development of pediatric radiology in Austria (chronology and pediatric radiological accommodations); development of pediatric radiology in Switzerland (chronology and pediatric radiological accommodations).

  16. Pediatric vascular access

    International Nuclear Information System (INIS)

    Donaldson, James S.

    2006-01-01

    Pediatric interventional radiologists are ideally suited to provide vascular access services to children because of inherent safety advantages and higher success from using image-guided techniques. The performance of vascular access procedures has become routine at many adult interventional radiology practices, but this service is not as widely developed at pediatric institutions. Although interventional radiologists at some children's hospitals offer full-service vascular access, there is little or none at others. Developing and maintaining a pediatric vascular access service is a challenge. Interventionalists skilled in performing such procedures are limited at pediatric institutions, and institutional support from clerical staff, nursing staff, and technologists might not be sufficiently available to fulfill the needs of such a service. There must also be a strong commitment by all members of the team to support such a demanding service. There is a slippery slope of expected services that becomes steeper and steeper as the vascular access service grows. This review is intended primarily as general education for pediatric radiologists learning vascular access techniques. Additionally, the pediatric or adult interventional radiologist seeking to expand services might find helpful tips. The article also provides education for the diagnostic radiologist who routinely interprets radiographs containing vascular access devices. (orig.)

  17. Assessment of a Conceptual Flap System Intended for Enhanced General Aviation Safety

    Science.gov (United States)

    Campbell, Bryan A.; Carter, Melissa B.

    2017-01-01

    A novel multielement trailing-edge flap system for light general aviation airplanes was conceived for enhanced safety during normal and emergency landings. The system is designed to significantly reduce stall speed, and thus approach speed, with the goal of reducing maneuveringflight accidents and enhancing pilot survivability in the event of an accident. The research objectives were to assess the aerodynamic performance characteristics of the system and to evaluate the extent to which it provided both increased lift and increased drag required for the low-speed landing goal. The flap system was applied to a model of a light general aviation, high-wing trainer and tested in the Langley 12- Foot Low-Speed Wind Tunnel. Data were obtained for several device deflection angles, and component combinations at a dynamic pressure of 4 pounds per square foot. The force and moment data supports the achievement of the desired increase in lift with substantially increased drag, all at relatively shallow angles of attack. The levels of lift and drag can be varied through device deflection angles and inboard/outboard differential deflections. As such, it appears that this flap system may provide an enabling technology to allow steep, controllable glide slopes for safe rapid descent to landing with reduced stall speed. However, a simple flat-plate lower surface spoiler (LSS) provided either similar or superior lift with little impact on pitch or drag as compared to the proposed system. Higher-fidelity studies are suggested prior to use of the proposed system.

  18. Efficacy and Safety of Combined Oral and Enema Therapy Using Polyethylene Glycol 3350-Electrolyte for Disimpaction in Pediatric Constipation.

    Science.gov (United States)

    Yoo, Taeyeon; Bae, Sun Hwan

    2017-12-01

    We evaluated the efficacy and safety of combined oral and enema therapy using polyethylene glycol (PEG) 3350 with electrolyte solution for disimpaction in hospitalized children. We retrospectively studied 28 children having functional constipation who received inpatient treatment between 2008 and 2016. The amount of oral PEG 3350 electrolyte solution administered was 50-70 mL/kg/d (PEG 3350, 3-4.1 g/kg/d), and an enema solution was administered 1-2 times a day as a single dose of 15-25 mL/kg (PEG 3350, 0.975-1.625 g/kg/d). A colon transit time (CTT) test based on the Metcalf protocol was performed in some patients. Administration of oral and enema doses of PEG 3350 electrolyte solution showed 2.1±0.3 times and 2.9±0.4 times, respectively. After disimpaction, the frequency of defecation increased from 2.2±0.3 per week to once a day (1.1±0.1 per day). The number of patients who complained of abdominal pain was reduced from 15 (53.6%) to 4 (14.3%). Before hospitalization, nine patients underwent a CTT test, and 5 of 9 patients (55.6%) were classified as belonging to a group showing abnormalities. And in some patients, mild adverse effects were noted. We examined electrolytes and osmolality before and after disimpaction in 16 of 28 patients, and no abnormalities were noted. In terms of therapeutic efficacy and safety, combined oral and enema therapy using high-dose PEG 3350 with electrolytes is considered superior to conventional oral monotherapy or combined oral and enema therapy on an outpatient basis.

  19. Obesity and Pediatric Drug Development.

    Science.gov (United States)

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

    2018-05-01

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

  20. Intrathecally enhanced spinal CT in the early diagnosis of cerebrospinal fluid-borne metastasis in pediatric patients with primary brain tumors

    International Nuclear Information System (INIS)

    Wang, H.; Rosenbaum, A.E.; Ahn, H.S.; Zinreich, S.J.; Diffley, D.M.; Killmond, T.A.; Strauss, L.C.

    1987-01-01

    Early diagnosis and treatment of asymptomatic intraspinal cerebrospinal fluid-borne metastases can obviate serious sequelae in pediatric patients with known intracranial tumors. MR imaging is a superior imaging modality; however, in very young patients who need general anesthesia for immobilization and also for evaluation of small subarachnoid seedings, the authors found CT to be a valuable alternative. Twelve patients ranging in age from 3 months to 13 years underwent CT screening of the entire spine after intrathecal enhancement with 3-5 ml of metrizamide (100 mg iodine per milliliter) via a lumbar puncture. Intrathecal spinal metastases were found in 67% of the studied patients and even in a patient whose MR imaging examination failed to disclose the lesion

  1. Safety of peritoneal and pleural drain placement in pediatric stem cell transplant recipients with severe veno-occlusive disease.

    Science.gov (United States)

    Madenci, Arin L; Stetson, Alyssa; Weldon, Christopher B; Lehmann, Leslie E

    2016-08-01

    Hepatic VOD (veno-occlusive disease) is a serious complication of HSCT (hematopoietic stem cell transplantation) and has historically been associated with high mortality. This obstruction to hepatic flow often results in fluid collections in the peritoneal and pleural cavities. Catheter placement to drain ascites or pleural fluid may reduce intra-abdominal hypertension and/or improve respiratory parameters. The safety of these interventions among critically ill, immunocompromised children is unknown. Among 32 HSCT recipients (2000-2012) with severe VOD, we assessed the primary outcome of procedural complication from peritoneal drain placement. Twenty-four (75%) patients underwent peritoneal drain placement. No patient sustained visceral perforation or hemorrhage with drain placement. Overall mortality was 47% (n = 15). The procedure was not associated with increased overall mortality (p > 0.99). Eight (25%) peritoneal drains required replacement for malfunction. Of 24 patients with peritoneal drains, one (4%) patient had a positive culture from ascitic fluid. Eight (25%) patients underwent pleural drain placement. No pleural drain-related procedural complication or infection occurred. Four (50%) of the eight patients with pleural drains had de-escalation in oxygen requirement at drain removal, compared to time of placement. In this study, peritoneal and pleural drains were safe interventions for children with severe VOD. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Medication errors in pediatric inpatients

    DEFF Research Database (Denmark)

    Rishoej, Rikke Mie; Almarsdóttir, Anna Birna; Christesen, Henrik Thybo

    2017-01-01

    The aim was to describe medication errors (MEs) in hospitalized children reported to the national mandatory reporting and learning system, the Danish Patient Safety Database (DPSD). MEs were extracted from DPSD from the 5-year period of 2010–2014. We included reports from public hospitals on pati...... safety in pediatric inpatients.(Table presented.)...

  3. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us ... or better than those obtained by CT scanning. Working together, your primary care physician or ... Safety in Pediatric Imaging's "Image Gently" Campaign top of ...

  4. A Lithium-Ion Battery with Enhanced Safety Prepared using an Environmentally Friendly Process.

    Science.gov (United States)

    Mueller, Franziska; Loeffler, Nicholas; Kim, Guk-Tae; Diemant, Thomas; Behm, R Jürgen; Passerini, Stefano

    2016-06-08

    A new lithium-ion battery chemistry is presented based on a conversion-alloying anode material, a carbon-coated Fe-doped ZnO (TMO-C), and a LiNi1/3 Mn1/3 Co1/3 O2 (NMC) cathode. Both electrodes were fabricated using an environmentally friendly cellulose-based binding agent. The performance of the new lithium-ion battery was evaluated with a conventional, carbonate-based electrolyte (ethylene carbonate:diethyl carbonate-1 m lithium hexafluorophosphate, EC:DEC 1 m LiPF6 ) and an ionic liquid (IL)-based electrolyte (N-butyl-N-methylpyrrolidinium bis(trifluoromethanesulfonyl)imide-0.2 m lithium bis(trifluoromethanesulfonyl)imide, Pyr14 TFSI 0.2 m LiTFSI), respectively. Galvanostatic charge/discharge tests revealed a reduced rate capability of the TMO-C/Pyr14 TFSI 0.2 m LiTFSI/NMC full-cell compared to the organic electrolyte, but the coulombic efficiency was significantly enhanced. Moreover, the IL-based electrolyte substantially improves the safety of the system due to a higher thermal stability of the formed anodic solid electrolyte interphase and the IL electrolyte itself. While the carbonate-based electrolyte shows sudden degradation reactions, the IL exhibits a slowly increasing heat flow, which does not constitute a serious safety risk. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Does Academic Blogging Enhance Promotion and Tenure? A Survey of US and Canadian Medicine and Pediatric Department Chairs.

    Science.gov (United States)

    Cameron, Christian Blake; Nair, Vinay; Varma, Manu; Adams, Martha; Jhaveri, Kenar D; Sparks, Matthew A

    2016-06-23

    Electronic educational (e-learning) technology usage continues to grow. Many medical journals operate companion blogs (an application of e-learning technology) that enable rapid dissemination of scientific knowledge and discourse. Faculty members participating in promotion and tenure academic tracks spend valuable time and effort contributing, editing, and directing these medical journal blogs. We sought to understand whether chairs of medicine and pediatric departments acknowledge blog authorship as academic achievement. The authors surveyed 267 chairs of US and Canadian medicine and pediatric departments regarding their attitudes toward the role of faculty participation in e-learning and blogging in the promotion and tenure process. The survey completion rate was 22.8% (61/267). A majority of respondents (87%, 53/61) viewed educational scholarship as either important or very important for promotion. However, only 23% (14/61) perceived importance to faculty effort in producing content for journal-based blogs. If faculty were to participate in blog authorship, 72% (44/61) of surveyed chairs favored involvement in a journal-based versus a society-based or a personal (nonaffiliated) blog. We identified a "favorable group" of chairs (19/59, 32%), who rated leadership roles in e-learning tools as important or very important, and an "unfavorable group" of chairs (40/59, 68%), who rated leadership roles in e-learning tools as somewhat important or not important. The favorable group were more likely to be aware of faculty bloggers within their departments (58%, 11/19 vs 25%, 10/40), viewed serving on editorial boards of e-learning tools more favorably (79%, 15/19 vs 31%, 12/39), and were more likely to value effort spent contributing to journal-based blogs (53%, 10/19 vs 10%, 4/40). Our findings demonstrate that although the majority of department chairs value educational scholarship, only a minority perceive value in faculty blogging effort.

  6. Adolescents' Perceptions of Safety at School and Their Solutions for Enhancing Safety and Reducing School Violence: A Rural Case Study.

    Science.gov (United States)

    deLara, Ellen

    An exploratory study of a small rural high school in upstate New York investigated students' perceptions of safety at school and empowered students to develop solutions to school violence. A mixed-methods approach drew on action research, youth-based phenomenology, and a general systems frame of reference. Data collection included two surveys of…

  7. Pediatric dental sedation: challenges and opportunities.

    Science.gov (United States)

    Nelson, Travis M; Xu, Zheng

    2015-01-01

    High levels of dental caries, challenging child behavior, and parent expectations support a need for sedation in pediatric dentistry. This paper reviews modern developments in pediatric sedation with a focus on implementing techniques to enhance success and patient safety. In recent years, sedation for dental procedures has been implicated in a disproportionate number of cases that resulted in death or permanent neurologic damage. The youngest children and those with more complicated medical backgrounds appear to be at greatest risk. To reduce complications, practitioners and regulatory bodies have supported a renewed focus on health care quality and safety. Implementation of high fidelity simulation training and improvements in patient monitoring, including end-tidal carbon dioxide, are becoming recognized as a new standard for sedated patients in dental offices and health care facilities. Safe and appropriate case selection and appropriate dosing for overweight children is also paramount. Oral sedation has been the mainstay of pediatric dental sedation; however, today practitioners are administering modern drugs in new ways with high levels of success. Employing contemporary transmucosal administration devices increases patient acceptance and sedation predictability. While recently there have been many positive developments in sedation technology, it is now thought that medications used in sedation and anesthesia may have adverse effects on the developing brain. The evidence for this is not definitive, but we suggest that practitioners recognize this developing area and counsel patients accordingly. Finally, there is a clear trend of increased use of ambulatory anesthesia services for pediatric dentistry. Today, parents and practitioners have become accustomed to children receiving general anesthesia in the outpatient setting. As a result of these changes, it is possible that dental providers will abandon the practice of personally administering large amounts of

  8. 47{sup th} Annual meeting on nuclear technology (AMNT 2016). Key Topics / Enhanced safety and operation excellence

    Energy Technology Data Exchange (ETDEWEB)

    Bohnstedt, Angelika [Karlsruher Institut fuer Technologie (KIT), Eggenstein-Leopoldshafen (Germany). Programm Nukleare Entsorgung, Sicherheit und Strahlenforschung (NUSAFE); Baumann, Erik [AREVA GmbH, Erlangen (Germany). Radiation Protection

    2016-12-15

    Summary report on the Key Topic 'Enhanced Safety and Operation Excellence' Focus Session 'Radiation Protection' of the 47{sup th} Annual Meeting on Nuclear Technology (AMNT 2016) held in Hamburg, 10 to 12 May 2016. Other Sessions of AMNT 2016 have been and will be covered in further issues of atw.

  9. Safety and Tolerability of Theta Burst Stimulation versus Single and Paired Pulse Transcranial Magnetic Stimulation: A Comparative Study of 165 Pediatric Subjects

    Directory of Open Access Journals (Sweden)

    Yaejee H Hong

    2015-02-01

    Full Text Available Background: Although single- and paired-pulse (sp/pp transcranial magnetic stimulation (TMS studies are considered minimal risk in adults and children, the safety profile for theta-burst TMS (TBS is unknown.Objective: In this comparative analysis, we explored the rate, severity, and specific symptoms of TMS-related adverse effects (AEs between sp/ppTMS and TBS in subjects between ages 6 and 18 years.Method: Data from 165 participants from 2009-2014 were analyzed. Assessment of AEs was performed based on baseline and post-TMS administration of a symptom-based questionnaire that rated AEs on a 5-level ordinal scale (minimal, mild, moderate, marked, severe. AE rates and severity were compared using Chi Square or Fisher’s Exact Test depending on data characteristics.Result: Overall, no seizures or severe-rated AEs were reported by 165 pediatric participants. The rate of AE in all TBS sessions was 10.5% (n=76, 95% CI: 4.7 - 19.7%, whereas the rate of AE in all sp/ppTMS sessions was 12.4% (n=89, 95% CI: 6.3 - 21.0%. There was no statistical difference in AE rates between TBS and sp/ppTMS (p=0.71. In all sp/ppTMS and TBS sessions, 20 subjects reported a total of 35 AEs, among these 31 (~88.6% were rated as minimal or mild. There was no difference in the severity of AE between TBS and sp/ppTMS (p=1.0. Only one of 76 TBS participants reported an AE rated as more than minimal/mild.Conclusion: Our comparative analysis showed that TBS appears to be as safe as sp/ppTMS in terms of AE rate and severity. This report supports further investigation of TBS in children.

  10. Clinical performance of a free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced pediatric abdominal MR angiography.

    Science.gov (United States)

    Zhang, Tao; Yousaf, Ufra; Hsiao, Albert; Cheng, Joseph Y; Alley, Marcus T; Lustig, Michael; Pauly, John M; Vasanawala, Shreyas S

    2015-10-01

    Pediatric contrast-enhanced MR angiography is often limited by respiration, other patient motion and compromised spatiotemporal resolution. To determine the reliability of a free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced MR angiography method for depicting abdominal arterial anatomy in young children. With IRB approval and informed consent, we retrospectively identified 27 consecutive children (16 males and 11 females; mean age: 3.8 years, range: 14 days to 8.4 years) referred for contrast-enhanced MR angiography at our institution, who had undergone free-breathing spatiotemporally accelerated time-resolved contrast-enhanced MR angiography studies. A radio-frequency-spoiled gradient echo sequence with Cartesian variable density k-space sampling and radial view ordering, intrinsic motion navigation and intermittent fat suppression was developed. Images were reconstructed with soft-gated parallel imaging locally low-rank method to achieve both motion correction and high spatiotemporal resolution. Quality of delineation of 13 abdominal arteries in the reconstructed images was assessed independently by two radiologists on a five-point scale. Ninety-five percent confidence intervals of the proportion of diagnostically adequate cases were calculated. Interobserver agreements were also analyzed. Eleven out of 13 arteries achieved acceptable image quality (mean score range: 3.9-5.0) for both readers. Fair to substantial interobserver agreement was reached on nine arteries. Free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced MR angiography frequently yields diagnostic image quality for most abdominal arteries in young children.

  11. Clinical performance of a free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced pediatric abdominal MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Tao; Cheng, Joseph Y. [Stanford University, Department of Radiology, Stanford, CA (United States); Stanford University, Department of Electrical Engineering, Stanford, CA (United States); Yousaf, Ufra; Alley, Marcus T.; Vasanawala, Shreyas S. [Stanford University, Department of Radiology, Stanford, CA (United States); Hsiao, Albert [University of California, San Diego, Department of Radiology, San Diego, CA (United States); Lustig, Michael [Stanford University, Department of Electrical Engineering, Stanford, CA (United States); University of California, Berkeley, Department of Electrical Engineering and Computer Sciences, Berkeley, CA (United States); Pauly, John M. [Stanford University, Department of Electrical Engineering, Stanford, CA (United States)

    2015-10-15

    Pediatric contrast-enhanced MR angiography is often limited by respiration, other patient motion and compromised spatiotemporal resolution. To determine the reliability of a free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced MR angiography method for depicting abdominal arterial anatomy in young children. With IRB approval and informed consent, we retrospectively identified 27 consecutive children (16 males and 11 females; mean age: 3.8 years, range: 14 days to 8.4 years) referred for contrast-enhanced MR angiography at our institution, who had undergone free-breathing spatiotemporally accelerated time-resolved contrast-enhanced MR angiography studies. A radio-frequency-spoiled gradient echo sequence with Cartesian variable density k-space sampling and radial view ordering, intrinsic motion navigation and intermittent fat suppression was developed. Images were reconstructed with soft-gated parallel imaging locally low-rank method to achieve both motion correction and high spatiotemporal resolution. Quality of delineation of 13 abdominal arteries in the reconstructed images was assessed independently by two radiologists on a five-point scale. Ninety-five percent confidence intervals of the proportion of diagnostically adequate cases were calculated. Interobserver agreements were also analyzed. Eleven out of 13 arteries achieved acceptable image quality (mean score range: 3.9-5.0) for both readers. Fair to substantial interobserver agreement was reached on nine arteries. Free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced MR angiography frequently yields diagnostic image quality for most abdominal arteries in young children. (orig.)

  12. Clinical performance of a free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced pediatric abdominal MR angiography

    International Nuclear Information System (INIS)

    Zhang, Tao; Cheng, Joseph Y.; Yousaf, Ufra; Alley, Marcus T.; Vasanawala, Shreyas S.; Hsiao, Albert; Lustig, Michael; Pauly, John M.

    2015-01-01

    Pediatric contrast-enhanced MR angiography is often limited by respiration, other patient motion and compromised spatiotemporal resolution. To determine the reliability of a free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced MR angiography method for depicting abdominal arterial anatomy in young children. With IRB approval and informed consent, we retrospectively identified 27 consecutive children (16 males and 11 females; mean age: 3.8 years, range: 14 days to 8.4 years) referred for contrast-enhanced MR angiography at our institution, who had undergone free-breathing spatiotemporally accelerated time-resolved contrast-enhanced MR angiography studies. A radio-frequency-spoiled gradient echo sequence with Cartesian variable density k-space sampling and radial view ordering, intrinsic motion navigation and intermittent fat suppression was developed. Images were reconstructed with soft-gated parallel imaging locally low-rank method to achieve both motion correction and high spatiotemporal resolution. Quality of delineation of 13 abdominal arteries in the reconstructed images was assessed independently by two radiologists on a five-point scale. Ninety-five percent confidence intervals of the proportion of diagnostically adequate cases were calculated. Interobserver agreements were also analyzed. Eleven out of 13 arteries achieved acceptable image quality (mean score range: 3.9-5.0) for both readers. Fair to substantial interobserver agreement was reached on nine arteries. Free-breathing spatiotemporally accelerated 3-D time-resolved contrast-enhanced MR angiography frequently yields diagnostic image quality for most abdominal arteries in young children. (orig.)

  13. The Integrated Safety Management System Verification Enhancement Review of the Plutonium Finishing Plant (PFP)

    International Nuclear Information System (INIS)

    BRIGGS, C.R.

    2000-01-01

    The primary purpose of the verification enhancement review was for the DOE Richland Operations Office (RL) to verify contractor readiness for the independent DOE Integrated Safety Management System Verification (ISMSV) on the Plutonium Finishing Plant (PFP). Secondary objectives included: (1) to reinforce the engagement of management and to gauge management commitment and accountability; (2) to evaluate the ''value added'' benefit of direct public involvement; (3) to evaluate the ''value added'' benefit of direct worker involvement; (4) to evaluate the ''value added'' benefit of the panel-to-panel review approach; and, (5) to evaluate the utility of the review's methodology/adaptability to periodic assessments of ISM status. The review was conducted on December 6-8, 1999, and involved the conduct of two-hour interviews with five separate panels of individuals with various management and operations responsibilities related to PFP. A semi-structured interview process was employed by a team of five ''reviewers'' who directed open-ended questions to the panels which focused on: (1) evidence of management commitment, accountability, and involvement; and, (2) consideration and demonstration of stakeholder (including worker) information and involvement opportunities. The purpose of a panel-to-panel dialogue approach was to better spotlight: (1) areas of mutual reinforcement and alignment that could serve as good examples of the management commitment and accountability aspects of ISMS implementation, and, (2) areas of potential discrepancy that could provide opportunities for improvement. In summary, the Review Team found major strengths to include: (1) the use of multi-disciplinary project work teams to plan and do work; (2) the availability and broad usage of multiple tools to help with planning and integrating work; (3) senior management presence and accessibility; (4) the institutionalization of worker involvement; (5) encouragement of self-reporting and self

  14. Pediatric Dentistese

    Directory of Open Access Journals (Sweden)

    Sharath Asokan

    2017-01-01

    Full Text Available Successful practice of pediatric dentistry depends on the establishment of a good relationship between the dentist and the child. Such a relationship is possible only through effective communication. Pediatric dentistry includes both an art and a science component. The focus has been mostly on the technical aspects of our science, and the soft skills we need to develop are often forgotten or neglected. This paper throws light on the communication skills we need to imbibe to be a successful pediatric dentist. A new terminology “Pediatric Dentistese” has been coined similar to motherese, parentese, or baby talk. Since baby talk cannot be applied to all age groups of children, pediatric dentistese has been defined as “the proactive development-based individualized communication between the pediatric dentist and the child which helps to build trust, allay fear, and treat the child effectively and efficiently.”

  15. Use of low-dose irradiation to enhance the safety and quality of chilled ready meals

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, E M [Department of Food Science, Queen' s University Belfast (QUB) (United Kingdom); Patterson, M F [Food Science Division, Department of Agriculture and Rural Development (DARD), Belfast (United Kingdom)

    2002-07-01

    The market for 'cook-chill' ready meals has expanded significantly during the past ten years. This specific category of food has been defined as a catering system based on the full cooking of food followed by fast chilling and storage in controlled temperature conditions (0-3 deg. C) and subsequent thorough re-heating before consumption. Such meals cover a wide range of commodities including meat, poultry, fish, vegetables, pasta and desserts and are used at home by consumers and by the catering industry for use, for example, as hospital meals or meals-on-wheels. These products have a relatively short shelf-life with a recommended maximum shelf-life of 5 days at 0-3 deg. C including the day of cooking. In addition, there are other concerns with regard to microbiological quality, reduced sensory quality and decreased nutritive value. It has been suggested that low-dose irradiation could be used to extend the shelf-life of these products while at the same time reducing the risk of food poisoning. Research carried out at QUB and DARD has readily demonstrated that the safety and shelf-life of chilled ready meals consisting of meat (chicken, beef or pork) and certain vegetables (e.g. broccoli, carrots and roast potatoes) can be enhanced by irradiation doses of 2 or 3 kGy without having a detrimental effect on sensory or nutritional quality. To date, investigations have been limited to such traditional meals with no research being carried out on the more popular ready meals such as lasagna, cottage pies, curries, etc. which have a relatively short shelf-life upon purchase. It is therefore the objective of this work program to investigate the effect of low-dose irradiation (1-5 kGy) on the microbiological, sensory and nutritional quality of these meals and to determine if their overall quality can be enhanced.

  16. Low-cost safety enhancements for stop-controlled and signalized intersections

    Science.gov (United States)

    2009-05-01

    The purpose of this document is to present information on suggested effective, low-cost intersection countermeasures developed using intersection safety research results and input from an intersection safety expert panel. These low-cost countermeasur...

  17. Food Safety and Sanitary Practices of Selected Hotels in Batangas Province, Philippines: Basis of Proposed Enhancement Measures

    Directory of Open Access Journals (Sweden)

    April M. Perez

    2017-02-01

    Full Text Available This study assessed the extent of food safety and sanitary practices of selected hotels in Batangas province as basis of proposed enhancement measures. The study utilized descriptive method to describe food safety and sanitary practices of selected hotels in Batangas province with a total of 8 hotels (256 respondents. Purposive sampling was used in the study. The questionnaires were designed using the provision of the Sanitation Code of the Philippines, validated and finalized to come up with legitimate results. The study showed that there were eight (8 hotel respondents classified as two, three, four star with considerable years of experience and adequate number of employees. The hotels demonstrated the food safety and sanitary practices always in the areas of restaurant, bar service, catering and banquet and room service. The significant pair-wise comparison for restaurant, bar service, catering and banquet and room service shows that 2 star hotels greatly differs. The researcher recommends that the management should maintain high standard of food safety and sanitary practices among its staff, upgrade the food safety and sanitary practices for food safety accreditation, continuous training of the hotel managers/employees on food safety and sanitary practices.

  18. Development of a portable bicycle/pedestrian monitoring system for safety enhancement

    Science.gov (United States)

    Usher, Colin; Daley, W. D. R.

    2015-03-01

    Pedestrians involved in roadway accidents account for nearly 12 percent of all traffic fatalities and 59,000 injuries each year. Most injuries occur when pedestrians attempt to cross roads, and there have been noted differences in accident rates midblock vs. at intersections. Collecting data on pedestrian behavior is a time consuming manual process that is prone to error. This leads to a lack of quality information to guide the proper design of lane markings and traffic signals to enhance pedestrian safety. Researchers at the Georgia Tech Research Institute are developing and testing an automated system that can be rapidly deployed for data collection to support the analysis of pedestrian behavior at intersections and midblock crossings with and without traffic signals. This system will analyze the collected video data to automatically identify and characterize the number of pedestrians and their behavior. It consists of a mobile trailer with four high definition pan-tilt cameras for data collection. The software is custom designed and uses state of the art commercial pedestrian detection algorithms. We will be presenting the system hardware and software design, challenges, and results from the preliminary system testing. Preliminary results indicate the ability to provide representative quantitative data on pedestrian motion data more efficiently than current techniques.

  19. Multivariate qualitative analysis of banned additives in food safety using surface enhanced Raman scattering spectroscopy.

    Science.gov (United States)

    He, Shixuan; Xie, Wanyi; Zhang, Wei; Zhang, Liqun; Wang, Yunxia; Liu, Xiaoling; Liu, Yulong; Du, Chunlei

    2015-02-25

    A novel strategy which combines iteratively cubic spline fitting baseline correction method with discriminant partial least squares qualitative analysis is employed to analyze the surface enhanced Raman scattering (SERS) spectroscopy of banned food additives, such as Sudan I dye and Rhodamine B in food, Malachite green residues in aquaculture fish. Multivariate qualitative analysis methods, using the combination of spectra preprocessing iteratively cubic spline fitting (ICSF) baseline correction with principal component analysis (PCA) and discriminant partial least squares (DPLS) classification respectively, are applied to investigate the effectiveness of SERS spectroscopy for predicting the class assignments of unknown banned food additives. PCA cannot be used to predict the class assignments of unknown samples. However, the DPLS classification can discriminate the class assignment of unknown banned additives using the information of differences in relative intensities. The results demonstrate that SERS spectroscopy combined with ICSF baseline correction method and exploratory analysis methodology DPLS classification can be potentially used for distinguishing the banned food additives in field of food safety. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Multivariate qualitative analysis of banned additives in food safety using surface enhanced Raman scattering spectroscopy

    Science.gov (United States)

    He, Shixuan; Xie, Wanyi; Zhang, Wei; Zhang, Liqun; Wang, Yunxia; Liu, Xiaoling; Liu, Yulong; Du, Chunlei

    2015-02-01

    A novel strategy which combines iteratively cubic spline fitting baseline correction method with discriminant partial least squares qualitative analysis is employed to analyze the surface enhanced Raman scattering (SERS) spectroscopy of banned food additives, such as Sudan I dye and Rhodamine B in food, Malachite green residues in aquaculture fish. Multivariate qualitative analysis methods, using the combination of spectra preprocessing iteratively cubic spline fitting (ICSF) baseline correction with principal component analysis (PCA) and discriminant partial least squares (DPLS) classification respectively, are applied to investigate the effectiveness of SERS spectroscopy for predicting the class assignments of unknown banned food additives. PCA cannot be used to predict the class assignments of unknown samples. However, the DPLS classification can discriminate the class assignment of unknown banned additives using the information of differences in relative intensities. The results demonstrate that SERS spectroscopy combined with ICSF baseline correction method and exploratory analysis methodology DPLS classification can be potentially used for distinguishing the banned food additives in field of food safety.

  1. Nuclear steam supply system KLT-40 enhanced safety as independent power supply source. Employment prospects

    International Nuclear Information System (INIS)

    Polunichev, V.I.; Sayanov, D.G.; Ardabievsky, A.A.

    1993-01-01

    High quality of KLT-40 nuclear steam supply system (NSSS) providing enhanced safety is attained owing to the development and operation experience of equipments and systems in Soviet nuclear icebreakers. First of all they are the operating nuclear-powered icebreakers open-quotes Arktikaclose quotes, open-quotes Sibirclose quotes, open-quotes Rossiyaclose quotes, open-quotes Sovetsky Soyuzclose quotes, the limited draught icebreakers of joint Soviet-Finnish manufacturing open-quotes Taimyrclose quotes open-quotes Vaigachclose quotes. 30-years trouble-free operation of icebreaker open-quotes Leninclose quotes, the ancestor of nuclear powered fleet, is unprecedented. Operation life of individual equipment items amounts to 107000 hours, that testifies to high reliability and life characteristics of NSSS. Trouble-free operation of the nuclear-powered icebreakers' reactor plants (RPs) exceeded 130 reactor years, that proves high quality of design decisions being underlain in the basis of the KLT-40 NSSS for the lighter-cargo carrier open-quotes Sevmorputclose quotes, which was put into operation into 1988. Besides it testifies to the expediency of KLT-40 NSSS employment as a power source in different power installations. The KLT-40 is a reactor plant with a pwr type reactor. The design is described in detail with diagrams

  2. Use of reactor plants of enhanced safety for sea water desalination, industrial and district heating

    International Nuclear Information System (INIS)

    Panov, Yu.; Polunichev, V.; Zverev, K.

    1997-01-01

    Russian designers have developed and can deliver nuclear complexes to provide sea water desalination, industrial and district heating. This paper provides an overview of these designs utilizing the ABV, KLT-40 and ATETS-80 reactor plants of enhanced safety. The most advanced nuclear powered water desalination project is the APVS-80. This design consists of a special ship equipped with the distillation desalination plant powered at a level of 160 MW(th) utilizing the type KLT-40 reactor plant. More than 20 years of experience with water desalination and reactor plants has been achieved in Aktau and Russian nuclear ships without radioactive contamination of desalinated water. Design is also proceeding on a two structure complex consisting of a floating nuclear power station and a reverse osmosis desalination plant. This new technology for sea water desalination provides the opportunity to considerably reduce the specific consumption of power for the desalination of sea water. The ABV reactor is utilized in the ''Volnolom'' type floating nuclear power stations. This design also features a desalinator ship which provides sea water desalination by the reverse osmosis process. The ATETS-80 is a nuclear two-reactor cogeneration complex which incorporates the integral vessel-type PWR which can be used in the production of electricity, steam, hot and desalinated water. (author). 9 figs

  3. Novel PEPA-functionalized graphene oxide for fire safety enhancement of polypropylene

    International Nuclear Information System (INIS)

    Xu, Jia You; Liu, Jie; Li, Kai Dan; Miao, Lei; Tanemura, Sakae

    2015-01-01

    Polypropylene (PP) is a general-purpose plastic, but some applications are constrained by its high flammability. Thus, flame retardant PP is urgently demanded. In this article, intumescent flame retardant PP (IFRPP) composites with enhanced fire safety were prepared using 1-oxo-4-hydroxymethyl-2,6,7-trioxa-1-phosphabicyclo [2.2.2] octane (PEPA) functionalized graphene oxide (PGO) as synergist. The PGO was prepared through a mild chemical reaction by the covalent attachment of a caged-structure organic compound, PEPA, onto GO nanosheets using toluene diisocynate (TDI) as the intermediary agent. The novel PEPA-functionalized graphene oxide not only improves the heat resistance of GO but also converts GO and PEPA from hydrophobic to hydrophilic materials, which leads to even distribution in PP. In our case, 7 wt% addition of PGO as one of the fillers for IFRPP composites significantly reduces its inflammability and fire hazards when compared with PEPA, by the improvement of first release rate peak (PHRR), total heat release, first smoke release rate peak (PSRR) and total smoke release, suggesting its great potential as the IFR synergist in industry. The reason is mainly attributed to the barrier effect of the unburned graphene sheets, which protects by the decomposition products of PEPA and TDI, promotes the formation of graphitized carbon and inhibits the heat and gas release. (paper)

  4. Novel PEPA-functionalized graphene oxide for fire safety enhancement of polypropylene

    Science.gov (United States)

    Xu, Jia You; Liu, Jie; Li, Kai Dan; Tanemura, Sakae

    2015-01-01

    Polypropylene (PP) is a general-purpose plastic, but some applications are constrained by its high flammability. Thus, flame retardant PP is urgently demanded. In this article, intumescent flame retardant PP (IFRPP) composites with enhanced fire safety were prepared using 1-oxo-4-hydroxymethyl-2,6,7-trioxa-1-phosphabicyclo [2.2.2] octane (PEPA) functionalized graphene oxide (PGO) as synergist. The PGO was prepared through a mild chemical reaction by the covalent attachment of a caged-structure organic compound, PEPA, onto GO nanosheets using toluene diisocynate (TDI) as the intermediary agent. The novel PEPA-functionalized graphene oxide not only improves the heat resistance of GO but also converts GO and PEPA from hydrophobic to hydrophilic materials, which leads to even distribution in PP. In our case, 7 wt% addition of PGO as one of the fillers for IFRPP composites significantly reduces its inflammability and fire hazards when compared with PEPA, by the improvement of first release rate peak (PHRR), total heat release, first smoke release rate peak (PSRR) and total smoke release, suggesting its great potential as the IFR synergist in industry. The reason is mainly attributed to the barrier effect of the unburned graphene sheets, which protects by the decomposition products of PEPA and TDI, promotes the formation of graphitized carbon and inhibits the heat and gas release. PMID:27877775

  5. A study of the international trend and comprehensive enhancement program on the Nuclear Power Plant safety

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Soon Hong; Cho, Nam Jin; Paek, Won Phil [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

    1990-12-15

    The objectives of this study are as follows : overview of the international trend related to the safety of Nuclear Power Plant(NPPs), study of the present status of NPP safety in Korea in aspects of design, construction and operation, suggestion of the comprehensive program to improve NPP safety in Korea. The results of this study can contribute to improve the safety of existing and future NPPs, and to establish the severe accident policy in Korea.

  6. A study of the international trend and comprehensive enhancement program on the Nuclear Power Plant safety

    International Nuclear Information System (INIS)

    Jang, Soon Hong; Cho, Nam Jin; Paek, Won Phil

    1990-12-01

    The objectives of this study are as follows : overview of the international trend related to the safety of Nuclear Power Plant(NPPs), study of the present status of NPP safety in Korea in aspects of design, construction and operation, suggestion of the comprehensive program to improve NPP safety in Korea. The results of this study can contribute to improve the safety of existing and future NPPs, and to establish the severe accident policy in Korea

  7. Role of effective nurse-patient relationships in enhancing patient safety.

    Science.gov (United States)

    Conroy, Tiffany; Feo, Rebecca; Boucaut, Rose; Alderman, Jan; Kitson, Alison

    2017-08-02

    Ensuring and maintaining patient safety is an essential aspect of care provision. Safety is a multidimensional concept, which incorporates interrelated elements such as physical and psychosocial safety. An effective nurse-patient relationship should ensure that these elements are considered when planning and providing care. This article discusses the importance of an effective nurse-patient relationship, as well as healthcare environments and working practices that promote safety, thus ensuring optimal patient care.

  8. Simulation in pediatric anesthesiology.

    Science.gov (United States)

    Fehr, James J; Honkanen, Anita; Murray, David J

    2012-10-01

    Simulation-based training, research and quality initiatives are expanding in pediatric anesthesiology just as in other medical specialties. Various modalities are available, from task trainers to standardized patients, and from computer-based simulations to mannequins. Computer-controlled mannequins can simulate pediatric vital signs with reasonable reliability; however the fidelity of skin temperature and color change, airway reflexes and breath and heart sounds remains rudimentary. Current pediatric mannequins are utilized in simulation centers, throughout hospitals in-situ, at national meetings for continuing medical education and in research into individual and team performance. Ongoing efforts by pediatric anesthesiologists dedicated to using simulation to improve patient care and educational delivery will result in further dissemination of this technology. Health care professionals who provide complex, subspecialty care to children require a curriculum supported by an active learning environment where skills directly relevant to pediatric care can be developed. The approach is not only the most effective method to educate adult learners, but meets calls for education reform and offers the potential to guide efforts toward evaluating competence. Simulation addresses patient safety imperatives by providing a method for trainees to develop skills and experience in various management strategies, without risk to the health and life of a child. A curriculum that provides pediatric anesthesiologists with the range of skills required in clinical practice settings must include a relatively broad range of task-training devises and electromechanical mannequins. Challenges remain in defining the best integration of this modality into training and clinical practice to meet the needs of pediatric patients. © 2012 Blackwell Publishing Ltd.

  9. Open Label, Phase II Study to Evaluate Efficacy and Safety of Oral Nilotinib in Philadelphia Positive (Ph+) Chronic Myelogenous Leukemia (CML) Pediatric Patients.

    Science.gov (United States)

    2018-04-20

    Leukemia; Leukemia,Pediatric; Leukemia, Myleiod; Leukemia, Mylegenous, Chronic; Leukemia, Mylegenous, Accelerated; BCR-ABL Positive; Myeloproliferative Disorder; Bone Marrow Disease; Hematologic Diseases; Neoplastic Processes; Imatinib; Dasatinib; Enzyme Inhibitor; Protein Kinase Inhibitor

  10. Pediatric emergency medicine: Optimizing risk assessment and safety netting in children with infectious diseases: Spoedeisende Kindergeneeskunde: Optimaliseren van risico inschatting en het vangnet rondom kinderen met koorts

    OpenAIRE

    Geurts, Dorien

    2018-01-01

    markdownabstractIntroduction In the introduction, the importance of good quality pediatric emergency care is explained. Acute illnesses in children differ among countries and settings. Regarding our population of the ED at the Erasmus MC in Rotterdam, The Netherlands, 1) we still observe mortality, although rare, 2) 45% of children with medical (non-trauma) complaints suffer from infectious diseases and 3) the number of revisits is high. As the main focus in research in pediatric emergency me...

  11. Incident factor as a learning aspect to enhance safety culture in the experimental fuel element installation of PTBN - BATAN

    International Nuclear Information System (INIS)

    Heri Hardiyanti; Agus Sartono; Bambang Herutomo; AS Latief

    2013-01-01

    The safety of a nuclear facility depends not only on the fulfillment of all technical requirements, but also on the role of non-technical aspects. The primary causation of incidents or accidents in a nuclear facility is human error which is non-technical. Therefore, in order to enhance safety, efforts from the technical aspects are as important as efforts to deal with the human factor which can be done through the application of safety culture in the facility. Incidents that took place in the Experimental Fuel Element Installation (EFEI) of PTBN - BATAN from 2011 to 2012 were caused by aging instruments and human error. In order to prevent accidents and to enhance safety, non-technical efforts that were done in the EFEI were, interalia, the obligations on all personnel to attend the pre-lab briefing, to prepare a work proposal, to compose a HIRADC (hazard identification, risk assessment, and determining control) document, to utilize self protection devices, to perform a routine maintenance, and to practice safe behavior. All personnel were involved in all those efforts. Safety is the first priority and can always be improved in the facility. A strong commitment of and cooperation between the top management and the staff are needed. (author)

  12. NMC and A and nuclear criticality safety systems integration: A prospective way for enhancement of the nuclear industry facilities safety

    International Nuclear Information System (INIS)

    Ryazanov, Boris G.; Sviridov, Victor I.; Frolov, Vladimir V.; Shvedov, Maxim O.; Mclaughlin, Thomas P.; Pruvost, Norman L.

    2003-01-01

    A considerable body of data has now been acquired about the principles, parameters and consequences of nuclear (criticality) accidents at facilities of the atomic industry in Russia, the United States, Great Britain and Japan. The total number of such accidents stands at 22. Russian and US specialists have prepared a rather extensive survey and analysis of these accidents. The final and important section of this survey is the lessons implied by the results of analysis of these 22 accidents. Among these lessons is the necessity of unconditional enforcement of control over the movement and transformations of special nuclear materials (SNM), and in particular fissile materials, (those SNMs with criticality accident concerns) during production and processing. Inadequacies in such control have been among the causes of most of the accidents that have occurred. Nuclear materials control and accounting (MC and A) for the purpose of ensuring storage reliability and nonproliferation safeguards is a major task of nuclear facilities in any nation. MC and A systems use the latest techniques and hardware for periodic control of SNM in specifically organized material balance areas. Immediate checking, periodic inventory of SNM, and measurements of the parameters of SNM at key points are the main sources of data for these systems. Data about the presence and sites of location of SNM in material balance areas that are acquired in inventories can be used for objective assessment of the status of nuclear safety. On the other hand, the inventory itself involves performance of operations that are unlike routine process engineering, and require special consideration of nuclear safety. Use of the techniques and hardware of MC and A systems not only for purposes of storage reliability, but also to ensure nuclear safety, will reduce the risk of nuclear accidents. This paper gives a concise overview of nuclear accidents that have occurred due to inadequacies in MC and A, and demonstrates

  13. Study on examples of safety culture enhancing activities at U.S. Nuclear Power Stations

    International Nuclear Information System (INIS)

    Ichiki, Kuniyasu

    2010-01-01

    After the wake of the incident of reactor vessel head degradation at Davis Basse in 2002, the NRC, the regulatory body in the U.S., included extraction of safety culture (SC) related elements from every failure into its inspection scheme of Reactor Oversight Process, since July 2006. The idea of SC itself was established some time ago, though, there are very few similar examples of such evaluation so far. This study is an attempt of making analyses on various activities with regard to SC in the U.S., to gain useful knowledge for considering the way to improve station's SC in Japan. Despite the fact that the numbers of inspection findings at stations are generally seen as unchanged, it is obvious that there are substantial difference in the number of the NRC's findings by each station. This appears to show that the condition of SC may largely different by stations. At several stations which accepted our investigation, those staff have made serious efforts to correct their area for improvements which were pointed out by the NRC. Such examples include improving management of their Corrective Action Program and establishing various measures to enable transmitting employee's concerns. It is thought that such activities aim to achieve efficient transfer of vital information among the station. This kind of activities should help every station solve various deficiencies in equipment, and also remove any obstacles in its communication. Their effort seem to result in not only the decrease in number of trouble but also much enhancement of mutual trust among the station, which would contribute to the great advance in their SC. (author)

  14. Implementation of enhanced recovery programme for laparoscopic distal pancreatectomy: feasibility, safety and cost analysis.

    Science.gov (United States)

    Richardson, John; Di Fabio, Francesco; Clarke, Hannah; Bajalan, Mohammed; Davids, Joe; Abu Hilal, Mohammed

    2015-01-01

    The adoption of laparoscopy for distal pancreatectomy has proven to substantially improve short-term outcomes. Stress response after major surgery can be further minimized within an enhanced recovery programme (ERP). However, data on the potential benefit of an ERP for laparoscopic distal pancreatectomy are still lacking. The aim was to assess the feasibility, safety and cost of ERP for patients undergoing laparoscopic distal pancreatectomy. This is a case-control study from a Tertiary University Hospital. Sixty-six consecutive patients who underwent laparoscopic distal pancreatectomy were analyzed. Twenty-two patients were enrolled for the ERP and compared with previous consecutive 44 patients managed traditionally (1:2 ratio). Operative details, post-operative outcome and cost analysis were compared in the two groups. Patients enrolled in the ERP had similar intraoperative blood loss (median 165 ml vs. 200 ml; p = 0.176), operation time (225 min vs. 210 min; p = 0.633), time to remove naso-gastric tube (1 vs. 1 day; p = 0.081) but significantly shorter time to mobilization (median 1 vs. 2 days; p = 0.0001), start solid diet (2 vs. 3 days; p = 0004), and pass stools (3 vs. 5 days; p = 0.002) compared to the control group. Median length of stay was significantly shorter in the ERP group (3 vs. 6 days; p pancreatectomy with significant earlier return to normal gut function, reduced length of stay and cost saving. Copyright © 2015 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  15. Workflow Enhancement (WE) Improves Safety in Radiation Oncology: Putting the WE and Team Together

    International Nuclear Information System (INIS)

    Chao, Samuel T.; Meier, Tim; Hugebeck, Brian; Reddy, Chandana A.; Godley, Andrew; Kolar, Matt; Suh, John H.

    2014-01-01

    Purpose: To review the impact of a workflow enhancement (WE) team in reducing treatment errors that reach patients within radiation oncology. Methods and Materials: It was determined that flaws in our workflow and processes resulted in errors reaching the patient. The process improvement team (PIT) was developed in 2010 to reduce errors and was later modified in 2012 into the current WE team. Workflow issues and solutions were discussed in PIT and WE team meetings. Due to tensions within PIT that resulted in employee dissatisfaction, there was a 6-month hiatus between the end of PIT and initiation of the renamed/redesigned WE team. In addition to the PIT/WE team forms, the department had separate incident forms to document treatment errors reaching the patient. These incident forms are rapidly reviewed and monitored by our departmental and institutional quality and safety groups, reflecting how seriously these forms are treated. The number of these incident forms was compared before and after instituting the WE team. Results: When PIT was disbanded, a number of errors seemed to occur in succession, requiring reinstitution and redesign of this team, rebranded the WE team. Interestingly, the number of incident forms per patient visits did not change when comparing 6 months during the PIT, 6 months during the hiatus, and the first 6 months after instituting the WE team (P=.85). However, 6 to 12 months after instituting the WE team, the number of incident forms per patient visits decreased (P=.028). After the WE team, employee satisfaction and commitment to quality increased as demonstrated by Gallup surveys, suggesting a correlation to the WE team. Conclusions: A team focused on addressing workflow and improving processes can reduce the number of errors reaching the patient. Time is necessary before a reduction in errors reaching patients will be seen

  16. Workflow Enhancement (WE) Improves Safety in Radiation Oncology: Putting the WE and Team Together

    Energy Technology Data Exchange (ETDEWEB)

    Chao, Samuel T., E-mail: chaos@ccf.org [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Meier, Tim; Hugebeck, Brian; Reddy, Chandana A.; Godley, Andrew; Kolar, Matt [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Suh, John H. [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States)

    2014-07-15

    Purpose: To review the impact of a workflow enhancement (WE) team in reducing treatment errors that reach patients within radiation oncology. Methods and Materials: It was determined that flaws in our workflow and processes resulted in errors reaching the patient. The process improvement team (PIT) was developed in 2010 to reduce errors and was later modified in 2012 into the current WE team. Workflow issues and solutions were discussed in PIT and WE team meetings. Due to tensions within PIT that resulted in employee dissatisfaction, there was a 6-month hiatus between the end of PIT and initiation of the renamed/redesigned WE team. In addition to the PIT/WE team forms, the department had separate incident forms to document treatment errors reaching the patient. These incident forms are rapidly reviewed and monitored by our departmental and institutional quality and safety groups, reflecting how seriously these forms are treated. The number of these incident forms was compared before and after instituting the WE team. Results: When PIT was disbanded, a number of errors seemed to occur in succession, requiring reinstitution and redesign of this team, rebranded the WE team. Interestingly, the number of incident forms per patient visits did not change when comparing 6 months during the PIT, 6 months during the hiatus, and the first 6 months after instituting the WE team (P=.85). However, 6 to 12 months after instituting the WE team, the number of incident forms per patient visits decreased (P=.028). After the WE team, employee satisfaction and commitment to quality increased as demonstrated by Gallup surveys, suggesting a correlation to the WE team. Conclusions: A team focused on addressing workflow and improving processes can reduce the number of errors reaching the patient. Time is necessary before a reduction in errors reaching patients will be seen.

  17. SAFETY

    CERN Multimedia

    M. Plagge, C. Schaefer and N. Dupont

    2013-01-01

    Fire Safety – Essential for a particle detector The CMS detector is a marvel of high technology, one of the most precise particle measurement devices we have built until now. Of course it has to be protected from external and internal incidents like the ones that can occur from fires. Due to the fire load, the permanent availability of oxygen and the presence of various ignition sources mostly based on electricity this has to be addressed. Starting from the beam pipe towards the magnet coil, the detector is protected by flooding it with pure gaseous nitrogen during operation. The outer shell of CMS, namely the yoke and the muon chambers are then covered by an emergency inertion system also based on nitrogen. To ensure maximum fire safety, all materials used comply with the CERN regulations IS 23 and IS 41 with only a few exceptions. Every piece of the 30-tonne polyethylene shielding is high-density material, borated, boxed within steel and coated with intumescent (a paint that creates a thick co...

  18. SAFETY

    CERN Multimedia

    C. Schaefer and N. Dupont

    2013-01-01

      “Safety is the highest priority”: this statement from CERN is endorsed by the CMS management. An interpretation of this statement may bring you to the conclusion that you should stop working in order to avoid risks. If the safety is the priority, work is not! This would be a misunderstanding and misinterpretation. One should understand that “working safely” or “operating safely” is the priority at CERN. CERN personnel are exposed to different hazards on many levels on a daily basis. However, risk analyses and assessments are done in order to limit the number and the gravity of accidents. For example, this process takes place each time you cross the road. The hazard is the moving vehicle, the stake is you and the risk might be the risk of collision between both. The same principle has to be applied during our daily work. In particular, keeping in mind the general principles of prevention defined in the late 1980s. These principles wer...

  19. A randomized controlled trial investigating the safety and efficacy of aripiprazole in the long-term maintenance treatment of pediatric patients with irritability associated with autistic disorder.

    Science.gov (United States)

    Findling, Robert L; Mankoski, Raymond; Timko, Karen; Lears, Katherine; McCartney, Theresa; McQuade, Robert D; Eudicone, James M; Amatniek, Joan; Marcus, Ronald N; Sheehan, John J

    2014-01-01

    To evaluate the efficacy and safety of aripiprazole versus placebo in preventing relapse of irritability symptoms associated with autistic disorder in pediatric patients. This multicenter, double-blind, randomized, placebo-controlled, relapse-prevention trial enrolled patients (6-17 years) who met the current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DMS-IV-TR) criteria for autistic disorder and who also had serious behavioral problems (ie, tantrums, aggression, self-injurious behavior, or a combination of these behavioral problems) between March 2011 and June 2012. In phase 1, single-blind aripiprazole was flexibly dosed (2-15 mg/d) for 13-26 weeks. Patients with a stable response (≥ 25% decrease in Aberrant Behavior Checklist-irritability subscale score and a rating of "much improved" or "very much improved" on the Clinical Global Impressions-Improvement scale) for 12 consecutive weeks were randomized into phase 2 to continue aripiprazole or switch to placebo. Treatment was continued until relapse or up to 16 weeks. The primary end point was time from randomization to relapse. Eighty-five patients were randomized in phase 2. The difference in time to relapse between aripiprazole and placebo was not statistically significant (P = .097). Kaplan-Meier relapse rates at week 16 were 35% for aripiprazole and 52% for placebo (hazard ratio [HR] = 0.57; number needed to treat [NNT] = 6). The most common adverse events during phase 1 were weight increase (25.2%), somnolence (14.8%), and vomiting (14.2%); and, during phase 2 (aripiprazole vs placebo), they were upper respiratory tract infection (10.3% vs 2.3%), constipation (5.1% vs 0%), and movement disorder (5.1% vs 0%). In this study, there was no statistically significant difference between aripiprazole and placebo in time to relapse during maintenance therapy. However, the HR and NNT suggest some patients will benefit from maintenance treatment. Patients receiving

  20. Virtual Pediatric Hospital

    Science.gov (United States)

    ... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant™ Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...

  1. Correlation between gadolinium-diethylenetriaminepentaacetic acid contrast enhancement and thallium-201 chloride uptake in pediatric brainstem glioma.

    Science.gov (United States)

    Maria, B L; Drane, W B; Quisling, R J; Hoang, K B

    1997-09-01

    We previously showed that thallium-201 (201Tl) chloride is accumulated in over 75% of brain tumors, including brainstem gliomas. The imaging of 201Tl with single photon emission computed tomography (SPECT) may require an abnormal increase in permeability of tumor vessels to allow penetration of the blood-brain barrier. To test this hypothesis, we evaluated the correlation between gadolinium enhancement and the degree of 201Tl uptake on SPECT and the contributions of either gadolinium enhancement or 201Tl uptake to the prognosis in children with brainstem gliomas. Forty-two sets of paired SPECT scans and magnetic resonance imaging (MRI) scans were obtained longitudinally in 13 cases. Altogether, 31 of 42 pairs (74%) of scans showed concordance between the presence of gadolinium enhancement and 201Tl uptake. There were no cases that demonstrated 201Tl uptake but lacked gadolinium enhancement. The results indicate that 201Tl SPECT is of value primarily when brainstem tumors have vessels that are demonstrably permeable to gadolinium, prior to or as a result of radiotherapy.

  2. Final report of the safety assessment of methacrylate ester monomers used in nail enhancement products.

    Science.gov (United States)

    2005-01-01

    Methacrylate ester monomers are used in as artificial nail builders in nail enhancement products. They undergo rapid polymerization to form a hard material on the nail that is then shaped. While Ethyl Methacrylate is the primary monomer used in nail enhancement products, other methacrylate esters are also used. This safety assessment addresses 22 other methacrylate esters reported by industry to be present in small percentages as artificial nail builders in cosmetic products. They function to speed up polymerization and/or form cross-links. Only Tetrahydrofurfuryl Methacrylate was reported to the FDA to be in current use. The polymerization rates of these methacrylate esters are within the same range as Ethyl Methacrylate. While data are not available on all of these methacrylate esters, the available data demonstrated little acute oral, dermal, or i.p. toxicity. In a 28-day inhalation study on rats, Butyl Methacrylate caused upper airway irritation; the NOAEL was 1801 mg/m3. In a 28-day oral toxicity study on rats, t-Butyl Methacrylate had a NOAEL of 20 mg/kg/day. Beagle dogs dosed with 0.2 to 2.0 g/kg/day of C12 to C18 methacrylate monomers for 13 weeks exhibited effects only in the highest dose group: weight loss, emesis, diarrhea, mucoid feces, or salivation were observed. Butyl Methacrylate (0.1 M) and Isobutyl Methacrylate (0.1 M) are mildly irritating to the rabbit eye. HEMA is corrosive when instilled in the rabbit eye, while PEG-4 Dimethacrylate and Trimethylolpropane Trimethacrylate are minimally irritating to the eye. Dermal irritation caused by methacrylates is documented in guinea pigs and rabbits. In guinea pigs, HEMA, Isopropylidenediphenyl Bisglycidyl Methacrylate, Lauryl Methacrylate, and Trimethylolpropane Trimethacrylate are strong sensitizers; Butyl Methacrylate, Cyclohexyl Methacrylate, Hexyl Methacrylate, and Urethane Methacrylate are moderate sensitizers; Hydroxypropyl Methacrylate is a weak sensitizer; and PEG-4 Dimethacrylate and

  3. Cost effective safety enhancements for research reactors in Uzbekistan and Kazakhstan - results of a joint program with US DOE

    International Nuclear Information System (INIS)

    Earle, O.K.; Carlson, R.B.; Rakhmanov, A.; Salikhbaev, U.S.; Chernyaev, V.; Chakrov, P.

    2004-01-01

    The US Department of Energy's Office of International Nuclear Safety and Cooperation established the Integrated Research Reactor Safety Enhancement Program (IRRSEP) in February 2002 to support U.S. nonproliferation goals by implementing safety upgrades, or assisting with the safe shutdown and decommissioning of foreign test and research reactors which present security concerns. IRRSEP's key program components are: Phase I: Self-evaluation by facility using provided checklists followed by prioritization to identify the 20 highest risk facilities; Phase II: Site visits with technical evaluation to finalize a list of projects that will enhance safety consistent with IAEA observations; Phase III: Corrective measures to implement the projects. Phases I, II and III are accomplished on a rolling basis, such that work is ongoing at three or four reactors per year. IRRSEP's key objective is to resolve the highest-priority nuclear safety issues at the most vulnerable foreign research reactors as quickly as possible. The prioritization methodology employed identified which research reactors fell into this category. The corrective measures mutually developed with the host facility are based on the premise of developing a sustainable infrastructure within each country to deal with its own nuclear material safety, security, and response issues in the future. IRRSEP also assists in creating an international framework of cooperation and openness between research and test reactor operators, and national and international regulators. The initial projects under IRRSEP are underway at research reactors in Kazakhstan, Uzbekistan, and Romania. This paper focuses on the projects undertaken at the WWR-K research reactor at the Institute of Nuclear Physics in Alatau, Kazakhstan and the WWR-SM research reactor at the Institute of Nuclear Physics in Ulugbek, Uzbekistan. These projects demonstrate the success and cost effectiveness of the IRRSEP program

  4. ENHANCED PROACTIVE PLANNING APPROACH: A CRUCIAL TO AN IMPROVED WORKERS’ SAFETY IN WESTERN NIGERIA SMALL SCALE INDUSTRY

    Directory of Open Access Journals (Sweden)

    H.O. ADEYEMI

    2016-12-01

    Full Text Available This study evaluated managements’ proactive planning approach (PPA to enhance safety among workers in South-western Nigeria small scale industry (SSI. The main objective was to rate the managements’ efforts at eliminating risk among their employees. By worker participatory and psychological survey approach, three tools were used; workplace observation (visual, management safety culture (questionnaire and managers interviews (oral. The survey included 200 workers, 120 supervisors and 80 managers, in 82 SSI. Four steps to a safety proactive action plans (PAP, (looking for clues, prioritization of identified potential hazard, making improvements to eliminate the risk and follow up, were rated by employees on a scale from 0 to 5. Paired t-test was used to appraise the significant difference between the managers’ mean scores rated by the supervisors and other workers. 77.1% of workers and 64.2% supervisors rated their managers as either “not done at all” or “poorly done”. Workers’ scores for managers PPA had statistically significantly lower ratings (mean=1.09, SEM = 0.22 compared to that of the supervisors rating (mean= 1.55, SEM = 0.32, with t (14 = -1.185, p = 0.784. There is a closed poor performance perception gaps, of managers’ PPA, of the two groups of employees. It can be concluded that safety is not emphasized, by managers of SSI, as overriding priority and this may have contributed to high reported injuries among their workforce. Courses to enhance managements’ understanding for inclusion of safety among the leading priorities becomes necessary. This will reduce work-related risks and promotes occupational safety and health among the group of workers.

  5. Cost effective safety enhancements for research reactors in Uzbekistan and Kazakhstan - results of a joint program with US DOE

    International Nuclear Information System (INIS)

    Earle, O.K.; Carlson, R.B.; Rakhmanov, A.; Salikhbaev, U.S.; Chernyaev, V.; Chakrov, P.

    2004-01-01

    Full text: The US Department of Energy's Office of International Nuclear Safety and Cooperation established the Integrated Research Reactor Safety Enhancement Program (IRRSEP) in February 2002 to support U.S. nonproliferation goals by (1) implementing safety upgrades, or (2) assisting with the safe shutdown and decommissioning of foreign test and research reactors which present security concerns. IRRSEP's key program components are: Phase I: Self-evaluation by facility using provided checklists followed by prioritization to identify the 20 highest risk facilities; Phase II: Site visits with technical evaluation to finalize a list of projects that will enhance safety consistent with IAEA observations; Phase III: Corrective measures to implement the projects. Phases I, II and III are accomplished on a rolling basis, such that work is ongoing at three or four reactors per year. IRRSEP's key objective is to resolve the highest-priority nuclear safety issues at the most vulnerable foreign research reactors as quickly as possible. The prioritization methodology employed identified which research reactors fell into this category. The corrective measures mutually developed with the host facility are based on the premise of developing a sustainable infrastructure within each country to deal with its own nuclear material safety, security, and response issues in the future. IRRSEP also assists in creating an international framework of cooperation and openness between research and test reactor operators, and national and international regulators. The initial projects under IRRSEP are underway at research reactors in Kazakhstan, Uzbekistan, and Romania. This paper focuses on the projects undertaken at the WWR-K research reactor at the Institute of Nuclear Physics in Alatau, Kazakhstan and the WWR-SM research reactor at the Institute of Nuclear Physics in Ulugbek, Uzbekistan. These projects demonstrate the success and cost effectiveness of the IRRSEP program

  6. Safety

    International Nuclear Information System (INIS)

    Jones, P.M.S.

    1987-01-01

    Aspects of fission reactors are considered - control, heat removal and containment. Brief descriptions of the reactor accidents at the SL-1 reactor (1961), Windscale (1957), Browns Ferry (1975), Three Mile Island (1979) and Chernobyl (1986) are given. The idea of inherently safe reactor designs is discussed. Safety assessment is considered under the headings of preliminary hazard analysis, failure mode analysis, event trees, fault trees, common mode failure and probabalistic risk assessments. These latter can result in a series of risk distributions linked to specific groups of fault sequences and specific consequences. A frequency-consequence diagram is shown. Fatal accident incidence rates in different countries including the United Kingdom for various industries are quoted. The incidence of fatal cancers from occupational exposure to chemicals is tabulated. Human factors and the acceptability of risk are considered. (U.K.)

  7. Pre- and post-exposure safety and efficacy of attenuated rabies virus vaccines are enhanced by their expression of IFNγ

    International Nuclear Information System (INIS)

    Barkhouse, Darryll A.; Faber, Milosz; Hooper, D. Craig

    2015-01-01

    Consistent with evidence of a strong correlation between interferon gamma (IFNγ) production and rabies virus (RABV) clearance from the CNS, we recently demonstrated that engineering a pathogenic RABV to express IFNγ highly attenuates the virus. Reasoning that IFNγ expression by RABV vaccines would enhance their safety and efficacy, we reverse-engineered two proven vaccine vectors, GAS and GASGAS, to express murine IFNγ. Mortality and morbidity were monitored during suckling mice infection, immunize/challenge experiments and mixed intracranial infections. We demonstrate that GASγ and GASγGAS are significantly attenuated in suckling mice compared to the GASGAS vaccine. GASγ better protects mice from lethal DRV4 RABV infection in both pre- and post-exposure experiments compared to GASGAS. Finally, GASγGAS reduces post-infection neurological sequelae, compared to control, during mixed intracranial infection with DRV4. These data show IFNγ expression by a vaccine vector can enhance its safety while increasing its efficacy as pre- and post-exposure treatment. - Highlights: • IFNγ expression improves attenuated rabies virus safety and immunogenicity. • IFNγ expression is safer and more immunogenic than doubling glycoprotein expression. • Co-infection with IFNγ-expressing RABV prevents wild-type rabies virus lethality. • Vaccine safety and efficacy is additive for IFNγ and double glycoprotein expression

  8. Pre- and post-exposure safety and efficacy of attenuated rabies virus vaccines are enhanced by their expression of IFNγ

    Energy Technology Data Exchange (ETDEWEB)

    Barkhouse, Darryll A. [Department of Cancer Biology, 1020 Locust St., Jefferson Alumni Hall, Room 454, Philadelphia, PA 19107 (United States); Center for Neurovirology 1020 Locust St., Jefferson Alumni Hall, Room 454, Philadelphia, PA 19107 (United States); Faber, Milosz [Center for Neurovirology 1020 Locust St., Jefferson Alumni Hall, Room 454, Philadelphia, PA 19107 (United States); Department of Microbiology and Immunology 1020 Locust St., Jefferson Alumni Hall, Room 465, Philadelphia, PA 19107 (United States); Hooper, D. Craig, E-mail: douglas.hooper@jefferson.edu [Department of Cancer Biology, 1020 Locust St., Jefferson Alumni Hall, Room 454, Philadelphia, PA 19107 (United States); Department of Neurological Surgery, 1020 Locust St., Jefferson Alumni Hall, Room 454, Philadelphia, PA 19107 (United States); Center for Neurovirology 1020 Locust St., Jefferson Alumni Hall, Room 454, Philadelphia, PA 19107 (United States)

    2015-01-01

    Consistent with evidence of a strong correlation between interferon gamma (IFNγ) production and rabies virus (RABV) clearance from the CNS, we recently demonstrated that engineering a pathogenic RABV to express IFNγ highly attenuates the virus. Reasoning that IFNγ expression by RABV vaccines would enhance their safety and efficacy, we reverse-engineered two proven vaccine vectors, GAS and GASGAS, to express murine IFNγ. Mortality and morbidity were monitored during suckling mice infection, immunize/challenge experiments and mixed intracranial infections. We demonstrate that GASγ and GASγGAS are significantly attenuated in suckling mice compared to the GASGAS vaccine. GASγ better protects mice from lethal DRV4 RABV infection in both pre- and post-exposure experiments compared to GASGAS. Finally, GASγGAS reduces post-infection neurological sequelae, compared to control, during mixed intracranial infection with DRV4. These data show IFNγ expression by a vaccine vector can enhance its safety while increasing its efficacy as pre- and post-exposure treatment. - Highlights: • IFNγ expression improves attenuated rabies virus safety and immunogenicity. • IFNγ expression is safer and more immunogenic than doubling glycoprotein expression. • Co-infection with IFNγ-expressing RABV prevents wild-type rabies virus lethality. • Vaccine safety and efficacy is additive for IFNγ and double glycoprotein expression.

  9. Integration of the advanced transparency framework to advanced nuclear systems : enhancing Safety, Operations, Security and Safeguards (SOSS)

    International Nuclear Information System (INIS)

    Mendez, Carmen Margarita; Rochau, Gary Eugene; Cleary, Virginia D.

    2008-01-01

    The advent of the nuclear renaissance gives rise to a concern for the effective design of nuclear fuel cycle systems that are safe, secure, nonproliferating and cost-effective. We propose to integrate the monitoring of the four major factors of nuclear facilities by focusing on the interactions between Safeguards, Operations, Security, and Safety (SOSS). We proposed to develop a framework that monitors process information continuously and can demonstrate the ability to enhance safety, operations, security, and safeguards by measuring and reducing relevant SOSS risks, thus ensuring the safe and legitimate use of the nuclear fuel cycle facility. A real-time comparison between expected and observed operations provides the foundation for the calculation of SOSS risk. The automation of new nuclear facilities requiring minimal manual operation provides an opportunity to utilize the abundance of process information for monitoring SOSS risk. A framework that monitors process information continuously can lead to greater transparency of nuclear fuel cycle activities and can demonstrate the ability to enhance the safety, operations, security and safeguards associated with the functioning of the nuclear fuel cycle facility. Sandia National Laboratories (SNL) has developed a risk algorithm for safeguards and is in the process of demonstrating the ability to monitor operational signals in real-time though a cooperative research project with the Japan Atomic Energy Agency (JAEA). The risk algorithms for safety, operations and security are under development. The next stage of this work will be to integrate the four algorithms into a single framework

  10. Optimization of electronic prescribing in pediatric patients

    NARCIS (Netherlands)

    Maat, B.

    2014-01-01

    Improving pediatric patient safety by preventing medication errors that may result in adverse drug events and consequent healthcare expenditure,is a worldwide challenge to healthcare. In pediatrics, reported medication error rates in general, and prescribing error rates in particular, vary between

  11. Consumers Valuations and choice Processes of Food Safety Enhancement Attributes: An International Study of Beef Consumers

    NARCIS (Netherlands)

    Tonsor, G.T.; Schroeder, T.C.; Pennings, J.M.E.; Mintert, J.

    2007-01-01

    Abstract Food safety concerns have had dramatic impacts on food and livestock markets in recent years. Here we examine consumer preferences for various beef food safety assurances. In particular, we evaluate the extent to which such preferences are heterogeneous within and across

  12. Consumer Valuations of Beef Steak Food Safety Enhancement in Canada, Japan, Mexico, and the United States

    NARCIS (Netherlands)

    Tonsor, G.T.; Schroeder, T.C.; Pennings, J.M.E.; Mintert, J.

    2009-01-01

    Food safety concerns have had dramatic impacts on food and livestock markets in recent years. We examine consumer preferences for beef steak food safety assurances. We evaluate the extent to which preferences are heterogeneous within and across country-of-residence defined groups and examine the

  13. Atypical choroid plexus papilloma: spontaneous resolution of diffuse leptomeningeal contrast enhancement after primary tumor removal in 2 pediatric cases.

    Science.gov (United States)

    Scala, Marcello; Morana, Giovanni; Milanaccio, Claudia; Pavanello, Marco; Nozza, Paolo; Garrè, Maria Luisa

    2017-09-01

    Atypical choroid plexus papillomas can metastasize in the form of leptomeningeal seeding. Postoperative chemotherapy is the recommended first-line treatment when gross-total removal is not achieved or in cases of disseminated disease. Here the authors report on 2 children with atypical choroid plexus papillomas and MRI findings of diffuse leptomeningeal enhancement at diagnosis, later presenting with spontaneous resolution of the leptomeningeal involvement after removal of the primary lesions. Observations in this report expand our knowledge about the natural history and biological behavior of these tumors and highlight the role of close neuroimaging surveillance in the management of atypical choroid plexus papillomas in cases with MRI evidence of diffuse leptomeningeal enhancement at presentation.

  14. ENHANCEMENT OF ROAD SAFETY THROUGH MORE EFFECTIVE ROAD AND TRAFFIC MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Tomasz SZCZURASZEK

    2016-07-01

    Full Text Available To make the policy aimed at mitigating the risk of road incidents more effective, Poland should see the introduction of the more efficient road and traffic management. In November 2008 the European Parliament and the European Council published the Directive on "infrastructure safety management" which provides guidance on the procedures for carrying impact assessments of traffic safety, traffic safety audits, safety management on the road network and monitoring traffic safety in Member States. In this article, the authors have proposed a systemic approach to road and traffic management, involving the implementation of consistent procedures that should include regular revisions of roads, eliminating hazardous sites, speed management, as well as the approval and implementation of traffic organization designs.

  15. Critical Elements for the Pediatric Perioperative Anesthesia Environment.

    Science.gov (United States)

    Polaner, David M; Houck, Constance S

    2015-12-01

    The American Academy of Pediatrics proposes guidance for the pediatric perioperative anesthesia environment. Essential components are identified to optimize the perioperative environment for the anesthetic care of infants and children. Such an environment promotes the safety and well-being of infants and children by reducing the risk of adverse events. Copyright © 2015 by the American Academy of Pediatrics.

  16. IAEA Says Finland's Loviisa Nuclear Power Plant Committed to Safety, Sees Areas for Enhancement

    International Nuclear Information System (INIS)

    2018-01-01

    An International Atomic Energy Agency (IAEA) team of experts said the operator of Finland’s Loviisa Nuclear Power Plant (NPP) demonstrated a commitment to safety. The team also identified areas for further enhancement. The Operational Safety Review Team (OSART) concluded an 18-day mission on 22 March to Loviisa NPP, whose two 531-MWe pressurized-water reactors started commercial operation in 1977 and 1980, respectively. Fortum Power and Heat OY operate the plant, located about 100 km east of Helsinki, the capital. Nuclear power generates one-third of electricity in Finland, which has four operating power reactors and is constructing a fifth reactor. OSART missions aim to improve operational safety by objectively assessing safety performance using the IAEA’s safety standards and proposing improvement where appropriate. The 16-member team comprised experts from Brazil, Canada, China, France, Germany, Hungary, Romania, Russia Federation, Slovak Republic, South Africa, Spain, Ukraine, United Kingdom, United States of America as well as IAEA officials. The review covered the areas of leadership and management for safety; training and qualification; operations; maintenance; technical support; operating experience; radiation protection; chemistry; emergency preparedness and response; accident management; human, technology and organizational interactions; and long-term operation. The team identified a number of good practices that will be shared with the nuclear industry globally, including: • The plant has developed the capability to automatically calculate leak rate tests of containment. • The plant established a process to test and improve modifications and updates early. • The plant has adopted a key system to effectively control access to various rooms in the plant. The mission made several proposals to improve operational safety, including: • The plant management should improve communications of their expectations and consistently reinforce their

  17. Completion of the VVER 440/213 NPP Mochovce incorporation enhanced safety features

    International Nuclear Information System (INIS)

    Charbonneau, S.; Eckert, G.

    1996-01-01

    The cooperation between the western countries and the countries of ex-eastern block in the field of nuclear safety is recent and still limited. The main reasons for this situation are limited or non existent capabilities of these countries for financing as well as non acceptable legal conditions concerning the third party nuclear liability in this part of Europe. Nevertheless, Framatome and Siemens associated in the consortium named EUCOM, have signed in April 1996 the contract of about 100 million US dollars with Slovak electricity company (SLOVENSKE ELEKTRARNE-SE) for upgrading the Units 1 and 2 of Mochovce Nuclear Power Plant according to the western safety standards. This is the first important project involving west-european companies in the modernisation of Russian type of pressurized water reactor (VVER 440/213). The consortium will cooperate with other partners involved in the project: Slovak, Czech and Russian. The financing of the project will be provided mainly form Slovak and Czech sources. The safety upgrading will be financed through French and German buyer credits. French company Electricite de France (EDF) will be the consultant for SE. The safety upgrading measures have been elaborated taking into account the recommendation of Vienna International Atomic Energy Agency (IAEA) and the evaluation of the safety realised by RISKAUDIT, the common organization of German and French safety authorities (GSR and IPSN). Hence all guaranties have been taken to fulfil the western safety criteria for Nuclear Power Plant Mochovce. (author)

  18. A Study on Enhancement of Understanding of Radiation and Safety Management

    International Nuclear Information System (INIS)

    Yoo, Dong Han; Park, Ji Young; Lee, Jae Uk; Bae, Jun Woo; Kim, Hee Reyoung

    2014-01-01

    Concerns for radiation exposure have been increased from small and big radiation works or experiments with radiation generator (RG) or radiation isotopes (RI) at institutions using radiation in Korea. Actually, due to radiation exposure occurred on the process of handling RI, etc., The exposure should be maintained as low as reasonably possible. To do this, above all, suitable training and establishment of safety culture have to be preceded. In this respect, an education institution is a place where people learn first about handling radiations in various specialties with purposes including academic research, and the first learned habits and practices acts as the basis for safety management of radiation when they continue to do radiation work after going into the society. Hereford, it is needed to establish the right safety culture on radiation for its safe managing. In the present study, the direction for the right understandings and safety improvement are suggested through the radiation survey on education institutions and preparation of safety guidances for users. The basic guidance at the radiation experiment was prepared for the right understanding of the radiation to prevent radiation accidents from careless handling by workers based on the surveyed results for education institutions. It is expected to be used as fundamentals for improvement for radiation safety management of workers and researchers and, further, safety policy for national nuclear energy and radiations

  19. A Study on Enhancement of Understanding of Radiation and Safety Management

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Dong Han; Park, Ji Young; Lee, Jae Uk; Bae, Jun Woo; Kim, Hee Reyoung [Ulsan National Institute of Science and Technology, Ulsan (Korea, Republic of)

    2014-10-15

    Concerns for radiation exposure have been increased from small and big radiation works or experiments with radiation generator (RG) or radiation isotopes (RI) at institutions using radiation in Korea. Actually, due to radiation exposure occurred on the process of handling RI, etc., The exposure should be maintained as low as reasonably possible. To do this, above all, suitable training and establishment of safety culture have to be preceded. In this respect, an education institution is a place where people learn first about handling radiations in various specialties with purposes including academic research, and the first learned habits and practices acts as the basis for safety management of radiation when they continue to do radiation work after going into the society. Hereford, it is needed to establish the right safety culture on radiation for its safe managing. In the present study, the direction for the right understandings and safety improvement are suggested through the radiation survey on education institutions and preparation of safety guidances for users. The basic guidance at the radiation experiment was prepared for the right understanding of the radiation to prevent radiation accidents from careless handling by workers based on the surveyed results for education institutions. It is expected to be used as fundamentals for improvement for radiation safety management of workers and researchers and, further, safety policy for national nuclear energy and radiations.

  20. Efficacy and safety of penile girth enhancement by autologous fat injection for patients with thin penises.

    Science.gov (United States)

    Kang, Dong Hyuk; Chung, Jae Hoon; Kim, Yong Jin; Lee, Haeng Nam; Cho, Seung Hoon; Chang, Taek Hee; Lee, Seung Wook

    2012-08-01

    This study aimed to investigate the efficacy and safety of autologous fat injection (AFI) for penile girth enhancement (PGE) in patients with thin penises. This study investigated 52 patients with a small penile circumference who underwent AFI for PGE and were followed up for more than 6 months. The patients whose proximal one third (G1) and distal one third of their penis (G2) had a mean thickness of 7.4 cm or less were selected as subjects. After fat suction using a liposuction device, fat was evenly injected into the superficial, middle, and deep layers of the Colles' fascia. Patient age and operative time were analyzed. The G1, G2, flaccid (L1), stretched length (L2), and five-item version of the International Index of Erectile Function-5 (IIEF-5) before and 6 months after the surgery were compared. Postoperative complications were surveyed. The patient mean age was 42.15 years (range, 22-56) years, and the operative time was 44.44 min (range, 37-49 min). The injected fat volume was 38.54 ml (range, 25-49 ml). Preoperatively, G1 was 7.01±0.39 cm, and G2 was 7.06±0.37 cm. Postoperatively, G1 was 9.29±0.82 cm (P<0.001), and G2 was 9.34±0.86 (P<0.001) cm 6 months after the surgery. The difference between L1 and L2 before and after the surgery was not significant. The IIEF-5 was 19.10±3.22 before the surgery and 19.90±3.05 after the surgery (P=0.001). The only complication was nodular fat observed in one case (1.92%). The use of AFI for PGE in men with thin penises was effective and safe without major complications. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266.

  1. Pediatric Terminology

    Science.gov (United States)

    The National Institute of Child Health and Human Development (NICHD) works with NCI Enterprise Vocabulary Services (EVS) to provide standardized terminology for coding pediatric clinical trials and other research activities.

  2. Pediatric MRI

    Data.gov (United States)

    U.S. Department of Health & Human Services — The NIH Study of Normal Brain Development is a longitudinal study using anatomical MRI, diffusion tensor imaging (DTI), and MR spectroscopy (MRS) to map pediatric...

  3. International conference on challenges faced by technical and scientific support organizations in enhancing nuclear safety. Contributed papers and presentations

    International Nuclear Information System (INIS)

    2007-01-01

    Over the past two decades, the IAEA has conducted a series of major conferences that have addressed topical issues and strategies critical to nuclear safety for consideration by the world's nuclear regulators. More recently, the IAEA organized the International Conference on Effective Nuclear Regulatory Systems - Facing Safety and Security Challenges, held in Moscow in 2006. The Moscow conference was the first of its kind, because it brought together senior regulators of nuclear safety, radiation safety and security from around the world to discuss how to improve regulatory effectiveness with the objective of improving the protection of the public and the users of nuclear and radioactive material. The International Conference on Challenges Faced by Technical and Scientific Support Organizations in Enhancing Nuclear Safety was held in Aix-en-Provence, France, from 23 to 27 April 2007. This conference, again, was the first of its kind, because it was the first to address technical and scientific support organizations (TSOs), the role they play in supporting either the national regulatory bodies or the industry in making optimum safety decisions and the challenges they face in providing this support. This conference provided a forum for the TSOs to discuss these and other issues with the organizations to which they provide this support - that is, the regulators and the operators/industry - as well as with other stakeholders such as research organizations and public authorities. This conference can also be considered to have a link to the Moscow conference. The Moscow conference concluded that effective regulation of nuclear safety is vital for the safe use of nuclear energy and associated technologies, both now and in the future, and is an essential prerequisite for establishing an effective Global Nuclear Safety Regime. The Moscow conference also highlighted the importance of continued and improved international cooperation in the area of nuclear safety. These

  4. Intelligent Information Processing for Enhanced Safety in the NAS, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose a system that focuses on how improved information flow between agents acting in a flight deck environment can improve safety performance. Agents are...

  5. High Energy Density Solid State Li-ion Battery with Enhanced Safety, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose to develop an all solid state Li-ion battery which is capable of delivering high energy density, combined with high safety over a wide operating...

  6. Intelligent Information Processing for Enhanced Safety in the NAS, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Our Phase I work focused on how improved information flow between actors in a flight deck environment can improve safety performance. An operational prototype was...

  7. Research activities of MPA, Stuttgart University, for enhanced safety and reliability of components under complex load

    International Nuclear Information System (INIS)

    Herter, K.H.; Roos, E.; Schuler, X.; Maile, K.

    2004-01-01

    MPA research activities focus on fracture prevention and on the development of a generally applicable method of component integrity testing which, independent of the safety relevance of the components involved, is also part of ageing management. (orig.) [de

  8. Enhancement of a radiation safety system through the use of a microprocessor-controlled speech synthesizer

    International Nuclear Information System (INIS)

    Keefe, D.J.; McDowell, W.P.

    1980-01-01

    A speech synthesizer is being used to differentiate eight separate safety alarms on a high energy accelerator at Argonne National Laboratory. A single board microcomputer monitors eight signals from an existing radiation safety logic circuit. The microcomputer is programmed to output the proper code at the proper time and sequence to a speech synthesizer which supplies the audio input to a local public address system. This eliminates the requirement for eight different alarm tones and the personnel training required to differentiate among them. A twenty-word vocabulary was found adequate to supply the necessary safety announcements. The article describes the techniques used to interface the speech synthesizer into the existing safety logic circuit

  9. Enhancing food safety: the role of the Food and Drug Administration

    National Research Council Canada - National Science Library

    Wallace, Robert B; Oria, Maria

    2010-01-01

    .... Food and Drug Administration's abilities to discover potential threats to food safety and prevent outbreaks of foodborne illness are hampered by impediments to efficient use of its limited resources...

  10. PRACA Enhancement Pilot Study Report: Engineering for Complex Systems Program (formerly Design for Safety), DFS-IC-0006

    Science.gov (United States)

    Korsmeyer, David; Schreiner, John

    2002-01-01

    This technology evaluation report documents the findings and recommendations of the Engineering for Complex Systems Program (formerly Design for Safety) PRACA Enhancement Pilot Study of the Space Shuttle Program's (SSP's) Problem Reporting and Corrective Action (PRACA) System. A team at NASA Ames Research Center (ARC) performed this Study. This Study was initiated as a follow-on to the NASA chartered Shuttle Independent Assessment Team (SIAT) review (performed in the Fall of 1999) which identified deficiencies in the current PRACA implementation. The Pilot Study was launched with an initial qualitative assessment and technical review performed during January 2000 with the quantitative formal Study (the subject of this report) started in March 2000. The goal of the PRACA Enhancement Pilot Study is to evaluate and quantify the technical aspects of the SSP PRACA systems and recommend enhancements to address deficiencies and in preparation for future system upgrades.

  11. The learning experiences of student nurses in pediatric medication management: a qualitative study.

    Science.gov (United States)

    Lin, Fang-Yi; Wu, Wei-Wen; Lin, Hung-Ru; Lee, Tzu-Ying

    2014-05-01

    Traditionally, the 'five rights' (right patient, right route, right drug, right time, and right dose) principle is taught to be practiced during every medication administration process. Nursing educators use this principle to evaluate student performance. However, health care unit factors and education system characteristics that can contribute to student errors should not be underestimated. Students often felt stressed when medicating children during clinical practicum. The voices of these students are rarely represented. To understand students' experiences and perceptions of medication administration during their pediatric clinical practicum. A descriptive qualitative study design was adopted. A university in Northern Taiwan. A total of 34 undergraduate students who had completed a pediatric clinical practicum participated in a one-on-one interview. Each student was interviewed according to a semi-structured interview guide and was encouraged to disclose individual feelings and thoughts toward their experiences in pediatric medication administration. Eight themes emerged. The findings suggest that to decrease students' anxiety and increase their competence, pediatric instructors should improve their teaching strategies to better prepare students for clinical training. Providing self-directed learning activities and resources to improve students' familiarity with medication and medication safety knowledge is necessary. Instructors should provide students with a secure environment to discuss their medication errors. The 'nine rights' should be taught in fundamental nursing courses to enhance students' awareness during the medication administration process, and students should continue to practice the 'nine rights' in later pediatric clinical courses. Equal importance should be given to system failures that impact patient safety. © 2013.

  12. Pediatric emergency medicine: Optimizing risk assessment and safety netting in children with infectious diseases : Spoedeisende Kindergeneeskunde: Optimaliseren van risico inschatting en het vangnet rondom kinderen met koorts

    NARCIS (Netherlands)

    D.H.F. Geurts (Dorien)

    2018-01-01

    markdownabstractIntroduction In the introduction, the importance of good quality pediatric emergency care is explained. Acute illnesses in children differ among countries and settings. Regarding our population of the ED at the Erasmus MC in Rotterdam, The Netherlands, 1) we still observe

  13. Combination treatment of extensive and recalcitrant alopecia areata with oral and topical steroids with topical minoxidil: An open-label study of efficacy and safety in pediatric patients

    Directory of Open Access Journals (Sweden)

    Vivek Kumar Dey

    2016-01-01

    Conclusion: Finding an effective and safe treatment regimen for AA, especially in children is difficult. Our regimen allows for more rapid lowering of oral doses with maintaining the cosmetic response and minimizing the side effects. Therefore, a trial course of this regiment would seem to be a reasonable approach for nearly hopeless but highly motivated pediatric patients of extensive and recalcitrant AA.

  14. The increased use of radiation requires enhanced activities regarding radiation safety control

    International Nuclear Information System (INIS)

    Lee, Yun Jong; Lee, Jin Woo; Jeong, Gyo Seong

    2015-01-01

    More recently, companies that have obtained permission to use radioactive materials or radiation device and registered radiation workers have increased by 10% and 4% respectively. The increased use of radiation could have an effect on radiation safety control. However, there is not nearly enough manpower and budget compared to the number of workers and facilities. This paper will suggest a counteroffer thought analyzing pending issues. The results of this paper indicate that there are 47 and 31.3 workers per radiation protection officer in educational and research institutes, respectively. There are 20.1 persons per RPO in hospitals, even though there are 2 RPOs appointed. Those with a special license as a radioisotope handler were ruled out as possible managers because medical doctors who have a special license for radioisotope handling normally have no experience with radiation safety. The number of staff members and budget have been insufficient for safety control at most educational and research institutes. It is necessary to build an optimized safety control system for effective Radiation Safety Control. This will reduce the risk factor of safety, and a few RPOs can be supplied for efficiency and convenience

  15. The increased use of radiation requires enhanced activities regarding radiation safety control

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yun Jong; Lee, Jin Woo; Jeong, Gyo Seong [Korea Atomic Energy Research Institute, Jeongeup (Korea, Republic of)

    2015-05-15

    More recently, companies that have obtained permission to use radioactive materials or radiation device and registered radiation workers have increased by 10% and 4% respectively. The increased use of radiation could have an effect on radiation safety control. However, there is not nearly enough manpower and budget compared to the number of workers and facilities. This paper will suggest a counteroffer thought analyzing pending issues. The results of this paper indicate that there are 47 and 31.3 workers per radiation protection officer in educational and research institutes, respectively. There are 20.1 persons per RPO in hospitals, even though there are 2 RPOs appointed. Those with a special license as a radioisotope handler were ruled out as possible managers because medical doctors who have a special license for radioisotope handling normally have no experience with radiation safety. The number of staff members and budget have been insufficient for safety control at most educational and research institutes. It is necessary to build an optimized safety control system for effective Radiation Safety Control. This will reduce the risk factor of safety, and a few RPOs can be supplied for efficiency and convenience.

  16. Pediatric sleep apnea

    Science.gov (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... Untreated pediatric sleep apnea may lead to: High blood pressure Heart or lung problems Slow growth and development

  17. The 2011 Tuscaloosa tornado: integration of pediatric disaster services into regional systems of care.

    Science.gov (United States)

    Kanter, Robert K

    2012-09-01

    To empirically describe the integration of pediatric disaster services into regional systems of care after the April 27, 2011, tornado in Tuscaloosa, Alabama, a community with no pediatric emergency department or pediatric intensive care unit and few pediatric subspecialists. Data were obtained in interviews with key informants including professional staff and managers from public health and emergency management agencies, prehospital emergency medical services, fire departments, hospital nurses, physicians, and the trauma program coordinator. A single hospital in Tuscaloosa served 800 patients on the night of the tornado. More than 100 of these patients were children, including more than 20 with critical injuries. Many children were unaccompanied and unidentified on arrival. Resuscitation and stabilization were performed by nonpediatric prehospital and emergency department staff. More than 20 children were secondarily transported to the nearest children's hospital an hour's drive away under the care of nonpediatric local emergency medical services providers. No preventable adverse events were identified in the resuscitation and secondary transport phases of care. Stockpiled supplies and equipment were adequate to serve the needs of the disaster victims, including the children. Essential aspects of preparation include pediatric-specific clinical skills, supplies and equipment, operational disaster plans, and interagency practice embedded in everyday work. Opportunities for improvement identified include more timely response to warnings, improved practices for identifying unaccompanied children, and enhanced child safety in shelters. Successful responses depended on integration of pediatric services into regional systems of care. Copyright © 2012 Mosby, Inc. All rights reserved.

  18. Pediatric digital chest imaging.

    Science.gov (United States)

    Tarver, R D; Cohen, M; Broderick, N J; Conces, D J

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology.

  19. Pediatric digital chest imaging

    International Nuclear Information System (INIS)

    Tarver, R.D.; Cohen, M.; Broderick, N.J.; Conces, D.J. Jr.

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology

  20. TPE upgrade for enhancing operational safety and improving in-vessel tritium inventory assessment in fusion nuclear environment

    Energy Technology Data Exchange (ETDEWEB)

    Shimada, M., E-mail: Masashi.Shimada@inl.gov [Fusion Safety Program, Idaho National Laboratory, Idaho Falls, ID 83415 (United States); Taylor, C.N.; Moore-McAteer, L.; Pawelko, R.J. [Fusion Safety Program, Idaho National Laboratory, Idaho Falls, ID 83415 (United States); Kolasinski, R.D.; Buchenauer, D.A. [Sandia National Laboratories, Hydrogen and Materials Science Department, Livermore, CA 94550 (United States); Cadwallader, L.C.; Merrill, B.J. [Fusion Safety Program, Idaho National Laboratory, Idaho Falls, ID 83415 (United States)

    2016-11-01

    The Tritium Plasma Experiment (TPE) is a unique high-flux linear plasma device that can handle beryllium, tritium, and neutron-irradiated plasma facing materials, and is the only existing device dedicated to evaluate in-vessel tritium inventory in the nuclear environment for fusion safety. The electrical upgrade were recently carried out to enhance operational safety and to improve plasma performance. New DC power supplies and a new control center enable remote plasma operations from outside of the contamination area for tritium, minimizing the possible exposure risk with tritium and beryllium and eliminating heat stress issue. In November 2015, the TPE successfully achieved first deuterium plasma via remote operation after a significant three-year upgrade. Simple linear scaling estimate showed that the TPE is expected to achieve Γ{sub i}{sup max} of >1.0 × 10{sup 23} m{sup −2} s{sup −1} and q{sub heat} of >1 MW m{sup −2} with new power supplies. This upgrade not only improves operational safety of the worker, but also enhances plasma performance to better simulate extreme plasma-material conditions expected in ITER, FNSF, and DEMO for improving in-vessel tritium inventory assessment in fusion nuclear environment.

  1. Pediatric melanoma: incidence, treatment, and prognosis

    Directory of Open Access Journals (Sweden)

    Saiyed FK

    2017-04-01

    Full Text Available Faiez K Saiyed,1 Emma C Hamilton,1 Mary T Austin,1,2 1Department of Pediatric Surgery, McGovern Medical School, 2Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: The purpose of this review is to outline recent advancements in diagnosis, treatment, and prevention of pediatric melanoma. Despite the recent decline in incidence, it continues to be the deadliest form of skin cancer in children and adolescents. Pediatric melanoma presents differently from adult melanoma; thus, the traditional asymmetry, border irregularity, color variegation, diameter >6 mm, and evolution (ABCDE criteria have been modified to include features unique to pediatric melanoma (amelanotic, bleeding/bump, color uniformity, de novo/any diameter, evolution of mole. Surgical and medical management of pediatric melanoma continues to derive guidelines from adult melanoma treatment. However, more drug trials are being conducted to determine the specific impact of drug combinations on pediatric patients. Alongside medical and surgical treatment, prevention is a central component of battling the incidence, as ultraviolet (UV-related mutations play a central role in the vast majority of pediatric melanoma cases. Aggressive prevention measures targeting sun safety and tanning bed usage have shown positive sun-safety behavior trends, as well as the potential to decrease melanomas that manifest later in life. As research into the field of pediatric melanoma continues to expand, a prevention paradigm needs to continue on a community-wide level. Keywords: melanoma, pediatric, adolescent, childhood

  2. Development of a Pediatric Adverse Events Terminology.

    Science.gov (United States)

    Gipson, Debbie S; Kirkendall, Eric S; Gumbs-Petty, Brenda; Quinn, Theresa; Steen, A; Hicks, Amanda; McMahon, Ann; Nicholas, Savian; Zhao-Wong, Anna; Taylor-Zapata, Perdita; Turner, Mark; Herreshoff, Emily; Jones, Charlotte; Davis, Jonathan M; Haber, Margaret; Hirschfeld, Steven

    2017-01-01

    In 2009, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) established the Pediatric Terminology Harmonization Initiative to establish a core library of terms to facilitate the acquisition and sharing of knowledge between pediatric clinical research, practice, and safety reporting. A coalition of partners established a Pediatric Terminology Adverse Event Working Group in 2013 to develop a specific terminology relevant to international pediatric adverse event (AE) reporting. Pediatric specialists with backgrounds in clinical care, research, safety reporting, or informatics, supported by biomedical terminology experts from the National Cancer Institute's Enterprise Vocabulary Services participated. The multinational group developed a working definition of AEs and reviewed concepts (terms, synonyms, and definitions) from 16 pediatric clinical domains. The resulting AE terminology contains >1000 pediatric diseases, disorders, or clinical findings. The terms were tested for proof of concept use in 2 different settings: hospital readmissions and the NICU. The advantages of the AE terminology include ease of adoption due to integration with well-established and internationally accepted biomedical terminologies, a uniquely temporal focus on pediatric health and disease from conception through adolescence, and terms that could be used in both well- and underresourced environments. The AE terminology is available for use without restriction through the National Cancer Institute's Enterprise Vocabulary Services and is fully compatible with, and represented in, the Medical Dictionary for Regulatory Activities. The terminology is intended to mature with use, user feedback, and optimization. Copyright © 2017 by the American Academy of Pediatrics.

  3. Enhanced prefrontal functional–structural networks to support postural control deficits after traumatic brain injury in a pediatric population

    Directory of Open Access Journals (Sweden)

    Ibai Diez

    2017-06-01

    Full Text Available Traumatic brain injury (TBI affects structural connectivity, triggering the reorganization of structural–functional circuits in a manner that remains poorly understood. We focus here on brain network reorganization in relation to postural control deficits after TBI. We enrolled young participants who had suffered moderate to severe TBI, comparing them to young, typically developing control participants. TBI patients (but not controls recruited prefrontal regions to interact with two separated networks: (1 a subcortical network, including parts of the motor network, basal ganglia, cerebellum, hippocampus, amygdala, posterior cingulate gyrus, and precuneus; and (2 a task-positive network, involving regions of the dorsal attention system, together with dorsolateral and ventrolateral prefrontal regions. We also found that the increased prefrontal connectivity in TBI patients was correlated with some postural control indices, such as the amount of body sway, whereby patients with worse balance increased their connectivity in frontal regions more strongly. The increased prefrontal connectivity found in TBI patients may provide the structural scaffolding for stronger cognitive control of certain behavioral functions, consistent with the observations that various motor tasks are performed less automatically following TBI and that more cognitive control is associated with such actions. Using a new hierarchical atlas whose modules are relevant for both structure and function, we found increased structural and functional connectivity in prefrontal regions in TBI patients as compared to controls, in addition to a general pattern of overall decreased connectivity across the TBI brain. Although this increased prefrontal connectivity reflected interactions between brain areas when participants were at rest, the enhanced connectivity was found to be negatively correlated with active behavior such as postural control performance. Thus our findings, obtained

  4. Using level-I PRA for enhanced safety of the advanced neutron source reactor

    International Nuclear Information System (INIS)

    Ramsey, C.T.; Linn, M.A.

    1995-01-01

    The phase-1, level-I probabilistic risk assessment (PRA) of the Advanced Neutron Source (ANS) reactor has been completed as part of the conceptual design phase of this proposed research facility. Since project inception, PRA and reliability concepts have been an integral part of the design evolutions contributing to many of the safety features in the current design. The level-I PRA has been used to evaluate the internal events core damage frequency against project goals and to identify systems important to safety and availability, and it will continue to guide and provide support to accident analysis, both severe and nonsevere. The results also reflect the risk value of defense-in-depth safety features in reducing the likelihood of core damage

  5. The SHIELD (Safety & Health Improvement: Enhancing Law Enforcement Departments Study: Feasibility and Findings

    Directory of Open Access Journals (Sweden)

    Kerry Stephen Kuehl

    2014-05-01

    Full Text Available This randomized prospective trial aimed to assess the feasibility and efficacy of a team-based worksite health and safety intervention for law enforcement personnel. Four-hundred and eight subjects were enrolled and half were randomized to meet participants met for weekly, peer-led sessions delivered from a scripted team-based health and safety curriculum. Curriculum addressed: exercise, nutrition, stress, sleep, body weight, injury, and other unhealthy lifestyle behaviours such as smoking and heavy alcohol use. Health and safety questionnaires administered before and after the intervention found significant improvements for increased fruit and vegetable consumption, overall healthy eating, increased sleep quantity and sleep quality, and reduced personal stress.

  6. Enhancing nuclear safety verification ability for personnel of regulatory body in Vietnam

    International Nuclear Information System (INIS)

    Tu, Nguyen Hoang; Choi, Kwang Sik

    2012-01-01

    A major issue dominating the nuclear energy development program is the availability of sufficient human resources. Vietnam needs to have significant numbers of engineers, technicians, and scientists in order to support and ensure the safety of nuclear power plant which will be paramount as the government's goal. In particular, to ensure safety in utilization of nuclear energy, a country embarking on a nuclear power program should consider the early establishment of a regulatory body which regulates nuclear power plants at all stages to protect public from radiation hazards and to preserve the environment. In this paper, some lessons learned and the status of human resource development for nuclear safety in Vietnam is presented. Some recommendations, proposed ideas are given on strategy development of human resource

  7. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed ...

  8. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen ...

  9. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance ...

  10. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... work? Unlike conventional x-ray examinations and computed tomography (CT) scans, MRI does not utilize ionizing radiation. Instead, ... Angiography Magnetic Resonance, Functional (fMRI) - Brain Children's (Pediatric) CT (Computed Tomography) Magnetic Resonance Imaging (MRI) Safety Contrast Materials Children ...

  11. Gadolinium-based contrast agents in pediatric magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gale, Eric M.; Caravan, Peter [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, The Martinos Center for Biomedical Imaging, Boston, MA (United States); Rao, Anil G. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); McDonald, Robert J. [College of Medicine, Mayo Clinic, Department of Radiology, Rochester, MN (United States); Winfeld, Matthew [University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (United States); Fleck, Robert J. [Cincinnati Children' s Hospital Medical Center, Department of Pediatric Radiology, Cincinnati, OH (United States); Gee, Michael S. [MassGeneral Hospital for Children, Harvard Medical School, Division of Pediatric Imaging, Department of Radiology, Boston, MA (United States)

    2017-05-15

    Gadolinium-based contrast agents can increase the accuracy and expediency of an MRI examination. However the benefits of a contrast-enhanced scan must be carefully weighed against the well-documented risks associated with administration of exogenous contrast media. The purpose of this review is to discuss commercially available gadolinium-based contrast agents (GBCAs) in the context of pediatric radiology. We discuss the chemistry, regulatory status, safety and clinical applications, with particular emphasis on imaging of the blood vessels, heart, hepatobiliary tree and central nervous system. We also discuss non-GBCA MRI contrast agents that are less frequently used or not commercially available. (orig.)

  12. Use of Active-Play Video Games to Enhance Aerobic Fitness in Schizophrenia: Feasibility, Safety, and Adherence.

    Science.gov (United States)

    Kimhy, David; Khan, Samira; Ayanrouh, Lindsey; Chang, Rachel W; Hansen, Marie C; Lister, Amanda; Ballon, Jacob S; Vakhrusheva, Julia; Armstrong, Hilary F; Bartels, Matthew N; Sloan, Richard P

    2016-02-01

    Active-play video games have been used to enhance aerobic fitness in various clinical populations, but their use among individuals with schizophrenia has been limited. Feasibility, acceptability, safety, and adherence data were obtained for use of aerobic exercise (AE) equipment by 16 individuals with schizophrenia during a 12-week AE program consisting of three one-hour exercise sessions per week. Equipment included exercise video games for Xbox 360 with Kinect motion sensing devices and traditional exercise equipment. Most participants (81%) completed the training, attending an average of 79% of sessions. The proportion of time spent playing Xbox (39%) exceeded time spent on any other type of equipment. When using Xbox, participants played 2.24±1.59 games per session and reported high acceptability and enjoyment ratings, with no adverse events. Measures of feasibility, acceptability, adherence, and safety support the integration of active-play video games into AE training for people with schizophrenia.

  13. Enhanced operational safety of BWRs by advanced computer technology and human engineering

    International Nuclear Information System (INIS)

    Tomizawa, T.; Fukumoto, A.; Neda, T.; Toda, Y.; Takizawa, Y.

    1984-01-01

    In BWR nuclear power plants, where unit capacity is increasing and the demand for assured safety is growing, it has become important for the information interface between man and machine to work smoothly. Efforts to improve man-machine communication have been going on for the past ten years in Japan. Computer facilities and colour CRT display systems are amongst the most useful new methods. Advanced computer technology has been applied to operating plants and found to be very helpful for safe operation. A display monitoring system (DMS) is in operation in a 1100 MW(e) BWR plant. A total combination test was successfully completed on the 'plant operation by displayed information and automation' system (PODIA) in February 1983 before shipment to the site. The objective of this test was to verify the improved qualification of the newly developed advanced PODIA man-machine system by this enlarged fabrication test concept. In addition, the development of special graphics displays for the main control room and technical support centre to assist operators in assessing plant safety and diagnosing problems is required to meet post-TMI regulations. For this purpose, a prototype safety parameter display system (called Toshiba SPDS) with two colour CRT displays and a computer (TOSBAC-7/70) was developed in 1981 as an independent safety monitoring system. The PODIA and SPDS are now independent systems, but their combination has been found to be more useful and valuable for nuclear power plant safety. The paper discusses supervisory and operational concepts in the advanced main control room including SPDS, and describes the PODIA and SPDS verification tests including the valuable experience obtained after improvements in the qualification of these systems had been made to satisfactory operational safety levels. (author)

  14. Efforts toward enhancing seismic safety at Kashiwazaki Kariwa nuclear power station

    Energy Technology Data Exchange (ETDEWEB)

    Yamashita, Kazuhiko

    2010-09-15

    Kashiwazaki-Kariwa Nuclear Power Station, 8212MW, was struck by M6.8 quakes in July 2007. TEPCO has steadily been conducting restoration and post-earthquake equipment integrity assessment, aiming to make it a disaster-resistant power station. 2 units among 7 resumed commercial operation by June 2010. This earthquake has provided a great deal of knowledge and information useful for nuclear safety improvement. It has also served as a valuable reference for the IAEA in developing earthquake-related guidelines. TEPCO would like to share the knowledge and information thereby contributing to improving the safety of nuclear power generation. We will introduce some of our activities.

  15. Bow tie methodology: a tool to enhance the visibility and understanding of nuclear safety cases

    International Nuclear Information System (INIS)

    Vannerem, Marc

    2013-01-01

    There is much common ground between the nuclear industry and other major hazard industries such as those subject to the Seveso II regulations, e.g. oil, gas and chemicals. They are all subject to legal requirements to identify and control hazards, and to demonstrate that all necessary measures have been taken to minimise risks posed by the site with regard to people and the environment. This places a requirement on the Operators of major hazard installations, whether nuclear or conventional, to understand and identify the hazards of their operations, the initiating events, the consequences, the prevention and mitigation measures. However, in the UK, nuclear and 'Seveso' type facilities seem to adopt a different approach to the presentation of their safety cases. Given the magnitude of the hazards, safety cases developed for nuclear fuel cycle facilities are rigorous, detailed and complex, which can have the effect of reducing the visibility of the key hazards and corresponding protective measures. In contrast, on installations in the oil and gas and chemical industries, a real attempt has been made over recent years to improve the visibility and accessibility of the safety case to all operating personnel, through the use of visual aids / diagrams. In particular, many Operators are choosing to use 'bow tie methodology', in which very simple overview diagrams are produced to illustrate, in a form understandable by all: - what the key hazards are; - the initiating events; - the consequences of an incident; - the barriers or 'Layers of Protection' which prevent an initiating event from developing into an incident; - the barriers or 'Layers of Defence' which mitigate the consequences of an incident, i.e. which prevent the incident from escalating into major consequences. The bow tie method is one of a number of methodologies that can be used to make safety cases more accessible. It is used in this paper to illustrate ways to

  16. Latanoprost systemic exposure in pediatric and adult patients with glaucoma

    DEFF Research Database (Denmark)

    Raber, Susan; Courtney, Rachel; Maeda-Chubachi, Tomoko

    2011-01-01

    To evaluate short-term safety and steady-state systemic pharmacokinetics (PK) of latanoprost acid in pediatric subjects with glaucoma or ocular hypertension who received the adult latanoprost dose.......To evaluate short-term safety and steady-state systemic pharmacokinetics (PK) of latanoprost acid in pediatric subjects with glaucoma or ocular hypertension who received the adult latanoprost dose....

  17. A novel approach to enhance food safety: industry-academia-government partnership for applied research.

    Science.gov (United States)

    Osterholm, Michael T; Ostrowsky, Julie; Farrar, Jeff A; Gravani, Robert B; Tauxe, Robert V; Buchanan, Robert L; Hedberg, Craig W

    2009-07-01

    An independent collaborative approach was developed for stimulating research on high-priority food safety issues. The Fresh Express Produce Safety Research Initiative was launched in 2007 with $2 million in unrestricted funds from industry and independent direction and oversight from a scientific advisory panel consisting of nationally recognized food safety experts from academia and government agencies. The program had two main objectives: (i) to fund rigorous, innovative, and multidisciplinary research addressing the safety of lettuce, spinach, and other leafy greens and (ii) to share research findings as widely and quickly as possible to support the development of advanced safeguards within the fresh-cut produce industry. Sixty-five proposals were submitted in response to a publicly announced request for proposals and were competitively evaluated. Nine research projects were funded to examine underlying factors involved in Escherichia coli O157:H7 contamination of lettuce, spinach, and other leafy greens and potential strategies for preventing the spread of foodborne pathogens. Results of the studies, published in the Journal of Food Protection, help to identify promising directions for future research into potential sources and entry points of contamination and specific factors associated with harvesting, processing, transporting, and storing produce that allow contaminants to persist and proliferate. The program provides a model for leveraging the strengths of industry, academia, and government to address high-priority issues quickly and directly through applied research. This model can be productively extended to other pathogens and other leafy and nonleafy produce.

  18. Can We Learn from Aviation : Safety Enhancements in Transport by Achieving Human Orientated Resilient Shipping Environment

    NARCIS (Netherlands)

    Turan, O.; Kurt, R.E.; Arslan, V.; Silvagni, S.; Ducci, M.; Liston, P.; Schraagen, J.M.; Fang, I.; Papadakis, G.

    2016-01-01

    It is well reported in the literature that more than 80% of shipping accidents are attributed to Human/organisational Error. Maritime community has realised that despite all the increased safety standards and technological developments, accidents are still occurring and the systems are not resilient

  19. Enhancing Nursing Staffing Forecasting With Safety Stock Over Lead Time Modeling.

    Science.gov (United States)

    McNair, Douglas S

    2015-01-01

    In balancing competing priorities, it is essential that nursing staffing provide enough nurses to safely and effectively care for the patients. Mathematical models to predict optimal "safety stocks" have been routine in supply chain management for many years but have up to now not been applied in nursing workforce management. There are various aspects that exhibit similarities between the 2 disciplines, such as an evolving demand forecast according to acuity and the fact that provisioning "stock" to meet demand in a future period has nonzero variable lead time. Under assumptions about the forecasts (eg, the demand process is well fit as an autoregressive process) and about the labor supply process (≥1 shifts' lead time), we show that safety stock over lead time for such systems is effectively equivalent to the corresponding well-studied problem for systems with stationary demand bounds and base stock policies. Hence, we can apply existing models from supply chain analytics to find the optimal safety levels of nurse staffing. We use a case study with real data to demonstrate that there are significant benefits from the inclusion of the forecast process when determining the optimal safety stocks.

  20. A systematic review of patient tracking systems for use in the pediatric emergency department.

    Science.gov (United States)

    Dobson, Ian; Doan, Quynh; Hung, Geoffrey

    2013-01-01

    Patient safety is of great importance in the pediatric emergency department (PED). The combination of acutely and critically ill patients and high patient volumes creates a need for systems to support physicians in making accurate and timely diagnoses. Electronic patient tracking systems can potentially improve PED safety by reducing overcrowding and enhancing security. To enhance our understanding of current electronic tracking technologies, how they are implemented in a clinical setting, and resulting effect on patient care outcomes including patient safety. Nine databases were searched. Two independent reviewers identified articles that contained reference to patient tracking technologies in pediatrics or emergency medicine. Quantitative studies were assessed independently for methodological strength by two reviewers using an external assessment tool. Of 2292 initial articles, 22 were deemed relevant. Seventeen were qualitative, and the remaining five quantitative articles were assessed as being methodologically weak. Existing patient tracking systems in the ED included: infant monitoring/abduction prevention; barcode identification; radiofrequency identification (RFID)- or infrared (IR)-based patient tracking. Twenty articles supported the use of tracking technology to enhance patient safety or improve efficiency. One article failed to support the use of IR patient sensors due to study design flaws. Support exists for the use of barcode-, IR-, and RFID-based patient tracking systems to improve ED patient safety and efficiency. A lack of methodologically strong studies indicates a need for further evidence-based support for the implementation of patient tracking technology in a clinical or research setting. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Potential safety enhancements to nuclear plant control: proof testing at EBR-II

    International Nuclear Information System (INIS)

    Lindsay, R.W.; Chisholm, G.H.

    1984-01-01

    Future changes in nuclear plant control and protective systems will reflect an evolutionary improvement through increased use of computers coupled with a better integration of man and machine. Before improvements can be accepted into the licensed commercial plant environment, significant testing must be accomplished to answer safety questions and to prove the worth of new ideas. The Experimental Breeder Reactor-II (EBR-II) is being used as a test-bed for both in-house development and testing for others in a DOE sponsored Man-Machine Integration program. The ultimate result of the development and testing would be a control system for which safety credit could be taken in the licensing process

  2. A Safety Enhancement Broadcasting Scheme Based on Context Sensing in VANETs

    Directory of Open Access Journals (Sweden)

    Chen Chen

    2016-01-01

    Full Text Available The broadcasting plays a vital role for context awareness in VANETs (Vehicular Ad Hoc Networks whose primary goal is to improve the driving safety depending on effective information exchanging. In this paper, based on the LQG (linear quadratic Gaussian optimal control theory, a broadcasting control scheme named LQG-CCA is proposed to improve the network throughput thus increasing the opportunities for the safety-related events to be successfully handled. By predicting the network throughput with the Kalman filter model, our LQG model is envisioned to minimize the difference between the predicted and expected throughput through the adjustment of CCA (Clear Channel Assessment sensing threshold. Numerical results show that our proposed model can significantly improve the network performance in terms of average throughput, average End-to-End delay, and average packets delivery ratio compared with a highly cited work D-FPAV and a latest published model APPR.

  3. IAEA Mission Says Chile Committed to Enhancing Safety, Sees Regulatory Challenges

    International Nuclear Information System (INIS)

    2018-01-01

    An International Atomic Energy Agency (IAEA) team of experts said Chile is committed to strengthening its regulatory framework for nuclear and radiation safety. To help achieve this aim, the team said the country should address challenges in some areas, including the need to ensure effective independence in regulatory decision-making. The Integrated Regulatory Review Service (IRRS) team today concluded a 12-day mission to assess the regulatory safety framework in Chile. The mission was conducted at the request of the Government and hosted by the Chilean Nuclear Energy Commission (CCHEN), which is responsible for regulatory supervision together with the Ministry of Health (MINSAL). The review mission covered all civilian nuclear and radiation source facilities and activities regulated in Chile.

  4. Conceptual studies of construction and safety enhancement of ocean SMART mounted on GBS

    International Nuclear Information System (INIS)

    Kim, Min-Gil; Lee, Kang-Heon; Kim, Seong Gu; Woo, Il-Guk; Han, Jeong-Hoon; Lee, Phill-Seung; Lee, Jeong Ik

    2014-01-01

    Highlights: • We suggested the concept of coupling the SMART to the GBS, and we made suggested improvements. • We describe the design concepts and GA of SMART ONPP. • We analyzed seismic feature of SMART ONPP preliminarily. • We suggested the concept of coupling the IPSS to the SMART ONPP, and we made suggested improvements. - Abstract: From the Fukushima accident, protection of NPPs from any imaginable natural disasters became very important. In this study, the authors suggest a new concept of ocean nuclear power plant (ONPP) by using SMART as a reference reactor, which is the most recent Small Modular Reactor (SMR) developed by Korea, to demonstrate that the proposed concept can improve the safety of NPP from earthquake and tsunami. The proposed concept utilizes Gravity Based Structure (GBS), which is a widely spread construction technique of offshore plants. Because, floating type or submerged type NPPs can be easily affected by severe ocean environments such as tsunamis and storms, additional safety features have to be added to the existing land based plant. In contrast, the newly proposed GBS-type ONPP does not require going through significant design modifications due to inherent characteristics of the construction method. The authors have demonstrated this concept can be applied to the large nuclear power plant in the previous work and will expand this concept for SMRs in this paper. The authors discuss the new concept by presenting design parameters, design requirements, and the new total general arrangement. Furthermore, due to the unique configuration of ONPP SMART, innovative passive safety features can be added to the existing SMART design. The performance of proposed concept to resist earthquake as well as newly added passive safety feature will be discussed by presenting simplified analysis results

  5. Non-Technical Skills (NTS) for enhancing patient safety: achievements and future directions

    OpenAIRE

    Kodate, Naonori; Ross, Anthony; Anderson, Janet E.; Flin, R.

    2012-01-01

    Problems in team communication and decision making have been implicated in accidents in high risk industries such as aviation, off shore oil processing, nuclear power generation. Recognition of the role that breakdowns in communication and teamwork play in patient safety incidents has led to a plethora of studies in the area of what has come to be widely known as non-technical skills (NTS); a term initially used in European aviation (1). This has led to increasing interest in i...

  6. Conceptual studies of construction and safety enhancement of ocean SMART mounted on GBS

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Min-Gil, E-mail: gggggtt@kaist.ac.kr [Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, 373-1 Guseong-dong Yuseong-gu, Daejeon 305-701 (Korea, Republic of); Lee, Kang-Heon, E-mail: welcome@kaist.ac.kr [Division of Ocean Systems Engineering, Korea Advanced Institute of Science and Technology, 373-1 Guseong-dong Yuseong-gu, Daejeon 305-701 (Korea, Republic of); Kim, Seong Gu, E-mail: skim07@kaist.ac.kr [Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, 373-1 Guseong-dong Yuseong-gu, Daejeon 305-701 (Korea, Republic of); Woo, Il-Guk, E-mail: igwoo@dsme.co.kr [Department of Energy System R and D (Plant R and D), Daewoo Shipbuilding and Marine Engineering Co., Ltd., 221-17, Nonhyun-Dong, Gangnam-Gu, Seoul 135-010 (Korea, Republic of); Han, Jeong-Hoon, E-mail: jhhan1@dsme.co.kr [Department of Energy System R and D (Plant R and D), Daewoo Shipbuilding and Marine Engineering Co., Ltd., 221-17, Nonhyun-Dong, Gangnam-Gu, Seoul 135-010 (Korea, Republic of); Lee, Phill-Seung, E-mail: philseung@kaist.edu [Division of Ocean Systems Engineering, Korea Advanced Institute of Science and Technology, 373-1 Guseong-dong Yuseong-gu, Daejeon 305-701 (Korea, Republic of); Lee, Jeong Ik, E-mail: jeongiklee@kaist.ac.kr [Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, 373-1 Guseong-dong Yuseong-gu, Daejeon 305-701 (Korea, Republic of)

    2014-10-15

    Highlights: • We suggested the concept of coupling the SMART to the GBS, and we made suggested improvements. • We describe the design concepts and GA of SMART ONPP. • We analyzed seismic feature of SMART ONPP preliminarily. • We suggested the concept of coupling the IPSS to the SMART ONPP, and we made suggested improvements. - Abstract: From the Fukushima accident, protection of NPPs from any imaginable natural disasters became very important. In this study, the authors suggest a new concept of ocean nuclear power plant (ONPP) by using SMART as a reference reactor, which is the most recent Small Modular Reactor (SMR) developed by Korea, to demonstrate that the proposed concept can improve the safety of NPP from earthquake and tsunami. The proposed concept utilizes Gravity Based Structure (GBS), which is a widely spread construction technique of offshore plants. Because, floating type or submerged type NPPs can be easily affected by severe ocean environments such as tsunamis and storms, additional safety features have to be added to the existing land based plant. In contrast, the newly proposed GBS-type ONPP does not require going through significant design modifications due to inherent characteristics of the construction method. The authors have demonstrated this concept can be applied to the large nuclear power plant in the previous work and will expand this concept for SMRs in this paper. The authors discuss the new concept by presenting design parameters, design requirements, and the new total general arrangement. Furthermore, due to the unique configuration of ONPP SMART, innovative passive safety features can be added to the existing SMART design. The performance of proposed concept to resist earthquake as well as newly added passive safety feature will be discussed by presenting simplified analysis results.

  7. A sequential-move game for enhancing safety and security cooperation within chemical clusters

    International Nuclear Information System (INIS)

    Pavlova, Yulia; Reniers, Genserik

    2011-01-01

    The present paper provides a game theoretic analysis of strategic cooperation on safety and security among chemical companies within a chemical industrial cluster. We suggest a two-stage sequential move game between adjacent chemical plants and the so-called Multi-Plant Council (MPC). The MPC is considered in the game as a leader player who makes the first move, and the individual chemical companies are the followers. The MPC's objective is to achieve full cooperation among players through establishing a subsidy system at minimum expense. The rest of the players rationally react to the subsidies proposed by the MPC and play Nash equilibrium. We show that such a case of conflict between safety and security, and social cooperation, belongs to the 'coordination with assurance' class of games, and we explore the role of cluster governance (fulfilled by the MPC) in achieving a full cooperative outcome in domino effects prevention negotiations. The paper proposes an algorithm that can be used by the MPC to develop the subsidy system. Furthermore, a stepwise plan to improve cross-company safety and security management in a chemical industrial cluster is suggested and an illustrative example is provided.

  8. A sequential-move game for enhancing safety and security cooperation within chemical clusters.

    Science.gov (United States)

    Pavlova, Yulia; Reniers, Genserik

    2011-02-15

    The present paper provides a game theoretic analysis of strategic cooperation on safety and security among chemical companies within a chemical industrial cluster. We suggest a two-stage sequential move game between adjacent chemical plants and the so-called Multi-Plant Council (MPC). The MPC is considered in the game as a leader player who makes the first move, and the individual chemical companies are the followers. The MPC's objective is to achieve full cooperation among players through establishing a subsidy system at minimum expense. The rest of the players rationally react to the subsidies proposed by the MPC and play Nash equilibrium. We show that such a case of conflict between safety and security, and social cooperation, belongs to the 'coordination with assurance' class of games, and we explore the role of cluster governance (fulfilled by the MPC) in achieving a full cooperative outcome in domino effects prevention negotiations. The paper proposes an algorithm that can be used by the MPC to develop the subsidy system. Furthermore, a stepwise plan to improve cross-company safety and security management in a chemical industrial cluster is suggested and an illustrative example is provided. Copyright © 2010 Elsevier B.V. All rights reserved.

  9. The use of information technology to enhance patient safety and nursing efficiency.

    Science.gov (United States)

    Lee, Tso-Ying; Sun, Gi-Tseng; Kou, Li-Tseng; Yeh, Mei-Ling

    2017-10-23

    Issues in patient safety and nursing efficiency have long been of concern. Advancing the role of nursing informatics is seen as the best way to address this. The aim of this study was to determine if the use, outcomes and satisfaction with a nursing information system (NIS) improved patient safety and the quality of nursing care in a hospital in Taiwan. This study adopts a quasi-experimental design. Nurses and patients were surveyed by questionnaire and data retrieval before and after the implementation of NIS in terms of blood drawing, nursing process, drug administration, bar code scanning, shift handover, and information and communication integration. Physiologic values were easier to read and interpret; it took less time to complete electronic records (3.7 vs. 9.1 min); the number of errors in drug administration was reduced (0.08% vs. 0.39%); bar codes reduced the number of errors in blood drawing (0 vs. 10) and transportation of specimens (0 vs. 0.42%); satisfaction with electronic shift handover increased significantly; there was a reduction in nursing turnover (14.9% vs. 16%); patient satisfaction increased significantly (3.46 vs. 3.34). Introduction of NIS improved patient safety and nursing efficiency and increased nurse and patient satisfaction. Medical organizations must continually improve the nursing information system if they are to provide patients with high quality service in a competitive environment.

  10. Development of reliability-based safety enhancement technology; development of organization concept model in nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Chang Hyun; Kim, Ju Youl; Kim, Yoon Ik; Yang, Hui Chang; Lee, Yong Sik; Kim, Se Hyung [Seoul National University, Seoul (Korea)

    2002-03-01

    The influences of organizational factors on safety of nuclear power plants are mentioned in the early 1970s and noticed after being focused on in the accident report of TMI in 1979. These needs let us implement this research and the purposes of this research are to assess the organizational influences and to develop the organizational conceptual model to establish the basis of identifying the organizational factors, using this model to contribute to enhance safety and economics in nuclear power plants. Eventually research on the organizational influences is expected to have two effects, which are to improve safety through identifying potential causes of accidents and to elevate economics as a new approach to more efficient operation of nuclear power plants. In this study, recent studies were surveyed on the organizational conceptual model, the identification of organizational factors, assessment of organizational influences and evaluation methods of organizational factors and organizational influences among the overseas and domestic researches. In addition specific characteristics of domestic nuclear power plants were tried to identify through plant visit and an evaluation method of organizational influences on component maintenance and human performance were developed and presented. 71 refs., 40 figs., 18 tabs. (Author)

  11. Pediatric vasculitis.

    Science.gov (United States)

    Barut, Kenan; Sahin, Sezgin; Kasapcopur, Ozgur

    2016-01-01

    The aim of this review is to define childhood vasculitis and to highlight new causative factors and treatment modalities under the guidance of recently published studies. Childhood vasculitis is difficult to diagnose because of the wide variation in the symptoms and signs. New nomenclature and classification criteria were proposed for the diagnosis of pediatric vasculitis. Recently, progress has been made toward understanding the genetic susceptibility to pediatric vasculitis as it was in other diseases. Various radiological techniques provide great opportunities in establishing the diagnosis of pediatric vasculitis. Mild central nervous system disease can accompany Henoch-Schonlein purpura and can go unnoticed. Antineutrophilic cytoplasmic antibody-associated vasculitis is rare in children. Increased severity of the disease, subglottic stenosis, and renal disease are described more frequently among children. Biological therapies are used with success in children as in adults. Future studies, whose aims are to evaluate treatment responses, prognosis and to design guidelines for activity, and damage index of vasculitis for children are required. Henoch-Schonlein purpura and Kawasaki disease are the most frequent vasculitides of children. Experience from adult studies for treatment and prognosis are usually used because of low incidence of other vasculitides in children. Multicenter studies of pediatric vasculitis should be conducted to detail treatment responses and prognosis in children.

  12. The Tapioca Bomb: A Demonstration to Enhance Learning about Combustion and Chemical Safety

    Science.gov (United States)

    Keeratichamroen, Wasana; Dechsri, Precharn; Panijpan, Bhinyo; Ruenwongsa, Pintip

    2010-01-01

    In any demonstration to students, producing light and sound usually ensures interest and can enhance understanding and retention of the concepts involved. A guided inquiry (Predict, Observe, Explain: POE) approach was used to involve the students actively in their learning about the explosive combustion of fine flour particles in air in the…

  13. First wall and blanket module safety enhancement by material selection and design decision

    International Nuclear Information System (INIS)

    Merrill, B.J.

    1980-01-01

    A thermal/mechanical study has been performed which illustrates the behavior of a fusion reactor first wall and blanket module during a loss of coolant flow event. The relative safety advantages of various material and design options were determined. A generalized first wall-blanket concept was developed to provide the flexibility to vary the structural material (stainless steel vs titanium), coolant (helium vs water), and breeder material (liquid lithium vs solid lithium aluminate). In addition, independent vs common first wall-blanket cooling and coupled adjacent module cooling design options were included in the study. The comparative analyses were performed using a modified thermal analysis code to handle phase change problems

  14. Recent developments in intelligent packaging for enhancing food quality and safety.

    Science.gov (United States)

    Sohail, Muhammad; Sun, Da-Wen; Zhu, Zhiwei

    2018-03-07

    The role of packaging cannot be denied in the life cycle of any food product. Intelligent packaging is an emerging technology in the food packaging sector. Although it still needs its full emergence in the market, its importance has been proved for the maintenance of food quality and safety. The present review describes several aspects of intelligent packaging. It first highlights different tools used in intelligent packaging and elucidates the role of these packaging devices for maintaining the quality of different food items in terms of controlling microbial growth and gas concentration, and for providing convenience and easiness to its users in the form of time temperature indication. This review also discusses other intelligent packaging solutions in supply chain management of food products to control theft and counterfeiting conducts and broaden the image of the food companies in terms of branding and marketing. Overall, intelligent packaging can ensure food quality and safety in the food industry, however there are still some concerns over this emerging technology including high cost and legal aspects, and thus future work should be performed to overcome these problems for further promoting its applications in the food industry. Moreover, work should also be carried out to combine several single intelligent packaging devices into a single one, so that most of the benefits from this emerging technology can be achieved.

  15. Challenges and Promises of Pediatric Psychopharmacology.

    Science.gov (United States)

    Giles, Lisa L; Martini, D Richard

    2016-08-01

    Most prescriptions for psychotropic medications are written by primary care physicians, yet pediatricians, many of whom are teaching residents and medical students about pediatric psychopharmacology, often feel inadequately trained to treat mental health concerns. Over the past several decades, the number, size, and quality of psychopharmacologic studies in youth has greatly increased. Here we review the current evidence for efficacy and safety of each of the major pharmacologic drug classes in youth (psychostimulants, antidepressants, mood stabilizers, and antipsychotics). Psychostimulants have a robust body of literature supporting their evidence as first-line treatment for attention-deficit/hyperactivity disorder. Selective serotonin reuptake inhibitors (SSRIs) have documented efficacy for pediatric depression and multiple different anxiety disorders with childhood onset. Combining cognitive-behavioral therapy with SSRI treatment enhances treatment benefit and minimizes adverse events of medication. Mood stabilizers, including lithium and anticonvulsant medications, have a less robust strength of evidence and come with more problematic side effects. However, they are increasingly prescribed to youth, often to treat irritability, mood lability, and aggression, along with treatment of bipolar disorder. Antipsychotics have long been a mainstay of treatment for childhood-onset schizophrenia, and in recent years, the evidence base for providing antipsychotics to youth with bipolar mania and autistic disorder has grown. Most concerning with antipsychotics are the metabolic side effects, which appear even more problematic in youth than adults. By better understanding the evidence-based psychopharmacologic interventions, academic pediatricians will be able to treat patients and prepare future pediatrician to address the growing mental health care needs of youth. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  16. Cortical gluing and Ringer lactate solution inflation to avoid cortical mantle collapse and subdural fluid collections in pediatric neurosurgery: safety and feasibility.

    Science.gov (United States)

    Mirone, Giuseppe; Ruggiero, Claudio; Spennato, Pietro; Aliberti, Ferdinando; Trischitta, Vincenzo; Cinalli, Giuseppe

    2015-06-01

    Subdural fluid collections following intraventricular and/or paraventricular procedures in pediatric neurosurgery are common and can be hard to treat. We describe our technique to close cortical defects by the aid of a fibrin adhesive and subsequent Ringer inflation with the aim to avoid cortical mantle collapse and to prevent the development of subdural fluid collections. We report the preliminary results of a prospective study on a consecutive series of 29 children who underwent 37 transcortical or transcallosal surgical procedures since 2008 in our department. In 17 procedures, we performed a transcortical approach on lesions, and in other 19 operations, we operated by a transcallosal. In 5/17 transcortical approaches (29%) and in 3/20 transcallosal approaches (15%), we observed a 5-mm-thick subdural fluid collection of the 5 patients with subdural fluid collections in the transcortical group, 3 patients (17%) underwent surgery for symptomatic or progressive subdural fluid collections. Of the 3 patients in the transcallosal group, a subduro-peritoneal shunt was necessary only for 1 patient (5%). At the very end of the treatment (including chemotherapy and radiotherapy), it was possible to remove the subduro-peritoneal shunt in all these patients because of disappearance of the subdural fluid collections. In pediatric patients after transcortical or transcallosal procedures, the use of a fibrin adhesive to seal surgical opening and subsequent inflation of the residual cavity with Ringer lactate solution to avoid cortical mantle collapse seems safe and appears to prevent the development of subdural fluid collections.

  17. Offsetting or Enhancing Behavior: An Empirical Analysis of Motorcycle Helmet Safety Legislation.

    Science.gov (United States)

    Lee, Jonathan M

    2015-10-01

    This study uses state-level panel data from a 33-year period to test the hypotheses of offsetting and enhancing behavior with regards to motorcycle helmet legislation. Results presented in this article find no evidence of offsetting behavior and are consistent with the presence of enhancing behavior. State motorcycle helmet laws are estimated to reduce motorcycle crashes by 18.4% to 31.9%. In the absence of any behavioral adaptations among motorcyclists mandatory helmet laws are not expected to have any significant impact on motorcycle crash rates. The estimated motorcycle crash reductions do not appear to be driven by omitted variable bias or nonclassical measurement error in reported crashes. Overall, the results strongly suggest that mandatory helmet laws yield significant changes in motorcycle mobility in the form of reduced risk taking and/or decreased utilization. © 2015 Society for Risk Analysis.

  18. Enhanced thermal expansion control rod drive lines for improving passive safety of fast reactors

    International Nuclear Information System (INIS)

    Edelmann, M.; Baumann, W.; Kuechle, M.; Kussmaul, G.; Vaeth, W.; Bertram, A.

    1992-01-01

    The paper presents a device for increasing the thermal expansion effect of control rod drive lines on negative reactivity feedback in fast reactors. The enhanced thermal expansion of this device can be utilized for both passive rod drop and forced insertion of absorbers in unprotected transients, e.g. ULOF. In this way the reactor is automatically brought into a permanently subcritical state and temperatures are kept well below the boiling point of the coolant. A prototype of such a device called ATHENa (German: Shut-down by THermal Expansion of Na) is presently under construction and will be tested. The paper presents the principle, design features and thermal properties of ATHENs as well as results of reactor dynamics calculations of ULOF's for EFR with enhanced thermal expansion control rod drive lines. (author)

  19. Dexmedetomidine in the pediatric population

    DEFF Research Database (Denmark)

    Plambech, Morten; Afshari, A

    2015-01-01

    Dexmedetomidine, an alpha-2 agonist approved only for sedation in adult intensive care patients, is increasingly used off-label in- and outside Europe in the pediatric setting for various indications such as to prevent agitation, as premedication in the form of intranasal, buccal and oral solution...... of sedation of children. In this paper, we assess 51 minor trials in the form of 44 randomized controlled trials and 7 prospective observational studies in an attempt to update the available evidence on dexmedetomidine use in pediatrics. Furthermore, we discuss its potential indications, benefits and adverse....... Based on the best current evidence dexmedetomidine is found suitable and safe for various indications. However, in order to discover its full potential, indications, dosing and safety profile for various ages and procedures, it should urgently be examined by conducting good quality pediatric trials...

  20. Pediatric procedural sedation and analgesia

    Directory of Open Access Journals (Sweden)

    Meredith James

    2008-01-01

    Full Text Available Procedural sedation and analgesia (PSA is an evolving field in pediatric emergency medicine. As new drugs breach the boundaries of anesthesia in the Pediatric Emergency Department, parents, patients, and physicians are finding new and more satisfactory methods of sedation. Short acting, rapid onset agents with little or no lingering effects and improved safety profiles are replacing archaic regimens. This article discusses the warning signs and areas of a patient′s medical history that are particularly pertinent to procedural sedation and the drugs used. The necessary equipment is detailed to provide the groundwork for implementing safe sedation in children. It is important for practitioners to familiarize themselves with a select few of the PSA drugs, rather than the entire list of sedatives. Those agents most relevant to PSA in the pediatric emergency department are presented.

  1. Use of artificial intelligence to enhance the safety of nuclear power plants

    International Nuclear Information System (INIS)

    Uhrig, R.E.

    1989-01-01

    In the operation of a nuclear power plant, the sheer magnitude of the number of process parameters and systems interactions poses difficulties for the operators, particularly during abnormal or emergency situations. Recovery from an upset situation depends upon the facility with which the available raw data can be converted into and assimilated as meaningful knowledge. Plant personnel are sometimes affected by stress and emotion, which may have varying degrees of influence on their performance. Expert systems can take some of the uncertainty and guesswork out of their decisions by providing expert advice and rapid access to a large information base. Application of artificial intelligence technologies, particularly expert systems, to control room activities in a nuclear power plant has the potential to reduce operator error and improve power plant safety and reliability

  2. Use of artificial intelligence to enhance the safety of nuclear power plants

    International Nuclear Information System (INIS)

    Uhrig, R.E.

    1988-01-01

    In the operation of a nuclear power plant, the sheer magnitude of the number of process parameters and systems interactions poses difficulties for the operators, particularly during abnormal or emergency situations. Recovery from an upset situation depends upon the facility with which the available raw data can be converted into and assimilated as meaningful knowledge. Plant personnel are sometimes affected by stress and emotion, which may have varying degrees of influence on their performance. Expert systems can take some of the uncertainty and guesswork out of their decisions by providing expert advice and rapid access to a large information base. Application of artificial intelligence technologies, particularly expert systems, to control room activities in a nuclear power plant has the potential to reduce operator error and improve power plant safety and reliability. 12 refs

  3. Using practical ergonomic evaluations in the restaurant industry to enhance safety and comfort: a case study.

    Science.gov (United States)

    Gentzler, Marc D; Smither, Janan A

    2012-01-01

    Restaurant employees must deal with loud noise, busy environments, difficult customers, heavy, awkward, sharp, and hot objects, repetitive motions, and stress on various joints, all of which can lead to fatigue, sudden accidents, and longterm musculoskeletal injury. The goal of this case study was to assess the risk of injuries and accidents from conducting various tasks in the restaurant, specifically carrying/lifting, table management, and polishing silverware. The nine participants were servers at a local country club restaurant. Physical workload was measured by a scale of physical exertion. Cognitive workload was assessed, as well as cumulative trauma disorder risk. Overall results show that there is sufficient risk in some of the tasks to warrant concern. Specific results are discussed, as well as recommendations for improved safety.

  4. Crew resource management training adapted to nuclear power plant operators for enhancing safety attitude

    International Nuclear Information System (INIS)

    Ishibashi, Akira; Kitamura, Masaharu; Takahashi, Makoto

    2015-01-01

    A conventional training program for nuclear power plant operators mainly focuses on the improvement of knowledge and skills of individual operators. Although it has certainly contributed to safety operation of nuclear power plants, some recent incidents have indicated the necessity of an additional training program aiming at the improvement of team performance. In the aviation domain, crew resource management (CRM) training has demonstrated the effectiveness in resolving team management issues of flight crews, aircraft maintenance crews, and so on. In the present research, we attempt to introduce the CRM concept into operator training in nuclear power plant for the training of conceptual skill (that is, non-technical skill). In this paper an adapted CRM training for nuclear power plant operators is proposed. The proposed training method has been practically utilized in the training course of the managers of nuclear power plants. (author)

  5. Pediatric tracheostomy.

    Science.gov (United States)

    Campisi, Paolo; Forte, Vito

    2016-06-01

    Tracheotomy refers to a surgical incision made into a trachea. Tracheostomy, on the other hand, refers to a surgical procedure whereby the tracheal lumen is positioned in close proximity to the skin surface. Tracheostomy is an uncommon procedure in the pediatric population. When required tracheostomy is typically performed as an open surgical procedure under general anesthesia with the patient intubated. However, it may need to be performed under local anesthesia or over a rigid bronchoscope in the patient with a precarious airway. Over the past half century, the primary indication for pediatric tracheostomy has shifted from acute infectious airway compromise to the need for prolonged ventilatory support in neurologically compromised children. The surgical technique, choice of tracheostomy tube, and post-operative care requires a nuanced approach in infants and young children. This article will review these topics in a comprehensive fashion. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Pediatric biobanking

    DEFF Research Database (Denmark)

    Salvaterra, Elena; Giorda, Roberto; Bassi, Maria T

    2012-01-01

    Ethical, legal, and social issues related to the collection, storage, and use of biospecimens and data derived from children raise critical concerns in the international debate. So far, a number of studies have considered a variety of the individual issues crucial to pediatric biobanking such as ......Ethical, legal, and social issues related to the collection, storage, and use of biospecimens and data derived from children raise critical concerns in the international debate. So far, a number of studies have considered a variety of the individual issues crucial to pediatric biobanking...... such as decision making, privacy protection, minor recontact, and research withdrawal by focusing on theoretical or empirical perspectives. Our research attempted to analyze such issues in a comprehensive manner by exploring practices, rules, and researcher opinions regarding proxy consent, minor assent, specimens...

  7. Roadside design in The Netherlands for enhancing safety : contribution to the conference `Traffic safety on Two Continents', Lisbon, Portugal, September 22-24, 1997.

    NARCIS (Netherlands)

    Schoon, C.C.

    1998-01-01

    Safety barriers are often used on motorways. Accident figures, however, show that a safety barrier is involved in approximately 20% of all fatal accidents. This paper considers safety barriers within the context of safe designs for shoulders on motorways. This research is related to the European

  8. Pediatric stroke

    International Nuclear Information System (INIS)

    Hoermann, M.

    2008-01-01

    Stroke in childhood has gained increasingly more attention and is accepted as an important disease in childhood. The reasons for this severe event and the consequences for the rest of the life are totally different than for adults. This is also true for the diagnosis and therapy. This paper gives a comprehensive overview on the characteristics of pediatric stroke to assist radiologists in making a rapid and safe diagnosis in order to identify the underlying disease. (orig.) [de

  9. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses ... limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of ...

  10. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  11. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  12. Children's (Pediatric) Nuclear Medicine

    Science.gov (United States)

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  13. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging ... the limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch ...

  14. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  15. Pediatric radiology

    International Nuclear Information System (INIS)

    Benz-Bohm, G.

    1997-01-01

    Pediatric radiology is an important subsection of diagnostic radiology involving specific difficulties, but unfortunately is quite too often neglected as a subject of further education and training. The book therefore is not intended for specialists in the field, but for radiologists wishing to plunge deeper into the matter of pediatric radiology and to acquire a sound, basic knowledge and information about well-proven modalities, the resulting diagnostic images, and interpretation of results. The book is a compact guide and a helpful source of reference and information required for every-day work, or in special cases. With patients who are babies or children, the challenges are different. The book offers all the information needed, including important experience from pediatric hospital units that may be helpful in diagnostic evaluation, information about specific dissimilarities in anatomy and physiology which affect the imaging results, hints for radiology planning and performance, as well as information about the various techniques and their indication and achievements. The book presents a wide spectrum of informative and annotated images. (orig./CB) [de

  16. Pediatric fibromyalgia

    Directory of Open Access Journals (Sweden)

    J. Ablin

    2012-09-01

    Full Text Available Fibromyalgia (FM is currently defined as chronic widespread pain (CWP with allodynia or hyperalgesia to pressure pain. It is classified as one of the large group of soft-tissue pain syndromes. Pain is the cardinal symptom of FM; however, most patients also experience additional symptoms such as debilitating fatigue, disrupted or non-restorative sleep, functional bowel disturbances, and a variety of neuropsychiatric problems, including cognitive dysfunction, anxiety and depressive symptoms. Its pathogenesis is not entirely understood, although it is currently believed to be the result of a central nervous system (CNS malfunction that increases pain transmission and perception. FMS usually involves females, and in these patients it often makes its first appearance during menopause. But it is often diagnosed both in young as well as elderly individuals. Pediatric FMS is a frustrating condition affecting children and adolescents at a crucial stage of their physical and emotional development. Pediatric FMS is an important differential diagnosis to be considered in the evaluation of children suffering from widespread musculoskeletal pain, and must be differentiated from a spectrum of inflammatory joint disorders such as juvenile idiopathic arthritis (JIA, juvenile ankylosing spondylitis, etc. The management of pediatric FMS is centered on the issues of education, behavioral and cognitive change (with a strong emphasis on physical exercise, and a relatively minor role for pharmacological treatment with medications such as muscle relaxants, analgesics and tricyclic agents.

  17. Development of Surface Modification Techniques for Enhanced Safety of Light Water Reactors: Recent Progress and Future Direction at THLAB

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Gwang Hyeok; Jeong, Ui Ju; Son, Hong Hyun; Jeun, Gyoo Dong; Kim, Sung Joong [Hanyang University, Daejeon (Korea, Republic of)

    2016-05-15

    They concluded that the CHF enhancement in nanofluid boiling was mainly affected by the surface characteristics of the developed layer. Furthermore, an introduction of surface modification can be utilized to secure the safety of nuclear reactor systems. At many components of the reactor systems, energetic boiling heat transfer occurs, and potential thermal attack to the systems is expected under normal or accident environments. In particular, during a reactor operation, fission energy is deposited in the fuel assemblies in a core. Also, under severe conditions, failure of a reactor vessel may occur by high temperature molten materials. In this article, we introduce the surface modification techniques and recent achievements. After a brief description of each deposition mechanism, an assessment of thermal margin for both the technologies is discussed based on pool boiling experiments conducted at THLAB. Moreover, in the latter part of each chapter, experimental facilities for applied heat transfer tests to consider reactor environments are presented.

  18. International Cooperation for Enhancing Nuclear Safety, Security, Safeguards and Non-proliferation : 60 Years of IAEA and EURATOM

    CERN Document Server

    Abousahl, Said; Plastino, Wolfango

    2018-01-01

    This open access book examines key aspects of international cooperation to enhance nuclear safety, security, safeguards, and non-proliferation, thereby assisting in development and maintenance of the verification regime and fostering progress toward a nuclear weapon-free world. The book opens by addressing important political, institutional, and legal dimensions. Current challenges are discussed and attempts made to identify possible solutions and future improvements. Subsequent sections consider scientific developments that have the potential to increase the effectiveness of implementation of international regimes, particularly in critical areas, technology foresight, and the ongoing evaluation of current capabilities. The closing sections examine scientific and technical challenges and discuss the role of international cooperation and actions of the scientific community in leading the world toward peace and security. The book – which celebrates 60 years of IAEA Atoms for Peace and Development and the EURA...

  19. Overview of PHARE projects implemented in Romania between 1997 and 2008 for enhancing the nuclear safety level

    Energy Technology Data Exchange (ETDEWEB)

    Sanda, Radian; Zerger, Benoit; Manna, Giustino; Farrar, Brian [European Commission, Petten (Netherlands). Joint Research Centre (JRC)

    2015-01-15

    Through the Poland Hungary Aid for Reconstruction of the Economy (PHARE) programme, the European Commission (EC) supported the transition of the Eastern European states to the European market economy. PHARE was a pre-accession financial assistance programme which involved countries from Central and Eastern Europe that applied to become members of the European Union. The paper presents a synthesis of the projects carried out in Romania for enhancing nuclear safety by consolidating key areas such as Regulatory Activities, Radioactive Waste Management and On-Site assistance, in order to fulfil the requirements for accession to the European Union. Statistical considerations on the impact of the projects are also proposed and an analysis of the methodology of intervention is made.