Wilburn, Dianne Williams [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bitteker, Leo John [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Brooks, Melynda Louise [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Romero-Trujillo, Natalie [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Currie, Scott Allister [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Martin, Joanne Skrivan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Sondheim, Walter E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Tovesson, Fredrik [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Young, Jennifer S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Crespin, Thomas Joe [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
The purpose of a Learning Team is to transfer and communicate the information into operational feedback and improvement. We want to pay attention to the small things that go wrong because they are often early warning signals and may provide insight into the health of the whole system. The incident involved the collision of a van with a forklift having raised tines in rainy, overcast weather.
Weiss Mona; Kolbe Michaela; Grote Gudela; Spahn Donat R.; Grande Bastian
Team decision making can go wrong when individuals fear to voice suggestions or concerns to higher status team members. We investigate how after event reviews (AERs) can be used to promote voice behaviour and hierarchy attenuating beliefs in multi professional action teams. We hypothesized that (1) lower status team members will speak up more following an assertiveness specific AER (ASAER) as compared to a teamwork generic AER (TGAER) and (2) that an ASAER leads to stronger endorsement of hie...
Rowland, Paula; Lising, Dean; Sinclair, Lynne; Baker, G Ross
This scoping review examines what is known about the processes of quality improvement (QI) teams, particularly related to how teams impact outcomes. The aim is to provide research-informed guidance for QI leaders and to inform future research questions. Databases searched included: MedLINE, EMBASE, CINAHL, Web of Science and SCOPUS. Eligible publications were written in English, published between 1999 and 2016. Articles were included in the review if they examined processes of the QI team, were related to healthcare QI and were primary research studies. Studies were excluded if they had insufficient detail regarding QI team processes. Descriptive detail extracted included: authors, geographical region and health sector. The Integrated (Health Care) Team Effectiveness Model was used to synthesize findings of studies along domains of team effectiveness: task design, team process, psychosocial traits and organizational context. Over two stages of searching, 4813 citations were reviewed. Of those, 48 full-text articles are included in the synthesis. This review demonstrates that QI teams are not immune from dysfunction. Further, a dysfunctional QI team is not likely to influence practice. However, a functional QI team alone is unlikely to create change. A positive QI team dynamic may be a necessary but insufficient condition for implementing QI strategies. Areas for further research include: interactions between QI teams and clinical microsystems, understanding the role of interprofessional representation on QI teams and exploring interactions between QI team task, composition and process.
By Melissa Porter, Staff Writer Spring Plant Swap 2013 This past October, you may have seen several members of the Green Team standing in front of Building 549 giving out free plants or offering to take extra plants off your hands—this was the first Green Team Fall Plant Swap.
Wagner, Herbert; Finkenzeller, Thomas; Würth, Sabine; von Duvillard, Serge P
Team handball is a complex sport game that is determined by the individual performance of each player as well as tactical components and interaction of the team. The aim of this review was to specify the elements of team-handball performance based on scientific studies and practical experience, and to convey perspectives for practical implication. Scientific studies were identified via data bases of PubMed, Web of Knowledge, SPORT Discus, Google Scholar, and Hercules. A total of 56 articles met the inclusion criteria. In addition, we supplemented the review with 13 additional articles, proceedings and book sections. It was found that the specific characteristics of team-handball with frequent intensity changes, team-handball techniques, hard body confrontations, mental skills and social factors specify the determinants of coordination, endurance, strength and cognition. Although we found comprehensive studies examining individual performance in team-handball players of different experience level, sex or age, there is a lack of studies, particularly for team-handball specific training, as well as cognition and social factors. Key PointsThe specific characteristics of team-handball with frequent intensity changes, specific skills, hard body confrontations, mental skills and social factors define the determinants of coordination, endurance, strength and cognition.To increase individual and team performance in team-handball specific training based on these determinants have been suggested.Although there are comprehensive studies examining individual performance in team-handball players of different experience level, sex, or age are published, there is a lack of training studies, particularly for team-handball specific techniques and endurance, as well as cognition and social factors.
Moon, S.; Nahan, R.; Warner, C.; Wassmer, M.
Solar Decathlon 2005: The Event in Review is a technical report describing the 2005 Solar Decathlon, an event sponsored by the U.S. Department of Energy wherein 18 collegiate teams competed in 10 contests to design, build, and operate an attractive, efficient, entirely solar-powered home. The report gives an overview of the competition, including final results, team strategies, and detailed descriptions the 18 homes.
de Mol, E.; Khapova, S.N.; Elfring, T.
Entrepreneurial team scholars highlight the importance of studying entrepreneurial team cognition in gaining a better understanding of why some entrepreneurial teams are capable of developing teamwork leading to successful entrepreneurial outcomes while others are not. However, in the absence of a
Full Text Available Fencing is a combat sport whose form of direct confrontation involves hitting the opponent with a weapon. The purpose of the study was to determine the properties of body composition of female representatives of the Polish national fencing team. The study involved 11 female athletes of the Polish national fencing team. Their age was 16-22 years (19±2.32, body weight 52-78 kg (59.7±7.4, body height 158-183 cm (167.46±6.10 and the training experience 7.64±3.47 years. The reference group consisted of 153 students of Warsaw University of Technology (Poland. Twenty basic somatic characteristics were measured. The following indices were calculated: slenderness, Rohrer’s, BMI, Manouvrier’s, and pelvic-shoulder indices. Density of the body, total body fat, active tissue, the overall profile of body composition and internal proportions of the body were determined. Analysis of internal proportions of factors of the athletes’ body composition revealed significant differences in particular groups of features. The total size of the athletes’ bodies is due to less-than-average magnitude of the length and stoutness characteristics and a high magnitude of adiposity (M = 0.63 in the Polish female national team of fencers (sabre calculated from the normalized values for the control group. The proportions of features within the analysed factors revealed a significant advantage of the length of the upper extremity over the lower one and a distinct advantage of forearm musculature. The specific profile of body composition of female athletes practising sabre fencing is most likely due to long-term effects of training as well as the system of selection of persons with specific somatic prerequisites developed in the course of many years of training practice.
performs, and auditory information that is provided through multiple audio devices with speech response. This paper extends previous discrete event workload...2008, pg. 1) notes that “Architecture modeling furnishes abstrac- tions for use in managing complexities, allowing engineers to visualise the proposed
Amir Mohammad Colabi
Full Text Available Although there are many potential benefits associated with the use of virtual product development teams, exploiting these benefits requires an appropriate management. Managing virtual product development team is a critical issue as many of these teams fail to accomplish their goals. Review of previous literature shows that body of knowledge in managing virtual product development teams is fragmented and inconsistent. The main objective of this paper is to categorize the previous research on the subject of virtual product development team management in order to integrate the research into a thematic model and to enable recommendations for future research. So, this study reviews and summarizes empirical research in the field, also conceptual and qualitative papers, experiences, reports and explorative case studies. Results show that there are three fields of research in this area, including: Virtual production and Virtual team in Product Development, Managing virtual team in R&D and product development, Managing global virtual product development teams. In order to organize previous studies in this area, a thematic map is proposed which shows the structure and sequence of research. Finally, a comprehensive discussion on the future directions in this field is proposed.
Rosenman, Elizabeth D; Ilgen, Jonathan S; Shandro, Jamie R; Harper, Amy L; Fernandez, Rosemarie
To summarize the characteristics of tools used to assess leadership in health care action (HCA) teams. HCA teams are interdisciplinary teams performing complex, critical tasks under high-pressure conditions. The authors conducted a systematic review of the PubMed/MEDLINE, CINAHL, ERIC, EMBASE, PsycINFO, and Web of Science databases, key journals, and review articles published through March 2012 for English-language articles that applied leadership assessment tools to HCA teams in all specialties. Pairs of reviewers assessed identified articles for inclusion and exclusion criteria and abstracted data on study characteristics, tool characteristics, and validity evidence. Of the 9,913 abstracts screened, 83 studies were included. They described 61 team leadership assessment tools. Forty-nine tools (80%) provided behaviors, skills, or characteristics to define leadership. Forty-four tools (72%) assessed leadership as one component of a larger assessment, 13 tools (21%) identified leadership as the primary focus of the assessment, and 4 (7%) assessed leadership style. Fifty-three studies (64%) assessed leadership at the team level; 29 (35%) did so at the individual level. Assessments of simulated (n = 55) and live (n = 30) patient care events were performed. Validity evidence included content validity (n = 75), internal structure (n = 61), relationship to other variables (n = 44), and response process (n = 15). Leadership assessment tools applied to HCA teams are heterogeneous in content and application. Comparisons between tools are limited by study variability. A systematic approach to team leadership tool development, evaluation, and implementation will strengthen understanding of this important competency.
A large team of U.S. fusion researchers last week began poring over the latest blueprints for a massive international machine designed to demonstrate fusion power and provide plasma physicists with an exciting new facility. The review of the $10 billion International Thermonuclear Experimental Reactor (ITER) was prompted by controversy over the reactor's design and the shrinking U.S. fusion budget
Luteberget, Live S; Spencer, Matt
International women's team handball is a physically demanding sport and is intermittent in nature. The aim of the study was to profile high-intensity events (HIEs) in international women's team handball matches with regard to playing positions. Twenty female national-team handball players were equipped with inertial movement units (OptimEye S5, Catapult Sports, Australia) in 9 official international matches. Players were categorized in 4 different playing positions: backs, wings, pivots, and goalkeepers (GKs). PlayerLoad™, accelerations (Acc), changes of direction (CoD), decelerations (Dec), and the sum of the latter 3, HIEs, were extracted from raw-data files using the manufacturer's software. All Acc, Dec, CoD, and HIEs >2.5 m/s were included. Data were log-transformed and differences were standardized for interpretation of magnitudes and reported with effect-size statistics. Mean numbers of events were 0.7 ± 0.4 Acc/min, 2.3 ± 0.9 Dec/min, and 1.0 ± 0.4 CoD/min. Substantial differences between playing positions, ranging from small to very large, were found in the 3 parameters. Backs showed a most likely greater frequency for HIE/min (5.0 ± 1.1 HIE/min) than all other playing positions. Differences between playing positions were also apparent in PlayerLoad/min. HIEs in international women's team handball are position specific, and the overall intensity depends on the positional role within a team. Specific HIE and intensity profiles from match play provide useful information for a better understanding of the overall game demands and for each playing position.
Epstein, Nancy E
The use of multidisciplinary in-hospital teams limits adverse events (AE), improves outcomes, and adds to patient and employee satisfaction. Acting like "well-oiled machines," multidisciplinary in-hospital teams include "staff" from different levels of the treatment pyramid (e.g. staff including nurses' aids, surgical technicians, nurses, anesthesiologists, attending physicians, and others). Their enhanced teamwork counters the "silo effect" by enhancing communication between the different levels of healthcare workers and thus reduces AE (e.g. morbidity/mortality) while improving patient and healthcare worker satisfaction. Multiple articles across diverse disciplines incorporate a variety of concepts of "teamwork" for staff covering emergency rooms (ERs), hospital wards, intensive care units (ICUs), and most critically, operating rooms (ORs). Cohesive teamwork improved communication between different levels of healthcare workers, and limited adverse events, improved outcomes, decreased the length of stay (LOS), and yielded greater patient "staff" satisfaction. Within hospitals, delivering the best medical/surgical care is a "team sport." The goals include: Maximizing patient safety (e.g. limiting AE) and satisfaction, decreasing the LOS, and increasing the quality of outcomes. Added benefits include optimizing healthcare workers' performance, reducing hospital costs/complications, and increasing job satisfaction. This review should remind hospital administrators of the critical need to keep multidisciplinary teams together, so that they can continue to operate their "well-oiled machines" enhancing the quality/safety of patient care, while enabling "staff" to optimize their performance and enhance their job satisfaction.
Tiferes, Judith; Bisantz, Ann M
Many studies on teams report measures of team communication; however, these studies vary widely in terms of the team characteristics, situations, and tasks studied making it difficult to understand impacts on team communication more generally. The objective of this review is systematically summarize relationships between measures of team communication and team characteristics and situational contexts. A literature review was conducted searching in four electronic databases (PsycINFO, MEDLINE, Ergonomics Abstracts, and SocINDEX). Additional studies were identified by cross-referencing. Articles included for final review had reported at least one team communication measure associated with some team and/or context dimension. Ninety-nine of 727 articles met the inclusion criteria. Data extracted from articles included characteristics of the studies and teams and the nature of each of the reported team and/or context dimensions-team communication properties relationships. Some dimensions (job role, situational stressors, training strategies, cognitive artifacts, and communication media) were found to be consistently linked to changes in team communication. A synthesized diagram that describes the possible associations between eleven team and context dimensions and nine team communication measures is provided along with research needs. Copyright © 2017 Elsevier Ltd. All rights reserved.
Rabøl, Louise Isager; Østergaard, Doris; Mogensen, Torben
Several studies show that communication errors in healthcare teams are frequent and can lead to adverse events. Team training has been suggested as a way to safer communication and has been implemented in healthcare as classroom-based or simulation-based team training or a combination of both. Th....... The objective of this paper is to systematically review studies evaluating the outcomes of classroom-based multiprofessional team training for hospital staff.......Several studies show that communication errors in healthcare teams are frequent and can lead to adverse events. Team training has been suggested as a way to safer communication and has been implemented in healthcare as classroom-based or simulation-based team training or a combination of both...
, transport and storage of the source; Redundant and diversified telecommunication means are deployed in the various on-site emergency response facilities; and In the event of a severe accident, the support which can be provided to plant staff through a wide range of expertise and analytical tools is commendable. The team has made recommendations and suggestions related to areas where operational safety of Cattenom NPP could be improved. Examples include: Ensuring that all management information, directives and expectations are clearly communicated to all staff and fully implemented; Enhancing the organization of the training programme in the areas of assessment, objectives and competencies; Improving the control of the plant surveillance test programme regarding scheduling and acceptance criteria; and Improving the effectiveness of the plant's Root Cause Analysis process. Cattenom management expressed a determination to address all the areas identified for improvement and requested the IAEA to schedule a follow-up mission in approximately 18 months' time. The team handed over a draft of their recommendations, suggestions and good practices to the plant management in the form of ''Technical Notes'' for factual comments. The technical notes will be reviewed at IAEA headquarters including any comments from Cattenom NPP and the French Safety Authority (ASN). The final report will be submitted to the Government of France within three months. This was the 166th mission of the OSART programme, which began in 1982, and the 23rd such mission in France. General information about OSART missions can be found on the IAEA website OSART Missions. Background An OSART mission is designed as a review of programmes and activities essential to operational safety. It is not a regulatory inspection, nor is it a design review or a substitute for an exhaustive assessment of the plant's overall safety status. Experts participating in the IAEA's June 2010 International Conference on Operational
Teams have become a key resource for learning and accomplishing work in organizations. The development of collective learning in specific contexts is not well understood, yet has become critical to organizational success. The purpose of this conceptual review is to inform human resource development (HRD) practice about specific team behaviors and…
Frencken, Wouter; De Poel, Harjo; Visscher, Chris; Lemmink, Koen
In soccer, critical match events like goal attempts can be preceded by periods of instability in the balance between the two teams' behaviours. Therefore, we determined periods of high variability in the distance between the teams' centroid positions longitudinally and laterally in an
Systematic review of team Nigeria's performance in olympic games: Causes, concerns, and remediation strategies. ... Participation and winning medals in Olympic Games have become a veritable avenue ... AJOL African Journals Online.
Participation in multi-coded sports events often involves travel to international ... Medication use by Team south africa during the XXVIIIth olympiad: a model .... individual sports included in the programme (e.g. athletes involved in contact sports ...
Wildman, Jessica L; Salas, Eduardo; Scott, Charles P R
The purpose of this article is twofold: to provide a critical cross-domain evaluation of team cognition measurement options and to provide novice researchers with practical guidance when selecting a measurement method. A vast selection of measurement approaches exist for measuring team cognition constructs including team mental models, transactive memory systems, team situation awareness, strategic consensus, and cognitive processes. Empirical studies and theoretical articles were reviewed to identify all of the existing approaches for measuring team cognition. These approaches were evaluated based on theoretical perspective assumed, constructs studied, resources required, level of obtrusiveness, internal consistency reliability, and predictive validity. The evaluations suggest that all existing methods are viable options from the point of view of reliability and validity, and that there are potential opportunities for cross-domain use. For example, methods traditionally used only to measure mental models may be useful for examining transactive memory and situation awareness. The selection of team cognition measures requires researchers to answer several key questions regarding the theoretical nature of team cognition and the practical feasibility of each method. We provide novice researchers with guidance regarding how to begin the search for a team cognition measure and suggest several new ideas regarding future measurement research. We provide (1) a broad overview and evaluation of existing team cognition measurement methods, (2) suggestions for new uses of those methods across research domains, and (3) critical guidance for novice researchers looking to measure team cognition.
The Operational Safety Review Team (OSART) programme was set up by the IAEA in 1982 to assist Member States to enhance the operational safety of nuclear power plants. Each team is staffed by senior experts in the relevant fields. The review team discusses with plant staff the existing operational programmes for plant which may be under construction, being commissioned or already operating. Following a detailed examination of a safety programme, the OSART team lists strengths and weaknesses and makes recommendations on how to overcome the latter. Since their conclusions are based on the best prevailing international practice, they may be more stringent than those based on national criteria. The results of the 77 missions conducted at 62 plants in 28 countries by the end of 1994 are summarised. (UK)
Eastment, M.; Hayter, S.; Nahan, R.; Stafford, B.; Warner, C.; Hancock, E.; Howard, R.
This book describes the first Solar Decathlon, a competition for college and university students, which took place on the National Mall in fall 2002. Student teams competed to design, build, and operate the most attractive, energy-efficient house that used only solar energy. In addition to the competition, the Solar Decathlon was also a public event. The book describes the events on the Mall, including technical details about the ten contests that comprised the competition and descriptions of the public's and the media's responses to the event. The book also provides information about the student teams' activities in the year and a half before they arrived to compete on the Mall.
National Highway Traffic Safety Administration (DOT), Washington, DC.
This document presents materials covering the television campaign against drunk driving called "TEAM" (Techniques for Effective Alcohol Management). It is noted that TEAM's purpose is to promote effective alcohol management in public facilities and other establishments that serve alcoholic beverages. TEAM sponsors are listed, including…
Dudden, Rosalind F; Protzko, Shandra L
While the role of the librarian as an expert searcher in the systematic review process is widely recognized, librarians also can be enlisted to help systematic review teams with other challenges. This article reviews the contributions of librarians to systematic reviews, including communicating methods of the review process, collaboratively formulating the research question and exclusion criteria, formulating the search strategy on a variety of databases, documenting the searches, record keeping, and writing the search methodology. It also discusses challenges encountered such as irregular timelines, providing education, communication, and learning new technologies for record keeping. Rewards include building relationships with researchers, expanding professional expertise, and receiving recognition for contributions to health care outcomes.
Hansen, Anders Peder Lysholm
This paper presents a systematic literature review of scientific papers on cross-functional sourcing teams in top journals within Purchasing and Supply Management. The review identifies four common research topics within the field; Determining factors of sourcing team success, Performance...... management/goals of sourcing teams, Behavior and decisions in sourcing teams and Involvement of purchasing in sourcing teams. Further research on Performance Management and how to create a holistic, teams based perspective in cross-functional sourcing teams is suggested....
Morgeson, Frederick P
Relatively little empirical research has been conducted on external leaders of self-managing teams. The integration of functional leadership theory with research on team routines suggests that leaders can intervene in teams in several different ways, and the effectiveness of this intervention depends on the nature of the events the team encounters. External team leaders from 3 organizations first described a series of events (N=117), and leaders and team members then completed surveys to quantitatively describe the events. Results indicated that leader preparation and supportive coaching were positively related to team perceptions of leader effectiveness, with preparation becoming more strongly related to effectiveness as event novelty increased. More active leader intervention activities (active coaching and sense making) were negatively related to satisfaction with leadership yet were positively related to effectiveness as events became more disruptive.
Ball, Anna L.; Bowling, Amanda M.; Sharpless, Justin D.
School Based Agricultural Education (SBAE) teachers can use coaching behaviors, along with their agricultural content knowledge to help their Career Development Event (CDE) teams succeed. This mixed methods, collective case study observed three SBAE teachers preparing multiple CDEs throughout the CDE season. The teachers observed had a previous…
Dafne Eva Corrêa Brandão
Full Text Available This integrative review aimed at analyzing evidences available in literature regarding stress levels in nursing teams during the perioperative period. Primary studies were searched in the following databases: PubMed, CINAHL and LILACS. Included studies were grouped into the following thematic categories: stress level in the workplace and stress factors (n=8 and stress coping strategies used by the nursing staff (n=6. Evidence suggests that stress in the workplace worsens the health of the nursing team, provoking undesirable effects both in the professional and personal lives of these professionals. The assessment of working conditions to identify the main stressing factors and the implementation of individual and organizational measures to reduce nursing teams stress may increase productivity and workers’ satisfaction, improving the assistance quality offered to surgical patients.
At the request of the NASA Administrator a team was formed to review the Space Shuttle Program and propose a new management system that could significantly reduce operating costs. Composed of a group of people with broad and extensive experience in spaceflight and related areas, the team received briefings from the NASA organizations and most of the supporting contractors involved in the Shuttle Program. In addition, a number of chief executives from the supporting contractors provided advice and suggestions. The team found that the present management system has functioned reasonably well despite its diffuse structure. The team also determined that the shuttle has become a mature and reliable system, and--in terms of a manned rocket-propelled space launch system--is about as safe as today's technology will provide. In addition, NASA has reduced shuttle operating costs by about 25 percent over the past 3 years. The program, however, remains in a quasi-development mode and yearly costs remain higher than required. Given the current NASA-contractor structure and incentives, it is difficult to establish cost reduction as a primary goal and implement changes to achieve efficiencies. As a result, the team sought to create a management structure and associated environment that enables and motivates the Program to further reduce operational costs. Accordingly, the review team concluded that the NASA Space Shuttle Program should (1) establish a clear set of program goals, placing a greater emphasis on cost-efficient operations and user-friendly payload integration; (2) redefine the management structure, separating development and operations and disengaging NASA from the daily operation of the space shuttle; and (3) provide the necessary environment and conditions within the program to pursue these goals.
This document is intended to be used by International regulatory review teams in reviewing the activities of a regulatory body as applicable to the regulation of nuclear power plants. The mission will, however, take note of any other activities of the regulatory body when drawing up the review report. The document does not specifically deal with the functions of a regulatory body responsible for other types of nuclear facilities or related nuclear activities, but it is intended that the concepts presented in the document could be applied where appropriate. Refs
Rosenman, Elizabeth D; Shandro, Jamie R; Ilgen, Jonathan S; Harper, Amy L; Fernandez, Rosemarie
To identify and describe the design, implementation, and evidence of effectiveness of leadership training interventions for health care action (HCA) teams, defined as interdisciplinary teams whose members coordinate their actions in time-pressured, unstable situations. The authors conducted a systematic search of the PubMed/MEDLINE, CINAHL, ERIC, EMBASE, PsycINFO, and Web of Science databases, key journals, and review articles published through March 2012. They identified peer-reviewed English-language articles describing leadership training interventions targeting HCA teams, at all levels of training and across all health care professions. Reviewers, working in duplicate, abstracted training characteristics and outcome data. Methodological quality was evaluated using the Medical Education Research Study Quality Instrument (MERSQI). Of the 52 included studies, 5 (10%) focused primarily on leadership training, whereas the remainder included leadership training as part of a larger teamwork curriculum. Few studies reported using a team leadership model (2; 4%) or a theoretical framework (9; 17%) to support their curricular design. Only 15 studies (29%) specified the leadership behaviors targeted by training. Forty-five studies (87%) reported an assessment component; of those, 31 (69%) provided objective outcome measures including assessment of knowledge or skills (21; 47%), behavior change (8; 18%), and patient- or system-level metrics (8; 18%). The mean MERSQI score was 11.4 (SD 2.9). Leadership training targeting HCA teams has become more prevalent. Determining best practices in leadership training is confounded by variability in leadership definitions, absence of supporting frameworks, and a paucity of robust assessments.
Full text: At the request of the Czech Government, the International Atomic Energy Agency (IAEA) assembled a team of national experts from Bulgaria, France, Germany, Spain, and the United Kingdom, with an observer from Austria, to review safety issues at the Temelin power plant that were identified in 1996 as relevant to reactors of the generic Temelin design (WWER-1000/320 type). Following a detailed on-site review from 18 to 23 November 2001, the experts concluded that most identified issues had been addressed and resolved. Work is continuing on the few remaining issues. These issues, however, are not judged by them to be significant and would not from the experts' standpoint preclude the safe operation of the Temelin nuclear power plant. The final report of the team of experts will be available to the Czech Government in one month's time. (author)
... 7 Agriculture 15 2010-01-01 2010-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...
Akemi Takeoka Chatfield
Full Text Available Globally, virtual teams (VT as ICT-enabled emergent network organisation forms have gained international validity by innovative organisations, with a corresponding surge of interest in understanding how organisations can leverage VT to create business value. Despite growing deliberations in VT literature on managing VT, tasks and outcomes, however, creating business value through VT remains an unresolved theoretical and pragmatic conundrum. A review of prior relevant literature is essential to advancing knowledge. The paucity of published review articles seems to have impeded the field’s accumulation of VT knowledge. This research, therefore, reviews the current literature on case studies of VT to address the question: What are organisational challenges in creating business value through VT in the organisation? The key challenges found in the literature are effective communication, knowledge sharing, trust, and interpersonal skills in the new virtual boundary-less environment. Drawing on the IT business value model, we also discuss their resource-based implications.
Hajimonfarednejad, Mahdie; Ostovar, Mohadeseh; Raee, Mohammad Javad; Hashempur, Mohammad Hashem; Mayer, Johannes Gottfried; Heydari, Mojtaba
Cinnamon, from the genus Cinnamomum and Lauraceae family, has been used as a popular spice for thousands of years around the world. Many studies have shown therapeutic effects of cinnamon including its antimicrobial, antiviral, antifungal, antioxidant, antitumor, antihypertensive, antilipemic, antidiabetic, gastroprotective, and immunomodulatory effects. Due to popular use of cinnamon and several human reports on adverse events associated with short or long term use of cinnamon, we aimed to systematically review its human reports of adverse event. Databases including Medline, Scopus, Science Direct, Embase, PubMed Central and Google scholar were searched using the key words "cinnamon" or "cinnamomum" for clinical trials, case reports and case series. Also spontaneous reports about adverse effects of cinnamon were collected from five national and international spontaneous reporting schemes. Thirty eight clinical trials were found, five of them reported adverse events. Twenty case reports and seven case series, as well as, spontaneous reports including 160 adverse events were also included. The most frequent adverse events were gastrointestinal disorders and allergic reactions which were self-limiting in the majority of cases. The available data suggests that despite the safety of cinnamon use as a spice and/or flavoring agent, its use may be associated with significant adverse effects in medicinal uses with larger doses or longer duration of use and should be clinically monitored. Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Fung, Lillia; Boet, Sylvain; Bould, M Dylan; Qosa, Haytham; Perrier, Laure; Tricco, Andrea; Tavares, Walter; Reeves, Scott
Crisis resource management (CRM) abilities are important for different healthcare providers to effectively manage critical clinical events. This study aims to review the effectiveness of simulation-based CRM training for interprofessional and interdisciplinary teams compared to other instructional methods (e.g., didactics). Interprofessional teams are composed of several professions (e.g., nurse, physician, midwife) while interdisciplinary teams are composed of several disciplines from the same profession (e.g., cardiologist, anaesthesiologist, orthopaedist). Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were searched using terms related to CRM, crisis management, crew resource management, teamwork, and simulation. Trials comparing simulation-based CRM team training versus any other methods of education were included. The educational interventions involved interprofessional or interdisciplinary healthcare teams. The initial search identified 7456 publications; 12 studies were included. Simulation-based CRM team training was associated with significant improvements in CRM skill acquisition in all but two studies when compared to didactic case-based CRM training or simulation without CRM training. Of the 12 included studies, one showed significant improvements in team behaviours in the workplace, while two studies demonstrated sustained reductions in adverse patient outcomes after a single simulation-based CRM team intervention. In conclusion, CRM simulation-based training for interprofessional and interdisciplinary teams show promise in teaching CRM in the simulator when compared to didactic case-based CRM education or simulation without CRM teaching. More research, however, is required to demonstrate transfer of learning to workplaces and potential impact on patient outcomes.
Lewis, Frank L.; Hudas, Greg R.; Pang, Chee Khiang; Middleton, Matthew B.; McMurrough, Christopher
During mission execution in military applications, the TRADOC Pamphlet 525-66 Battle Command and Battle Space Awareness capabilities prescribe expectations that networked teams will perform in a reliable manner under changing mission requirements, varying resource availability and reliability, and resource faults. In this paper, a Command and Control (C2) structure is presented that allows for computer-aided execution of the networked team decision-making process, control of force resources, shared resource dispatching, and adaptability to change based on battlefield conditions. A mathematically justified networked computing environment is provided called the Discrete Event Control (DEC) Framework. DEC has the ability to provide the logical connectivity among all team participants including mission planners, field commanders, war-fighters, and robotic platforms. The proposed data management tools are developed and demonstrated on a simulation study and an implementation on a distributed wireless sensor network. The results show that the tasks of multiple missions are correctly sequenced in real-time, and that shared resources are suitably assigned to competing tasks under dynamically changing conditions without conflicts and bottlenecks.
An international team of nuclear installation safety experts led by the International Atomic Energy Agency (IAEA) has evaluated the Gravelines Nuclear Power Plant (NPP) in France to assess how the station has followed up on an Operational Safety Review Team (OSART) mission undertaken in 2012. The IAEA assembled a team of experts at the request of the Government of France to conduct the follow-up OSART mission at Gravelines NPP from 19 to 23 May 2014. Follow-up missions are standard components of the OSART programme; they are typically conducted 15-24 months after the initial OSART mission. The IAEA mission in 2012 made a number of recommendations and suggestions for consideration by the Gravelines NPP operators. The station thoroughly analyzed the OSART recommendations and suggestions and developed corrective action plans. In 18 months, the Gravelines plant has achieved the level ''resolved;; or ''satisfactory progress'' in almost all of the recommendations and suggestions made by the OSART in November 2012. During the follow-up mission, the team assessed that the operators have resolved the issues in several areas, including: Undertaking initiatives to improve fire prevention; Reinforcing contamination control practices; and Enhancing capabilities to protect emergency workers in the event of a release of radioactivity. The team identified some issues which have achieved satisfactory progress toward resolution, but need further work, including: Further improvement of measures to preventing the ingress of items or chemicals into circuits and equipment; Comprehensive application of the corrective actions programme; and Reinforcement of the containment protection system in the event of an extremely adverse situation. The team identified the following issue as one which has made insufficient progress toward resolution and needs further work: Emergency response arrangements do not follow current IAEA safety standards recommending that the plant should have a person on
Almost, Joan; Wolff, Angela C; Stewart-Pyne, Althea; McCormick, Loretta G; Strachan, Diane; D'Souza, Christine
To review empirical studies examining antecedents (sources, causes, predictors) in the management and mitigation of interpersonal conflict. Providing quality care requires positive, collaborative working relationships among healthcare team members. In today's increasingly stress-laden work environments, such relationships can be threatened by interpersonal conflict. Identifying the underlying causes of conflict and choice of conflict management style will help practitioners, leaders and managers build an organizational culture that fosters collegiality and create the best possible environment to engage in effective conflict management. Integrative literature review. CINAHL, MEDLINE, PsycINFO, Proquest ABI/Inform, Cochrane Library and Joanne Briggs Institute Library were searched for empirical studies published between 2002-May 2014. The review was informed by the approach of Whittemore and Knafl. Findings were extracted, critically examined and grouped into themes. Forty-four papers met the inclusion criteria. Several antecedents influence conflict and choice of conflict management style including individual characteristics, contextual factors and interpersonal conditions. Sources most frequently identified include lack of emotional intelligence, certain personality traits, poor work environment, role ambiguity, lack of support and poor communication. Very few published interventions were found. By synthesizing the knowledge and identifying antecedents, this review offers evidence to support recommendations on managing and mitigating conflict. As inevitable as conflict is, it is the responsibility of everyone to increase their own awareness, accountability and active participation in understanding conflict and minimizing it. Future research should investigate the testing of interventions to minimize these antecedents and, subsequently, reduce conflict. © 2016 John Wiley & Sons Ltd.
indicator for the Collective Effective Dose of Dukovany NPP has shown exceptionally good results in comparison with other Pressurized Water Reactors (PWRs) and Water-Water Energetic Reactors (VVERs). During the past three years, the value was less than 0.15 manSv per Unit; and A comprehensive station blackout simulator scenario has been developed and implemented for several years at the plant. The scenario involves multiple off-site agencies and has a high degree of realism. It is used to practise and improve response times for power restoration activities and familiarize off-site personnel with nuclear safety principles. The team has also made recommendations and suggestions related to areas where the operational safety of the Dukovany NPP could be improved. Examples include: Improving the effectiveness of using its root cause analysis method to prevent the repetition of events; Clarifying and reinforcing expectations regarding the use of error prevention tools and enhancing their application; and Ensuring adequate protection of emergency workers and evacuees following a possible radioactive release. The plant's management expressed a determination to address all the areas identified for improvement and requested that the IAEA schedule a follow-up mission in approximately 18 months. The team handed over a draft of their recommendations, suggestions and good practices to the plant management in the form of ''Technical Notes'' for factual comments. The technical notes will be reviewed at the IAEA headquarters, including any comments from Dukovany NPP and the Czech regulatory body, the State Office for Nuclear Safety (SUJB). The final report will be submitted to the Government of the Czech Republic within three months. This was the 162nd mission of the OSART programme, which began in 1982. Video and photos are available from the OSART Mission. General information about OSART missions can be found on the IAEA Website. (IAEA)
The IAEA International Regulatory Review Team (IRRT) programme provides advice and assistance to Member States to strengthen and enhance the effectiveness of the nuclear regulatory body whilst recognizing the ultimate responsibility of each Member State for nuclear safety. The IRRT programme, initiated in 1989, is not restricted to any particular group of Member States, whether developing or industrialized, but is available to all countries with nuclear installations in operation or approaching operation. The basic concepts, purposes and functions of a national regulatory body are well recognized in all Member States having a nuclear power programme. The IAEA Safety Standards Series publication entitled 'Legal and Governmental Infrastructure for Nuclear, Radiation, Radioactive Waste and Transport Safety, Safety: Requirements', No. GS-R-1 (2000), provides a general consensus reference for the practices necessary for a national organization to fulfil the regulatory purposes and discharge the regulatory functions. The Requirements also defines the terms used in these guidelines. The guidance given in the Requirements recognizes that the organizational structure and regulatory processes will vary from country to country depending on their existing constitutional, legal and administrative systems; the size and structure of their nuclear programme; the technical skills and professional and financial resources available to their regulatory body, and social customs and cultural traditions. The objective of this report is to provide guidance on the basic structure of an IRRT mission and provide a common reference both across the various areas covered by an IRRT mission and across all the missions in the programme. As such, it is addressed, principally, to the team members of IRRT missions but it also provides guidance to a host regulatory body receiving a mission. This report identifies the objectives of the IRRT mission and sets out the scope of the topic areas that are
Dumon, F. [Faculte de Pharmacie, 13 - Marseille (France); Pizzocaro, Y. [CSP, Risques Technologiques, 83 - Toulon (France)
Nowadays, the intervention in ionizing environment is increasingly probable. It is still rare, but with the development of the nuclear programme of electricity production which was held in the french past and the significant rise in the use of the radioelements, as well in the medical field as industrial, the radioactive risk cannot be neglected. Technical and human resources, brought by mobile emergency teams called CMIR, were thus implemented to ensure either the safety of only hard-working exposed to the ionizing radiations, but also that of the population. In France, the organization of the public authorities in the event of nuclear accident, fixed by Directives of the Prime Minister which relate to nuclear safety, protection against radiation, the law and order and the civil safety, is described in Particular Plan for Intervention (PPI). (author)
Dumon, F.; Pizzocaro, Y.
Nowadays, the intervention in ionizing environment is increasingly probable. It is still rare, but with the development of the nuclear programme of electricity production which was held in the french past and the significant rise in the use of the radioelements, as well in the medical field as industrial, the radioactive risk cannot be neglected. Technical and human resources, brought by mobile emergency teams called CMIR, were thus implemented to ensure either the safety of only hard-working exposed to the ionizing radiations, but also that of the population. In France, the organization of the public authorities in the event of nuclear accident, fixed by Directives of the Prime Minister which relate to nuclear safety, protection against radiation, the law and order and the civil safety, is described in Particular Plan for Intervention (PPI). (author)
Kennelty, Korey A; Polgreen, Linnea A; Carter, Barry L
We review studies published since 2014 that examined team-based care strategies and involved pharmacists to improve blood pressure (BP). We then discuss opportunities and challenges to sustainment of team-based care models in primary care clinics. Multiple studies presented in this review have demonstrated that team-based care including pharmacists can improve BP management. Studies highlighted the cost-effectiveness of a team-based pharmacy intervention for BP control in primary care clinics. Little information was found on factors influencing sustainability of team-based care interventions to improve BP control. Future work is needed to determine the best populations to target with team-based BP programs and how to implement team-based approaches utilizing pharmacists in diverse clinical settings. Future studies need to not only identify unmet clinical needs but also address reimbursement issues and stakeholder engagement that may impact sustainment of team-based care interventions.
Report of the ASSET (Assessment of Safety Significant Events Team) mission to the Khmelnitsky nuclear power plant in Ukraine 8-19 March 1993. Root cause analysis of operational events with a view to enhancing the prevention of accidents
This IAEA Assessment of Safety Significant Events Team (ASSET) Report presents the result of an ASSET team's assessment of their investigation of the effectiveness of the plant policy for prevention of incidents since 1988 at Khmelnitsky nuclear power plant. The plant's one WWER 1000 MW(e) type unit has been in commercial operation since 1987. The results, conclusions and suggestions presented herein reflect the views of the ASSET experts. They are provided for consideration by the responsible authorities in Ukraine. The ASSET team's views presented in this report are based on visits to the plant, on review of documentation made available by the operating organization and on discussion with utility personnel. The report is intended to enhance operational safety at Khmelnitsky by proposing improvements to the policy for the prevention of incidents at the plant. The report includes, as a usual practices, the official responses of the regulatory body operating organization to the ASSET recommendations. Figs, tabs
Norris Jill M
Full Text Available Abstract Background The purpose of this study was to conduct a scoping review of the literature about the establishment and impact of quality and safety team initiatives in acute care. Methods Studies were identified through electronic searches of Medline, Embase, CINAHL, PsycINFO, ABI Inform, Cochrane databases. Grey literature and bibliographies were also searched. Qualitative or quantitative studies that occurred in acute care, describing how quality and safety teams were established or implemented, the impact of teams, or the barriers and/or facilitators of teams were included. Two reviewers independently extracted data on study design, sample, interventions, and outcomes. Quality assessment of full text articles was done independently by two reviewers. Studies were categorized according to dimensions of quality. Results Of 6,674 articles identified, 99 were included in the study. The heterogeneity of studies and results reported precluded quantitative data analyses. Findings revealed limited information about attributes of successful and unsuccessful team initiatives, barriers and facilitators to team initiatives, unique or combined contribution of selected interventions, or how to effectively establish these teams. Conclusions Not unlike systematic reviews of quality improvement collaboratives, this broad review revealed that while teams reported a number of positive results, there are many methodological issues. This study is unique in utilizing traditional quality assessment and more novel methods of quality assessment and reporting of results (SQUIRE to appraise studies. Rigorous design, evaluation, and reporting of quality and safety team initiatives are required.
Burgess, Darren J; Naughton, Geraldine A
Traditional talent development pathways for adolescents in team sports follow talent identification procedures based on subjective games ratings and isolated athletic assessment. Most talent development models are exclusive rather than inclusive in nature. Subsequently, talent identification may result in discontentment, premature stratification, or dropout from team sports. Understanding the multidimensional differences among the requirements of adolescent and elite adult athletes could provide more realistic goals for potential talented players. Coach education should include adolescent development, and rewards for team success at the adolescent level should reflect the needs of long-term player development. Effective talent development needs to incorporate physical and psychological maturity, the relative age effect, objective measures of game sense, and athletic prowess. The influences of media and culture on the individual, and the competing time demands between various competitions for player training time should be monitored and mediated where appropriate. Despite the complexity, talent development is a worthy investment in professional team sport.
Schildmeijer, Kristina; Nilsson, Lena; Perk, Joep; Arestedt, Kristofer; Nilsson, Gunilla
The aim was to describe the strengths and weaknesses, from team member perspectives, of working with the Global Trigger Tool (GTT) method of retrospective record review to identify adverse events causing patient harm. A qualitative, descriptive approach with focus group interviews using content analysis. 5 Swedish hospitals in 2011. 5 GTT teams, with 5 physicians and 11 registered nurses. 5 focus group interviews were carried out with the five teams. Interviews were taped and transcribed verbatim. 8 categories emerged relating to the strengths and weaknesses of the GTT method. The categories found were: Usefulness of the GTT, Application of the GTT, Triggers, Preventability of harm, Team composition, Team tasks, Team members' knowledge development and Documentation. Gradually, changes in the methodology were made by the teams, for example, the teams reported how the registered nurses divided up the charts into two sets, each being read respectively. The teams described the method as important and well functioning. Not only the most important, but also the most difficult, was the task of bringing the results back to the clinic. The teams found it easier to discuss findings at their own clinics. The GTT method functions well for identifying adverse events and is strengthened by its adaptability to different specialties. However, small, gradual methodological changes together with continuingly developed expertise and adaption to looking at harm from a patient's perspective may contribute to large differences in assessment over time.
Miller, Christopher J; Kim, Bo; Silverman, Allie; Bauer, Mark S
Healthcare is increasingly delivered in a team-based format emphasizing interdisciplinary coordination. While recent reviews have investigated team-building interventions primarily in acute healthcare settings (e.g. emergency or surgery departments), we aimed to systematically review the evidence base for team-building interventions in non-acute settings (e.g. primary care or rehabilitation clinics). We conducted a systematic review in PubMed and Embase to identify team-building interventions, and conducted follow-up literature searches to identify articles describing empirical studies of those interventions. This process identified 14 team-building interventions for non-acute healthcare settings, and 25 manuscripts describing empirical studies of these interventions. We evaluated outcomes in four domains: trainee evaluations, teamwork attitudes/knowledge, team functioning, and patient impact. Trainee evaluations for team-building interventions were generally positive, but only one study associated team-building with statistically significant improvement in teamwork attitudes/knowledge. Similarly mixed results emerged for team functioning and patient impact. The evidence base for healthcare team-building interventions in non-acute healthcare settings is much less developed than the parallel literature for short-term team function in acute care settings. Only one intervention we identified has been tested in multiple non-acute settings by distinct research teams. Positive findings regarding the utility of team-building interventions are tempered by a lack of control conditions, inconsistency in outcome measures, and high probability of bias. Considering these results alongside the well-recognized costs of poor healthcare teamwork suggests that additional research is sorely needed to develop the evidence base for team-building in non-acute settings.
Hernandez, H.; Gasca, C.; Beltran, F.; Salvat, M.; Pifarre, D.; Canadell, F.; Aleman, A.
Within the process of maintaining and updating the risk analysis of CN Vandellos II, results from the review of the study of vulnerability of the plant against severe accidents caused by external events (Individual Plant Examination on Extornal Events, IPEEE).
Gast, Inken; Schildkamp, Kim; van der Veen, Jan T
Most professional development activities focus on individual teachers, such as mentoring or the use of portfolios. However, new developments in higher education require teachers to work together in teams more often. Due to these changes, there is a growing need for professional development activities focusing on teams. Therefore, this review study was conducted to provide an overview of what is known about professional development in teams in the context of higher education. A total of 18 articles were reviewed that describe the effects of professional development in teams on teacher attitudes and teacher learning. Furthermore, several factors that can either hinder or support professional development in teams are identified at the individual teacher level, at the team level, and also at the organizational level.
Chotai, Pranit N; Manning, Lisa; Eithun, Benjamin; Ross, Joshua C; Eubanks, James W; Hamner, Chad; Gosain, Ankush
The purpose of this study was to determine the incidence of traumatic injuries, factors associated with mortality, and need for pediatric trauma surgery involvement for drowning and near-drowning events in children. An institutional review board-approved, retrospective chart review was performed at three American College of Surgeons-verified Pediatric Trauma Centers (2011-2014). Patients with International Classification of Diseases, Ninth Revision, codes or E-codes for fatal-nonfatal drowning, fall into water, accidental drowning, or submersion were included. Bivariate analysis using chi-square or Fisher exact test for nominal variables and Mann-Whitney U test for continuous variables was performed. A total of 363 patients (median 3.17 y [18 d-17 y]) met the inclusion criteria. Drowning sites included pool (81.5%), bathtub (12.9%), and natural water (5.2%). A witnessed fall or dive was reported in 34.9%, 57.9% did not fall or dive, and 7% had an unwitnessed event. Most patients did not undergo cervical spine (83%) or brain imaging (75.5%). Seven patients (1.92%) had associated soft tissue injuries. Two patients (0.006%) received surgical intervention (bronchoscopy and extracorporeal membrane oxygenation) within 24 h of presentation. Only 2.2% were admitted to the pediatric trauma service. The percentage of patients discharged home from the emergency department was 10.2%. Overall mortality was 12.4%. Factors associated with mortality included transfer from outside hospital (P = 0.016), presence of hypothermia on arrival (P drowning in a pool (P = 0.013), or undergoing brain cooling at admission (P = 0.011). This is the largest reported series of pediatric near-drowning events. Only rarely did patients require immediate surgical attention and the majority were admitted to nonsurgical services. These data suggest that routine pediatric trauma surgery service involvement in patients with near-drowning events may be unnecessary. Copyright © 2017 Elsevier
van Dijk, J.; Meyer, B.; van Engen, M.L.; Loyd, D.L.
Research on the consequences of diversity in teams continues to produce inconsistent results. We review the recent developments in diversity research and identify two shortcomings. First, an understanding of the microdynamics affecting processes and outcomes in diverse teams is lacking. Second,
Gast, Inken; Schildkamp, Kim; van der Veen, Jan T.
Most professional development activities focus on individual teachers, such as mentoring or the use of portfolios. However, new developments in higher education require teachers to work together in teams more often. Due to these changes, there is a growing need for professional development activities focusing on teams. Therefore, this review study…
the notification of nuclear and radiation safety-related events; Provisions established by the BNRA to manage its technical support organisations provide a good basis to use them effectively; The process to establish and keep updated regulations and guidelines is well structured and involves, as necessary, relevant interested parties; The BNRA has a policy of transparency and openness with the public, which covers in an effective manner the provision of information on safety-related events and protective actions during emergencies; and There is a complete national dose registry system that includes provision for comprehensive information gathering, which allows for thorough cause-effect analyses to be performed. The IRRS team identified the following areas where the overall performance of the regulatory system could be enhanced: Demarcation of the respective roles of state authorities in the area of radiation protection safety, and establishment of formal coordination and cooperation of their regulatory functions; BNRA's resources and competence for oversight of future facilities and activities; BNRA's establishment of an integrated management system that contributes to meeting its goals in an efficient manner; BNRA procedures used for the review and assessment process for all facilities and activities; and Inspection processes, including the development and implementation of planned and systematic inspection programmes that cover all facilities and activities, and coordination among different regulatory organisations. A final report will be submitted to the Government of Bulgaria in about three months. The BNRA announced to the mission that the report will be made publicly available. The IAEA encourages nations to invite a follow-up IRRS mission about two years after the initial mission has been completed. Background The team reviewed the legal and regulatory framework for nuclear and radiation safety, addressing all facilities and activities regulated by BNRA
Thayer, Amanda L; Petruzzelli, Alexandra; McClurg, Caitlin E
Facilitating team innovation is paramount to promoting progress in the science, technology, engineering, and math fields, as well as advancing national health, safety, prosperity, and welfare. However, innovation teams face a unique set of challenges due to the novelty and uncertainty that is core to the definition of innovation, as well as the paradoxical nature of idea generation and idea implementation processes. These and other challenges must be overcome for innovation teams to realize their full potential for producing change. The purpose of this review is, thus, to provide insight into the unique context that these teams function within and provide an integrative, evidence-based, and practically useful, organizing heuristic that focuses on the most important considerations for facilitating team innovation. Finally, we provide practical guidance for psychologists, organizations, practitioners, scientists, educators, policymakers, and others who employ teams to produce novel, innovative solutions to today's problems. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Geach, Nicole; Moghaddam, Nima G; De Boos, Danielle
Team formulation is promoted by professional practice guidelines for clinical psychologists. However, it is unclear whether team formulation is understood/implemented in consistent ways - or whether there is outcome evidence to support the promotion of this practice. This systematic review aimed to (1) synthesize how team formulation practice is defined and implemented by practitioner psychologists and (2) analyse the range of team formulation outcomes in the peer-reviewed literature. Seven electronic bibliographic databases were searched in June 2016. Eleven articles met inclusion criteria and were quality assessed. Extracted data were synthesized using content analysis. Descriptions of team formulation revealed three main forms of instantiation: (1) a structured, consultation approach; (2) semi-structured, reflective practice meetings; and (3) unstructured/informal sharing of ideas through routine interactions. Outcome evidence linked team formulation to a range of outcomes for staff teams and service users, including some negative outcomes. Quality appraisal identified significant issues with evaluation methods; such that, overall, outcomes were not well-supported. There is weak evidence to support the claimed beneficial outcomes of team formulation in practice. There is a need for greater specification and standardization of 'team formulation' practices, to enable a clearer understanding of any relationships with outcomes and implications for best-practice implementations. Under the umbrella term of 'team formulation', three types of practice are reported: (1) highly structured consultation; (2) reflective practice meetings; and (3) informal sharing of ideas. Outcomes linked to team formulation, including some negative outcomes, were not well evidenced. Research using robust study designs is required to investigate the process and outcomes of team formulation practice. © 2017 The British Psychological Society.
Davis, D [Comanche Peak Steam Electric Staion, Texas Utilities, TX (United States)
The presentations describes the following issues: levels of defense in depth; internal safety review organizations; methods used to perform safety assessment; safety committee review; quality verification; root cause analysis; human performance program; industry operating experience.
Garrison, A.; Aponte, C.
A process upset occurred in the Modular Caustic-Side Solvent Extraction Unit (MCU) facility on April 6th, 2014. During recovery efforts, a significant amount of solids were found in the Salt Solution Feed Tank (SSFT), Salt Solution Receipt Tanks (SSRTs), two extraction contactors, and scrub contactors. The solids were identified by Savannah River National Laboratory (SRNL) as primarily sodium oxalate and sodium alumina silicate (NAS) with the presence of some aluminum hydroxide. NAS solids have been present in the SSFT since simulant runs during cold chemical startup of MCU in 2007, and have not hindered operations since that time. During the process upset in April 2014, the oxalate solids partially blocked the aqueous outlet of the extraction contactors, causing salt solution to exit through the contactor organic outlet to the scrub contactors with the organic phase. This salt solution overwhelmed the scrub contactors and passed with the organic phase to the strip section of MCU. The partially reversed flow of salt solution resulted in a Strip Effluent (SE) stream that was high in Isopar™ L, pH and sodium. The primary cause of the excessive solids accumulation in the SSRTs and SSFT at MCU is attributed to an increase in the frequency of oxalic acid cleaning of the 512-S primary filter. Agitation in the SSRTs at MCU in response to cold weather likely provided the primary mechanism to transfer the solids to the contactors. Sources of the sodium oxalate solids are attributed to the oxalic acid cleaning solution used to clean the primary filter at the Actinide Removal Process (ARP) filtration at 512-S, as well as precipitation from the salt batch feed, which is at or near oxalate saturation. The Solids Recovery Team was formed to determine the cause of the solids formation and develop recommendations to prevent or mitigate this event in the future. A total of 53 recommendations were generated. These recommendations were organized into 4 focus areas: • Improve
Riyadi, Eko H.
Initiating event is defined as any event either internal or external to the nuclear power plants (NPPs) that perturbs the steady state operation of the plant, if operating, thereby initiating an abnormal event such as transient or loss of coolant accident (LOCA) within the NPPs. These initiating events trigger sequences of events that challenge plant control and safety systems whose failure could potentially lead to core damage or large early release. Selection for initiating events consists of two steps i.e. first step, definition of possible events, such as by evaluating a comprehensive engineering, and by constructing a top level logic model. Then the second step, grouping of identified initiating event's by the safety function to be performed or combinations of systems responses. Therefore, the purpose of this paper is to discuss initiating events identification in event tree development process and to reviews other probabilistic safety assessments (PSA). The identification of initiating events also involves the past operating experience, review of other PSA, failure mode and effect analysis (FMEA), feedback from system modeling, and master logic diagram (special type of fault tree). By using the method of study for the condition of the traditional US PSA categorization in detail, could be obtained the important initiating events that are categorized into LOCA, transients and external events
Riyadi, Eko H., E-mail: email@example.com [Center for Regulatory Assessment of Nuclear Installation and Materials, Nuclear Energy Regulatory Agency (BAPETEN), Jl. Gajah Mada 8 Jakarta 10120 (Indonesia)
Initiating event is defined as any event either internal or external to the nuclear power plants (NPPs) that perturbs the steady state operation of the plant, if operating, thereby initiating an abnormal event such as transient or loss of coolant accident (LOCA) within the NPPs. These initiating events trigger sequences of events that challenge plant control and safety systems whose failure could potentially lead to core damage or large early release. Selection for initiating events consists of two steps i.e. first step, definition of possible events, such as by evaluating a comprehensive engineering, and by constructing a top level logic model. Then the second step, grouping of identified initiating event's by the safety function to be performed or combinations of systems responses. Therefore, the purpose of this paper is to discuss initiating events identification in event tree development process and to reviews other probabilistic safety assessments (PSA). The identification of initiating events also involves the past operating experience, review of other PSA, failure mode and effect analysis (FMEA), feedback from system modeling, and master logic diagram (special type of fault tree). By using the method of study for the condition of the traditional US PSA categorization in detail, could be obtained the important initiating events that are categorized into LOCA, transients and external events.
Full text: An international team of senior nuclear safety and radiation protection experts yesterday concluded an 11-day mission to review the regulatory framework for nuclear and radiation safety in Greece. The Integrated Regulatory Review Service (IRRS) mission, which was conducted at the request of the Government of the Hellenic Republic, noted good practices in the country's nuclear regulatory system and also identified issues for improvement for the Greek Atomic Energy Commission (GAEC) and the Greek competent authorities. These are aimed at strengthening the effectiveness of the country's regulatory framework and functions in line with IAEA Safety Standards. ''The IRRS team enjoyed excellent cooperation from the GAEC throughout its mission,'' said Tom Ryan, mission leader and Director of Regulations and Information Management at the Radiological Protection Institute of Ireland. ''The GAEC staff were very open and candid in their discussions and provided the fullest practicable assistance.'' The main observations of the IRRS Review team included: While the Greek Government's commitment to safety is being demonstrated through its actions, the development of a comprehensive national policy and strategy expressed in a consolidated statement would provide a valuable framework and guidance for future actions in terms of safety; and GAEC has effective independence. The Greek government has ensured that GAEC is effectively independent in its safety-related decision-making and that it has functional separation from entities having responsibility or interests that could unduly influence its decision making. Strengths and good practices identified by the IRRS team included: Greece actively participates in the global safety regime including all relevant safety conventions; The nation's radiation monitoring system for the detection of illicit trafficking contributes significantly to identifying potential radiation emergencies due to events within or outside the country
Manchado, Carmen; Tortosa-Martínez, Juan; Vila, Helena; Ferragut, Carmen; Platen, Petra
Team handball is an Olympic sport played professionally in many European countries. Nevertheless, a scientific knowledge regarding women's elite team handball demands is limited. Thus, the purpose of this article was to review a series of studies (n = 33) on physical characteristics, physiological attributes, physical attributes, throwing velocity, and on-court performances of women's team handball players. Such empirical and practical information is essential to design and implement successful short-term and long-term training programs for women's team handball players. Our review revealed that (a) players that have a higher skill level are taller and have a higher fat-free mass; (b) players who are more aerobically resistant are at an advantage in international level women team handball; (c) strength and power exercises should be emphasized in conditioning programs, because they are associated with both sprint performance and throwing velocity; (d) speed drills should also be implemented in conditioning programs but after a decrease in physical training volume; (e) a time-motion analysis is an effective method of quantifying the demands of team handball and provides a conceptual framework for the specific physical preparation of players. According to our results, there are only few studies on on-court performance and time-motion analysis for women's team handball players, especially concerning acceleration profiles. More studies are needed to examine the effectiveness of different training programs of women's team handball players' physiological and physical attributes.
Goh, Teik T; Eccles, Martin P
Abstract Background Attributes of teams could affect the quality of care delivered in primary care. The aim of this study was to systematically review studies conducted within the UK NHS primary care that have measured team climate using the Team Climate Inventory (TCI), and to describe, if reported, the relationship between the TCI and measures of quality of care. Findings The databases MEDLINE, EMBASE, and CINAHL were searched. The reference lists of included article were checked and one re...
Leenders, R.T.A.J.; Contractor, N.; DeChurch, L.
For as long as groups and teams have been the subject of scientific inquiry, researchers have been interested in understanding the relationships that form within them, and the pace at which these relationships develop and change. Despite this interest in understanding the process underlying the
LBS Management Review. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 9, No 1 (2004) >. Log in or Register to get access to full text downloads.
Shoemaker, Sarah J; Parchman, Michael L; Fuda, Kathleen Kerwin; Schaefer, Judith; Levin, Jessica; Hunt, Meaghan; Ricciardi, Richard
Interprofessional team-based care is increasingly regarded as an important feature of delivery systems redesigned to provide more efficient and higher quality care, including primary care. Measurement of the functioning of such teams might enable improvement of team effectiveness and could facilitate research on team-based primary care. Our aims were to develop a conceptual framework of high-functioning primary care teams to identify and review instruments that measure the constructs identified in the framework, and to create a searchable, web-based atlas of such instruments (available at: http://primarycaremeasures.ahrq.gov/team-based-care/ ). Our conceptual framework was developed from existing frameworks, the teamwork literature, and expert input. The framework is based on an Input-Mediator-Output model and includes 12 constructs to which we mapped both instruments as a whole, and individual instrument items. Instruments were also reviewed for relevance to measuring team-based care, and characterized. Instruments were identified from peer-reviewed and grey literature, measure databases, and expert input. From nearly 200 instruments initially identified, we found 48 to be relevant to measuring team-based primary care. The majority of instruments were surveys (n = 44), and the remainder (n = 4) were observational checklists. Most instruments had been developed/tested in healthcare settings (n = 30) and addressed multiple constructs, most commonly communication (n = 42), heedful interrelating (n = 42), respectful interactions (n = 40), and shared explicit goals (n = 37). The majority of instruments had some reliability testing (n = 39) and over half included validity testing (n = 29). Currently available instruments offer promise to researchers and practitioners to assess teams' performance, but additional work is needed to adapt these instruments for primary care settings.
Lake, Warren; Wallin, Margie; Boyd, Bill; Woolcott, Geoff; Markopoulos, Christos; Boyd, Wendy; Foster, Alan
Undertaking a systematic review can have many benefits, beyond any theoretical or conceptual discoveries pertaining to the underlying research question. This paper explores the value of utilising a hybrid academic team when undertaking the systematic review process, and shares a range of practical strategies. The paper also comments on how such a…
Bjørn, Brian; Anhøj, Jacob; Østergaard, Mette
and review 2 and between period 1 and period 2. The increase was solely in category E, minor temporary harm. CONCLUSIONS: The very experienced GTT team could not reproduce harm rates found in earlier reviews. We conclude that GTT in its present form is not a reliable measure of harm rate over time....
Canadell, F.; Aleman, A.; Beltran, F.; Pifarre, D.; Hernandez, H.; Gasca, C.
Within the process of maintaining and updating the risk analysis of the NPP Asco, results from the review of the vulnerability study of the plant against severe accidents caused by external success (Individual Plant Examination of External Events, IPEEE).
McPhillips, Lauren E.; Chang, Heejun; Chester, Mikhail V.; Depietri, Yaella; Friedman, Erin; Grimm, Nancy B.; Kominoski, John S.; McPhearson, Timon; Méndez-Lázaro, Pablo; Rosi, Emma J.; Shafiei Shiva, Javad
Extreme events are of interest worldwide given their potential for substantial impacts on social, ecological, and technical systems. Many climate-related extreme events are increasing in frequency and/or magnitude due to anthropogenic climate change, and there is increased potential for impacts due to the location of urbanization and the expansion of urban centers and infrastructures. Many disciplines are engaged in research and management of these events. However, a lack of coherence exists in what constitutes and defines an extreme event across these fields, which impedes our ability to holistically understand and manage these events. Here, we review 10 years of academic literature and use text analysis to elucidate how six major disciplines—climatology, earth sciences, ecology, engineering, hydrology, and social sciences—define and communicate extreme events. Our results highlight critical disciplinary differences in the language used to communicate extreme events. Additionally, we found a wide range in definitions and thresholds, with more than half of examined papers not providing an explicit definition, and disagreement over whether impacts are included in the definition. We urge distinction between extreme events and their impacts, so that we can better assess when responses to extreme events have actually enhanced resilience. Additionally, we suggest that all researchers and managers of extreme events be more explicit in their definition of such events as well as be more cognizant of how they are communicating extreme events. We believe clearer and more consistent definitions and communication can support transdisciplinary understanding and management of extreme events.
Chan, Vincent; Patounas, Marea; Dornbusch, Debbie; Tran, Hung; Watson, Patricia
Homelessness is a significant public health problem. It is well-documented that people experiencing homelessness exhibit more serious illnesses and have poorer health than the general population. The provision of services and interventions by health-care professionals, including pharmacists, may make a simple yet important contribution to improved health outcomes in those experiencing homelessness, but evidence of roles and interventions is limited and variable. In Australia, the Queensland University of Technology Health Clinic connects with the homeless community by taking part in community outreach events. This paper provides details of one such event, as well as the roles, interventions and experiences of pharmacists. Participation and inclusion of pharmacists in a multidisciplinary health-care team approach at homeless outreach events should be supported and encouraged.
Johansson, Gudrun; Eklund, Kajsa; Gosman-Hedström, Gunilla
As the number of elderly persons with complex health needs is increasing, teams for their care have been recommended as a means of meeting these needs, particularly in the case of elderly persons with multi-diseases. Occupational therapists, in their role as team members, exert significant influence in guiding team recommendations. However, it has been emphasized that there is a lack of sound research to show the impact of teamwork from the perspective of elderly persons. The aim of this paper was to explore literature concerning multidisciplinary teams that work with elderly persons living in the community. The research method was a systematic literature review and a total of 37 articles was analysed. The result describes team organisation, team intervention and outcome, and factors that influence teamwork. Working in a team is multifaceted and complex. It is important to enhance awareness about factors that influence teamwork. The team process itself is also of great importance. Clinical implications for developing effective and efficient teamwork are also presented and discussed.
Full Text Available Much like the parade of claimants for the hand of Penelope in Homer’s Odyssey, the theoretical humanities have been presented with a string of would-be maîtres à pensers, each bringing with them claims of radical originality, and the promise of hope for the disciplines in question. Not only is the philosophy of Alain Badiou among the very few who have serious justifications to the claim of originality, the rigour, scope and goals of his philosophy reveal him as the first thinker in a long time to have the resources necessary to engage with the ailments of theoretical discourse in the contemporary environment of global capitalism, and the steady dismantling of the traditional infrastructure of the human sciences and philosophy. This article provides an outline of the key positions espoused in Badiou's key work Being and Event, and an assessment of its contemporary import.
Doumouras, Aristithes G; Keshet, Itay; Nathens, Avery B; Ahmed, Najma; Hicks, Christopher M
Team-based training using crisis resource management (CRM) has gained popularity as a strategy to minimize the impact of medical error during critical events. The purpose of this review was to appraise and summarize the design, implementation, and efficacy of peer-reviewed, simulation-based CRM training programs for postgraduate trainees (residents). Two independent reviewers conducted a structured literature review, querying multiple medical and allied health databases from 1950 to May 2010 (MEDLINE, EMBASE, CINAHL, EBM, and PsycINFO). We included articles that (1) were written in English, (2) were published in peer-reviewed journals, (3) included residents, (4) contained a simulation component, and (5) included a team-based component. Peer-reviewed articles describing the implementation of CRM instruction were critically appraised using the Kirkpatrick framework for evaluating training programs. Fifteen studies involving a total of 404 residents met inclusion criteria; most studies reported high resident satisfaction for CRM training. In several CRM domains, residents demonstrated significant improvements after training, which did not decay over time. With regard to design, oral feedback may be equivalent to video feedback and single-day interventions may be as efficacious as multiple-day interventions for residents. No studies demonstrated a link between simulation-based CRM training and performance during real-life critical events. The findings support the utility of CRM programs for residents. A high degree of satisfaction and perceived value reflect robust resident engagement. The iteration of themes from our review provides the basis for the development of best practices in curricula design. A dearth of well-designed, randomized studies preclude the quantification of impact of simulation-based training in the clinical environment. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Streater, Amy; Coleston-Shields, Donna Maria; Yates, Jennifer; Stanyon, Miriam; Orrell, Martin
Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis. The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8%) of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors. Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required to deliver a standardized care pathway and measurable intervention as part of a large-scale evaluation of effectiveness.
Wen, Jin; Schulman, Kevin A.
Background Team-based approaches to patient care are a relatively recent innovation in health care delivery. The effectiveness of these approaches on patient outcomes has not been well documented. This paper reports a systematic review of the relationship between team-based care and patient satisfaction. Methods We searched MEDLINE, EMBASE, Cochrane Library, CINAHL, and PSYCHOINFO for eligible studies dating from inception to October 8, 2012. Eligible studies reported (1) a randomized controlled trial, (2) interventions including both team-based care and non-team-based care (or usual care), and (3) outcomes including an assessment of patient satisfaction. Articles with different settings between intervention and control were excluded, as were trial protocols. The reference lists of retrieved papers were also evaluated for inclusion. Results The literature search yielded 319 citations, of which 77 were screened for further full-text evaluation. Of these, 27 articles were included in the systematic review. The 26 trials with a total of 15,526 participants were included in this systematic review. The pooling result of dichotomous data (number of studies: 10) showed that team-based care had a positive effect on patient satisfaction compared with usual care (odds ratio, 2.09; 95% confidence interval, 1.54 to 2.84); however, combined continuous data (number of studies: 7) demonstrated that there was no significant difference in patient satisfaction between team-based care and usual care (standardized mean difference, −0.02; 95% confidence interval, −0.40 to 0.36). Conclusions Some evidence showed that team-based care is better than usual care in improving patient satisfaction. However, considering the pooling result of continuous data, along with the suboptimal quality of included trials, further large-scale and high-quality randomized controlled trials comparing team-based care and usual care are needed. PMID:25014674
lead to or re- sult in violent acts. 2. Finding 2.3 - DoD standards for denying requests for recognition as an ecclesiastical endorser of chaplains may...review and pos- sible revision to ensure the supporting architecture and capabilities exist to support the mission. No cost estimate is necessary to...enterprise architecture . The goal is to field interoperable installation physi- cal access control systems that can access the Defense Manpower Data
Franklin, Catherine M; Bernhardt, Jean M; Lopez, Ruth Palan; Long-Middleton, Ellen R; Davis, Sheila
Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1) shared understanding of roles, norms, values, and goals of the team; (2) egalitarianism; (3) cooperation; (4) interdependence; and(5) synergy. Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamwork. Four studies identified in this integrative review serve as exemplars for effective interprofessional teamwork between CHWs and health care teams. Further study is needed to describe the nature of interprofessional teamwork and collaboration in relation to patient health outcomes.
O'Sullivan, M; Cullen, W; MacFarlane, A
The Irish government published its primary care strategy, Primary Care: A New Direction in 2001. Progress with the implementation of Primary care teams is modest. The aim of this paper is to map the Irish grey literature and peer-reviewed publications to determine what research has been carried out in relation to primary care teams, the reform process and interdisciplinary working in primary care in Ireland. This scoping review employed three methods: a review of Web of Science, Medline and Embase databases, an email survey of researchers across academic institutions, the HSE and independent researchers and a review of Lenus and the Health Well repository. N = 123 outputs were identified. N = 14 were selected for inclusion. A thematic analysis was undertaken. Common themes identified were resources, GP participation, leadership, clarity regarding roles in primary care teams, skills and knowledge for primary care team working, communication and community. There is evidence of significant problems that disrupt team formation and functioning that warrants more comprehensive research.
O'Shea, Thomas J.; Cryan, Paul; Hayman, David TH; Plowright, Raina K.; Streicker, Daniel G.
Despite conservation concerns for many species of bats, factors causing mortality in bats have not been reviewed since 1970. Here, we review and qualitatively describe trends in the occurrence and apparent causes of multiple mortality events (MMEs) in bats around the world.
Jagiełło, Władysław; Marina, Jagiełło; Maciej, Kalina Roman; Jan, Barczyński Bartłomiej; Artur, Litwiniuk; Jarosław, Klimczak
Fencing is a combat sport whose form of direct confrontation involves hitting the opponent with a weapon. The purpose of the study was to determine the properties of body composition of female representatives of the Polish national fencing team. The study involved 11 female athletes of the Polish national fencing team. Their age was 16-22 years (19±2.32), body weight 52-78 kg (59.7±7.4), body height 158-183 cm (167.46±6.10) and the training experience 7.64±3.47 years. The reference group consisted of 153 students of Warsaw University of Technology (Poland). Twenty basic somatic characteristics were measured. The following indices were calculated: slenderness, Rohrer's, BMI, Manouvrier's, and pelvic-shoulder indices. Density of the body, total body fat, active tissue, the overall profile of body composition and internal proportions of the body were determined. Analysis of internal proportions of factors of the athletes' body composition revealed significant differences in particular groups of features. The total size of the athletes' bodies is due to less-than-average magnitude of the length and stoutness characteristics and a high magnitude of adiposity (M = 0.63) in the Polish female national team of fencers (sabre) calculated from the normalized values for the control group. The proportions of features within the analysed factors revealed a significant advantage of the length of the upper extremity over the lower one and a distinct advantage of forearm musculature. The specific profile of body composition of female athletes practising sabre fencing is most likely due to long-term effects of training as well as the system of selection of persons with specific somatic prerequisites developed in the course of many years of training practice.
The IAEA Uranium Production Safety Assessment Team (UPSAT) programme is designed to assist Member States to improve the safe operation of uranium production facilities. This programme facilitates the exchange of knowledge and experience between team members and industry personnel. An UPSAT mission is an international expert review, conducted outside of any regulatory framework. The programme is implemented in the spirit of voluntary co-operation to contribute to the enhancement of operational safety and practices where it is most effective, at the facility itself. An UPSAT review supplements other facility and regulatory efforts which may have the same objective
Vlayen, Annemie; Verelst, Sandra; Bekkering, Geertruida E; Schrooten, Ward; Hellings, Johan; Claes, Neree
Adverse events are unintended patient injuries or complications that arise from health care management resulting in death, disability or prolonged hospital stay. Adverse events that require critical care are a considerable financial burden to the health care system, but also their global impact on patients and society is probably underestimated. The objectives of this systematic review were to synthesize the best available evidence regarding the estimates of the incidence and preventability of adverse events that necessitate intensive care admission, to determine the type and consequences [mortality, length of intensive care unit (ICU) stay and costs] of these adverse events. MEDLINE (from 1966 to present), EMBASE (from 1974 to present) and CENTRAL (version 1-2010) were searched for studies reporting on unplanned admissions on ICUs. Several other sources were searched for additional studies. Only quantitative studies that used chart review for the detection of adverse events requiring intensive care admission were considered for eligibility. For the purposes of this systematic review, ICUs were defined as specialized hospital facilities which provide continuous monitoring and intensive care for acutely ill patients. Studies that were published in the English, Dutch, German, French or Spanish language were eligible for inclusion. Two reviewers independently extracted data and assessed the methodological quality of the included studies. A total of 27 studies were reviewed. Meta-analysis of the data was not appropriate because of methodological and statistical heterogeneity between studies; therefore, results are presented in a descriptive way. The percentage of surgical and medical adverse events that required ICU admission ranged from 1.1% to 37.2%. ICU readmissions varied from 0% to 18.3%. Preventability of the adverse events varied from 17% to 76.5%. Preventable adverse events are further synthesized by type of event. Consequences of the adverse events included a
Bittner, Paulina; Polich, Paul; Gore, Jane; Ali, Sherif Mohamed; Medinskaya, Tatiana; Mialle, Pierrick
Until 2003 two waveform technologies, i.e. seismic and hydroacoustic were used to detect and locate events included in the International Data Centre (IDC) Reviewed Event Bulletin (REB). The first atmospheric event was published in the REB in 2003 but infrasound detections could not be used by the Global Association (GA) Software due to the unmanageable high number of spurious associations. Offline improvements of the automatic processing took place to reduce the number of false detections to a reasonable level. In February 2010 the infrasound technology was reintroduced to the IDC operations and has contributed to both automatic and reviewed IDC bulletins. The primary contribution of infrasound technology is to detect atmospheric events. These events may also be observed at seismic stations, which will significantly improve event location. Examples of REB events, which were detected by the International Monitoring System (IMS) infrasound network were fireballs (e.g. Bangkok fireball, 2015), volcanic eruptions (e.g. Calbuco, Chile 2015) and large surface explosions (e.g. Tjanjin, China 2015). Query blasts and large earthquakes belong to events primarily recorded at seismic stations of the IMS network but often detected at the infrasound stations. Presence of infrasound detection associated to an event from a mining area indicates a surface explosion. Satellite imaging and a database of active mines can be used to confirm the origin of such events. This presentation will summarize the contribution of 6 years of infrasound data to IDC bulletins and provide examples of events recorded at the IMS infrasound network. Results of this study may help to improve location of small events with observations on infrasound stations.
This report was prepared in response to a request by the Chairman of the US Nuclear Regulatory Commission for the Advisory Committee on Reactor Safeguards to review, with specific objectives, the Licensee Event Reports (LERs) issued fom 1976 through 1978. A principal objective of the present study was to identify those events which have implications for improved reactor safety. Approximately 8,700 LERs were filed during the three-year period under review. These described events ranging from the trivial to those of major safety significance. This study has confirmed that LERs represent a source of valuable data and information. However, it must be recognized that a detailed review of LERs will not identify all safety problems likely to be encountered in the operation of nuclear power plants. As a result of this review, a number of classes of events were identified. These classes were subsequently categorized into three groups: (a) those having potentially serious safety implications, (b) events that must be regarded as matters of concern, and (c) events of lower safety significance but with excessive frequency
van de Sandt, Femke; Umans, Victor
The incidence of acute cardiac events - including out-of-hospital cardiac arrest - may be increased in visitors of large sports stadiums when compared with the general population. This study sought to investigate the incidence of acute cardiac events inside large Dutch football stadiums, as well as the emergency response systems deployed in these stadiums and the success rate for in-stadium resuscitation. Retrospective cohort study using a questionnaire sent to the 20 Dutch stadiums that hosted professional matches during the 2006-2007 and 2007-2008 football seasons. Stadium capacity ranged from 3600 to 51 600 spectators. Nearly 13 million spectators attended 686 'Eredivisie' (Honorary Division) and European football matches. All stadiums distribute multiple emergency medical teams among the spectators. Eighty-five percent of the stadiums have an ambulance standby during matches, 95% of the stadiums were equipped with automated external defibrillators (AEDs) during the study period. On an average, one AED was available for every 7576 spectators (range 1800-29 600). Ninety-three cardiac events were reported (7.3 per 1 million spectators). An AED was used 22 times (1.7 per 1 million spectators). Resuscitation was successful in 18 cases (82%, 95% confidence interval: 61-93). The incidence of out-of-hospital cardiac arrest inside large football stadiums in the Netherlands, albeit increased when compared with the general population, is low. The success rate for in-stadium resuscitation by medical teams equipped with AEDs is high. Dutch stadiums appear vigilant in regard to acute cardiac events. This report highlights the importance of adequate emergency medical response systems (including AEDs) in large sports venues.
Bunderson, J. Stuart; van der Vegt, Gerben S.
The promise and perils of heterogeneity in team member characteristics has been and continues to be one of the central questions in research on management teams. We review the literature on member heterogeneity within management teams, with a focus on summarizing and integrating research on both
The IAEA works to provide a global nuclear safety and security framework for the protection of people and the environment from the effects of ionizing radiation, the minimization of the likelihood of accidents that could endanger life and property, and effective mitigation of the effects of any such events, should they occur. The strategic approach to achieving such a framework involves continual improvement in four areas: national and international safety infrastructures; the establishment and global acceptance of IAEA safety standards; an integrated approach to the provision for the application of the safety standards; and a global network of knowledge and experience. The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the safety of nuclear power plants during commissioning and operation. The OSART programme, initiated in 1982, is available to all Member States with nuclear power plants under commissioning or in operation. Conservative design, careful manufacture and sound construction are all prerequisites for the safe operation of nuclear power plants. However, the safety of the plant also depends ultimately on: sound management, policies, procedures, processes and practices; the capability and reliability of commissioning and operating personnel; comprehensive instructions; sound accident management and emergency preparedness; and adequate resources. Finally, a positive attitude and conscientiousness on the part of all staff in discharging their responsibilities is important to safety. The OSART programme is based on the safety standards applicable to nuclear power plants. IAEA safety standards reflect the consensus of Member States on nuclear safety matters. The reports of the International Nuclear Safety Group identify important current nuclear safety issues and also serve as references during an OSART review. The publication OSART Guidelines provides overall guidance on the conduct of OSART
Full text: International safety experts last week concluded a two-week International Atomic Energy Agency (IAEA) mission to review the regulatory framework for nuclear and radiation safety in Poland. In its preliminary report, the Integrated Regulatory Review Service (IRRS) mission team found that Poland's nuclear regulator, Panstwowa Agencja Atomistyki (PAA), has a clear commitment to safety, a high level of transparency, competent staff and leadership, and a good recognition of challenges ahead related to Poland's efforts to develop nuclear power. ''Poland's regulatory framework and the work of PAA give high confidence of strong radiation protection for the Polish people. Further, there has been significant progress in the development of Poland's regulatory framework in preparation for the challenge of regulating nuclear power,'' said team leader Robert Lewis, a senior executive in the US Nuclear Regulatory Commission. The mission was conducted at the request of the Government of Poland from 15-25 April. The team was made up of 11 regulatory experts from Belgium, the Czech Republic, Finland, France, the Republic of Korea, Slovakia, Slovenia, Sweden, the United Arab Emirates, the United Kingdom and the United States, as well as five IAEA staff members. The IRRS review team was very thorough in its review, and we welcome its advice on how to continue to improve our programmes to protect people and the environment , said Janusz Wlodarski, President of PAA. The team interviewed members of PAA and officials from various ministries, as well as key players in the Polish safety framework. Such IRRS missions are peer reviews based on IAEA Safety Standards, not inspections or audits. Among its main observations the IRRS review team identified the following good practices: Applying the considerable experience of PAA's senior management to regulatory issues; The introduction of changes to Poland's laws and regulations following broad public consultation at an early stage in
This report describes the results of an independent review team brought in to assess CH2M HILL Hanford's readiness and ability to support the RPP's move into its next major phase - retrieval and delivery of tank waste to the Privatization Contractor
This report describes the results of an independent review team brought in to assess CH2M Hill Hanford Group's readiness and ability to support the RPP's move into its next major phase - retrieval and delivery of tank waste to the Privatization Contractor
Basta, Y.L.; Bolle, S.; Fockens, P.; Tytgat, K.M.A.J.
Introduction The incidence of gastrointestinal (GI) cancer is rising and most patients with GI malignancies are discussed by a multidisciplinary team (MDT). We performed a systematic review to assess whether MDTs for patients with GI malignancies can correctly change diagnosis, tumor stage and
Basta, Yara L.; Bolle, Sifra; Fockens, Paul; Tytgat, Kristien M. A. J.
Introduction. The incidence of gastrointestinal (GI) cancer is rising and most patients with GI malignancies are discussed by a multidisciplinary team (MDT). We performed a systematic review to assess whether MDTs for patients with GI malignancies can correctly change diagnosis, tumor stage and
Barton, Glenn; Bruce, Anne; Schreiber, Rita
Widespread demands for high reliability healthcare teamwork have given rise to many educational initiatives aimed at building team competence. Most effort has focused on interprofessional team training however; Registered Nursing teams comprise the largest human resource delivering direct patient care in hospitals. Nurses also influence many other health team outcomes, yet little is known about the team training curricula they receive, and furthermore what specific factors help translate teamwork competency to nursing practice. The aim of this review is to critically analyse empirical published work reporting on teamwork education interventions in nursing, and identify key educational considerations enabling teamwork competency in this group. CINAHL, Web of Science, Academic Search Complete, and ERIC databases were searched and detailed inclusion-exclusion criteria applied. Studies (n = 19) were selected and evaluated using established qualitative-quantitative appraisal tools and a systematic constant comparative approach. Nursing teamwork knowledge is rooted in High Reliability Teams theory and Crew or Crisis Resource Management sources. Constructivist pedagogy is used to teach, practice, and refine teamwork competency. Nursing teamwork assessment is complex; involving integrated yet individualized determinations of knowledge, skills, and attitudes. Future initiatives need consider frontline leadership, supportive followership and skilled communication emphasis. Collective stakeholder support is required to translate teamwork competency into nursing practice. Copyright © 2017 Elsevier Ltd. All rights reserved.
Vardaxi, Chrysoula Ch; Gonda, Xenia; Fountoulakis, Konstantinos N
Life events play a central role in the development of psychiatric disorders and impact course and outcome. We present a systematic review of the literature on the relationship of life events with the onset and long-term course of schizoaffective disorder. MEDLINE was searched with the combination of the key words: 'life events' plus 'schizoaffective'. The PRISMA method was followed in the review process. From the identified 66 papers only 12 were considered to be of relevance to the current study and 6 more papers were identified by inspecting the reference lists of the identified papers. There are very few studies focusing on the role of life events in schizoaffective disorder indicating insufficient data concerning the relationship of life events with onset and long-term course of schizoaffective disorder. Reported effects are not generic but concern specific events like the loss of mother, and females seem to be more vulnerable. Patients with schizoaffective disorder manifest high rates of PTSD. The literature on life events with the development and course of schizoaffective disorder is limited and precludes solid conclusions. Copyright © 2017 Elsevier B.V. All rights reserved.
Full Text Available Melioidosis is an endemic infection in Cambodia, a lower middle income SE Asian country. Despite more laboratories isolating and identifying Burkholderia pseudomallei in recent years, the infection remains under-recognised and under-diagnosed, particularly in the adult population. Lack of knowledge about the disease and lack of utilization of microbiology laboratories contributes to this, along with laboratory capacity issues. Treatment costs often hamper optimal management. In response to these issues, a national one-health training event was held in October 2017 to raise awareness of the disease amongst clinical, laboratory, and public health professionals. The meeting format, findings, and outcomes are described here.
Hur, Yera; Cho, A Ra; Kim, Sun
Team-based learning (TBL) is an active learning approach. In recent years, medical educators have been increasingly using TBL in their classes. We reviewed the concepts of TBL and discuss examples of international cases. Two types of TBL are administered: classic TBL and adapted TBL. Combining TBL and problem-based learning (PBL) might be a useful strategy for medical schools. TBL is an attainable and efficient educational approach in preparing large classes with regard to PBL. TBL improves student performance, team communication skills, leadership skills, problem solving skills, and cognitive conceptual structures and increases student engagement and satisfaction. This study suggests recommendations for administering TBL effectively in medical education.
Full Text Available Amy Streater,1,2 Donna Maria Coleston-Shields,2 Jennifer Yates,2 Miriam Stanyon,2 Martin Orrell2 1Research and Development, North East London NHS Foundation Trust, Ilford, 2Institute of Mental Health, University of Nottingham, Nottingham, UK Background: Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1 conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2 conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice.Methods: For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis.Results: The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8% of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors.Conclusion: Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required
Terrados, Nicolas; Mielgo-Ayuso, Juan; Delextrat, Anne; Ostojic, Sergej M; Calleja-González, Julio
To a proper recovery, is absolutely necessary to know that athletes with enhanced recovery after maximal exercise are likely to perform better in sports. Recovery strategies are commonly used in team sports despite limited scientific evidence to support their effectiveness in facilitating optimal recovery and the players spend a much greater proportion of their time recovering than they do in training. According to authors, some studies investigated the effect of recovery strategies on physical performance in team sports, lack of experimental studies about the real origin of the fatigue, certify the need for further study this phenomenon. Thus, developing effective methods for helping athletes to recover is deemed essential. Therefore, the aim of this review is provide information for his practical application, based on scientific evidence about recovery in team sports.
Goh, Teik T; Eccles, Martin P
Attributes of teams could affect the quality of care delivered in primary care. The aim of this study was to systematically review studies conducted within the UK NHS primary care that have measured team climate using the Team Climate Inventory (TCI), and to describe, if reported, the relationship between the TCI and measures of quality of care. The databases MEDLINE, EMBASE, and CINAHL were searched. The reference lists of included article were checked and one relevant journal was hand-searched. Eight papers were included. Three studies used a random sample; the remaining five used convenience or purposive samples. Six studies were cross sectional surveys, whilst two were before and after studies. Four studies examined the relationship between team climate and quality of care. Only one study found a positive association between team climate and higher quality care in patients with diabetes, positive patient satisfaction and self-reported effectiveness. While the TCI has been used to measure team attributes in primary care settings in the UK it is difficult to generalise from these data. A small number of studies reported higher TCI scores being associated with only certain aspects of quality of care; reasons for the pattern of association are unclear. There are a number of methodological challenges to conducting such studies in routine service settings. Further research is needed in order to understand how to measure team functioning in relation to quality of care.
Goh Teik T
Full Text Available Abstract Background Attributes of teams could affect the quality of care delivered in primary care. The aim of this study was to systematically review studies conducted within the UK NHS primary care that have measured team climate using the Team Climate Inventory (TCI, and to describe, if reported, the relationship between the TCI and measures of quality of care. Findings The databases MEDLINE, EMBASE, and CINAHL were searched. The reference lists of included article were checked and one relevant journal was hand-searched. Eight papers were included. Three studies used a random sample; the remaining five used convenience or purposive samples. Six studies were cross sectional surveys, whilst two were before and after studies. Four studies examined the relationship between team climate and quality of care. Only one study found a positive association between team climate and higher quality care in patients with diabetes, positive patient satisfaction and self-reported effectiveness. Conclusion While the TCI has been used to measure team attributes in primary care settings in the UK it is difficult to generalise from these data. A small number of studies reported higher TCI scores being associated with only certain aspects of quality of care; reasons for the pattern of association are unclear. There are a number of methodological challenges to conducting such studies in routine service settings. Further research is needed in order to understand how to measure team functioning in relation to quality of care.
van den Berg, Johannes; Olsson, Linn; Svensson, Amelie; Håkansson, Stellan
To study the prevalence of adverse events (AEs) associated with neonatal transport, and to categorize, classify and assess the risk estimation of these events. Written comments in 1082 transport records during the period 1999-2011 were reviewed. Comments related to events that infringed on patient and staff safety were included as AEs, and categorized and further classified as complaint, imminent risk of incident/negative event, actual incident or actual negative event. AEs were also grouped into emergency or planned transports, and risk estimation was calculated according to a risk assessment tool and defined as low, intermediate, high or extreme risk. AEs (N = 883) were divided into five categories: logistics (n = 337), organization (n = 177), equipment (n = 165), vehicle (n = 129) and medical/nursing care (n = 75). Eighty-five percent of AEs were classified as incidents or negative events. The majority of AEs were estimated to be of low or intermediate risk in both planned and emergency transports. AEs estimated to be of high or extreme risk were significantly more frequent in emergency transports (OR = 10.1; 95% CI: 5.0-20.9; p transport, often related to imperfect transport logistics or equipment failure. AEs of high or extreme risk were more frequent in emergency transports.
Brinkley, Andrew; McDermott, Hilary; Munir, Fehmidah
Physical inactivity is proven to be a risk factor for non-communicable diseases and all-cost mortality. Public health policy recommends community settings worldwide such as the workplace to promote physical activity. Despite the growing prevalence of workplace team sports, studies have not synthesised their benefits within the workplace. A systematic review was carried out to identify articles related to workplace team sports, including intervention, observational and qualitative studies. Eighteen studies met the inclusion criteria. The findings suggest team sport holds benefits not only for individual health but also for group cohesion and performance and organisational benefits such as the increased work performance. However, it is unclear how sport is most associated with these benefits as most of the studies included poorly described samples and unclear sports activities. Our review highlights the need to explore and empirically understand the benefits of workplace team sport for individual, group and organisational health outcomes. Researches carried out in this field must provide details regarding their respective samples, the sports profile and utilise objective measures (e.g., sickness absence register data, accelerometer data).
Report of the ASSET (Assessment of Safety Significant Events Team) mission to the Cernavoda nuclear power plant in Romania 8-12 August 1994 Division of Nuclear Safety. Root cause analysis of a significant event that occurred during commissioning of unit 1
The IAEA Assessment of Safety Significant Events Team (ASSET) report presents the results of the team's investigation of a significant event that occurred during commissioning of Unit 1 of Cernavoda nuclear power plant. The results, conclusions and suggestions presented herein reflect the views of the ASSET experts. They are provided for consideration by the responsible authorities in Romania. The ASSET team's views presented in this report are based on visits to the plant, on review of documentation made available by the operating organization and on discussions with utility personnel. The report is intended to enhance operational safety at Cernavoda by proposing improvements to the policy for the prevention of incidents at the plant. The report includes, as a usual practice, the official response of the Regulatory Body and Operating Organization to the ASSET recommendations. Figs
Full text: An international team of nuclear installation safety experts, led by the International Atomic Energy Agency (IAEA), has reviewed safety practices at France's Saint-Alban Nuclear Power Plant (NPP) and has highlighted a set of strong practices as well as a series of recommendations to reinforce them. The IAEA assembled the team at the request of the Government of France to conduct an Operational Safety Review (OSART) of the Saint-Alban NPP. Under the leadership of the IAEA's Division of Nuclear Installation Safety in Vienna, the OSART team performed an in-depth operational safety review from 20 September to 6 October 2010. The team was made up of experts from Belgium, Canada, the Czech Republic, Germany, Lithuania, the Netherlands, Slovakia, Sweden and the USA. An OSART mission is designed to review programmes and activities essential to operational safety. It is not a regulatory inspection, nor is it a design review or a substitute for an exhaustive assessment of the plant's overall safety status. The team at Saint-Alban conducted an in-depth review of the aspects essential to the safe operation of the NPP, which largely are under the control of the site management. The conclusions of the review are based on the IAEA's Safety Standards and proven good international practices. The review covered the areas of Management, Organization and Administration; Training and Qualification; Operations; Maintenance; Technical Support; Operating Experience; Radiation Protection; Chemistry; and Emergency Planning and Preparedness. The OSART team has identified good plant practices, which will be shared with the rest of the nuclear industry for consideration of their application. Examples include: A safety guideline for outages; The use of remote video surveillance of fuel inspection and handling activities; A motivational tool for plant staff regarding the benefits of operating experience and associated corrective actions; and Use of a sophisticated key control system
Full text: An international team of nuclear installation safety experts, led by the International Atomic Energy Agency (IAEA), has reviewed Slovakia's Bohunice Nuclear Power Plant (BNPP) for its safety practices and has noted a series of good practices as well as recommendations to reinforce them. The IAEA assembled an international team of experts at the request of the Government of Slovak Republic to conduct an Operational Safety Review (OSART) of Bohunice NPP. Under the leadership of the IAEA's Division of Nuclear Installation Safety, the OSART team performed an in-depth operational safety review from 1 to 18 November 2010. The team was made up of experts from Belgium, Canada, China, the Czech Republic, France, Sweden, the United Kingdom and the IAEA. An OSART mission is designed as a review of programmes and activities essential to operational safety. It is not a regulatory inspection, nor is it a design review or a substitute for an exhaustive assessment of the plant's overall safety status. The team at BNPP conducted an in-depth review of the aspects essential to the safe operation of the NPP, which largely is under the control of the site management. The conclusions of the review are based on the IAEA's Safety Standards and proven good international practices. The review covered the areas of Management, Organization and Administration; Operations; Maintenance; Technical Support; Operating Experience; Radiation Protection; Chemistry and Emergency Planning and Preparedness. Long Term Operation assessment has been requested by the plant in addition to the standard OSART program. The OSART team has identified good plant practices which will be shared with the rest of the nuclear industry for consideration of their application. Examples include: BNPP has implemented a comprehensive set of technical and organizational measures which have significantly reduced the production of liquid radioactive waste; BNPP has developed an automatic transfer of dosimetry data
Agbabiaka, Taofikat B; Pittler, Max H; Wider, Barbara; Ernst, Edzard
Serenoa repens (W. Bartram) Small, also known as saw palmetto, is one of the most widely used herbal preparations for the treatment of lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Although a number of randomized controlled trials (RCTs) and systematic reviews of the efficacy of S. repens for the treatment of LUTS and BPH have been published, no systematic review on its drug interactions or adverse events currently exists. This review assesses all available human safety data of S. repens monopreparations. Systematic literature searches were conducted from date of inception to February 2008 in five electronic databases; reference lists and our departmental files were checked for further relevant publications. Information was requested from spontaneous reporting schemes of the WHO and national safety bodies. Twenty-four manufacturers/distributors of S. repens preparations and four herbalist organizations were contacted for additional information. No language restrictions were imposed. Only reports of adverse events in humans from monopreparations of S. repens were included. Data from all articles, regardless of study design, reporting adverse events or interactions were independently extracted by the first author and validated by the second. Forty articles (26 randomized controlled trials, 4 non-randomized controlled trials, 6 uncontrolled trials and 4 case reports/series) were included. They suggest that adverse events associated with the use of S. repens are mild and similar to those with placebo. The most frequently reported adverse events are abdominal pain, diarrhoea, nausea, fatigue, headache, decreased libido and rhinitis. More serious adverse events such as death and cerebral haemorrhage are reported in isolated case reports and data from spontaneous reporting schemes, but causality is questionable. No drug interactions were reported. Currently available data suggest that S. repens is well tolerated by most users and is not
Spessard, R.L.; Coley, J.; Crowley, W.; Walton, G.
In response to congressional concerns about the adequacy of the welding and nondestructive examination (NDE) programs at the Seabrook Nuclear Station, NRC senior management established an independent review team (IRT) to conduct an assessment. The IRT focused on the quality of the finished hardware and associated records, as well as on the adequacy of the overall quality assurance program as applied to the fabrication and NDE programs for pipe welds. This report documents the findings of that investigation
Forester, J.A.; Ramey-Smith, A.; Bley, D.C.; Kolaczkowski, A.M.; Cooper, S.E.; Wreathall, J.
In May of 1998, a technical basis and implementation guidelines document for A Technique for Human Event Analysis (ATHEANA) was issued as a draft report for public comment (NUREG-1624). In conjunction with the release of the draft NUREG, a paper review of the method, its documentation, and the results of an initial test of the method was held over a two-day period in Seattle, Washington, in June of 1998. Four internationally-known and respected experts in human reliability analysis (HRA) were selected to serve as the peer reviewers and were paid for their services. In addition, approximately 20 other individuals with an interest in HRA and ATHEANA also attended the peer review meeting and were invited to provide comments. The peer review team was asked to comment on any aspect of the method or the report in which improvements could be made and to discuss its strengths and weaknesses. All of the reviewers thought the ATEANA method had made significant contributions to the field of PRA/HRA, in particular by addressing the most important open questions and issues in HRA, by attempting to develop an integrated approach, and by developing a framework capable of identifying types of unsafe actions that generally have not been considered using existing methods. The reviewers had many concerns about specific aspects of the methodology and made many recommendations for ways to improve and extend the method, and to make its application more cost effective and useful to PRA in general. Details of the reviewers' comments and the ATHEANA team's responses to specific criticisms will be discussed
Slimani, Maamer; Chamari, Karim; Miarka, Bianca; Del Vecchio, Fabricio B; Chéour, Foued
Plyometric training (PT) is a very popular form of physical conditioning of healthy individuals that has been extensively studied over the last decades. In this article, we critically review the available literature related to PT and its effects on physical fitness in team sport athletes. We also considered studies that combined PT with other popular training modalities (e.g. strength/sprint training). Generally, short-term PT (i.e. 2-3 sessions a week for 4-16 weeks) improves jump height, sprint and agility performances in team sport players. Literature shows that short PT (plyometric exercises and the bilateral and unilateral jumps could improve these performances more than the use of single plyometric drills or traditional PT. Thus, the present review shows a greater effect of PT alone on jump and sprint (30 m sprint performance only) performances than the combination of PT with sprint/strength training. Although many issues related to PT remain to be resolved, the results presented in this review allow recommending the use of well-designed and sport-specific PT as a safe and effective training modality for improving jumping and sprint performance as well as agility in team sport athletes.
Report of the ASSET (Assessment of Safety Significant Events Team) follow-up mission to the Bohunice (units 1-2) nuclear power plant in Slovakia 5-9 July 1993. Root cause analysis of operational events with a view to enhancing the prevention of accidents
This Report of the IAEA Assessment of Safety Significant Events Team (ASSET) presents the results of the team's review of the status of implementation of the recommendations made by the 1988 ASSET mission to Bohunice nuclear power plant in Slovakia, and of progress made by plant management in prevention of incidents. The findings, conclusions and suggestions presented herein reflect the views of the ASSET experts. They are provided for consideration by the responsible Slovakian authorities. The ASSET team's views presented in this report are based on review of the documentation made available and on the discussions with plant staff. The report includes the official response of the operating and regulatory organizations of Slovakia to the ASSET findings and conclusions. Figs, tabs
The International Atomic Energy Agency (IAEA) has put forward the vision of a global nuclear safety regime that provides for the protection of people and the environment from the effects of ionizing radiation from nuclear facilities, the minimization of the likelihood of accidents that could endanger life and property and effective mitigation of the effects of any such events should they occur. The strategic approach for achieving the vision of enhancing this regime involves four elements and aims at ensuring that the overall nuclear safety level in Member States continues to improve: - Improvement of national and international safety infrastructures: - Establishment and global acceptance of IAEA safety standards; - Integrated approach to the provision for the application of safety standards; and - Global network of knowledge and experience. The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the safety of nuclear power plants during commissioning and operation. The OSART programme, initiated in 1982, is available to all Member States with nuclear power plants under commissioning or in operation. The OSART methodology and its safety services may also be applied to other nuclear installations (e.g. fuel cycle facilities, research reactors). Conservative design, careful manufacture and sound construction are all prerequisites for safe operation of nuclear power plants. However, the safety of the plant depends ultimately on sound policies, procedures, processes and practices; on the capability and reliability of the commissioning and operating personnel; on comprehensive instructions; and on adequate resources. A positive attitude and conscientiousness on the part of the management and staff in discharging their responsibilities is important to safety. OSART missions consider these aspects in assessing a facility's operational practices in comparison with those used successfully in other countries and
The International Atomic Energy Agency (IAEA) has put forward the vision of a global nuclear safety regime that provides for the protection of people and the environment from the effects of ionizing radiation from nuclear facilities, the minimization of the likelihood of accidents that could endanger life and property and effective mitigation of the effects of any such events should they occur. The strategic approach for achieving the vision of enhancing this regime involves four elements and aims at ensuring that the overall nuclear safety level in Member States continues to improve: - Improvement of national and international safety infrastructures: - Establishment and global acceptance of IAEA safety standards. - Integrated approach to the provision for the application of safety standards. And - Global network of knowledge and experience. The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the safety of nuclear power plants during commissioning and operation. The OSART programme, initiated in 1982, is available to all Member States with nuclear power plants under commissioning or in operation. The OSART methodology and its safety services may also be applied to other nuclear installations (e.g. fuel cycle facilities, research reactors). Conservative design, careful manufacture and sound construction are all prerequisites for safe operation of nuclear power plants. However, the safety of the plant depends ultimately on sound policies, procedures, processes and practices. On the capability and reliability of the commissioning and operating personnel. On comprehensive instructions. And on adequate resources. A positive attitude and conscientiousness on the part of the management and staff in discharging their responsibilities is important to safety. OSART missions consider these aspects in assessing a facility's operational practices in comparison with those used successfully in other countries and
The International Atomic Energy Agency (IAEA) has put forward the vision of a global nuclear safety regime that provides for the protection of people and the environment from the effects of ionizing radiation from nuclear facilities, the minimization of the likelihood of accidents that could endanger life and property and effective mitigation of the effects of any such events should they occur. The strategic approach for achieving the vision of enhancing this regime involves four elements and aims at ensuring that the overall nuclear safety level in Member States continues to improve: - Improvement of national and international safety infrastructures: - Establishment and global acceptance of IAEA safety standards. - Integrated approach to the provision for the application of safety standards. And - Global network of knowledge and experience. The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the safety of nuclear power plants during commissioning and operation. The OSART programme, initiated in 1982, is available to all Member States with nuclear power plants under commissioning or in operation. The OSART methodology and its safety services may also be applied to other nuclear installations (e.g. fuel cycle facilities, research reactors). Conservative design, careful manufacture and sound construction are all prerequisites for safe operation of nuclear power plants. However, the safety of the plant depends ultimately on sound policies, procedures, processes and practices. On the capability and reliability of the commissioning and operating personnel. On comprehensive instructions. And on adequate resources. A positive attitude and conscientiousness on the part of the management and staff in discharging their responsibilities is important to safety. OSART missions consider these aspects in assessing a facility's operational practices in comparison with those used successfully in other countries and
Daniele, Claudia; Thompson Coon, Joanna; Pittler, Max H; Ernst, Edzard
Vitex agnus castus L. (VAC) [Verbenaceae] is a deciduous shrub that is native to Mediterranean Europe and Central Asia. Traditionally, VAC fruit extract has been used in the treatment of many female conditions, including menstrual disorders (amenorrhoea, dysmenorrhoea), premenstrual syndrome (PMS), corpus luteum insufficiency, hyperprolactinaemia, infertility, acne, menopause and disrupted lactation. The German Commission E has approved the use of VAC for irregularities of the menstrual cycle, premenstrual disturbances and mastodynia. Clinical reviews are available for the efficacy of VAC in PMS, cycle disorders, hyperprolactinaemia and mastalgia, but so far no systematic review has been published on adverse events or drug interactions associated with VAC. Therefore, this review was conducted to evaluate all the available human safety data of VAC monopreparations. Literature searches were conducted in six electronic databases, in references lists of all identified papers and in departmental files. Data from spontaneous reporting schemes of the WHO and national drug safety bodies were also included. Twelve manufacturers of VAC-containing preparations and five herbalist organisations were contacted for additional information. No language restrictions were imposed. Combination preparations including VAC or homeopathic preparations of VAC were excluded. Data extraction of key data from all articles reporting adverse events or interactions was performed independently by at least two reviewers, regardless of study design. Data from clinical trials, postmarketing surveillance studies, surveys, spontaneous reporting schemes, manufacturers and herbalist organisations indicate that the adverse events following VAC treatment are mild and reversible. The most frequent adverse events are nausea, headache, gastrointestinal disturbances, menstrual disorders, acne, pruritus and erythematous rash. No drug interactions were reported. Use of VAC should be avoided during pregnancy or
V. V. Surkov; M. Hayakawa
Transient luminous events (TLEs) occasionally observed above a strong thunderstorm system have been the subject of a great deal of research during recent years. The main goal of this review is to introduce readers to recent theories of electrodynamics processes associated with TLEs. We examine the simplest versions of these theories in order to make their physics as transparent as possible. The study is begun with the conventional mechanism for air breakdown at stratospheric...
Allison, Rosalie; Bird, Emma L; McClean, Stuart
It is estimated that 21% of boys and 16% of girls in England meet recommended physical activity guidelines. Team sport has the potential to increase physical activity levels; however, studies show that gender-based factors can influence girls' participation in team sport. Furthermore, evidence for the effectiveness of interventions promoting team sport among girls is limited. This systematic review aimed to assess the impact of physical activity interventions on secondary school-aged girls' (aged 11-18 years) participation in team sport and to identify potential strategies for increasing participation. Electronic databases and grey literature were systematically searched for studies of interventions targeting team sport participation among girls in the UK. Results were exported to Refworks, duplicates removed and eligible studies identified. Extracted data included: participant details, such as sample size and age; components of the intervention; outcomes assessed; and each study was quality appraised. Due to heterogeneity across studies, results were presented narratively. Four studies sourced from the grey literature met the inclusion criteria. Findings suggest that physical activity interventions can encourage girls to try new sports, but evidence is limited in relation to sustained participation. Potential strategies for promoting participation included: consultation with girls, implementation of appropriate peer-leaders and friendship group strategies, early intervention and consideration of intervention setting. This review highlights the limited availability of evidence on the effectiveness of physical activity interventions for promoting team sport participation among girls in the UK. Findings indicate that future research is needed to improve the methodological quality of complex intervention evaluation. Physical activity interventions may have the potential to encourage girls to try team sport, but their impact on sustained participation, and subsequent
Full text: An international team of nuclear installation safety experts, led by the International Atomic Energy Agency (IAEA), has evaluated the French Nuclear Power Plant (NPP) at Fessenheim to assess how the facility has followed up on an Operational Safety Review Team (OSART) mission undertaken in 2009. The IAEA assembled a team of experts at the request of the Government of France to conduct the mission. Follow-up missions are standard components of the OSART programme and are conducted 18-24 months after the initial OSART mission. Under the leadership of the IAEA's Division of Nuclear Installation Safety, the team performed its review from 7 to 11 February 2011. The team assessed how the Fessenheim NPP has addressed the recommendations and suggestions made during the 2009 OSART mission. The team was made up of experts from Slovakia, Switzerland and the IAEA. The review covered the areas of Management, Organization and Administration; Training and Qualifications; Operations; Maintenance; Technical Support; Operating Experience; Radiation Protection; Chemistry and Emergency Planning and Preparedness. The conclusions of the follow-up review are based on the IAEA's Safety Standards and proven good international practices. There were 21 issues raised by the 2009 mission. During the follow-up mission, the team assessed that six issues had been resolved, thirteen had made satisfactory progress to date and two had made insufficient progress to date. 'Resolved' describes action plans for improvement that have been fully implemented; 'satisfactory progress to date' describes action plans that have been developed but are not yet fully implemented; and 'insufficient progress to date' describes situations where additional consideration or strengthening of improvement plans is necessary. Examples of issues falling into different resolution categories include: The plant has resolved the suggestion to establish a process to review initial training materials on a regular basis
Konstantin Maschke; Dodo zu Knyphausen-Aufseß
This paper reviews research findings on entrepreneurial top management teams within the last 20 years. It concentrates on team-based management factors and their influence on a new ventures growth and ability to raise capital. This paper integrates recent findings and provides an overview of the current state of research. Moreover, it contributes to the overall topic by proposing five clusters of major team-specific influences, derives determinants of success and failure, and reveals recomme...
Cummins, Cloe; Orr, Rhonda; O'Connor, Helen; West, Cameron
Use of Global positioning system (GPS) technology in team sport permits measurement of player position, velocity, and movement patterns. GPS provides scope for better understanding of the specific and positional physiological demands of team sport and can be used to design training programs that adequately prepare athletes for competition with the aim of optimizing on-field performance. The objective of this study was to conduct a systematic review of the depth and scope of reported GPS and microtechnology measures used within individual sports in order to present the contemporary and emerging themes of GPS application within team sports. A systematic review of the application of GPS technology in team sports was conducted. We systematically searched electronic databases from earliest record to June 2012. Permutations of key words included GPS; male and female; age 12-50 years; able-bodied; and recreational to elite competitive team sports. The 35 manuscripts meeting the eligibility criteria included 1,276 participants (age 11.2-31.5 years; 95 % males; 53.8 % elite adult athletes). The majority of manuscripts reported on GPS use in various football codes: Australian football league (AFL; n = 8), soccer (n = 7), rugby union (n = 6), and rugby league (n = 6), with limited representation in other team sports: cricket (n = 3), hockey (n = 3), lacrosse (n = 1), and netball (n = 1). Of the included manuscripts, 34 (97 %) detailed work rate patterns such as distance, relative distance, speed, and accelerations, with only five (14.3 %) reporting on impact variables. Activity profiles characterizing positional play and competitive levels were also described. Work rate patterns were typically categorized into six speed zones, ranging from 0 to 36.0 km·h⁻¹, with descriptors ranging from walking to sprinting used to identify the type of activity mainly performed in each zone. With the exception of cricket, no standardized speed zones or definitions were observed within or
Effective and efficient caseload management requires extensive skills to ensure that patients receive the right care by the right person at the right time. District nursing caseloads are continually increasing in size and complexity, which requires specialist district nursing knowledge and skills. This article reviews the literature related to caseload management with the aim of identifying the most effective method for district nursing teams. The findings from this review are that there are different styles and methods of caseload management. The literature review was unable to identify a single validated tool or method, but identified themes for implementing effective caseload management, specifically caseload analysis; workload measurement; work allocation; service and practice development and workforce planning. This review also identified some areas for further research.
Full text: An international team of senior nuclear safety and radiation protection experts today concluded an 11-day mission to review the regulatory framework for nuclear safety in Slovakia. At the request of the Slovak Government, the IAEA assembled a team of 12 senior regulatory experts from 12 nations to conduct the Integrated Regulatory Review Service (IRRS) mission involving the Nuclear Regulatory Authority of the Slovak Republic (UJD SR). The international experts also met officials from the Public Health Authority of the Slovak Republic (UVZ SR) regarding the regulation of occupational radiation protection in nuclear facilities. The mission is a peer review based on the IAEA Safety Standards. Marta Ziakova, Chairperson of the Nuclear Regulatory Authority of Slovak Republic, declared that ''The IRRS mission has a great value for the future development and orientation of the UJD SR.'' ''Slovakia has established a regulatory framework for nuclear safety which is in line with international standards and practice,'' said Mission Team Leader Andrej Stritar, Director of the Slovenian Nuclear Safety Administration. The main observations of the IRRS Review team included: UJD SR operates with independence and transparency; UJD SR has developed and implemented a systematic training approach to meet its competence needs; and in response to the accident at TEPCO's Fukushima Daiichi Nuclear Power Station, UJD SR has reacted and communicated to interested parties, including the public. The good practices identified by the IRRS Review Team include: UJD SR has a comprehensive and well-formalized strategic approach to informing and consulting interested parties; UJD SR has developed and implemented a structured approach to training and developing its staff; and Detailed legal requirements provide a solid basis for on-site and off-site response in nuclear emergencies coordinated with local authorities. The IRRS Review team identified areas for further improvement and believes
Andriessen, Karl; Krysinska, Karolina
Engagement in sports and physical activity, either actively as an athlete or in a passive way as a spectator, impacts interpersonal behavior and physical and mental health. The study reviews literature on the relationship between sports spectatorship and suicidal behavior to ascertain whether sports spectatorship has an impact on suicidal behavior, either increasing the risk or being a protective factor. The literature was searched via PubMed/MEDLINE and PsycINFO. Nine studies published between 1986 and 2006 were identified. The reviewed studies focused on the impact of sports events on the societal level, and analyzed data regarding national or local suicide rates. Their results indicate that sports events can have an impact on suicide mortality and morbidity, but this relationship seems to be mediated by age, gender, marital status, and alcohol consumption, as well as the process and outcome of the game (e.g., victory vs. defeat of the favored team). There is some evidence that sports events can reduce the rates of suicide on the societal level; however, there is a lack of studies exploring how sports spectatorship might influence levels of suicide risk in individuals and how mediating variables might operate on the individual level.
Theo van Achterberg; Joke Mintjes; G. Holleman; E. Poot
Implementation of innovations is a complex and intensive procedure in which different strategies can be successful. In nursing, strategies often focus on intrinsic motivation, competencies and attitudes of individual nurses while ignoring the social context. Since nurses often work in teams,
The TRT was impressed with the quality and volume of laboratory and pilot scale development work that had been conducted over the past year. Many of the doubts and questions raised by the TRP on technical details had been examined, either by theoretical calculations or in the pilot facility. Moreover, a more open and forthcoming attitude was evident among the MMT staff who either presented briefings or responded to the Team`s questions. Of special note to DOE, the TRP recognized a year ago that the pilot facility at Fall River was not designed for radioactive pilot tests. However, from the dialogue surrounding the TRP review, it was evident that not much thought had been given to the hazards, concerns, and special requirements incumbent with radioactive operations -- everything from doing pours of hot radioactive metal from a vessel to remote-handling equipment and operations. This year the TRT noticed a significant improvement in this respect.
Bonetto, Caterina; Trotta, Francesco; Felicetti, Patrizia; Alarcón, Graciela S; Santuccio, Carmela; Bachtiar, Novilia Sjafri; Brauchli Pernus, Yolanda; Chandler, Rebecca; Girolomoni, Giampiero; Hadden, Robert D M; Kucuku, Merita; Ozen, Seza; Pahud, Barbara; Top, Karina; Varricchio, Frederick; Wise, Robert P; Zanoni, Giovanna; Živković, Saša; Bonhoeffer, Jan
Several types of vasculitis have been observed and reported in temporal association with the administration of various vaccines. A systematic review of current evidence is lacking. This systematic literature review aimed to assess available evidence and current reporting practice of vasculitides as adverse events following immunization (AEFI). We reviewed the literature from 1st January 1994 to 30th June 2014. This review comprises randomized controlled trials, observational studies, case series, case reports, reviews and comments regardless of vaccine and target population. The initial search resulted in the identification of 6656 articles. Of these, 157 articles were assessed for eligibility and 75 studies were considered for analysis, including 6 retrospective/observational studies, 2 randomized controlled trials, 7 reviews, 11 case series, 46 case reports and 3 comments. Most of the larger, higher quality studies found no causal association between vaccination and subsequent development of vasculitis, including several studies on Kawasaki disease and Henoch-Schönlein purpura (IgA vasculitis). Smaller case series reported a few cases of vasculitis following BCG and vaccines against influenza and hepatitis. Only 24% of the articles reported using a case definition of vasculitis. Existing literature does not allow establishing a causative link between vaccination and vasculitides. Further investigations were strengthened by the use of standardized case definitions and methods for data collection, analysis and presentation to improve data comparability and interpretation of vasculitis cases following immunization. Published by Elsevier Ltd.
Valente, Ana Rita S; Jesus, Luis M T; Hall, Andreia; Leahy, Margaret
Event- and interval-based measurements are two different ways of computing frequency of stuttering. Interval-based methodology emerged as an alternative measure to overcome problems associated with reproducibility in the event-based methodology. No review has been made to study the effect of methodological factors in interval-based absolute reliability data or to compute the agreement between the two methodologies in terms of inter-judge, intra-judge and accuracy (i.e., correspondence between raters' scores and an established criterion). To provide a review related to reproducibility of event-based and time-interval measurement, and to verify the effect of methodological factors (training, experience, interval duration, sample presentation order and judgment conditions) on agreement of time-interval measurement; in addition, to determine if it is possible to quantify the agreement between the two methodologies The first two authors searched for articles on ERIC, MEDLINE, PubMed, B-on, CENTRAL and Dissertation Abstracts during January-February 2013 and retrieved 495 articles. Forty-eight articles were selected for review. Content tables were constructed with the main findings. Articles related to event-based measurements revealed values of inter- and intra-judge greater than 0.70 and agreement percentages beyond 80%. The articles related to time-interval measures revealed that, in general, judges with more experience with stuttering presented significantly higher levels of intra- and inter-judge agreement. Inter- and intra-judge values were beyond the references for high reproducibility values for both methodologies. Accuracy (regarding the closeness of raters' judgements with an established criterion), intra- and inter-judge agreement were higher for trained groups when compared with non-trained groups. Sample presentation order and audio/video conditions did not result in differences in inter- or intra-judge results. A duration of 5 s for an interval appears to be
.... Training and military doctrine has been evolving to reflect this emphasis on teamwork. The purpose of this annotated bibliography is to review literature published over the last ten years concerning team and small group performance...
Ma, R.; Kaber, D. B.; Jones, J. M.; Starkey, R. L.
Operator achievement and maintenance of situation awareness (SA) in nuclear power plant (NPP) process control has emerged as an important concept in defining effective relationships between humans and automation in this complex system. A literature review on factors influencing SA revealed several variables to be important to team SA, including the overall task and team goals, individual tasks, team member roles, and the team members themselves. Team SA can also be adversely affected by a range of factors, including stress, mental over- or under-loading, system design (including human-machine interface design), complexity, human error in perception, and automation. Our research focused on the analysis of 'shared' SA and team SA among an assumed three-person, main-control-room team. Shared SA requirements represent the knowledge that is held in common by NPP operators, and team SA represents the collective, unique knowledge of all operators. The paper describes an approach to goal-directed task analysis (GDTA) applied to NPP main control room operations. In general, the GDTA method reveals critical operator decision and information requirements. It identifies operator SA requirements relevant to performing complex systems control. The GDTA can reveal requirements at various levels of cognitive processing, including perception, comprehension and projection, in NPP process control. Based on the literature review and GDTA approach, a number of potential research issues are proposed with an aim toward understanding and facilitating team SA in NPP process control. (authors)
Full text: An international team of senior nuclear safety and radiation protection experts today concluded a 12-day mission to review the regulatory framework for nuclear and radiation safety in Sweden. The Integrated Regulatory Review Service (IRRS) mission, which was conducted at the request of Sweden, noted good practices in the country's nuclear regulatory system and also made recommendations and suggestions for the Swedish Radiation Safety Authority (SSM) and the government. These are aimed at strengthening the effectiveness of the country's regulatory framework and functions in line with IAEA Safety Standards. ''Throughout the mission, the IRRS team received full cooperation from SSM staff in its review of Sweden's regulatory, technical and policy issues,'' said Georg Schwarz, mission leader and Deputy Director General of the Swiss nuclear regulator (ENSI). 'The staff were open and candid in their discussions and provided the fullest practicable assistance', he commented. The main observations of the IRRS Review team included the following: SSM operates as an independent regulator in an open and transparent manner with well-organized regulatory processes; SSM is receptive to feedback and strives to maintain a culture of continuous learning; and Following the TEPCO Fukushima Daiichi accident, SSM responded promptly to public demand for information and communicated effectively with the national government, the public and other interested parties. Good practices identified by the IRRS team included, though they are not limited to, the following: The consolidation of the two previous national regulatory authorities into SSM was successful; Overall, SSM's management system is comprehensive and contributes to staff efficiency and effectiveness; The nuclear power plant refurbishment programme as required by SSM enhanced safety; and Sweden's regulatory framework for high-level waste disposal is comprehensive and technically sound. The IRRS Review team identified
Berry, Gregory R.
Effective and efficient teams communicate, collaborate, and perform, even if these teams are not co-located. Although much is known about enabling effectiveness on face-to-face teams, considerably less is known about similarly enabling effectiveness on virtual teams. Yet the use of virtual teams is common and will likely become more commonplace as…
River, Jo; Currie, Jane; Crawford, Tonia; Betihavas, Vasiliki; Randall, Sue
Technological advancements are rapidly changing nursing education in higher education settings. Nursing academics are enthusiastically blending technology with active learning approaches such as Team Based Learning (TBL). While the educational outcomes of TBL are well documented, the value of blending technology with TBL (blended-TBL) remains unclear. This paper presents a systematic review examining the effectiveness of blended-TBL in higher education health disciplines. This paper aimed to identify how technology has been incorporated into TBL in higher education health disciplines. It also sought to evaluate the educational outcomes of blended-TBL in terms of student learning and preference. A review of TBL research in Medline, CINAHL, ERIC and Embase databases was undertaken including the search terms, team based learning, nursing, health science, medical, pharmaceutical, allied health education and allied health education. Papers were appraised using the Critical Appraisal Skills Program (CASP). The final review included 9 papers involving 2094 student participants. A variety of technologies were blended with TBL including interactive eLearning and social media. There is limited evidence that blended-TBL improved student learning outcomes or student preference. Enthusiasm to blend technology with TBL may not be as well founded as initially thought. However, few studies explicitly examined the value of incorporating technology into TBL. There is a clear need for research that can discern the impact of technology into TBL on student preference and learning outcomes, with a particular focus on barriers to student participation with online learning components. Copyright © 2016 Elsevier Ltd. All rights reserved.
Burgess, Annette W; McGregor, Deborah M; Mellis, Craig M
Team-based learning (TBL), a structured form of small-group learning, has gained popularity in medical education in recent years. A growing number of medical schools have adopted TBL in a variety of combinations and permutations across a diversity of settings, learners, and content areas. The authors conducted this systematic review to establish the extent, design, and practice of TBL programs within medical schools to inform curriculum planners and education designers. The authors searched the MEDLINE, PubMed, Web of Knowledge, and ERIC databases for articles on TBL in undergraduate medical education published between 2002 and 2012. They selected and reviewed articles that included original research on TBL programs and assessed the articles according to the seven core TBL design elements (team formation, readiness assurance, immediate feedback, sequencing of in-class problem solving, the four S's [significant problem, same problem, specific choice, and simultaneous reporting], incentive structure, and peer review) described in established guidelines. The authors identified 20 articles that satisfied the inclusion criteria. They found significant variability across the articles in terms of the application of the seven core design elements and the depth with which they were described. The majority of the articles, however, reported that TBL provided a positive learning experience for students. In the future, faculty should adhere to a standardized TBL framework to better understand the impact and relative merits of each feature of their program.
Full Text Available Plyometric training (PT is a very popular form of physical conditioning of healthy individuals that has been extensively studied over the last decades. In this article, we critically review the available literature related to PT and its effects on physical fitness in team sport athletes. We also considered studies that combined PT with other popular training modalities (e.g. strength/sprint training. Generally, short-term PT (i.e. 2-3 sessions a week for 4-16 weeks improves jump height, sprint and agility performances in team sport players. Literature shows that short PT (<8 weeks has the potential to enhance a wide range of athletic performance (i.e. jumping, sprinting and agility in children and young adult amateur players. Nevertheless, 6 to 7 weeks training appears to be too short to improve physical performance in elite male players. Available evidence suggests that short-term PT on non-rigid surfaces (i.e. aquatic, grass or sand-based PT could elicit similar increases in jumping, sprinting and agility performances as traditional PT. Furthermore, the combination of various plyometric exercises and the bilateral and unilateral jumps could improve these performances more than the use of single plyometric drills or traditional PT. Thus, the present review shows a greater effect of PT alone on jump and sprint (30 m sprint performance only performances than the combination of PT with sprint/strength training. Although many issues related to PT remain to be resolved, the results presented in this review allow recommending the use of well-designed and sport-specific PT as a safe and effective training modality for improving jumping and sprint performance as well as agility in team sport athletes.
Parker, Rachael Sv; Parker, P
Fatigue in military operations leads to safety and operational problems due to a decrease in alertness and performance. The primary method of counteracting the effects of sleep deprivation is to increase nightly sleep time, which in operational situations is not always feasible. History has taught us that surgeons and surgical teams are finite resources that cannot operate on patients indefinitely. A systematic review was conducted using the search terms ' sleep ' and ' deprivation ' examining the impact of sleep deprivation on cognitive performance in military surgical teams. Studies examining outcomes on intensive care patients and subjects with comorbidities were not addressed in this review. Sleep deprivation in any ' out-of-hours ' surgery has a significant impact on overall morbidity and mortality. Sleep deprivation in surgeons and surgical trainees negatively impacts cognitive performance and puts their own and patients' health at risk. All published research lacks consensus when defining ' sleep deprivation ' and ' rested ' states. It is recognised that it would be unethical to conduct a well-designed randomised controlled trial, to determine the effects of fatigue on performance in surgery; however, there is a paucity between surrogate markers and applying simulated results to actual clinical performance. This requires further research. Recommended methods of combating fatigue include: prophylactically ' sleep-banking ' prior to known periods of sleep deprivation, napping, use of stimulant or alerting substances such as modafinil, coordinated work schedules to reduce circadian desynchronisation and regular breaks with enforced rest periods. A forward surgical team will become combat-ineffective after 48 hours of continuous operations. This systematic review recommends implementing on-call periods of no more than 12 hours in duration, with adequate rest periods every 24 hours. Drug therapies and sleep banking may, in the short term, prevent negative
Wranik, W Dominika; Hayden, Jill A; Price, Sheri; Parker, Robin M N; Haydt, Susan M; Edwards, Jeanette M; Suter, Esther; Katz, Alan; Gambold, Liesl L; Levy, Adrian R
Western publicly funded health care systems increasingly rely on interdisciplinary teams to support primary care delivery and management of chronic conditions. This knowledge synthesis focuses on what is known in the academic and grey literature about optimal structural characteristics of teams. Its goal is to assess which factors contribute to the effective functioning of interdisciplinary primary care teams and improved health system outcomes, with specific focus on (i) team structure contribution to team process, (ii) team process contribution to primary care goals, and (iii) team structure contribution to primary care goals. The systematic search of academic literature focuses on four chronic conditions and co-morbidities. Within this scope, qualitative and quantitative studies that assess the effects of team characteristics (funding, governance, organization) on care process and patient outcomes will be searched. Electronic databases (Ovid MEDLINE, Embase, CINAHL, PAIS, Web of Science) will be searched systematically. Online web-based searches will be supported by the Grey Matters Tool. Studies will be included, if they report on interdisciplinary primary care in publicly funded Western health systems, and address the relationships between team structure, process, and/or patient outcomes. Studies will be selected in a three-stage screening process (title/abstract/full text) by two independent reviewers in each stage. Study quality will be assessed using the Mixed Methods Assessment Tool. An a priori framework will be applied to data extraction, and a narrative framework approach is used for the synthesis. Using an integrated knowledge translation approach, an electronic decision support tool will be developed for decision makers. It will be searchable along two axes of inquiry: (i) what primary care goals are supported by specific team characteristics and (ii) how should teams be structured to support specific primary care goals? The results of this evidence
Reimschisel, Tyler; Herring, Anna L; Huang, Jennifer; Minor, Tara J
Summarize the published literature on team-based learning (TBL) in health professions education (HPE) using the TBL conceptual framework to identify gaps that can guide future research Methods: PubMed, Web of Science, ERIC, and Google Scholar were searched through May 2016 for English-language articles regarding the use of TBL in HPE. Reviewers independently extracted data and coded for the seven elements in Michaelsen's Model of TBL. A total of 118 articles met inclusion criteria. The number of articles published yearly on TBL has grown steadily, more than tripling between 2011 and 2016. Most studies (55; 47%) involved undergraduate medical students and took place in the US (72; 61%). The most commonly studied framework component was Teacher and Learner Attitudes (97; 82%). Other commonly studied elements included Learning Outcomes (85; 72%) and Team Characteristics (25; 21%). Contextual Factors affecting TBL was addressed in one study. A substantial body of literature examines the effect that TBL has on traditional measures of achievement. However, many dimensions of TBL have not been well studied, including Teacher Decisions about TBL, Contextual Factors that affect TBL, Learners' Engagement, and Pattern of Engagement within Teams. Future research in these areas could determine the best use of TBL in HPE.
An external peer review was conducted to review the groundwater models used in the corrective action investigation stage of the Underground Test Area (UGTA) subproject to forecast zones of potential contamination in 1,000 years for the Frenchman Flat area. The goal of the external peer review was to provide technical evaluation of the studies and to assist in assessing the readiness of the UGTA subproject to progress to monitoring activities for further model evaluation. The external peer review team consisted of six independent technical experts with expertise in geology, hydrogeology,'''groundwater modeling, and radiochemistry. The peer review team was tasked with addressing the following questions: 1. Are the modeling approaches, assumptions, and model results for Frenchman Flat consistent with the use of modeling studies as a decision tool for resolution of environmental and regulatory requirements? 2. Do the modeling results adequately account for uncertainty in models of flow and transport in the Frenchman Flat hydrological setting? a. Are the models of sufficient scale/resolution to adequately predict contaminant transport in the Frenchman Flat setting? b. Have all key processes been included in the model? c. Are the methods used to forecast contaminant boundaries from the transport modeling studies reasonable and appropriate? d. Are the assessments of uncertainty technically sound and consistent with state-of-the-art approaches currently used in the hydrological sciences? 3. Are the datasets and modeling results adequate for a transition to Corrective Action Unit monitoring studies—the next stage in the UGTA strategy for Frenchman Flat? The peer review team is of the opinion that, with some limitations, the modeling approaches, assumptions, and model results are consistent with the use of modeling studies for resolution of environmental and regulatory requirements. The peer review team further finds that the modeling studies have accounted
An external peer review was conducted to review the groundwater models used in the corrective action investigation stage of the Underground Test Area (UGTA) subproject to forecast zones of potential contamination in 1,000 years for the Frenchman Flat area. The goal of the external peer review was to provide technical evaluation of the studies and to assist in assessing the readiness of the UGTA subproject to progress to monitoring activities for further model evaluation. The external peer review team consisted of six independent technical experts with expertise in geology, hydrogeology,'groundwater modeling, and radiochemistry. The peer review team was tasked with addressing the following questions: 1. Are the modeling approaches, assumptions, and model results for Frenchman Flat consistent with the use of modeling studies as a decision tool for resolution of environmental and regulatory requirements? 2. Do the modeling results adequately account for uncertainty in models of flow and transport in the Frenchman Flat hydrological setting? a. Are the models of sufficient scale/resolution to adequately predict contaminant transport in the Frenchman Flat setting? b. Have all key processes been included in the model? c. Are the methods used to forecast contaminant boundaries from the transport modeling studies reasonable and appropriate? d. Are the assessments of uncertainty technically sound and consistent with state-of-the-art approaches currently used in the hydrological sciences? 3. Are the datasets and modeling results adequate for a transition to Corrective Action Unit monitoring studies the next stage in the UGTA strategy for Frenchman Flat? The peer review team is of the opinion that, with some limitations, the modeling approaches, assumptions, and model results are consistent with the use of modeling studies for resolution of environmental and regulatory requirements. The peer review team further finds that the modeling studies have accounted for uncertainty in
Report of the ASSET (Assessment of Safety Significant Events Team) mission to the Zaporozhe nuclear power plant in Ukraine 13-24 June 1994 Division of Nuclear Safety. Root cause analysis of operational events with a view to enhancing the prevention of incidents
The IAEA Assessment of Safety Significant Events Team (ASSET) report presents the results of an ASSET team's assessment of their investigation of the effectiveness of the plant for prevention of incidents since 1990 at Zaporozhe nuclear power plant. The results, conclusions and suggestions presented herein reflect the views of the ASSET experts. They are provided for consideration by the responsible authorities in Ukraine. The ASSET team's views presented in this report are based on visits to the plant, on review of documentation made available by the operating organization and on discussions with utility personnel. The report is intended to enhance operational safety at Zaporozhe by proposing improvements to the policy for the prevention of incidents at the plant. The report includes, as a usual practice, the official response of the operating organization as well as of the regulatory body to the ASSET recommendations. Figs
Onan, Arif; Simsek, Nurettin; Elcin, Melih; Turan, Sevgi; Erbil, Bülent; Deniz, Kaan Zülfikar
Cardiopulmonary resuscitation training is an essential element of clinical skill development for healthcare providers. The International Liaison Committee on Resuscitation has described issues related to cardiopulmonary resuscitation and emergency cardiovascular care education. Educational interventions have been initiated to try to address these issues using a team-based approach and simulation technologies that offer a controlled, safe learning environment. The aim of the study is to review and synthesize published studies that address the primary question "What are the features and effectiveness of educational interventions related to simulation-enhanced, team-based cardiopulmonary resuscitation training?" We conducted a systematic review focused on educational interventions pertaining to cardiac arrest and emergencies that addressed this main question. The findings are presented together with a discussion of the effectiveness of various educational interventions. In conclusion, student attitudes toward interprofessional learning and simulation experiences were more positive. Research reports emphasized the importance of adherence to established guidelines, adopting a holistic approach to training, and that preliminary training, briefing, deliberate practices, and debriefing should help to overcome deficiencies in cardiopulmonary resuscitation training. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full text: International safety experts today concluded a two-week International Atomic Energy Agency (IAEA) mission to review the regulatory framework for nuclear and radiation safety in Finland. In its preliminary report, the Integrated Regulatory Review Service (IRRS) mission team found that the Radiation and Nuclear Safety Authority of Finland (STUK) is a competent and highly credible regulator that is open and transparent and derives great strength from the technical competence of its staff. ''Finland's comprehensive regulatory framework allows STUK to operate in practice as an independent regulatory body,'' said team leader Philippe Jamet, a commissioner of the French regulatory body ASN. The mission was conducted at the request of the Government of Finland from 15-26 October. The team interviewed members of STUK and officials from various ministries, as well as key players in the Finnish safety framework. Such IRRS missions are peer reviews based on IAEA Safety Standards, not inspections or audits. The team was made up of 18 members from Bulgaria, Canada, the Czech Republic, France, Germany, Iceland, Ireland, Romania, the Russian Federation, South Africa, Slovakia, Slovenia, Spain, Sweden, the United Arab Emirates, the United Kingdom and the United States, as well as six IAEA staff members. 'The IRRS mission and preparation for it was a unique occasion that involved the whole organization, provided motivation for improvement of the safety framework in Finland and assists STUK review its mission', said Tero Varjoranta, Director General of STUK. The IRRS team identified a number of good practices and achievements, including: - STUK's excellence in its safety assessment of nuclear power plants and waste repositories, in particular its demonstration that long-term political commitment is a necessity to sustain the creation of a waste repository as well as its regulatory oversight of medical applications of radiation sources; and - STUK's excellent record in
Vöhringer, Paul A; Castro, Ariel; Martínez, Pablo; Tala, Álvaro; Medina, Simón; Rojas, Graciela
Although evidence from Latin America and the Caribbean suggests that depression can be effectively treated in primary care settings, depression management remains unevenly performed. This systematic review evaluates all the international evidence on healthcare team training programs aimed at improving the outcomes of patients with depression. Three databases were searched for articles in English or Spanish indexed up to November 20, 2014. Studies were included if they fulfilled the following conditions: clinical trials, meta-analyses, or systematic reviews; and if they evaluated a training or educational program intended to improve the management of depression by primary healthcare teams, and assessed change in depressive symptoms, diagnosis or response rates, referral rates, patients' satisfaction and/or quality of life, and the effectiveness of treatments. Nine studies were included in this systematic review. Five trials tested the effectiveness of multi-component interventions (training included), and the remaining studies evaluated the effectiveness of specific training programs for depression management. All the studies that implemented multi-component interventions were efficacious, and half of the training trials were shown to be effective. Contribution of training programs alone to the effectiveness of multi-component interventions is yet to be established. The lack of specificity regarding health providers' characteristics might be a confounding factor. The review conducted suggests that stand-alone training programs are less effective than multi-component interventions. In applying the evidence gathered from developed countries to Latin America and the Caribbean, these training programs must consider and address local conditions of mental health systems, and therefore multi-component interventions may be warranted. Copyright © 2016 Elsevier B.V. All rights reserved.
Full Text Available Abstract Background Significant event analysis (SEA is promoted as a team-based approach to enhancing patient safety through reflective learning. Evidence of SEA participation is required for appraisal and contractual purposes in UK general practice. A voluntary educational model in the west of Scotland enables general practitioners (GPs and doctors-in-training to submit SEA reports for feedback from trained peers. We reviewed reports to identify the range of safety issues analysed, learning needs raised and actions taken by GP teams. Method Content analysis of SEA reports submitted in an 18 month period between 2005 and 2007. Results 191 SEA reports were reviewed. 48 described patient harm (25.1%. A further 109 reports (57.1% outlined circumstances that had the potential to cause patient harm. Individual 'error' was cited as the most common reason for event occurrence (32.5%. Learning opportunities were identified in 182 reports (95.3% but were often non-specific professional issues not shared with the wider practice team. 154 SEA reports (80.1% described actions taken to improve practice systems or professional behaviour. However, non-medical staff were less likely to be involved in the changes resulting from event analyses describing patient harm (p Conclusion The study provides some evidence of the potential of SEA to improve healthcare quality and safety. If applied rigorously, GP teams and doctors in training can use the technique to investigate and learn from a wide variety of quality issues including those resulting in patient harm. This leads to reported change but it is unclear if such improvement is sustained.
Nijhuis, B. J. G.; Reinders-Messelink, H. A.; de Blecourt, A. C. E.; Olijve, W. G.; Groothoff, J. W.; Nakken, H.; Postema, K.; Postuma, K.
Objective: To explicate the complex process of team collaboration and identify salient elements of team collaboration in paediatric rehabilitation. Data sources: After an initial search to define key features of team collaboration a systematic search on team collaboration and the key features was
Full Text Available Many physicians have received a frantic call from anxious parents stating that their child had stopped breathing, become limp, or turned blue but then had recovered quickly. An apparent life-threatening event (ALTE is defined as “an episode that is frightening to the observer, and is characterized by some combination of apnea, color change, marked change in muscle tone, choking, gagging, or coughing”. The incidence of ALTE is reported to be 0.05% to 6%. The knowledge about the most common causes and factors associated with higher risk of ALTE could be resulted in a more purposeful approach, improving the decision making process, and benefiting both children and parents. The aim of this review article was to report the epidemiology, etiology, evaluation, management, and disposition of ALTE. Infants with an ALTE might present no signs of acute illness and are commonly managed in the emergency settings that often require significant medical attention; hence, the emergency medicine personnel should be aware of the its clinical importance. There is no specific treatment for ALTE; therefore, the clinical evaluations should be focused on the detection of the underlying causes, which will define the outcomes and prognosis. ALTE is a confusing entity, representing a constellation of descriptive symptoms and signs; in other words, it is not a diagnosis. There are multiple possible etiologies and difficulties in evaluating and managing infants with these events, which are challenges to primary care physicians, emergency medicine specialists, and subspecialty pediatricians. The evaluation of these events in infants includes a detailed history, appropriate physical examination, diagnostic tests guided by obtained clues from the history and physical examination, and observation in the emergency department.
Full Text Available This paper reviews research findings on entrepreneurial top management teams within the last 20 years. It concentrates on team-based management factors and their influence on a new venture’s growth and ability to raise capital. This paper integrates recent findings and provides an overview of the current state of research. Moreover, it contributes to the overall topic by proposing five clusters of major team-specific influences, derives determinants of success and failure, and reveals recommendations for further research.
The IAEA Director General stressed the role of safety culture in his concluding remarks at the Meeting of the Contracting Parties to the Convention on Nuclear Safety in 2002: 'As we have learned in other areas, it is not enough simply to have a structure; it is not enough to say that we have the necessary laws and the appropriate regulatory bodies. All these are important, but equally important is that we have in place a safety culture that gives effect to the structure that we have developed. To me, effectiveness and transparency are keys. So, it is an issue which I am pleased to see, you are giving the attention it deserves and we will continue to work with you in clarifying, developing and applying safety culture through our programmes and through our technical cooperation activities.' The concept of safety culture was initially developed by the International Nuclear Safety Advisory Group (INSAG) after the Chernobyl accident in 1986. Since then the IAEA's perspective of safety culture has expanded with time as its recognition of the complexities of the concept developed. Safety culture is considered to be specific organizational culture in all types of organizations with activities that give rise to radiation risks. The aim is to make safety culture strong and sustainable, so that safety becomes a primary focus for all activities in such organizations, even for those, which might not look safety-related at first. SCART (Safety Culture Assessment Review Team) is a safety review service, which reflects the expressed interest of Members States for methods and tools for safety culture assessment. It is a replacement for the earlier service ASCOT (Assessment of Safety Culture in Organizations Team). The IAEA Safety Fundamentals, Requirements and Guides (Safety Standards) are the basis for the SCART Safety Review Service. The reports of INSAG, identifying important current nuclear safety issues, serve also as references during a SCART mission. SCART missions are based
The TRT was impressed with the quality and volume of laboratory and pilot scale development work that had been conducted over the past year. Many of the doubts and questions raised by the TRP on technical details had been examined, either by theoretical calculations or in the pilot facility. Moreover, a more open and forthcoming attitude was evident among the MMT staff who either presented briefings or responded to the Team's questions. Of special note to DOE, the TRP recognized a year ago that the pilot facility at Fall River was not designed for radioactive pilot tests. However, from the dialogue surrounding the TRP review, it was evident that not much thought had been given to the hazards, concerns, and special requirements incumbent with radioactive operations -- everything from doing pours of hot radioactive metal from a vessel to remote-handling equipment and operations. This year the TRT noticed a significant improvement in this respect
Currey, Judy; Allen, Josh; Jones, Daryl
The introduction of rapid response systems has reduced the incidence of in-hospital cardiac arrest; however, many instances of clinical deterioration are unrecognised. Afferent limb failure is common and may be associated with unplanned intensive care admissions, heightened mortality and prolonged length of stay. Patients reviewed by a Medical Emergency Team are inherently vulnerable with a high in-hospital mortality. To explore perceptions of intensive care unit (ICU) staff who attend deteriorating acute care ward patients regarding current problems, barriers and potential solutions to recognising and responding to clinical deterioration that culminates in a Medical Emergency Team review. A descriptive exploratory design was used. Registered intensive care nurses and medical staff (N=207) were recruited during a professional conference using purposive sampling for experience in attending deteriorating patients. Written response surveys were used to address the study aim. Data were analysed using content analysis. Four major themes were identified: Governance, Teamwork, Clinical Care Delivery and End of Life Care. Participants perceived there was a lack of sufficient and senior staff with the required theoretical knowledge; and inadequate assessment and critical thinking skills for anticipating, recognising and responding to clinical deterioration. Senior doctors were perceived to inappropriately manage End of Life Care issues and displayed Teamwork behaviours rendering ward clinicians feeling fearful and intimidated. A lack of System and Clinical Governance hindered identification of clinical deterioration. To improve patient safety related to recognising and responding to clinical deterioration, suboptimal care due to professionals' knowledge, skills and behaviours need addressing, along with End of Life Care and Governance. Copyright © 2017 Australian College of Critical Care Nurses Ltd. All rights reserved.
Unbeck, Maria; Schildmeijer, Kristina; Henriksson, Peter; Jürgensen, Urban; Muren, Olav; Nilsson, Lena; Pukk Härenstam, Karin
There has been a theoretical debate as to which retrospective record review method is the most valid, reliable, cost efficient and feasible for detecting adverse events. The aim of the present study was to evaluate the feasibility and capability of two common retrospective record review methods, the "Harvard Medical Practice Study" method and the "Global Trigger Tool" in detecting adverse events in adult orthopaedic inpatients. We performed a three-stage structured retrospective record review process in a random sample of 350 orthopaedic admissions during 2009 at a Swedish university hospital. Two teams comprised each of a registered nurse and two physicians were assigned, one to each method. All records were primarily reviewed by registered nurses. Records containing a potential adverse event were forwarded to physicians for review in stage 2. Physicians made an independent review regarding, for example, healthcare causation, preventability and severity. In the third review stage all adverse events that were found with the two methods together were compared and all discrepancies after review stage 2 were analysed. Events that had not been identified by one of the methods in the first two review stages were reviewed by the respective physicians. Altogether, 160 different adverse events were identified in 105 (30.0%) of the 350 records with both methods combined. The "Harvard Medical Practice Study" method identified 155 of the 160 (96.9%, 95% CI: 92.9-99.0) adverse events in 104 (29.7%) records compared with 137 (85.6%, 95% CI: 79.2-90.7) adverse events in 98 (28.0%) records using the "Global Trigger Tool". Adverse events "causing harm without permanent disability" accounted for most of the observed difference. The overall positive predictive value for criteria and triggers using the "Harvard Medical Practice Study" method and the "Global Trigger Tool" was 40.3% and 30.4%, respectively. More adverse events were identified using the "Harvard Medical Practice Study
O’Reilly, Pauline; Lee, Siew Hwa; O’Sullivan, Madeleine; Cullen, Walter; Kennedy, Catriona; MacFarlane, Anne
Background Interdisciplinary team working is of paramount importance in the reform of primary care in order to provide cost-effective and comprehensive care. However, international research shows that it is not routine practice in many healthcare jurisdictions. It is imperative to understand levers and barriers to the implementation process. This review examines interdisciplinary team working in practice, in primary care, from the perspective of service providers and analyses 1 barriers and facilitators to implementation of interdisciplinary teams in primary care and 2 the main research gaps. Methods and findings An integrative review following the PRISMA guidelines was conducted. Following a search of 10 international databases, 8,827 titles were screened for relevance and 49 met the criteria. Quality of evidence was appraised using predetermined criteria. Data were analysed following the principles of framework analysis using Normalisation Process Theory (NPT), which has four constructs: sense making, enrolment, enactment, and appraisal. The literature is dominated by a focus on interdisciplinary working between physicians and nurses. There is a dearth of evidence about all NPT constructs apart from enactment. Physicians play a key role in encouraging the enrolment of others in primary care team working and in enabling effective divisions of labour in the team. The experience of interdisciplinary working emerged as a lever for its implementation, particularly where communication and respect were strong between professionals. Conclusion A key lever for interdisciplinary team working in primary care is to get professionals working together and to learn from each other in practice. However, the evidence base is limited as it does not reflect the experiences of all primary care professionals and it is primarily about the enactment of team working. We need to know much more about the experiences of the full network of primary care professionals regarding all aspects
Fan, Mark; Petrosoniak, Andrew; Pinkney, Sonia; Hicks, Christopher; White, Kari; Almeida, Ana Paula Siquiera Silva; Campbell, Douglas; McGowan, Melissa; Gray, Alice; Trbovich, Patricia
Errors in trauma resuscitation are common and have been attributed to breakdowns in the coordination of system elements (eg, tools/technology, physical environment and layout, individual skills/knowledge, team interaction). These breakdowns are triggered by unique circumstances and may go unrecognised by trauma team members or hospital administrators; they can be described as latent safety threats (LSTs). Retrospective approaches to identifying LSTs (ie, after they occur) are likely to be incomplete and prone to bias. To date, prospective studies have not used video review as the primary mechanism to identify any and all LSTs in trauma resuscitation. A series of 12 unannounced in situ simulations (ISS) will be conducted to prospectively identify LSTs at a level 1 Canadian trauma centre (over 800 dedicated trauma team activations annually). 4 scenarios have already been designed as part of this protocol based on 5 recurring themes found in the hospital's mortality and morbidity process. The actual trauma team will be activated to participate in the study. Each simulation will be audio/video recorded from 4 different camera angles and transcribed to conduct a framework analysis. Video reviewers will code the videos deductively based on a priori themes of LSTs identified from the literature, and/or inductively based on the events occurring in the simulation. LSTs will be prioritised to target interventions in future work. Institutional research ethics approval has been acquired (SMH REB #15-046). Results will be published in peer-reviewed journals and presented at relevant conferences. Findings will also be presented to key institutional stakeholders to inform mitigation strategies for improved patient safety. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Buggy, A; Moore, Z
To assess the impact of the multidisciplinary team in the management of the diabetic foot compared with those who did not receive multidisciplinary care. A systematic review of the literature was conducted using the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase and Cochrane Library. The following search terms were used: diabetic foot, multidisciplinary team, patient care team, multidisciplinary care team. Data were extracted using a bespoke data extraction tool and quality appraisal of the studies was undertaken using the EBL Critical Appraisal checklist. Data analysis was undertaken using RevMan with results presented as odds ratio for dichotomous data, or mean difference for continuous data, all with the associated 95% confidence intervals. The search identified 19 eligible studies. Severity of amputation, death rates and length of hospital stay of clients receiving multidisciplinary team care were improved when compared with those who did not receive multidisciplinary team care. Ulcer healing and quality of life showed an improvement but not all studies explored these outcomes. Only 7 of the 19 articles appraised were found to be of acceptable quality, questioning the generalisability of the results. From the currently available evidence a positive impact of the multidisciplinary team on diabetic foot outcomes can be seen, but due to the lack of high-quality evidence and substantial heterogeneity in the studies, these results should be interpreted with caution.
The ability to work effectively in teams has been a key competence for information systems engineers for a long time. Gradually, more attention is being paid to developing this generic competence as part of academic curricula, resulting in two questions: how to best promote team competencies and how to implement team projects successfully. These…
V. V. Surkov
Full Text Available Transient luminous events (TLEs occasionally observed above a strong thunderstorm system have been the subject of a great deal of research during recent years. The main goal of this review is to introduce readers to recent theories of electrodynamics processes associated with TLEs. We examine the simplest versions of these theories in order to make their physics as transparent as possible. The study is begun with the conventional mechanism for air breakdown at stratospheric and mesospheric altitudes. An electron impact ionization and dissociative attachment to neutrals are discussed. A streamer size and mobility of electrons as a function of altitude in the atmosphere are estimated on the basis of similarity law. An alternative mechanism of air breakdown, runaway electron mechanism, is discussed. In this section we focus on a runaway breakdown field, characteristic length to increase avalanche of runaway electrons and on the role played by fast seed electrons in generation of the runaway breakdown. An effect of thunderclouds charge distribution on initiation of blue jets and gigantic jets is examined. A model in which the blue jet is treated as upward-propagating positive leader with a streamer zone/corona on the top is discussed. Sprite models based on streamer-like mechanism of air breakdown in the presence of atmospheric conductivity are reviewed. To analyze conditions for sprite generation, thunderstorm electric field arising just after positive cloud-to-ground stroke is compared with the thresholds for propagation of positively/negatively charged streamers and with runway breakdown. Our own estimate of tendril's length at the bottom of sprite is obtained to demonstrate that the runaway breakdown can trigger the streamer formation. In conclusion we discuss physical mechanisms of VLF (very low frequency and ELF (extremely low frequency phenomena associated with sprites.
Tam, Benjamin; Salib, Mary; Fox-Robichaud, Alison
BACKGROUND: A subset of critically ill patients have end-of-life (EOL) goals that are unclear. Rapid response teams (RRTs) may aid in the identification of these patients and the delivery of their EOL care. OBJECTIVES: To characterize the impact of RRT discussion on EOL care, and to examine how a preprinted order (PPO) set for EOL care influenced EOL discussions and outcomes. METHODS: A single-centre retrospective chart review of all RRT calls (January 2009 to December 2010) was performed. The effect of RRT EOL discussions and the effect of a hospital-wide PPO set on EOL care was examined. Charts were from the Ontario Ministry of Health and Long-Term Care Critical Care Information Systemic database, and were interrogated by two reviewers. RESULTS: In patients whose EOL status changed following RRT EOL discussion, there were fewer intensive care unit (ICU) transfers (8.4% versus 17%; PEOL status following the introduction of an EOL PPO, from 20% (before) to 31% (after) (PEOL status following RRT-led EOL discussion was associated with reduced ICU transfers and enhanced access to palliative care services. Further study is required to identify and deconstruct barriers impairing timely and appropriate EOL discussions. PMID:25299222
O'Reilly, Pauline; Lee, Siew Hwa; O'Sullivan, Madeleine; Cullen, Walter; Kennedy, Catriona; MacFarlane, Anne
Interdisciplinary team working is of paramount importance in the reform of primary care in order to provide cost-effective and comprehensive care. However, international research shows that it is not routine practice in many healthcare jurisdictions. It is imperative to understand levers and barriers to the implementation process. This review examines interdisciplinary team working in practice, in primary care, from the perspective of service providers and analyses 1 barriers and facilitators to implementation of interdisciplinary teams in primary care and 2 the main research gaps. An integrative review following the PRISMA guidelines was conducted. Following a search of 10 international databases, 8,827 titles were screened for relevance and 49 met the criteria. Quality of evidence was appraised using predetermined criteria. Data were analysed following the principles of framework analysis using Normalisation Process Theory (NPT), which has four constructs: sense making, enrolment, enactment, and appraisal. The literature is dominated by a focus on interdisciplinary working between physicians and nurses. There is a dearth of evidence about all NPT constructs apart from enactment. Physicians play a key role in encouraging the enrolment of others in primary care team working and in enabling effective divisions of labour in the team. The experience of interdisciplinary working emerged as a lever for its implementation, particularly where communication and respect were strong between professionals. A key lever for interdisciplinary team working in primary care is to get professionals working together and to learn from each other in practice. However, the evidence base is limited as it does not reflect the experiences of all primary care professionals and it is primarily about the enactment of team working. We need to know much more about the experiences of the full network of primary care professionals regarding all aspects of implementation work. International
Hempel, Susanne; Maggard-Gibbons, Melinda; Nguyen, David K; Dawes, Aaron J; Miake-Lye, Isomi; Beroes, Jessica M; Booth, Marika J; Miles, Jeremy N V; Shanman, Roberta; Shekelle, Paul G
Serious, preventable surgical events, termed never events, continue to occur despite considerable patient safety efforts. To examine the incidence and root causes of and interventions to prevent wrong-site surgery, retained surgical items, and surgical fires in the era after the implementation of the Universal Protocol in 2004. We searched 9 electronic databases for entries from 2004 through June 30, 2014, screened references, and consulted experts. Two independent reviewers identified relevant publications in June 2014. One reviewer used a standardized form to extract data and a second reviewer checked the data. Strength of evidence was established by the review team. Data extraction was completed in January 2015. Incidence of wrong-site surgery, retained surgical items, and surgical fires. We found 138 empirical studies that met our inclusion criteria. Incidence estimates for wrong-site surgery in US settings varied by data source and procedure (median estimate, 0.09 events per 10,000 surgical procedures). The median estimate for retained surgical items was 1.32 events per 10,000 procedures, but estimates varied by item and procedure. The per-procedure surgical fire incidence is unknown. A frequently reported root cause was inadequate communication. Methodologic challenges associated with investigating changes in rare events limit the conclusions of 78 intervention evaluations. Limited evidence supported the Universal Protocol (5 studies), education (4 studies), and team training (4 studies) interventions to prevent wrong-site surgery. Limited evidence exists to prevent retained surgical items by using data-matrix-coded sponge-counting systems (5 pertinent studies). Evidence for preventing surgical fires was insufficient, and intervention effects were not estimable. Current estimates for wrong-site surgery and retained surgical items are 1 event per 100,000 and 1 event per 10,000 procedures, respectively, but the precision is uncertain, and the per
Basta, Yara L; Bolle, Sifra; Fockens, Paul; Tytgat, Kristien M A J
The incidence of gastrointestinal (GI) cancer is rising and most patients with GI malignancies are discussed by a multidisciplinary team (MDT). We performed a systematic review to assess whether MDTs for patients with GI malignancies can correctly change diagnosis, tumor stage and subsequent treatment plan, and whether the treatment plan was implemented. We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted a search of the PubMed, MEDLINE and EMBASE electronic databases, and included studies relating to adults with a GI malignancy discussed by an MDT prior to the start of treatment which described a change of initial diagnosis, stage or treatment plan. Two researchers independently evaluated all retrieved titles and abstracts from the abovementioned databases. Overall, 16 studies were included; the study quality was rated as fair. Four studies reported that MDTs changed the diagnoses formulated by individual physicians in 18.4-26.9% of evaluated cases; two studies reported that MDTs formulated an accurate diagnosis in 89 and 93.5% of evaluated cases, respectively; nine studies described that the treatment plan was altered in 23.0-41.7% of evaluated cases; and four studies found that MDT decisions were implemented in 90-100% of evaluated cases. The reasons for altering a treatment plan included the patient's wishes, and comorbidities. MDT meetings for patients with a GI malignancy are responsible for changes in diagnoses and management in a significant number of patients. Treatment plans formulated by MDTs are implemented in 90-100% of discussed patients. All patients with a GI malignancy should be discussed by an MDT.
Team learning is a cure for bureaucracy; it facilitates team innovation and team performance. But team learning occurs only when necessary conditions were met. This research focused on differences of team learning influential factors between self-management team and superior-direction team. Four variables were chosen as predictors of team learning though literature review and pilot interview. The 4 variables are team motivation, team trust, team conflict and team leadership. Selected 54 self ...
Fong, Allan; Harriott, Nicole; Walters, Donna M; Foley, Hanan; Morrissey, Richard; Ratwani, Raj R
Many healthcare providers have implemented patient safety event reporting systems to better understand and improve patient safety. Reviewing and analyzing these reports is often time consuming and resource intensive because of both the quantity of reports and length of free-text descriptions in the reports. Natural language processing (NLP) experts collaborated with clinical experts on a patient safety committee to assist in the identification and analysis of medication related patient safety events. Different NLP algorithmic approaches were developed to identify four types of medication related patient safety events and the models were compared. Well performing NLP models were generated to categorize medication related events into pharmacy delivery delays, dispensing errors, Pyxis discrepancies, and prescriber errors with receiver operating characteristic areas under the curve of 0.96, 0.87, 0.96, and 0.81 respectively. We also found that modeling the brief without the resolution text generally improved model performance. These models were integrated into a dashboard visualization to support the patient safety committee review process. We demonstrate the capabilities of various NLP models and the use of two text inclusion strategies at categorizing medication related patient safety events. The NLP models and visualization could be used to improve the efficiency of patient safety event data review and analysis. Copyright © 2017 Elsevier B.V. All rights reserved.
Wickramasinghe, Leelani K; Schattner, Peter; Hibbert, Marienne E; Enticott, Joanne C; Georgeff, Michael P; Russell, Grant M
To investigate whether General Practice Management Plans (GPMPs), Team Care Arrangements (TCAs) and reviews of these improve the management and outcomes of patients with diabetes when supported by cdmNet, a web-based chronic disease management system; and to investigate adherence to the annual cycle of care (ACOC), as recommended in diabetes guidelines. A before-and-after study to analyse prospectively collected data on 577 patients with type 1 or 2 diabetes mellitus who were managed with a GPMP created using cdmNet between June 2008 and November 2012. Completion of the clinical tests in the ACOC (process outcome) and values of six of these clinical measurements (clinical outcomes). Significant improvements were seen after creation of a GPMP in the proportion of ACOC clinical tests completed (57.9% v 74.8%, P < 0.001), total cholesterol level (P < 0.01), low-density lipoprotein (LDL) cholesterol level (P < 0.001) and body mass index (BMI) (P < 0.01). Patients using GPMPs and TCAs also improved their glycated haemoglobin (HbA1c) level (P < 0.05). Patients followed up with irregular reviews had significant improvements in the proportion of ACOC clinical tests completed (59.2% v 77.6%, P < 0.001), total cholesterol level (P < 0.05), and BMI (P < 0.01), but patients with regular reviews had greater improvements in the proportion of ACOC clinical tests completed (58.9% v 85.0%, P < 0.001), HbA(1c) level (57.7 v 53.0 mmol/mol, P < 0.05), total cholesterol level (4.8 v 4.5 mmol/L, P < 0.05), LDL cholesterol level (2.8 v 2.4 mmol/L, P < 0.01) and diastolic blood pressure (76.0 v 74.0 mmHg, P < 0.05). There were significant improvements in process and clinical outcomes for patients on a GPMP or a GPMP and TCA, particularly when these were followed up by regular reviews. Patients using cdmNet were four times more likely to have their GPMP or TCA followed up through regular reviews than the national average.
Hickey, Graeme L; Philipson, Pete; Jorgensen, Andrea; Kolamunnage-Dona, Ruwanthi
Methodological development and clinical application of joint models of longitudinal and time-to-event outcomes have grown substantially over the past two decades. However, much of this research has concentrated on a single longitudinal outcome and a single event time outcome. In clinical and public health research, patients who are followed up over time may often experience multiple, recurrent, or a succession of clinical events. Models that utilise such multivariate event time outcomes are quite valuable in clinical decision-making. We comprehensively review the literature for implementation of joint models involving more than a single event time per subject. We consider the distributional and modelling assumptions, including the association structure, estimation approaches, software implementations, and clinical applications. Research into this area is proving highly promising, but to-date remains in its infancy.
Trager, E.A. Jr.
Large pool-type gamma irradiators are used in applications such as the ''cold'' sterilization of medical and pharmaceutical supplies, and recent changes in federal regulations make it possible they will be used extensively in the preservation of foodstuffs. Because of this possible large increase in the use of irradiators, the Office of Nuclear Materials Safety and Safeguards was interested in knowing what events had occurred at irradiators. The event data would be used as background in developing new regulations on irradiators. Therefore, AEOD began a study of the operating experience at large, wet source storage gamma irradiators. The scope of the study was to assess all available operating information on large (≥ 250,000 curie), pool-type irradiators licensed by both the NRC and the Agreement States, and events at foreign facilities. The study found that about 0.12 events have been reported per irradiator-year. Most of these events were precursor events, in that there was no evidence of damage to the radioactive sources or degradation in the level of safety of the facility. Events with more significant impacts had a reported frequency of about 0.01 event per irradiator-year. However, the actual rate of occurrence of events of concern to the staff may be higher because there are few specific reporting requirements for events at irradiators. It is suggested that during development of a regulation for large pool-type irradiators consideration be given to specifying requirements for: reporting breakdowns in access control systems; periodic inspection of the source movement and suspension system; systems to detect source leakage and product contamination; allowable pool leakage; and feedback of information on operational events involving safety-important systems
Dunwoody, John Tyler [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Obrey, Kimberly Ann [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bridgewater, Jon S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Griego, Frank X. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Brenner, Andrew Karl [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Lopez, Ted T. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Henderson, Kevin C. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Gordon, Lloyd Baumgardner [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Blumberg, Paul A. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wilburn, Dianne Williams [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
The purpose of a Learning Team is to transfer and communicate the information into operational feedback and improvement. We want to pay attention to the small things that go wrong because they are often early warning signals and may provide insight into the health of the whole system. An ESR was placed in the October of 2015 to move/install a number of 120V and 208V outlets in 455-104B to support programmatic furnace needs. Electrical design review was completed for ESR 22217 on February 22, 2016 and a Design Change Form completed describing the modification needed as: demolish 1 existing receptacle and circuit leaving conduit and jbox for use to install new receptacle and 5 new receptacles/circuits are required and one existing receptacle is to be relocated, listed under FSR 149229. The FSR scope of work was written:: Please have the Electricians come out to perform demolition (1ea.), installation (6ea.)& relocation (1ea.) of receptacles / circuits. ESR 22217 & DCF-16-35-0455-1281 is in place for this work. Coordinate final receptacle locations with Laboratory Resident. Contact John Dunwoody or O-MC for this information. WO# 545580-01 was signed on April 20, 2016.: Electricians to perform demolition, installation, & relocation of receptacles / circuits PER attached DCF-16-0455-1281-SK-1.
Fortington, Lauren V; van der Worp, Henk; van den Akker-Scheek, Inge; Finch, Caroline F
To identify and prioritise targets for injury prevention efforts, injury incidence studies are widely reported. The accuracy and consistency in calculation and reporting of injury incidence is crucial. Many individuals experience more than one injury but multiple injuries are not consistently reported in sport injury incidence studies. The aim of this systematic review was to evaluate current practice of how multiple injuries within individuals have been defined and reported in prospective, long-term, injury studies in team ball sports. A systematic search of three online databases for articles published before 2016. Publications were included if (1) they collected prospective data on musculoskeletal injuries in individual participants; (2) the study duration was >1 consecutive calendar year/season; and (3) individuals were the unit of analysis. Key study features were summarised, including definitions of injury, how multiple individual injuries were reported and results relating to multiple injuries. Of the 71 publications included, half did not specifically indicate multiple individual injuries; those that did were largely limited to reporting recurrent injuries. Eight studies reported the number/proportion of athletes with more than one injury, and 11 studies presented the mean/number of injuries per athlete. Despite it being relatively common to collect data on individuals across more than one season, the reporting of multiple injuries within individuals is much more limited. Ultimately, better addressing of multiple injuries will improve the accuracy of injury incidence studies and enable more precise targeting and monitoring of the effectiveness of preventive interventions.
González-Víllora, Sixto; Serra-Olivares, Jaime; Pastor-Vicedo, Juan Carlos; da Costa, Israel Teoldo
For sports assessment to be comprehensive, it must address all variables of sports development, such as psychological, social-emotional, physical and physiological, technical and tactical. Tactical assessment has been a neglected variable until the 1980s or 1990s. In the last two decades (1995-2015), the evolution of tactical assessment has grown considerably, given its importance in game performance. The aim of this paper is to compile and analyze different tactical measuring tools in team sports, particularly in soccer, through a bibliographical review. Six tools have been selected on five different criteria: (1) Instruments which assess tactics, (2) The studies have an evolution approach related to the tactical principles, (3) With a valid and reliable method, (4) The existence of publications mentioning the tool in the method, v. Applicable in different sports contexts. All six tools are structured around seven headings: introduction, objective(s), tactical principles, materials, procedures, instructions/rules of the game and published studies. In conclusion, the teaching-learning processes more tactical oriented have useful tactical assessment instrument in the literature. The selection of one or another depends some context information, like age and level of expertise of the players.
Abendstern, M; Harrington, V; Brand, C; Tucker, S; Wilberforce, M; Challis, D
In the UK and elsewhere, specialist community mental health teams (CMHTs) are central to the provision of comprehensive services for older people with mental ill health. Recent guidance documents suggest a core set of attributes that such teams should encompass. This article reports on a systematic literature review undertaken to collate existing evidence regarding the structures and processes of CMHTs for older people and to evaluate evidence linking approaches to effectiveness. Relevant publications were identified via systematic searches, both electronic and manual. Searches were limited to the UK for descriptions of organisation and practice but included international literature where comparisons between different CMHT arrangements were evaluated. Empirical, peer-reviewed studies from 1989 onward were included, extended to non peer-reviewed nationally or regionally representative reports, published after 1998, for the descriptive element. Forty-five studies met inclusion criteria of which seven provided comparative outcome data. All but one were UK based. The most robust evidence related to research conducted in exemplar teams. Limited evidence was found regarding the effectiveness of many of the core attributes recommended in policy directives although their presence was reported in much of the literature. The contrast between presentation and evaluation of attributes is stark. Whilst some gaps can be filled from related fields, further research is required that moves beyond description to evaluation of the impact of team design on service user outcomes in order to inform future policy directives and practice guidance. A framework for an evidence-based model of CMHTs for older people is provided.
Dallinga, Joan M; Benjaminse, Anne; Lemmink, Koen A P M
Injuries to lower extremities are common in team sports such as soccer, basketball, volleyball, football and field hockey. Considering personal grief, disabling consequences and high costs caused by injuries to lower extremities, the importance for the prevention of these injuries is evident. From this point of view it is important to know which screening tools can identify athletes who are at risk of injury to their lower extremities. The aim of this article is to determine the predictive values of anthropometric and/or physical screening tests for injuries to the leg, anterior cruciate ligament (ACL), knee, hamstring, groin and ankle in team sports. A systematic review was conducted in MEDLINE (1966 to September 2011), EMBASE (1989 to September 2011) and CINAHL (1982 to September 2011). Based on inclusion criteria defined a priori, titles, abstracts and full texts were analysed to find relevant studies. The analysis showed that different screening tools can be predictive for injuries to the knee, ACL, hamstring, groin and ankle. For injuries in general there is some support in the literature to suggest that general joint laxity is a predictive measure for leg injuries. The anterior right/left reach distance >4 cm and the composite reach distance injuries. Furthermore, an increasing age, a lower hamstring/quadriceps (H : Q) ratio and a decreased range of motion (ROM) of hip abduction may predict the occurrence of leg injuries. Hyperextension of the knee, side-to-side differences in anterior-posterior knee laxity and differences in knee abduction moment between both legs are suggested to be predictive tests for sustaining an ACL injury and height was a predictive screening tool for knee ligament injuries. There is some evidence that when age increases, the probability of sustaining a hamstring injury increases. Debate exists in the analysed literature regarding measurement of the flexibility of the hamstring as a predictive screening tool, as well as using the H
Dearnley, Chris; Rhodes, Christine; Roberts, Peter; Williams, Pam; Prenton, Sarah
The aim of this study is to review the evidence in relation to the experiences and outcomes of students on nursing and/or midwifery higher education programmes, who experience team based learning. To examine the relationship between team based learning and attainment for nursing and midwifery students in professional higher education. To examine the relationship between team based learning and student satisfaction for nurses and midwifery students in higher education. To identify and report examples of good practice in the implementation of team based learning in Nursing and Midwifery higher education. A systematic Review of the literature was undertaken. The population were nurses and midwives studying on higher education pre and post registration professional programmes. The intervention was learning and teaching activities based on a team-based learning approach. Data sources included CINAHL and MEDLINE. ERIC and Index to Theses were also searched. International research papers published in English between 2011 and 2017 that met the inclusion criteria were included in the study. Papers that met the criteria were subjected to quality appraisal and agreement amongst authors for inclusion in the review. A total of sixteen papers were reviewed and four themes emerged for discussion. These were Student Engagement, Student Satisfaction, Attainment and Practice Development and Transformational Teaching and Learning. There is a tentative, though growing body of evidence to support TBL as a strategy that can impact on student engagement, student satisfaction, attainment, practice development and transformative teaching and learning. The literature indicates that implementing TBL within the curriculum is not without challenge and requires a sustained and structured approach. Staff and students need to understand the processes involved, and why they should be adhered to, in the pursuit of enhanced student experiences and outcomes for nurses and midwives in Higher Education
Full Text Available Baikal Economic ForumInternational Scientific and Practical Conference"Culture of Wood - Wood in Culture"Summer Ateliers of UrbanistsMemorandum of Understanding between UIA and Active House AllianceKorean Team Wins the First Prize in the VELUX AwardUIA Professional Practice Commission"Zodchestvo 2010" International FestivalRainbow of "Zodchestvo 2010" in ManezhThree Opinions on One Book about Gogol's Two"Soviet Modernism" BookV Plenum of the Board of the Union of Architects of RussiaXXX Meeting of Chief ArchitectsCompetition of Graduation ProjectsInternational Day of Architecture
Full Text Available Background: Presence of a trauma team leader (TTL in the trauma team is associated with positive patient outcomes in major trauma. The TTL is traditionally a surgeon who coordinates the resuscitation and ensures adherence to Advanced Trauma Life Support (ATLS guidelines. The necessity of routine surgical leadership in the resuscitative component of trauma care has been questioned by some authors. Therefore, it remains controversial who should lead the trauma team. We aimed to evaluate outcomes associated with surgeon versus non-surgeon TTLs in management of trauma patients. Methods: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA statement standards, we performed a systematic review. Electronic databases MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials (CENTRAL were searched to identify randomized and non-randomized studies investigating outcomes associated with surgeon versus non-surgeon TTL in management of trauma patients. The Newcastle-Ottawa scale was used to assess the methodological quality and risk of bias of the selected studies. Fixed-effect model was applied to calculate pooled outcome data. Results: Three retrospective cohort studies, enrolling 2,519 adult major trauma patients, were included. Our analysis showed that there was no difference in survival [odds ratio (OR: 0.82, 95% confidence interval (CI 0.61-1.10, P=0.19] and length of stay when trauma team was led by surgeon or non-surgeon TTLs; however, fewer injuries were missed when the trauma team was led by a surgeon (OR: 0.48, 95% CI 0.25-0.92, P=0.03. Conclusions: Despite constant debate, the comparative evidence about outcomes associated with surgeon and non-surgeon trauma team leader is insufficient. The best available evidence suggests that there is no significant difference in outcomes of surgeon or non-surgeon trauma team leaders. High quality randomized controlled trials are required to compare
Alice J. Sweeting
Full Text Available The external load of a team-sport athlete can be measured by tracking technologies, including global positioning systems (GPS, local positioning systems (LPS, and vision-based systems. These technologies allow for the calculation of displacement, velocity and acceleration during a match or training session. The accurate quantification of these variables is critical so that meaningful changes in team-sport athlete external load can be detected. High-velocity running, including sprinting, may be important for specific team-sport match activities, including evading an opponent or creating a shot on goal. Maximal accelerations are energetically demanding and frequently occur from a low velocity during team-sport matches. Despite extensive research, conjecture exists regarding the thresholds by which to classify the high velocity and acceleration activity of a team-sport athlete. There is currently no consensus on the definition of a sprint or acceleration effort, even within a single sport. The aim of this narrative review was to examine the varying velocity and acceleration thresholds reported in athlete activity profiling. The purposes of this review were therefore to (1 identify the various thresholds used to classify high-velocity or -intensity running plus accelerations; (2 examine the impact of individualized thresholds on reported team-sport activity profile; (3 evaluate the use of thresholds for court-based team-sports and; (4 discuss potential areas for future research. The presentation of velocity thresholds as a single value, with equivocal qualitative descriptors, is confusing when data lies between two thresholds. In Australian football, sprint efforts have been defined as activity >4.00 or >4.17 m·s−1. Acceleration thresholds differ across the literature, with >1.11, 2.78, 3.00, and 4.00 m·s−2 utilized across a number of sports. It is difficult to compare literature on field-based sports due to inconsistencies in velocity and
Chen, Jingqiu; Bamberger, Peter A; Song, Yifan; Vashdi, Dana R
While the impact of team reflexivity (a.k.a. after-event-reviews, team debriefs) on team performance has been widely examined, we know little about its implications on other team outcomes such as member well-being. Drawing from prior team reflexivity research, we propose that reflexivity-related team processes reduce demands, and enhance control and support. Given the centrality of these factors to work-based strain, we posit that team reflexivity, by affecting these factors, may have beneficial implications on 3 core dimensions of employee burnout, namely exhaustion, cynicism, and inefficacy (reduced personal accomplishment). Using a sample of 469 unskilled manufacturing workers employed in 73 production teams in a Southern Chinese factory, we implemented a time lagged, quasi-field experiment, with half of the teams trained in and executing an end-of-shift team debriefing, and the other half assigned to a control condition and undergoing periodic postshift team-building exercises. Our findings largely supported our hypotheses, demonstrating that relative to team members assigned to the control condition, those assigned to the reflexivity condition experienced a significant improvement in all 3 burnout dimensions over time. These effects were mediated by control and support (but not demands) and amplified as a function of team longevity. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
de Boer, M.; Boeker, E. B.; Ramrattan, M. A.; Kiewiet, J. J. S.; Ram, K.; Gombert-Handoko, K. B.; van Lent-Evers, N. A. E. M.; Kuks, P. F. M.; Mulder, W. M. C.; Breslau, P. J.; Oostenbroek, R. J.; Dijkgraaf, M. G. W.; Lie-A-Huen, L.; Boermeester, M. A.
Surgical patients are at risk of adverse drug events (ADEs) causing morbidity and mortality. Much harm is preventable. Ward-based pharmacy interventions to reduce medication-related harm have not been evaluated in surgical patients. This multicentre prospective clinical trial evaluated a
Full text: A team of international nuclear safety experts today completed a review of Japan's two-stage process for assessing nuclear safety at the nation's nuclear power plants. The team began its work on 23 January and delivered a Preliminary Summary Report to Japanese officials today and plans to finish the final report by the end of February. National safety assessments and their peer review by the IAEA are a key component of the IAEA's Action Plan on Nuclear Safety, which was approved by the Agency's 152 Member States following last year's nuclear accident at Fukushima Daiichi Nuclear Power Station. At the request of the Government of Japan, the International Atomic Energy Agency (IAEA) organized a 10-person team to review the Japanese Nuclear and Industrial Safety Agency's (NISA) approach to the Comprehensive Assessments for the Safety of Existing Power Reactor Facilities and how NISA examines the results submitted by nuclear operators. The IAEA safety review mission consisted of five IAEA and three international nuclear safety experts. To help its review, the team held meetings in Tokyo with officials from NISA, the Japanese Nuclear Energy Safety (JNES) Organization, and the Kansai Electric Power Company (KEPCO), and the team visited the Ohi Nuclear Power Station to see an example of how Japan's Comprehensive Safety Assessment is being implemented by nuclear operators. 'We concluded that NISA's instructions to power plants and its review process for the Comprehensive Safety Assessments are generally consistent with IAEA Safety Standards', said team leader James Lyons, director of the IAEA's Nuclear Installation Safety Division. In its Preliminary Summary Report delivered today, the team highlighted a number of good practices and identified some improvements that would enhance the overall effectiveness of the Comprehensive Safety Assessment process. Good practices identified by the mission team include: Based on NISA instructions and commitments of the
Ummenhofer, Caroline C; Meehl, Gerald A
Robust evidence exists that certain extreme weather and climate events, especially daily temperature and precipitation extremes, have changed in regard to intensity and frequency over recent decades. These changes have been linked to human-induced climate change, while the degree to which climate change impacts an individual extreme climate event (ECE) is more difficult to quantify. Rapid progress in event attribution has recently been made through improved understanding of observed and simulated climate variability, methods for event attribution and advances in numerical modelling. Attribution for extreme temperature events is stronger compared with other event types, notably those related to the hydrological cycle. Recent advances in the understanding of ECEs, both in observations and their representation in state-of-the-art climate models, open new opportunities for assessing their effect on human and natural systems. Improved spatial resolution in global climate models and advances in statistical and dynamical downscaling now provide climatic information at appropriate spatial and temporal scales. Together with the continued development of Earth System Models that simulate biogeochemical cycles and interactions with the biosphere at increasing complexity, these make it possible to develop a mechanistic understanding of how ECEs affect biological processes, ecosystem functioning and adaptation capabilities. Limitations in the observational network, both for physical climate system parameters and even more so for long-term ecological monitoring, have hampered progress in understanding bio-physical interactions across a range of scales. New opportunities for assessing how ECEs modulate ecosystem structure and functioning arise from better scientific understanding of ECEs coupled with technological advances in observing systems and instrumentation.This article is part of the themed issue 'Behavioural, ecological and evolutionary responses to extreme climatic events
van der Haar, Selma; Koeslag-Kreunen, Mieke; Euwe, Eline; Segers, Mien
Due to their crucial and highly consequential task, it is of utmost importance to understand the levers leading to effectiveness of multidisciplinary emergency management command-and-control (EMCC) teams. We argue that the formal EMCC team leader needs to initiate structure in the team meetings to support organizing the work as well as facilitate team learning, especially the team learning process of constructive conflict. In a sample of 17 EMCC teams performing a realistic EMCC exercise, including one or two team meetings (28 in sum), we coded the team leader’s verbal structuring behaviors (1,704 events), rated constructive conflict by external experts, and rated team effectiveness by field experts. Results show that leaders of effective teams use structuring behaviors more often (except asking procedural questions) but decreasingly over time. They support constructive conflict by clarifying and by making summaries that conclude in a command or decision in a decreasing frequency over time. PMID:28490856
van der Haar, Selma; Koeslag-Kreunen, Mieke; Euwe, Eline; Segers, Mien
Due to their crucial and highly consequential task, it is of utmost importance to understand the levers leading to effectiveness of multidisciplinary emergency management command-and-control (EMCC) teams. We argue that the formal EMCC team leader needs to initiate structure in the team meetings to support organizing the work as well as facilitate team learning, especially the team learning process of constructive conflict. In a sample of 17 EMCC teams performing a realistic EMCC exercise, including one or two team meetings (28 in sum), we coded the team leader's verbal structuring behaviors (1,704 events), rated constructive conflict by external experts, and rated team effectiveness by field experts. Results show that leaders of effective teams use structuring behaviors more often (except asking procedural questions) but decreasingly over time. They support constructive conflict by clarifying and by making summaries that conclude in a command or decision in a decreasing frequency over time.
Bonzel, Tassilo; Schächinger, Volker; Dörge, Hilmar
We present a first description of a Heart Team (HT)-guided approach to coronary revascularization and its long-term effect on clinical events after percutaneous coronary intervention (PCI). The HT approach is a structured process to decide for coronary bypass grafting (CABG), PCI or conservative therapy in ad hoc situations as well as in HT conferences. As a hypothesis, during the long-term course after a PCI performed according to HT rules, a low number of late revascularizations, especially CABGs, are expected (F-PCI study). In this monocentric study, the HT approach to an all-comer population was first analyzed and described in general with the help of a database. Next the use of a HT approach was described for a more homogeneous subgroup with newly detected CAD (1.CAD). Those patients in whom the HT decision was PCI (which was a 1.PCI) were then studied with the help of questionnaires for clinical events during a very long-term follow-up. Events were CABG, PCI, diagnostic catheterization (DCath) and death. A significant number of patients were presented to HT conferences: 22 % out of all 11,174 catheterizations, 24 % out of all 7867 CAD cases and 35 % out of 3408 1.CAD cases. Most of these patients had multi-vessel disease (MVD). Conference decisions were isolated CABG in 46-66 %, PCI in 10-14 %, valvular surgery in 9-16 %, HTx in 10-21 % (Endstage heart failure candidates for surgery) and conservative therapy (Medical or no therapy, additional diagnostic procedures or no adherence to recommended therapy) in 2-3 %. However, most PCIs, ad hoc and elective, were performed under Heart Team rules, but without conference. During follow-up of 1.PCI patients (Kaplan-Meier analysis), CABG occurred in only 15 % of patients, PCI in 37 % and DCath in 65 %; mortality of any course was 51 %. Mortalities were similar in one-vessel disease and in a population of the same year, matched for age and sex (p PCI patients with MVD (p PCI) rates after a 1.PCI, without
Gaetano R. Lotrecchiano
Full Text Available This paper identifies a gap in the team science literature that considers intrapersonal indicators of collaboration as motivations and threats to participating in collaborative knowledge producing teams (KPTs. Through a scoping review process, over 150 resources were consulted to organize 6 domains of motivation and threat to collaboration in KPTs: Resource Acquisition, Advancing Science, Building Relationships, Knowledge Transfer, Recognition and Reward, and Maintenance of Beliefs. Findings show how domains vary in their presentation of depth and diversity of motivation and threat indicators as well as their relationship with each other within and across domains. The findings of 51 indicators resulting from the review provide a psychosocial framework for which to establish a hierarchy of collaborative reasoning for individual engagement in KPTs thus allowing for further research into the mechanism of collaborative engagement. The indicators serve as a preliminary step in establishing a protocol for testing of the psychometric properties of intrapersonal measures of collaboration readiness.
Lee, Ju-Ry; Kim, Eun-Mi; Kim, Sun-Aee; Oh, Eui Geum
Early warning systems (EWSs) are an integral part of processes that aim to improve the early identification and management of deteriorating patients in general wards. However, the widespread implementation of these systems has not generated robust data regarding nurses' clinical performance and patients' adverse events. This review aimed to determine the ability of EWSs to improve nurses' clinical performance and prevent adverse events among deteriorating ward patients. The PubMed, CINAHL, EMBASE, and Cochrane Library databases were searched for relevant publications (January 1, 1997, to April 12, 2017). In addition, a grey literature search evaluated several guideline Web sites. The main outcome measures were nurses' clinical performance (vital sign monitoring and rapid response team notification) and patients' adverse events (in-hospital mortality, cardiac arrest, and unplanned intensive care unit [ICU] admission). The search identified 888 reports, although only five studies fulfilled the inclusion criteria. The findings of these studies revealed that EWSs implementation had a positive effect on nurses' clinical performance, based on their frequency of documenting vital signs that were related to the patient's clinical deterioration. In addition, postimplementation reductions were identified for cardiac arrest, unplanned ICU admission, and unexpected death. It seems that EWSs can improve nurses' clinical performance and prevent adverse events (e.g., in-hospital mortality, unplanned ICU admission, and cardiac arrest) among deteriorating ward patients. However, additional high-quality evidence is needed to more comprehensively evaluate the effects of EWSs on these outcomes.
Full Text Available Abstract Background Adverse events are unintended patient injuries that arise from healthcare management resulting in disability, prolonged hospital stay or death. Adverse events that require intensive care admission imply a considerable financial burden to the healthcare system. The epidemiology of adverse events in Belgian hospitals has never been assessed systematically. Findings A multistage retrospective review study of patients requiring a transfer to a higher level of care will be conducted in six hospitals in the province of Limburg. Patient records are reviewed starting from January 2012 by a clinical team consisting of a research nurse, a physician and a clinical pharmacist. Besides the incidence and the level of causation and preventability, also the type of adverse events and their consequences (patient harm, mortality and length of stay will be assessed. Moreover, the adequacy of the patient records and quality/usefulness of the method of medical record review will be evaluated. Discussion This paper describes the rationale for a retrospective review study of adverse events that necessitate a higher level of care. More specifically, we are particularly interested in increasing our understanding in the preventability and root causes of these events in order to implement improvement strategies. Attention is paid to the strengths and limitations of the study design.
Giffin, W. C.; Rockwell, T. H.; Smith, P. E.
Pilot's cognitive responses to critical in-flight events (CIFE's) were investigated, using pilots, who had on the average about 2540 flight hours each, in four experiments: (1) full-mission simulation in a general aviation trainer, (2) paper and pencil CIFE tests, (3) interactive computer-aided scenario testing, and (4) verbal protocols in fault diagnosis tasks. The results of both computer and paper and pencil tests showed only 50 percent efficiency in correct diagnosis of critical events. The efficiency in arriving at a diagnosis was also low: over 20 inquiries were made for 21 percent of the scenarios diagnosed. The information-seeking pattern was random, with frequent retracing over old inquiries. The measures for developing improved cognitive skills for CIFE's are discussed.
Full Text Available Colorectal cancer (CRC is a heterogeneous disease, developing through a multipathway sequence of events guided by clonal selections. Pathways included in the development of CRC may be broadly categorized into (a genomic instability, including chromosomal instability (CIN, microsatellite instability (MSI, and CpG island methylator phenotype (CIMP, (b genomic mutations including suppression of tumour suppressor genes and activation of tumour oncogenes, (c microRNA, and (d epigenetic changes. As cancer becomes more advanced, invasion and metastases are facilitated through the epithelial-mesenchymal transition (EMT, with additional genetic alterations. Despite ongoing identification of genetic and epigenetic markers and the understanding of alternative pathways involved in the development and progression of this disease, CRC remains the second highest cause of malignancy-related mortality in Canada. The molecular events that underlie the tumorigenesis of primary and metastatic colorectal carcinoma are detailed in this manuscript.
Alan J Forster
Full Text Available Adverse events are poor patient outcomes caused by medical care. Their identification requires the peer-review of poor outcomes, which may be unreliable. Combining physician ratings might improve the accuracy of adverse event classification.To evaluate the variation in peer-reviewer ratings of adverse outcomes; determine the impact of this variation on estimates of reviewer accuracy; and determine the number of reviewers who judge an adverse event occurred that is required to ensure that the true probability of an adverse event exceeded 50%, 75% or 95%.Thirty physicians rated 319 case reports giving details of poor patient outcomes following hospital discharge. They rated whether medical management caused the outcome using a six-point ordinal scale. We conducted latent class analyses to estimate the prevalence of adverse events as well as the sensitivity and specificity of each reviewer. We used this model and Bayesian calculations to determine the probability that an adverse event truly occurred to each patient as function of their number of positive ratings.The overall median score on the 6-point ordinal scale was 3 (IQR 2,4 but the individual rater median score ranged from a minimum of 1 (in four reviewers to a maximum median score of 5. The overall percentage of cases rated as an adverse event was 39.7% (3798/9570. The median kappa for all pair-wise combinations of the 30 reviewers was 0.26 (IQR 0.16, 0.42; Min = -0.07, Max = 0.62. Reviewer sensitivity and specificity for adverse event classification ranged from 0.06 to 0.93 and 0.50 to 0.98, respectively. The estimated prevalence of adverse events using a latent class model with a common sensitivity and specificity for all reviewers (0.64 and 0.83 respectively was 47.6%. For patients to have a 95% chance of truly having an adverse event, at least 3 of 3 reviewers are required to deem the outcome an adverse event.Adverse event classification is unreliable. To be certain that a case
Wharton, S; Lundquist, J K; Marjanovic, N; Williams, J L; Rhodes, M; Chow, T K; Maxwell, R
Tall onshore wind turbines, with hub heights between 80 m and 100 m, can extract large amounts of energy from the atmosphere since they generally encounter higher wind speeds, but they face challenges given the complexity of boundary layer flows. This complexity of the lowest layers of the atmosphere, where wind turbines reside, has made conventional modeling efforts less than ideal. To meet the nation's goal of increasing wind power into the U.S. electrical grid, the accuracy of wind power forecasts must be improved. In this report, the Lawrence Livermore National Laboratory, in collaboration with the University of Colorado at Boulder, University of California at Berkeley, and Colorado School of Mines, evaluates innovative approaches to forecasting sudden changes in wind speed or 'ramping events' at an onshore, multimegawatt wind farm. The forecast simulations are compared to observations of wind speed and direction from tall meteorological towers and a remote-sensing Sound Detection and Ranging (SODAR) instrument. Ramping events, i.e., sudden increases or decreases in wind speed and hence, power generated by a turbine, are especially problematic for wind farm operators. Sudden changes in wind speed or direction can lead to large power generation differences across a wind farm and are very difficult to predict with current forecasting tools. Here, we quantify the ability of three models, mesoscale WRF, WRF-LES, and PF.WRF, which vary in sophistication and required user expertise, to predict three ramping events at a North American wind farm.
Igor V. Karyakin
Full Text Available The 9th ARRCN Symposium 2015 was held during 21st–25th October 2015 at the Novotel Hotel, Chumphon, Thailand, one of the most favored travel destinations in Asia. The 10th ARRCN Symposium 2017 will be held during October 2017 in the Davao, Philippines. International Symposium on the Montagu's Harrier (Circus pygargus «The Montagu's Harrier in Europe. Status. Threats. Protection», organized by the environmental organization «Landesbund für Vogelschutz in Bayern e.V.» (LBV was held on November 20-22, 2015 in Germany. The location of this event was the city of Wurzburg in Bavaria.
Kirkman, Bradley L; Shapiro, Debra L; Lu, Shuye; McGurrin, Daniel P
We first review research on culture effects in teams, illustrating that mean levels of team cultural values have main (i.e. direct) effects, indirect effects (i.e. mediated by intervening variables), and moderating influences on team processes and outcomes. Variance in team cultural values or on country of origin (i.e. nationality diversity) also has main effects on team functioning, and we highlight contextual variables that strengthen or weaken these main effects. We next review research examining the effect of variance in team cultural values on global virtual teams, specifically. Finally, we review research on how cultural values shape employees' receptivity to empowering leadership behavior in teams. We conclude by discussing critical areas for future research. Published by Elsevier Ltd.
The Chief Executive of Southern Electric plc, one of the thirteen recently privatised Regional Electricity Companies, reviews the performance of the United Kingdom electricity distribution sector for 1992, and considers the effects of competition in the Electricity Supply Industry. Three areas of progress are discussed. These include benefits to shareholders (in terms of profits) and to customers, who enjoyed lower prices, better service and more choice. A review of transmission prices was undertaken by the Director General and led to regulations on the effective operation of the pool, improved service standards and power generation competition. Finally, the Coal Review had ramifications for the industry by broadening the debate on competitively priced energy generation and the electricity market since privatization. (UK)
Gjeraa, K; Møller, T P; Østergaard, D
Trauma resuscitation is a complex situation, and most organisations have multi-professional trauma teams. Non-technical skills are challenged during trauma resuscitation, and they play an important role in the prevention of critical incidents. Simulation-based training of these is recommended. Our research question was: Does simulation-based trauma team training of non-technical skills have effect on reaction, learning, behaviour or patient outcome? The authors searched PubMed, EMBASE and the Cochrane Library and found 13 studies eligible for analysis. We described and compared the educational interventions and the evaluations of effect according to the four Kirkpatrick levels: reaction, learning (knowledge, skills, attitudes), behaviour (in a clinical setting) and patient outcome. No studies were randomised, controlled and blinded, resulting in a moderate to high risk of bias. The multi-professional trauma teams had positive reactions to simulation-based training of non-technical skills. Knowledge and skills improved in all studies evaluating the effect on learning. Three studies found improvements in team performance (behaviour) in the clinical setting. One of these found difficulties in maintaining these skills. Two studies evaluated on patient outcome, of which none showed improvements in mortality, complication rate or duration of hospitalisation. A significant effect on learning was found after simulation-based training of the multi-professional trauma team in non-technical skills. Three studies demonstrated significantly increased clinical team performance. No effect on patient outcome was found. All studies had a moderate to high risk of bias. More comprehensive randomised studies are needed to evaluate the effect on patient outcome. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Dallinga, Joan M.; Benjaminse, Anne; Lemmink, Koen A. P. M.
Background: Injuries to lower extremities are common in team sports such as soccer, basketball, volleyball, football and field hockey. Considering personal grief, disabling consequences and high costs caused by injuries to lower extremities, the importance for the prevention of these injuries is
Gast, Inken; Schildkamp, Kim; van der Veen, Jan T.
Most professional development activities focus on individual teachers, such as mentoring or the use of portfolios. However, new developments in higher education require teachers to work together in teams more often. Due to these changes, there is a growing need for professional development
Doeven, Steven H; Brink, Michel S; Kosse, Silke J; Lemmink, Koen A P M
Background: Insufficient postmatch recovery in elite players may cause an increased risk of injuries, illnesses and non-functional over-reaching. Objective: To evaluate postmatch recovery time courses of physical performance and biochemical markers in team ball sport players. Study design:
A part of the Severe Accident Risk Reduction Program, researchers at Sandia National Laboratories have constructed a group of containment event trees to be used in the analysis of key accident sequences for light water reactors (LWR) during postulated severe accidents. The ultimate goal of the program is to provide to the NRC staff a current assessment of the risk from severe reactor accidents for a group of five light water reactors. This review specifically focuses on the development and construction of the containment event trees and the results for containment failure probability, modes and timing. The report first gives the background on the program, the review criteria, and a summary of the observations, findings and recommendations. secondly, the individual reviews of each committee member on the event trees is presented. Finally, a review is provided on the computer model used to construct and evaluate the event trees
Gayes, P. T.; Bao, S.; Yan, T.; Pietrafesa, L. J.; Hallstrom, J.; Stirling, D.; Mullikin, T.; McClam, M.; Byrd, M.; Aucoin, K.; Marosites, B.
HUGO: The HUrricane Genesis and Outlook program is a research initiative spanning new approaches to Atlantic tropical season outlooking to a storm event-related interactively coupled model system. In addition to supporting faculty and student academic research it has progressively been engaged by diverse regional interests in the public and private sector. The seasonal outlook incorporates 22 regional-to-global climate drivers developed from the historical storm database and has shown good skill related to historical storm seasons within the development of the model as well as the last several years in an outlook capacity. The event scale model is a based upon a fully interactively coupled model system incorporating ocean, atmosphere, wave and surge/flood models. The recent cluster of storms impacting the Southeast US provided an opportunity to test the model system and helped develop strong collaborative interests across diverse groups seeking to facilitate local capacity and access to additional storm-related information, observations and expertise. The SC State Guard has actively engaged the HUGO team in carrying out their charge in emergency responders planning and activities during several recent storms and flooding events. They were instrumental in developing support to expand observational systems aiding model validation and development as well as develop access pathways for deployment of new observational technology developed through NSF sponsored projects (Intelligent River and Hurricane-RAPID) with ISENSE at Florida Atlantic University to advance observational capability and density especially during or immediately following events. At the same time an increasing number of county-level emergency and environmental managers and private sector interests have similarly been working collaborately towards expanding observational systems contributing to the goals of the growing storm-oriented cooperative and as well as broader national MesoUS goals. Collectively
Dellaserra, Carla L; Gao, Yong; Ransdell, Lynda
Integrated technology (IT), which includes accelerometers, global positioning systems (GPSs), and heart rate monitors, has been used frequently in public health. More recently, IT data have been used in sports settings to assess training and performance demands. However, the impact of IT in sports settings is yet to be evaluated, particularly in field-based team sports. This narrative-qualitative review provides an overview of the emerging impact of IT in sports settings. Twenty electronic databases (e.g., Medline, SPORTdiscus, and ScienceDirect), print publications (e.g., Signal Processing Magazine and Catapult Innovations news releases), and internet resources were searched using different combinations of keywords as follows: accelerometers, heart rate monitors, GPS, sport training, and field-based sports for relevant articles published from 1990 to the present. A total of 114 publications were identified, and 39 that examined a field-based team sport using a form of IT were analyzed. The articles chosen for analysis examined a field-based team sport using a form of IT. The uses of IT can be divided into 4 categories: (a) quantifying movement patterns (n = 22), (b) assessing the differences between demands of training and competition (n = 12), (c) measuring physiological and metabolic responses (n = 16), and (d) determining a valid definition for velocity and a sprint effort (n = 8). Most studies used elite adult male athletes as participants and analyzed the sports of Australian Rules football, field hockey, cricket, and soccer, with sample sizes between 5 and 20 participants. The limitations of IT in a sports setting include scalability issues, cost, and the inability to receive signals within indoor environments. Integrated technology can contribute to significant improvements in the preparation, training, and recovery aspects of field-based team sports. Future research should focus on using IT with female athlete populations and developing resources to use IT
Chen, J.T.; Connell, E.; Chokshi, N.
As a result of the U.S. Nuclear Regulatory Commission (USNRC) initiated Individual plant Examination of External Events (IPEEE) program, every operating nuclear power reactor in the United States has performed an assessment of severe accident due to external events. This paper provides a summary of the preliminary insights gained through the review of 24 IPEEE submittals
Kokajko, L.; Skay, D.; Wang, H.; Murphy, D. [Nuclear Regulatory Commission, Washington, DC (United States)
This report provides the results of the South Texas Project Allegations Review Team of the US Nuclear Regulatory Commission. This team was formed to obtain and review allegations from individuals represented by three attorneys who had contacted Congressional staff members. The allegers were employed in various capacities at South Texas Project Electric Generating Station, licensed by Houston Lighting and Power Company, et al.; therefore, the allegations are confined to this site. The South Texas Project Allegations Review Team reviewed, referred, and dispositioned concerns related to discriminatory issues (harassment and intimidation), falsification of records and omission of information, and various technical issues. The team was able to substantiate certain technical issues of minor safety significance or regulatory concern at the South Texas Project facility, but it did not find widespread discriminatory practices such as harassment and intimidation.
Kokajko, L.; Skay, D.; Wang, H.; Murphy, D.
This report provides the results of the South Texas Project Allegations Review Team of the US Nuclear Regulatory Commission. This team was formed to obtain and review allegations from individuals represented by three attorneys who had contacted Congressional staff members. The allegers were employed in various capacities at South Texas Project Electric Generating Station, licensed by Houston Lighting and Power Company, et al.; therefore, the allegations are confined to this site. The South Texas Project Allegations Review Team reviewed, referred, and dispositioned concerns related to discriminatory issues (harassment and intimidation), falsification of records and omission of information, and various technical issues. The team was able to substantiate certain technical issues of minor safety significance or regulatory concern at the South Texas Project facility, but it did not find widespread discriminatory practices such as harassment and intimidation
Full Text Available The article is based on literature review and authors’ own recent experience in managing multicultural project teams, in international environment. This comparative study considers two groups of projects: technical assistance (TA projects versus information technology (IT projects. The aim is to explore the size and structure of the project teams – according to the team formation and its lifecycle, and to identify some distinctive attributes of the project teams – both similarities and differences between the above mentioned types of projects. Distinct focus of the research is on the multiculturalism of the project teams: how the cultural background of the team members influences the team performance and team management. Besides the results of the study are the managerial implications: how the team managers could soften the cultural clash, and avoid inter-cultural misunderstandings and even conflicts – in order to get a better performance. Some practical examples are provided as well.
Meekums, Bonnie; Macaskie, Jane; Kapur, Tricia
The authors conducted a scoping review of the peer-reviewed literature associated with Interpersonal Process Recall (IPR) and Reflecting Team (RT) methods in order to find evidence for their use within skills development in therapist trainings. Inclusion criteria were: empirical research, reviews of empirical research, and responses to these; RT…
identified general skills required by small-unit leaders which affect the team process: management , communication, problem-solving, tactical, and...skills such as ccoperation, simulation fidelity, feedback/ knowlede of results, and team structur- qr n c.position were categorized in this two...identified: management skills, communication skills, problem solving skills, tactical skills, and teehnical skills. A more detailed description of these
Buljac, M.; van Woerkom, M.; van Wijngaarden, P.
This study examines the impact of real-team--as opposed to a team in name only--characteristics (i.e., team boundaries, stability of membership, and task interdependence) on team processes (i.e., team learning and emotional support) and team effectiveness in the long-term care sector. We employed a
Humphreys B Kim
Full Text Available Abstract Background Pediatric manual therapy is controversial within the medical community particularly with respect to adverse events. Pediatric manual therapy (Ped MT is commonly used by a number of professions such as chiropractors, osteopaths and naturopaths for a variety of treatments in children. Ped MT interventions range from advice, light touch, massage, through to mobilisation and high velocity spinal manipulation. However, current evidence related to adverse events associated with Ped MT is not well understood. Objective To update the clinical research literature from the 2007 report by Vohra, Johnston, Cramer and Humphreys on possible adverse events in children treated by spinal manipulation. Methods A review of the clinical research literature from June 2004 until January 2010 as reported in MEDLINE, PubMed and PubMed Central for adverse events specifically related to the treatment of pediatric cases by manual therapy. Results Only three new clinical studies, one systematic review with meta-analysis and one evidence report were identified. Two clinical studies reported on chiropractic care and one on osteopathic spinal manipulation in children. The systematic review investigated all studies of adverse events and manual therapy and was not specific for pediatric patients. The evidence review focused on effectiveness of spinal manipulation in a variety of musculoskeletal conditions. No serious or catastrophic adverse events were reported in the clinical studies or systematic review. However for adults, it has been estimated that between 0.003% and 0.13% of manual therapy treatments may result in a serious adverse event. Although mild to moderate adverse events are common in adults, an accurate estimate from high quality pediatric studies is currently not available. Conclusions There is currently insufficient research evidence related to adverse events and manual therapy. However, clinical studies and systematic reviews from adult
Riskin, Arieh; Bamberger, Peter
Team reflexivity is a collective activity in which team members review their previous work, and develop ideas on how to modify their work behavior in order to achieve better future results. It is an important learning tool and a key factor in explaining the varying effectiveness of teams. Team reflexivity encompasses both self-awareness and agency, and includes three main activities: reflection, planning, and adaptation. The model of briefing-debriefing cycles promotes team reflexivity. Its key elements include: Pre-action briefing--setting objectives, roles, and strategies the mission, as well as proposing adaptations based on what was previously learnt from similar procedures; Post-action debriefing--reflecting on the procedure performed and reviewing the extent to which objectives were met, and what can be learnt for future tasks. Given the widespread attention to team-based work systems and organizational learning, efforts should be made toward ntroducing team reflexivity in health administration systems. Implementation could be difficult because most teams in hospitals are short-lived action teams formed for a particular event, with limited time and opportunity to consciously reflect upon their actions. But it is precisely in these contexts that reflexive processes have the most to offer instead of the natural impulsive collective logics. Team reflexivity suggests a potential solution to the major problems of iatorgenesis--avoidable medical errors, as it forces all team members to participate in a reflexive process together. Briefing-debriefing technology was studied mainly in surgical teams and was shown to enhance team-based learning and to improve quality-related outcomes and safety.
Escoffery, Cam; Rodgers, Kirsten C; Kegler, Michelle C; Ayala, Mary; Pinsker, Erika; Haardörfer, Regine
Cancer remains the second leading cause of mortality in the United States. Special events such as health fairs, screening days or cultural festivals are employed often for community education about cancer screening. A previous systematic review of the published literature was conducted in 2012-2013. The purpose of this study was to conduct a grey literature component of special events that promote breast, cervical and colorectal cancer screening in the U.S. We conducted a grey literature search of dissertations/theses and conference abstracts. The theses/dissertations were restricted to those: 1) written in English, 2) published from January 1990 to December 2011, 3) examined at least one of the predefined categories of special events, 4) involved cancer screening for breast, cervical, and/or colorectal cancer, 5) included outcome data, and 6) conducted in the United States. A review of U.S. public health and cancer conference abstracts, that were readily available and had focused on at least of 3 cancer types and included outcome data, was conducted. Data were abstracted on the purpose, location, primary audience(s), activities conducted, screening provided onsite or referrals, and evaluation results. The grey literature review found 6 special events. The types of events found added to the numbers found in the systematic review, especially receptions or parties and cultural festivals/events. All focused on increasing breast and cervical cancer screening except one that focused on breast cancer only. The reach of these events was targeted at mostly minorities or underserved communities. Common evidence-based strategies were group education, small media, and reducing structural barriers. Group education involved presentations from physicians, lay-health advisors, or cancer survivors, while reducing structural barriers included activities such as providing screening appointment sign-ups at the event or providing transportation for event participants. Mammogram
Aleman, A.; Canadell, F.; Beltran, F.; Pifarre, D.; Hernandez, H.; Gasca, C.
During the risk analysis update of Asco NPP (2010), it has been carried out a review of the vulnerabilities against severe accidents caused by external events (individual Plant Examination of external Events, IPEEE). The assessment has includent analysis of accidents in industrial and military facilities nearby and transportation accidents (i.e., rail, road and aircraft impact) release of hazardous materials on site, external flooding, turbine missiles and strong winds. (Author)
Learning from nuclear regulatory self-assessment. International peer review of the CSN report on lessons learnt from the essential service water system degradation event at the Vandellos nuclear power plant
Nuclear regulatory self-assessment together with the benchmarking of regulatory practices against those of other countries operating nuclear power plants are key elements in maintaining a high level of nuclear safety. In that light, the Spanish Consejo de Seguridad Nuclear (CSN) formally asked the OECD Nuclear Energy Agency (NEA) to establish an international peer review team to assess the CSN report on the lessons learnt as a result of the 2004 Vandellos II event involving essential service water system degradation. The International Review Team considers the CSN report prepared in follow-up to the Vandellos event to be a commendable effort in regulatory self-assessment. The report, complemented by this international peer review, should enable the CSN to take appropriate action to ensure that its regulatory supervision is in line with best international practice. (authors)
Goldberg, Scott A; Maggin, Jeremy; Molloy, Michael S; Baker, Olesya; Sarin, Ritu; Kelleher, Michael; Mont, Kevin; Fajana, Adedeji; Goralnick, Eric
Mass gathering events can substantially impact public safety. Analyzing patient presentation and transport rates at various mass gathering events can help inform staffing models and improve preparedness. A retrospective review of all patients seeking medical attention across a variety of event types at a single venue with a capacity of 68,756 from January 2010 through September 2015. We examined 232 events with a total of 8,260,349 attendees generating 8157 medical contacts. Rates were 10 presentations and 1.6 transports per 10,000 attendees with a non-significant trend towards increased rates in postseason National Football League games. Concerts had significantly higher rates of presentation and transport than all other event types. Presenting concern varied significantly by event type and gender, and transport rate increased predictably with age. For cold weather events, transport rates increased at colder temperatures. Overall, on-site physicians did not impact rates. At a single venue hosting a variety of events across a 6-year period, we demonstrated significant variations in presentation and transport rates. Weather, gender, event type, and age all play important roles. Our analysis, while representative only of our specific venue, may be useful in developing response plans and staffing models for similar mass gathering venues. (Disaster Med Public Health Preparedness. 2018;page 1 of 7).
Golder, Su; Norman, Gill; Loke, Yoon K
Aim The aim of this review was to summarize the prevalence, frequency and comparative value of information on the adverse events of healthcare interventions from user comments and videos in social media. Methods A systematic review of assessments of the prevalence or type of information on adverse events in social media was undertaken. Sixteen databases and two internet search engines were searched in addition to handsearching, reference checking and contacting experts. The results were sifted independently by two researchers. Data extraction and quality assessment were carried out by one researcher and checked by a second. The quality assessment tool was devised in-house and a narrative synthesis of the results followed. Results From 3064 records, 51 studies met the inclusion criteria. The studies assessed over 174 social media sites with discussion forums (71%) being the most popular. The overall prevalence of adverse events reports in social media varied from 0.2% to 8% of posts. Twenty-nine studies compared the results from searching social media with using other data sources to identify adverse events. There was general agreement that a higher frequency of adverse events was found in social media and that this was particularly true for ‘symptom’ related and ‘mild’ adverse events. Those adverse events that were under-represented in social media were laboratory-based and serious adverse events. Conclusions Reports of adverse events are identifiable within social media. However, there is considerable heterogeneity in the frequency and type of events reported, and the reliability or validity of the data has not been thoroughly evaluated. PMID:26271492
Toot, Sandeep; Devine, Mike; Orrell, Martin
To assess the effectiveness of crisis resolution/home treatment services for older people with mental health problems. A systematic review was conducted to report on the effectiveness of crisis resolution/home treatment teams (CRHTTs) for older people with mental health problems. As part of the review, we also carried out a scoping exercise to assess the typologies of older people's CRHTTs in practice, and to review these in the context of policy and research findings. The literature contains Grade C evidence, according to the Oxford Centre of Evidence Based Medicine (CEBM) guidelines, that CRHTTs are effective in reducing numbers of admissions to hospitals. Outcomes such as length of hospital stay and maintenance of community residence were reviewed but evidence was inadequate for drawing conclusions. The scoping exercise defined three types of home treatment service model: generic home treatment teams; specialist older adults home treatment teams; and intermediate care services. These home treatment teams seemed to be effectively managing crises and reducing admissions. This review has shown a lack of evidence for the efficacy of crisis resolution/home treatment teams in supporting older people with mental health problems to remain at home. There is clearly a need for a randomised controlled trial to establish the efficacy of crisis resolution/home treatment services for older people with mental health problems, as well as a more focussed assessment of the different home treatment service models which have developed in the UK. Copyright © 2011 John Wiley & Sons, Ltd.
Merién, A.E.R.; Ven, van de J.; Mol, B.W.J.; Houterman, S.; Oei, S.G.
OBJECTIVE: To perform a systematic review of the literature on the effectiveness of multidisciplinary teamwork training in a simulation setting for the reduction of medical adverse outcomes in obstetric emergency situations. DATA SOURCES: We searched Medline, Embase, and the Cochrane Library from
Merién, A. E. R.; van de Ven, J.; Mol, B. W.; Houterman, S.; Oei, S. G.
OBJECTIVE: To perform a systematic review of the literature on the effectiveness of multidisciplinary teamwork training in a simulation setting for the reduction of medical adverse outcomes in obstetric emergency situations. DATA SOURCES: We searched Medline, Embase, and the Cochrane Library from
Parrish, Jared W; Schnitzer, Patricia G; Lanier, Paul; Shanahan, Meghan E; Daniels, Julie L; Marshall, Stephen W
Accurate estimation of the incidence of maltreatment-related child mortality depends on reliable child fatality review. We examined the inter-rater reliability of maltreatment designation for two Alaskan Child Death Review (CDR) panels. Two different multidisciplinary CDR panels each reviewed a series of 101 infant and child deaths (ages 0-4 years) in Alaska. Both panels independently reviewed identical medical, autopsy, law enforcement, child welfare, and administrative records for each death utilizing the same maltreatment criteria. Percent agreement for maltreatment was 64.7% with a weighted Kappa of 0.61 (95% CI 0.51, 0.70). Across maltreatment subtypes, agreement was highest for abuse (69.3%) and lowest for negligence (60.4%). Discordance was higher if the mother was unmarried or a smoker, if residence was rural, or if there was a family history of child protective services report(s). Incidence estimates did not depend on which panel's data were used. There is substantial room for improvement in the reliability of CDR panel assessment of maltreatment related mortality. Standardized decision guidance for CDR panels may improve the reliability of their data. Copyright © 2017 Elsevier Ltd. All rights reserved.
Koch, Karl; Kebede, Fekadu
For monitoring the Comprehensive Nuclear-Test-Ban Treaty (CTBT) the International Monitoring System (IMS) network is currently being established that will eventually consists of 241 seismic, hydroacoustic and infrasound stations. The final result of processing and analysis of seismological and other waveform technology data from these stations is the Reviewed Event Bulletin (REB), which has been issued by the International Data Center (IDC) under provisional operation since February 2000 on a daily basis, except for a total of 28 days. The nearly 300,000 events produced since then correspond to more than 25,000 events per year. As an accompanying effort to the bulletin production at the IDC, quality assurance work has been carried out for the REB for the years from 2000 to 2008 through comparisons to similar bulletins of global seismicity, issued by the ISC and the National Earthquake Information Center (NEIC) of the United States Geological Survey. The comparisons with the NEIC bulletin concentrate on a timely identification of larger events that were either missed during interactive analysis at the IDC or which have been significantly mislocated. For the scope of this study the comparisons with the ISC bulletin are the focus, as this bulletin provides the most complete reference to global seismicity, even though it becomes available only after about two years of event occurrence. In our quality assessments we aimed at evaluating the consistency of event locations for common events, i.e. found in both the REB and the ISC bulletin having been relocated by ISC; the degree and the geospatial location of the events only produced in the REB and verified not being bogus, and those ISC relocated events not contained in the REB and which were missed during IDC analysis. Even though the seismic component of the IMS network with its maximum 170 seismometer stations is a sparse teleseismic network, locations differences of less than 1° (0.5° ) are observed, on average, for
Fortington, Lauren V; van der Worp, Henk; van den Akker-Scheek, Inge; Finch, Caroline F
Background To identify and prioritise targets for injury prevention efforts, injury incidence studies are widely reported. The accuracy and consistency in calculation and reporting of injury incidence is crucial. Many individuals experience more than one injury but multiple injuries are not consistently reported in sport injury incidence studies. Objective The aim of this systematic review was to evaluate current practice of how multiple injuries within individuals have been defined and repor...
Høyer, Christian B; Christensen, Erika F; Eika, Berit
Junior physicians are sometimes sent in ambulances with critically ill patients who require urgent transfer to another hospital. Unfamiliar surroundings and personnel, time pressure, and lack of experience may imply a risk of insufficient treatment during transportation as this can cause the physician to loose the expected overview of the situation. While health care professionals are expected to follow complex algorithms when resuscitating, stress can compromise both solo-performance and teamwork. To examine whether inter-hospital resuscitation improved with a structured team briefing between physician and ambulance crew in preparation for transfer vs. review of resuscitation guidelines. The effect parameters were physician team leadership (requesting help, delegating tasks), time to resuscitation key elements (chest compressions, defibrillation, ventilations, medication, or a combination of these termed "the first meaningful action"), and hands-off ratio. 46 physicians graduated within 5 years. A simulation intervention study with a control group and two interventions (structured team briefing or review of guidelines). Scenario: Cardiac arrest during simulated inter-hospital transfer. Forty-six candidates participated: 16 (control), 13 (review), and 17 (team briefing). Reviewing guidelines delayed requesting help to 162 seconds, compared to 21 seconds in control and team briefing groups (p = 0.021). Help was not requested in 15% of cases; never requesting help was associated with an increased hands-off ratio, from 39% if the driver's assistance was requested to 54% if not (p delegating tasks and warrants the need for further studies focusing on how to avoid this cognitive impairment.
Belbin, R Meredith Meredith
Meredith Belbin's work on teams has become part of everyday language in organizations all over the world. All kinds of teams and team behaviours are covered. At the end of the book is a self-perception inventory so that readers can match their own personalities to particular team roles. Management Teams is required reading for managers concerned with achieving results by getting the best from their key personnel.
Christensen Erika F
Full Text Available Abstract Background Junior physicians are sometimes sent in ambulances with critically ill patients who require urgent transfer to another hospital. Unfamiliar surroundings and personnel, time pressure, and lack of experience may imply a risk of insufficient treatment during transportation as this can cause the physician to loose the expected overview of the situation. While health care professionals are expected to follow complex algorithms when resuscitating, stress can compromise both solo-performance and teamwork. Aim To examine whether inter-hospital resuscitation improved with a structured team briefing between physician and ambulance crew in preparation for transfer vs. review of resuscitation guidelines. The effect parameters were physician team leadership (requesting help, delegating tasks, time to resuscitation key elements (chest compressions, defibrillation, ventilations, medication, or a combination of these termed "the first meaningful action", and hands-off ratio. Methods Participants: 46 physicians graduated within 5 years. Design: A simulation intervention study with a control group and two interventions (structured team briefing or review of guidelines. Scenario: Cardiac arrest during simulated inter-hospital transfer. Results Forty-six candidates participated: 16 (control, 13 (review, and 17 (team briefing. Reviewing guidelines delayed requesting help to 162 seconds, compared to 21 seconds in control and team briefing groups (p = 0.021. Help was not requested in 15% of cases; never requesting help was associated with an increased hands-off ratio, from 39% if the driver's assistance was requested to 54% if not (p Conclusion Neither review nor team briefing improved the time to resuscitation key elements. Review led to an eight-fold increase in the delay to requesting help. The association between never requesting help and an increased hands-off ratio underpins the importance of prioritising available resources. Other medical
Lithuania's national Radioactive Waste Management Agency (RATA) is mandated by national legislation to find a disposal solution for radioactive waste arising mainly from the operation and decommissioning of the Ignalina nuclear power plant. A key step in the process of obtaining a disposal solution is to identify potential sites for detailed consideration. The RATA has completed this first step and is now directing a programme for detailed investigation of these sites. In this context, the RATA requested that the IAEA, on the basis of its statutory mandate to establish safety standards and provide for their application, conduct a peer review of the safety of the proposed disposal concept. The objective of the peer review, carried out in December 2005, was to provide an independent assessment of the safety related aspects of the sites under consideration on the basis of international safety standards and applicable national standards. The review also considered the feasibility of the proposed reference design and its suitability for the local conditions. The peer review provides an independent opinion as to whether the RATA's siting and site characterization programme is consistent with international standards and agrees with good practice in other national disposal programmes. Peer reviews are increasingly being acknowledged as an important component in building broader stakeholder confidence in the safety of facilities. For this reason, an increase in their number and frequency is anticipated. The coming into force of the Joint Convention on the Safety of Spent Fuel Management and on the Safety of Radioactive Waste Management has also focused attention on the demonstration of the safety of waste management facilities. This report presents the consensus view of the international group of experts convened by the IAEA to carry out the review. The findings and recommendations of the Review Team were grouped under six topics considered to be of fundamental importance
Pittler, M H; Schmidt, K; Ernst, E
Herbal weight-loss supplements are marketed with claims of effectiveness. Our earlier systematic review identified data from double-blind, randomized controlled trials for a number of herbal supplements. The aim of this systematic review was to assess all clinical evidence of adverse events of herbal food supplements for body weight reduction for which effectiveness data from rigorous clinical trials exist. We assessed Ephedra sinica, Garcinia cambogia, Paullinia cupana, guar gum, Plantago psyllium, Ilex paraguariensis and Pausinystalia yohimbe. Literature searches were conducted on Medline, Embase, Amed and The Cochrane Library. Data were also requested from the spontaneous reporting scheme of the World Health Organization. We hand-searched relevant medical journals and our own files. There were no restrictions regarding the language of publication. The results show that adverse events including hepatic injury and death have been reported with the use of some herbal food supplements. For herbal ephedra and ephedrine-containing food supplements an increased risk of psychiatric, autonomic or gastrointestinal adverse events and heart palpitations has been reported. In conclusion, adverse events are reported for a number of herbal food supplements, which are used for reducing body weight. Although the quality of the data does not justify definitive attribution of causality in most cases, the reported risks are sufficient to shift the risk-benefit balance against the use of most of the reviewed herbal weight-loss supplements. Exceptions are Garcinia cambogia and yerba mate, which merit further investigation.
Schmitt, Laetitia H. M.; Graham, Hilary M.; White, Piran C. L.
The frequency and severity of extreme events is expected to increase under climate change. There is a need to understand the economic consequences of human exposure to these extreme events, to underpin decisions on risk reduction. We undertook a scoping review of economic evaluations of the adverse health effects from exposure to weather-related extreme events. We searched PubMed, Embase and Web of Science databases with no restrictions to the type of evaluations. Twenty studies were included, most of which were recently published. Most studies have been undertaken in the U.S. (nine studies) or Asia (seven studies), whereas we found no studies in Africa, Central and Latin America nor the Middle East. Extreme temperatures accounted for more than a third of the pool of studies (seven studies), closely followed by flooding (six studies). No economic study was found on drought. Whilst studies were heterogeneous in terms of objectives and methodology, they clearly indicate that extreme events will become a pressing public health issue with strong welfare and distributional implications. The current body of evidence, however, provides little information to support decisions on the allocation of scarce resources between risk reduction options. In particular, the review highlights a significant lack of research attention to the potential cost-effectiveness of interventions that exploit the capacity of natural ecosystems to reduce our exposure to, or ameliorate the consequences of, extreme events. PMID:27834843
Laetitia H. M. Schmitt
Full Text Available The frequency and severity of extreme events is expected to increase under climate change. There is a need to understand the economic consequences of human exposure to these extreme events, to underpin decisions on risk reduction. We undertook a scoping review of economic evaluations of the adverse health effects from exposure to weather-related extreme events. We searched PubMed, Embase and Web of Science databases with no restrictions to the type of evaluations. Twenty studies were included, most of which were recently published. Most studies have been undertaken in the U.S. (nine studies or Asia (seven studies, whereas we found no studies in Africa, Central and Latin America nor the Middle East. Extreme temperatures accounted for more than a third of the pool of studies (seven studies, closely followed by flooding (six studies. No economic study was found on drought. Whilst studies were heterogeneous in terms of objectives and methodology, they clearly indicate that extreme events will become a pressing public health issue with strong welfare and distributional implications. The current body of evidence, however, provides little information to support decisions on the allocation of scarce resources between risk reduction options. In particular, the review highlights a significant lack of research attention to the potential cost-effectiveness of interventions that exploit the capacity of natural ecosystems to reduce our exposure to, or ameliorate the consequences of, extreme events.
Pohan, Vivi Gusrini Rahmadani; Ancok, Djamaludin
This research attempted to observe team learning from the level of team diversity and team efficacy of work teams. This research used an individual level of analysis rather than the group level. The team members measured the level of team diversity, team efficacy and team learning of the teams through three scales, namely team learning scale, team diversity scale, and team efficacy scale. Respondents in this research were the active team members in a company, PT. Alkindo Mitraraya. The total ...
Vivi Gusrini Rahmadani Pohan; Djamaludin Ancok
This research attempted to observe team learning from the level of team diversity and team efficacy of work teams. This research used an individual level of analysis rather than the group level. The team members measured the level of team diversity, team efficacy and team learning of the teams through three scales, namely team learning scale, team diversity scale, and team efficacy scale. Respondents in this research were the active team members in a company, PT. Alkindo Mitraraya. The total ...
Taylor, Jeffrey B; Wright, Alexis A; Dischiavi, Steven L; Townsend, M Allison; Marmon, Adam R
Late-stage rehabilitation programs often incorporate 'sport-specific' demands, but may not optimally simulate the in-game volume or intensity of such activities as sprinting, cutting, jumping, and lateral movement. The aim of this review was to characterize, quantify, and compare straight-line running and multi-directional demands during sport competition. A systematic review of PubMed, CINAHL, SPORTDiscus, and Cochrane Central Register of Controlled Trials databases was conducted. Studies that reported time-motion analysis data on straight-line running, accelerations/decelerations, activity changes, jumping, cutting, or lateral movement over the course of an entire competition in a multi-directional sport (soccer, basketball, lacrosse, handball, field hockey, futsal, volleyball) were included. Data was organized based on sport, age level, and sex and descriptive statistics of the frequency, intensity, time, and volume of the characteristics of running and multi-directional demands were extracted from each study. Eighty-one studies were included in the review (n = 47 soccer, n = 11 basketball, n = 9 handball, n = 7 field hockey, n = 3 futsal, n = 4 volleyball). Variability of sport demand data was found across sports, sexes, and age levels. Specifically, soccer and field hockey demanded the most volume of running, while basketball required the highest ratio of high-intensity running to sprinting. Athletes change activity between 500 and 3000 times over the course of a competition, or once every 2-4 s. Studies of soccer reported the most frequent cutting (up to 800 per game), while studies of basketball reported the highest frequency of lateral movement (up to 450 per game). Basketball (42-56 per game), handball (up to 90 per game), and volleyball (up to 35 per game) were found to require the most jumping. These data may provide an incomplete view of an athlete's straight-line running load, considering that only competition and not practice data was
Full Text Available Failure to work as an effective team is commonly cited as a cause of adverse events and errors in emergency medicine. Until recently, individual knowledge and skills in managing emergencies were taught, without reference to the additional skills required to work as part of a team. Team training courses are now becoming commonplace, however their strategies and modes of delivery are varied. Just as different delivery methods of traditional education can result in different levels of retention and transfer to the real world, the same is true in team training of the material in different ways in traditional forms of education may lead to different levels of retention and transfer to the real world, the same is true in team training. As team training becomes more widespread, the effectiveness of different modes of delivery including the role of simulation-based education needs to be clearly understood. This review examines the basis of team working in emergency medicine, and the components of an effective emergency medical team. Lessons from other domains with more experience in team training are discussed, as well as the variations from these settings that can be observed in medical contexts. Methods and strategies for team training are listed, and experiences in other health care settings as well as emergency medicine are assessed. Finally, best practice guidelines for the development of team training programs in emergency medicine are presented.
Finnell, John S; Saul, Bradley C; Goldhamer, Alan C; Myers, Toshia R
Evidence suggests that fasting, during which only water is consumed, results in potentially health promoting physiological effects. However, peer-reviewed research assessing the safety of water-only fasting is lacking. To address this, we conducted a chart review to describe adverse events (AEs) that occurred during medically supervised, water-only fasting. Electronic charts from patient visits to a residential medical facility from 2006 to 2011 were reviewed. Patients who were at least 21 years of age and water-only fasted for ≥2 consecutive days with a refeeding period equal to half of the fast length were included. Out of 2539 charts, 768 visits met our inclusion and exclusion criteria. AEs were abstracted from chart notes and classified according to CTCAE (v4.03) and MedDRA (v12.1) terminology. Descriptive analysis of AEs is reported. During the protocol period, the highest grade AE (HGAE) in 555 visits was a grade 2 event or lower, in 212 visits it was a grade 3 event, in 1 visit it was a grade 4 event, and there were no grade 5 events. There were 2 (0.002%) visits with a serious adverse event (SAE). The majority of AEs identified were mild (n = 4490, 75%) in nature and known reactions to fasting. To our knowledge, this is the most comprehensive analysis of AEs experienced during medically supervised, water-only fasting conducted to date. Overall, our data indicate that the majority of AEs experienced were mild to moderate and known reactions to fasting. This suggests that the protocol used in this study can be safely implemented in a medical setting with minimal risk of a SAE.
Onasanya, Oluwadamilola; Iyer, Geetha; Lucas, Eleanor; Lin, Dora; Singh, Sonal; Alexander, G Caleb
Given the conflicting evidence regarding the association between exogenous testosterone and cardiovascular events, we systematically assessed published systematic reviews for evidence of the association between exogenous testosterone and cardiovascular events. We searched PubMed, MEDLINE, Embase, Cochrane Collaboration Clinical Trials, ClinicalTrials.gov, and the US Food and Drug Administration website for systematic reviews of randomised controlled trials published up to July 19, 2016. Two independent reviewers screened 954 full texts from 29 335 abstracts to identify systematic reviews of randomised controlled trials in which the cardiovascular effects of exogenous testosterone on men aged 18 years or older were examined. We extracted data for study characteristics, analytic methods, and key findings, and applied the AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklist to assess methodological quality of each review. Our primary outcome measure was the direction and magnitude of association between exogenous testosterone and cardiovascular events. We identified seven reviews and meta-analyses, which had substantial clinical heterogeneity, differing statistical methods, and variable methodological quality and quality of data abstraction. AMSTAR scores ranged from 3 to 9 out of 11. Six systematic reviews that each included a meta-analysis showed no significant association between exogenous testosterone and cardiovascular events, with summary estimates ranging from 1·07 to 1·82 and imprecise confidence intervals. Two of these six meta-analyses showed increased risk in subgroup analyses of oral testosterone and men aged 65 years or older during their first treatment year. One meta-analysis showed a significant association between exogenous testosterone and cardiovascular events, in men aged 18 years or older generally, with a summary estimate of 1·54 (95% CI 1·09-2·18). Our optimal information size analysis showed that any randomised controlled
Today in most scientific and technical fields more than 90% of research studies and publications are collaborative, often resulting in high-impact research and development of commercial applications, as reflected in patents. Nowadays in many areas of science, collaboration is not a preference but, literally, a work prerequisite. The purpose of this book is to review and critique the burgeoning scholarship on research collaboration. The authors seek to identify gaps in theory and research and identify the ways in which existing research can be used to improve public policy for collaboration and to improve project-level management of collaborations using Scientific and Technical Human Capital (STHC) theory as a framework. Broadly speaking, STHC is the sum of scientific and technical and social knowledge, skills and resources embodied in a particular individual. It is both human capital endowments, such as formal education and training and social relations and network ties that bind scientists and the users of ...
Sagar, Budhi; Devillers, C.; Smith, Paul; Laliuex, P.; Pescatore, C.
The recently completed SITE-94 project is an SKI effort directed at building competence and capacity in the assessment of safety of a spent-fuel geologic repository. Emphasis is given to the assimilation of site-specific data, with its associated uncertainties, into the performance assessment. Specific attention is also given to improving the understanding of mechanisms that might compromise canister integrity. This report represents the common views of an International Review Team (IRT) established by the NEA Secretariat, at the request of SKI, to perform a peer review of SITE-94. The basis for the report is the understanding of SITE-94 and its background obtained by IRT in the course of several months of study of SITE-94 documentation, internal discussions and a meeting with SKI in Stockholm. The report is limited to the main findings of IRT. The intended audience of the report is the staff of SKI and, accordingly, the style of the report is suited to a technical audience familiar with the contents of the SITE-94 project
Doocy, Shannon; Daniels, Amy; Dick, Anna; Kirsch, Thomas D
Introduction. Although rare, tsunamis have the potential to cause considerable loss of life and injury as well as widespread damage to the natural and built environments. The objectives of this review were to describe the impact of tsunamis on human populations in terms of mortality, injury, and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters. Methods. Data on the impact of tsunamis were compiled using two methods, a historical review from 1900 to mid 2009 of tsunami events from multiple databases and a systematic literature review to October 2012 of publications. Analysis included descriptive statistics and bivariate tests for associations between tsunami mortality and characteristics using STATA 11. Findings. There were 255,195 deaths (range 252,619-275,784) and 48,462 injuries (range 45,466-51,457) as a result of tsunamis from 1900 to 2009. The majority of deaths (89%) and injuries reported during this time period were attributed to a single event -the 2004 Indian Ocean tsunami. Findings from the systematic literature review indicate that the primary cause of tsunami-related mortality is drowning, and that females, children and the elderly are at increased mortality risk. The few studies that reported on tsunami-related injury suggest that males and young adults are at increased injury-risk. Conclusions. Early warning systems may help mitigate tsunami-related loss of life.
This article reviews the use of transdisciplinary teaming and integrated therapy for young children with multiple disabilities. It presents examples and suggestions for implementation, in the areas of flexibility, Individualized Education Program development, and parent participation. (JDD)
Lee, Hopin; Sullivan, S John; Schneiders, Anthony G; Ahmed, Osman Hassan; Balasundaram, Arun Prasad; Williams, David; Meeuwisse, Willem H; McCrory, Paul
Mobile technologies are steadily replacing traditional assessment approaches for the recognition and assessment of a sports concussion. Their ease of access, while facilitating the early identification of a concussion, also raises issues regarding the content of the applications (apps) and their suitability for different user groups. To locate and review apps that assist in the recognition and assessment of a sports concussion and to assess their content with respect to that of internationally accepted best-practice instruments. A search of international app stores and of the web using key terms such as 'concussion', 'sports concussion' and variants was conducted. For those apps meeting the inclusion criteria, data were extracted on the platform, intended users and price. The content of each app was benchmarked to the Sport Concussion Assessment Tool 2 (SCAT2) and Pocket SCAT2 using a custom scoring scheme to generate a percentage compliance statistic. 18 of the 155 apps identified met the inclusion criteria. Almost all (16/18) were available on an iOS platform and only five required a payment to purchase. The apps were marketed for a wide range of intended users from medical professionals to the general public. The content of the apps varied from 0% to 100% compliance with the selected standard, and 'symptom evaluation' components demonstrated the highest level of compliance. The surge in availability of apps in an unregulated market raises concerns as to the appropriateness of their content for different groups of end users. The consolidation of best-practice concussion instruments now provides a framework to inform the development of future apps. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
... Games. USA Hockey offers additional information and resources. Softball It's not easy to field full teams of ... an annual tournament sponsored by the National Wheelchair Softball Association , where thirty or so teams show up ...
Latorre, José M; Serrano, Juan P; Ricarte, Jorge; Bonete, Beatriz; Ros, Laura; Sitges, Esther
The aim of this study is to evaluate the effectiveness of life review (LR) based on specific positive events in non-depressed older adults taking part in an active aging program. Fifty-five older adults were randomly assigned to an experimental group or an active control (AC) group. A six-session individual training of LR based on specific positive events was carried out with the experimental group. The AC group undertook a "media workshop" of six sessions focused on learning journalistic techniques. Pre-test and post-test measures included life satisfaction, depressive symptoms, experiencing the environment as rewarding, and autobiographical memory (AM) scales. LR intervention decreased depressive symptomatology, improved life satisfaction, and increased specific memories. The findings suggest that practice in AM for specific events is an effective component of LR that could be a useful tool in enhancing emotional well-being in active aging programs, thus reducing depressive symptoms. © The Author(s) 2014.
Thomas, Sian; Thomson, Hilary; Scott, John; Hamilton, Val; Hanlon, Phil; Morrison, David S; Bond, Lyndal
Objective To assess the effects of major multi-sport events on health and socioeconomic determinants of health in the population of the city hosting the event. Design Systematic review. Data sources We searched the following sources without language restrictions for papers published between 1978 and 2008: Applied Social Science Index and Abstracts (ASSIA), British Humanities Index (BHI), Cochrane database of systematic reviews, Econlit database, Embase, Education Resources Information Center (ERIC) database, Health Management Information Consortium (HMIC) database, International Bibliography of the Social Sciences (IBSS), Medline, PreMedline, PsycINFO, Sociological Abstracts, Sportdiscus, Web of Knowledge, Worldwide Political Science Abstracts, and the grey literature. Review methods Studies of any design that assessed the health and socioeconomic impacts of major multi-sport events on the host population were included. We excluded studies that used exclusively estimated data rather than actual data, that investigated host population support for an event or media portrayals of host cities, or that described new physical infrastructure. Studies were selected and critically appraised by two independent reviewers. Results Fifty four studies were included. Study quality was poor, with 69% of studies using a repeat cross-sectional design and 85% of quantitative studies assessed as being below 2+ on the Health Development Agency appraisal scale, often because of a lack of comparison group. Five studies, each with a high risk of bias, reported health related outcomes, which were suicide, paediatric health service demand, presentations for asthma in children (two studies), and problems related to illicit drug use. Overall, the data did not indicate clear negative or positive health impacts of major multi-sport events on host populations. The most frequently reported outcomes were economic outcomes (18 studies). The outcomes used were similar enough to allow us to perform a
McCartney, Gerry; Thomas, Sian; Thomson, Hilary; Scott, John; Hamilton, Val; Hanlon, Phil; Morrison, David S; Bond, Lyndal
To assess the effects of major multi-sport events on health and socioeconomic determinants of health in the population of the city hosting the event. Systematic review. We searched the following sources without language restrictions for papers published between 1978 and 2008: Applied Social Science Index and Abstracts (ASSIA), British Humanities Index (BHI), Cochrane database of systematic reviews, Econlit database, Embase, Education Resources Information Center (ERIC) database, Health Management Information Consortium (HMIC) database, International Bibliography of the Social Sciences (IBSS), Medline, PreMedline, PsycINFO, Sociological Abstracts, Sportdiscus, Web of Knowledge, Worldwide Political Science Abstracts, and the grey literature. Review methods Studies of any design that assessed the health and socioeconomic impacts of major multi-sport events on the host population were included. We excluded studies that used exclusively estimated data rather than actual data, that investigated host population support for an event or media portrayals of host cities, or that described new physical infrastructure. Studies were selected and critically appraised by two independent reviewers. Fifty four studies were included. Study quality was poor, with 69% of studies using a repeat cross-sectional design and 85% of quantitative studies assessed as being below 2+ on the Health Development Agency appraisal scale, often because of a lack of comparison group. Five studies, each with a high risk of bias, reported health related outcomes, which were suicide, paediatric health service demand, presentations for asthma in children (two studies), and problems related to illicit drug use. Overall, the data did not indicate clear negative or positive health impacts of major multi-sport events on host populations. The most frequently reported outcomes were economic outcomes (18 studies). The outcomes used were similar enough to allow us to perform a narrative synthesis, but the overall
Marik, Paul E; Varon, Joseph
Epidemiologic data suggest that omega-3 fatty acids derived from fish oil reduce cardiovascular disease. The clinical benefit of dietary fish oil supplementation in preventing cardiovascular events in both high and low risk patients is unclear. To assess whether dietary supplements of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) decrease cardiovascular events across a spectrum of patients. MEDLINE, Embase, the Cochrane Database of Systematic Reviews, and citation review of relevant primary and review articles. Prospective, randomized, placebo-controlled clinical trials that evaluated clinical cardiovascular end points (cardiovascular death, sudden death, and nonfatal cardiovascular events) and all-cause mortality in patients randomized to EPA/DHA or placebo. We only included studies that used dietary supplements of EPA/DHA which were administered for at least 1 year. Data were abstracted on study design, study size, type and dose of omega-3 supplement, cardiovascular events, all-cause mortality, and duration of follow-up. Studies were grouped according to the risk of cardiovascular events (high risk and moderate risk). Meta-analytic techniques were used to analyze the data. We identified 11 studies that included a total of 39 044 patients. The studies included patients after recent myocardial infarction, those with an implanted cardioverter defibrillator, and patients with heart failure, peripheral vascular disease, and hypercholesterolemia. The average dose of EPA/DHA was 1.8 +/- 1.2 g/day and the mean duration of follow-up was 2.2 +/- 1.2 years. Dietary supplementation with omega-3 fatty acids significantly reduced the risk of cardiovascular deaths (odds ratio [OR]: 0.87, 95% confidence interval [CI]: 0.79-0.95, p = 0.002), sudden cardiac death (OR: 0.87, 95% CI: 0.76-0.99, p = 0.04), all-cause mortality (OR: 0.92, 95% CI: 0.85-0.99, p = 0.02), and nonfatal cardiovascular events (OR: 0.92, 95% CI: 0.85-0.99, p = 0.02). The mortality benefit was
Fitzpatrick, R.G.; Bozoki, G.; Sabek, M.
The review of the Diablo Canyon Probabilistic Risk Assessment (DCRPA) incorporated some new and innovative approaches. These were necessitated by the unprecedented size, scope and level of detail of the DCRPA, which was submitted to the NRC for licensing purposes. This paper outlines the elements of the internal events portion of the review citing selected findings to illustrate the various approaches employed. The paper also provides a description of the extensive and comprehensive importance analysis applied by BNL to the DCRPA model. Importance calculations included: top event/function level; individual split fractions; pair importances between frontline-support and support-support systems; system importance by initiator; and others. The paper concludes with a brief discussion of the effectiveness of the applied methodology. 3 refs., 5 tabs
Oostrom, Martinus; Vail, Lance W.
Researchers at Pacific Northwest National Laboratory served as members of a U.S. Nuclear Regulatory Commission review team for the Florida Power & Light Company's application for two combined construction permits and operating licenses (combined licenses or COLs) for two proposed new reactor units-Turkey Point Units 6 and 7. The review team evaluated the environmental impacts of the proposed action based on the October 29, 2014 revision of the COL application, including the Environmental Report, responses to requests for additional information, and supplemental information. As part of this effort, team members tasked with assessing the environmental effects of proposed construction and operation of Units 6 and 7 at the Turkey Point site reviewed two separate modeling studies that analyzed the interaction between surface water and groundwater that would be altered by the operation of radial collector wells (RCWs) at the site. To further confirm their understanding of the groundwater hydrodynamics and to consider whether certain actions, proposed after the two earlier modeling studies were completed, would alter the earlier conclusions documented by the review team in their draft environmental impact statement (EIS; NRC 2015), a third modeling analysis was performed. The third modeling analysis is discussed in this report.
Oostrom, Martinus [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Vail, Lance W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)
Researchers at Pacific Northwest National Laboratory served as members of a U.S. Nuclear Regulatory Commission review team for the Florida Power & Light Company’s application for two combined construction permits and operating licenses (combined licenses or COLs) for two proposed new reactor units—Turkey Point Units 6 and 7. The review team evaluated the environmental impacts of the proposed action based on the October 29, 2014 revision of the COL application, including the Environmental Report, responses to requests for additional information, and supplemental information. As part of this effort, team members tasked with assessing the environmental effects of proposed construction and operation of Units 6 and 7 at the Turkey Point site reviewed two separate modeling studies that analyzed the interaction between surface water and groundwater that would be altered by the operation of radial collector wells (RCWs) at the site. To further confirm their understanding of the groundwater hydrodynamics and to consider whether certain actions, proposed after the two earlier modeling studies were completed, would alter the earlier conclusions documented by the review team in their draft environmental impact statement (EIS; NRC 2015), a third modeling analysis was performed. The third modeling analysis is discussed in this report.
Full Text Available Venous thromboembolic event after traumatic brain injury represents a unique clinical challenge. Physicians must balance appropriate timing of chemoprophylaxis with risk of increased cerebral hemorrhage. Despite an increase in the literature since the 1990s, there are clear disparities in treatment strategies. This review discusses the prominent studies and subsequent findings regarding the topic with an attempt to establish recommendations using the existing evidence-based literature.
Llorente Nieto, Pedro; González-Alcaide, Gregorio; Ramos, José M
We reviewed the literature on mass gatherings published worldwide to determine event types and topics or epidemiologic aspects covered. Articles using the term mass gatherings indexed in the Scopus database between 2000 and 2015 were reviewed. Of the 518 returned, we selected 96 with relevant information. The main event types studied were related to sports (46%), music (25%) or religious/social content (23%), and the most commonly studied locations were the United States (n=21), the Kingdom of Saudi Arabia (n=17), Australia (n=11), and the United Kingdom (n=10). The four most often studied events were the Hajj (n=17), the Olympic games (n=13), World Youth Day (n=8), and the FIFA World Cup (n=6). The main topics studied were models of health care (n=55), health care evaluation by means of rates of patients presenting for care or transferred to hospitals (n=21), respiratory pathogens (n=18), syndromic surveillance (n=10), and the global spread of diseases (n=10). Mass gatherings are an emerging area of study addressed by various medical specialties that have focused on studying the health care models used at such events. Emergency medicine is particularly involved with this research topic.
Summary Using a framework that distinguishes autobiographical belief, recollective experience, and confidence in memory, we review three major paradigms used to suggest false childhood events to adults: imagination inflation, false feedback and memory implantation. Imagination inflation and false feedback studies increase the belief that a suggested event occurred by a small amount such that events are still thought unlikely to have happened. In memory implantation studies, some recollective experience for the suggested events is induced on average in 47% of participants, but only in 15% are these experiences likely to be rated as full memories. We conclude that susceptibility to false memories of childhood events appears more limited than has been suggested. The data emphasise the complex judgements involved in distinguishing real from imaginary recollections and caution against accepting investigator‐based ratings as necessarily corresponding to participants' self‐reports. Recommendations are made for presenting the results of these studies in courtroom settings. © 2016 The Authors Applied Cognitive Psychology Published by John Wiley & Sons Ltd. PMID:28163368
Marutzky, Sam J. [Navarro-Intera, LLC (N-I), Las Vegas, NV (United States); Andrews, Robert [Navarro-Intera, LLC (N-I), Las Vegas, NV (United States)
The peer review team commends the Navarro-Intera, LLC (N-I), team for its efforts in using limited data to model the fate of radionuclides in groundwater at Yucca Flat. Recognizing the key uncertainties and related recommendations discussed in Section 6.0 of this report, the peer review team has concluded that U.S. Department of Energy (DOE) is ready for a transition to model evaluation studies in the corrective action decision document (CADD)/corrective action plan (CAP) stage. The DOE, National Nuclear Security Administration Nevada Field Office (NNSA/NFO) clarified the charge to the peer review team in a letter dated October 9, 2014, from Bill R. Wilborn, NNSA/NFO Underground Test Area (UGTA) Activity Lead, to Sam J. Marutzky, N-I UGTA Project Manager: “The model and supporting information should be sufficiently complete that the key uncertainties can be adequately identified such that they can be addressed by appropriate model evaluation studies. The model evaluation studies may include data collection and model refinements conducted during the CADD/CAP stage. One major input to identifying ‘key uncertainties’ is the detailed peer review provided by independent qualified peers.” The key uncertainties that the peer review team recognized and potential concerns associated with each are outlined in Section 6.0, along with recommendations corresponding to each uncertainty. The uncertainties, concerns, and recommendations are summarized in Table ES-1. The number associated with each concern refers to the section in this report where the concern is discussed in detail.
Jeppe Bennekou Schroll
Full Text Available BACKGROUND: Misclassification of adverse events in clinical trials can sometimes have serious consequences. Therefore, each of the many steps involved, from a patient's adverse experience to presentation in tables in publications, should be as standardised as possible, minimising the scope for interpretation. Adverse events are categorised by a predefined dictionary, e.g. MedDRA, which is updated biannually with many new categories. The objective of this paper is to study interobserver variation and other challenges of coding. METHODS: Systematic review using PRISMA. We searched PubMed, EMBASE and The Cochrane Library. All studies were screened for eligibility by two authors. RESULTS: Our search returned 520 unique studies of which 12 were included. Only one study investigated interobserver variation. It reported that 12% of the codes were evaluated differently by two coders. Independent physicians found that 8% of all the codes deviated from the original description. Other studies found that product summaries could be greatly affected by the choice of dictionary. With the introduction of MedDRA, it seems to have become harder to identify adverse events statistically because each code is divided in subgroups. To account for this, lumping techniques have been developed but are rarely used, and guidance on when to use them is vague. An additional challenge is that adverse events are censored if they already occurred in the run-in period of a trial. As there are more than 26 ways of determining whether an event has already occurred, this can lead to bias, particularly because data analysis is rarely performed blindly. CONCLUSION: There is a lack of evidence that coding of adverse events is a reliable, unbiased and reproducible process. The increase in categories has made detecting adverse events harder, potentially compromising safety. It is crucial that readers of medical publications are aware of these challenges. Comprehensive interobserver
Cramer, Holger; Ostermann, Thomas; Dobos, Gustav
To systematically assess the prevalence of yoga-associated injuries and other adverse events in epidemiological studies. Systematic review of observational studies. Medline/PubMed, Scopus, the Cochrane Library, and IndMed were searched through October 2016 for epidemiological studies assessing the prevalence of adverse events of yoga practice or comparing the risk of any adverse events between yoga practitioners and non-yoga practitioners. Nine observational studies with a total 9129 yoga practitioners and 9903 non-yoga practitioners were included. Incidence proportion of adverse events during a yoga class was 22.7% (95% confidence interval [CI]=21.1%-24.3%); 12-months prevalence was 4.6% (95%CI=3.8%-5.4%), and lifetime prevalence ranged from 21.3% (95%CI=19.7%-22.9%) to 61.8% (95%CI=52.8%-70.8%) of yoga practitioners. Serious adverse events occurred in 1.9% (95%CI=1.4%-2.4%). The most common adverse events related to the musculoskeletal system; the most common injuries were sprains and strains. Compared to non-yoga practitioners, yoga practitioners had a comparable risk of falls (odds ratio [OR]=0.90; 95%CI=0.76-1.08), and falls-related injuries (OR=1.04; 95%CI=0.83-1.29), and higher risk of meniscus injuries (OR=1.72; 95%CI=1.23-2.41). A considerable proportion of yoga practitioners experienced injuries or other adverse events; however most were mild and transient and risks were comparable to those of non-yoga practitioners. There is no need to discourage yoga practice for healthy people. People with serious acute or chronic illnesses should seek medical advice before practicing yoga. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Warhuus, Jan; Günzel-Jensen, Franziska; Robinson, Sarah
types of team formation: random teacher pre-assigned, student selection, and teacher directed diversity. In each of these modules, ethnographic methods (interviews and observations) were employed. Additionally, we had access to students learning logs, formative and summative assessments, and final exams...... functioning entrepreneurial student teams as most teams lack personal chemistry which makes them anchor their work too much in a pre-defined project. In contrast, we find that students that can form their own teams aim for less diverse teams than what is achieved by random assignment. However, the homophily......Questions we care about (Objectives): When students have to work on challenging tasks, as it is often the case in entrepreneurship classrooms that leverage experiential learning, team success becomes central to the students learning. Yet, the formation of teams is often left up to the students...
Mekonnen, Alemayehu B; Alhawassi, Tariq M; McLachlan, Andrew J; Brien, Jo-Anne E
/training) and environmental factors, such as workplace distraction and high workload. Medication errors in the African healthcare setting are relatively common, and the impact of adverse drug events is substantial but many are preventable. This review supports the design and implementation of preventative strategies targeting the most likely contributing factors.
Van Luik, Abraham E.
The session started with Abe Van Luik (IGSC Chair, US-DOE-YM, USA) who presented the feedback of the international peer review of the US-DOE Yucca Mountain TSPA (Total System Performance Assessment) supporting the successful designation of the site by the Congress and the President of the U.S. In particular, he listed key implications of the IRT (International Review team) recommendations on the forthcoming US-DOE documentation of its case for safety to be submitted to the regulator, the U.S. Nuclear Regulatory Commission, mainly: - The documentation submitted to the licensing authority should address technical aspects and compliance with regulatory criteria. - That documentation should reflect sound science and good engineering practice; it should present detailed and rigorous modelling. - In addition, it should present both quantitative and qualitative arguments, make a statement on why there can be confidence in the face of uncertainty, acknowledge remaining issues and provide the strategy to resolve them. - Demonstrating understanding is as important as demonstrating compliance. - There is a need to provide a clear explanation of the case made to the regulator for more general audiences to complement the large amount of technical documents that will be produced. The US-DOE response to these recommendations for the License Application, which is under preparation, is that the recommendations will be implemented to the maximum extent possible. In subsequent discussion, with respect to the License Application, it was acknowledged that detailed guidance from the U.S. regulator was very useful, and guidance of this type would be generally useful. At the current time, the words 'safety case' are not mentioned in U.S. regulations, but if one reads both the regulation and guidance documents it becomes evident that all aspects of a safety case need to be provided in the License Application and its accompanying documents
This book is a report by Ohio's Emergency Evacuation Review Team, at the request of Governor Richard Celeste. The Team concludes that the current emergency response plan for Ohio's reactors is inadequate to protect the public and recommends changes in the current emergency plant requirements. The report also includes a summary of the litigation that has occurred since Celeste withdrew his support for the plans, a list of experts consulted, and sources used to prepare the report. An important document, and a study which every state should undertake
Fazel, Maryam T; Bagalagel, Alaa; Lee, Jeannie K; Martin, Jennifer R; Slack, Marion K
To conduct a comprehensive systematic review and meta-analyses examining the impact of pharmacist interventions as part of health care teams on diabetes therapeutic outcomes in ambulatory care settings. PubMed/MEDLINE, EMBASE, Cochrane Library, International Pharmaceutical Abstracts, Web of Science, Scopus, WHO's Global Health Library, ClinicalTrials.gov , and Google Scholar were searched (1995 to February 2017). Search terms included pharmacist, team, and diabetes. Full-text articles published in English with comparative designs, including randomized controlled trials, nonrandomized controlled trials, and pretest-posttest studies evaluating hemoglobin A 1C (A1C), were assessed. Two reviewers independently screened for study inclusion and extracted data. Quality of the studies was assessed using tools developed based on the framework of the Cochrane Collaboration's recommendations. A total of 1908 studies were identified from the literature and reference searches; 42 studies were included in the systematic review (n = 10 860) and 35 in the meta-analyses (n = 7417). Mean age ranged from 42 to 73 years, and 8% to 100% were male. The overall standardized mean difference (SMD) for A1C for pharmacist care versus comparison was 0.57 ( P 83%), indicating functional differences among the studies. No publication bias was detected. Pharmacists' interventions as part of the patient's health care team improved diabetes therapeutic outcomes, substantiating the important role of pharmacists in team-based diabetes management.
This paper will continue the review of HVAC/NATS related LERS presented at past Air Cleaning Conferences by Dr. D. W. Moeller and his associates. The general approach and format are similar. LER abstracts from mid 1985 through 1987 were reviewed and those related to HVAC/NATS classified and analyzed. The categories were jointly developed by Dr. Moeller, Dr. Casper Sun and myself. In appropriate cases both primary and secondary categories fora problem are given. A basic listing by category and brief statistical review are presented. Additionally a number of categories are discussed in some detail. The categories chosen for specific review are intended to highlight particular problem areas. NUREG/CR-2000 License Event Report (LER) Compilation is the basis for the initial review and coding. In essentially all cases where an LER is classified as of interest the complete LER was obtained and reviewed in full. The intent of this paper is to provide a basis for the industry to document and analyze problem areas that require additional attention. It appears that about 15% of all LERS in the subject period are HVAC/NATS related. This figure is generally consistent with those reported at the 17th DOE Nuclear Air Cleaning Conference. It is hoped that such attention will allow additional resources to be allocated to upgrade systems, procedures and training as well as in some cases government regulation
The Lunar Exploration Analysis Group (LEAG) was tasked by the Human Exploration Operations Mission Directorate (HEOMD) to establish a Specific Action Team (SAT) to review lunar Strategic Knowledge Gaps (SKGs) within the context of new lunar data and some specific human mission scenarios. Within this review, the SAT was to identify the SKGs that have been fully or partially retired, identify new SKGs resulting from new data and observations, and review quantitative descriptions of measurements that are required to fill knowledge gaps, the fidelity of the measurements needed, and if relevant, provide examples of existing instruments or potential missions capable of filling the SKGs.
Full Text Available Pain-related massage, important in traditional Eastern medicine, is increasingly used in the Western world. So the widening acceptance demands continual safety assessment. This review is an evaluation of the frequency and severity of adverse events (AEs reported mainly for pain-related massage between 2003 and 2013. Relevant all-languages reports in 6 databases were identified and assessed by two coauthors. During the 11-year period, 40 reports of 138 AEs were associated with massage. Author, year of publication, country of occurrence, participant related (age, sex or number of patients affected, the details of manual therapy, and clinician type were extracted. Disc herniation, soft tissue trauma, neurologic compromise, spinal cord injury, dissection of the vertebral arteries, and others were the main complications of massage. Spinal manipulation in massage has repeatedly been associated with serious AEs especially. Clearly, massage therapies are not totally devoid of risks. But the incidence of such events is low.
Fein, Erich C; Mackie, Benjamin; Chernyak-Hai, Lily; O'Quinn, C Richard V; Ahmed, Ezaz
Effective team decision making has the potential to improve the quality of health care outcomes. Medical Emergency Teams (METs), a specific type of team led by either critical care nurses or physicians, must respond to and improve the outcomes of deteriorating patients. METs routinely make decisions under conditions of uncertainty and suboptimal care outcomes still occur. In response, the development and use of Shared Mental Models (SMMs), which have been shown to promote higher team performance under stress, may enhance patient outcomes. This discussion paper specifically focuses on the development and use of SMMs in the context of METs. Within this process, the psychological mechanisms promoting enhanced team performance are examined and the utility of this model is discussed through the narrative of six habits applied to MET interactions. A two stage, reciprocal model of both nonanalytic decision making within the acute care environment and analytic decision making during reflective action learning was developed. These habits are explored within the context of a MET, illustrating how applying SMMs and action learning processes may enhance team-based problem solving under stress. Based on this model, we make recommendations to enhance MET decision making under stress. It is suggested that the corresponding habits embedded within this model could be imparted to MET members and tested by health care researchers to assess the efficacy of this integrated decision making approach in respect to enhanced team performance and patient outcomes. Copyright © 2015. Published by Elsevier Ltd.
Doocy, Shannon; Daniels, Amy; Dooling, Shayna; Gorokhovich, Yuri
Introduction. More than 500 million people live within the potential exposure range of a volcano. The risk of catastrophic losses in future eruptions is significant given population growth, proximities of major cities to volcanoes, and the possibility of larger eruptions. The objectives of this review are to describe the impact of volcanoes on the human population, in terms of mortality, injury, and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters. Methods. Data on the impact of volcanoes were compiled using two methods, a historical review of volcano events from 1900 to 2009 from multiple databases and a systematic literature review of publications ending in October 2012. Analysis included descriptive statistics and bivariate tests for associations between volcano mortality and characteristics using STATA 11. Findings. There were a total of 91,789 deaths (range: 81,703-102,372), 14,068 injuries (range 11,541-17,922), and 4.72 million people affected by volcanic events between 1900 and 2008. Inconsistent reporting suggests this is an underestimate, particularly in terms of numbers injured and affected. The primary causes of mortality in recent volcanic eruptions were ash asphyxiation, thermal injuries from pyroclastic flow, and trauma. Mortality was concentrated with the ten deadliest eruptions accounting for more than 80% of deaths; 84% of fatalities occurred in four locations (the Island of Martinique (France), Colombia, Indonesia, and Guatemala). Conclusions. Changes in land use practices and population growth provide a background for increasing risk; in conjunction with increasing urbanization in at risk areas, this poses a challenge for future volcano preparedness and mitigation efforts.
Bai, Yan; Yao, Zhong; Cong, Fengyu; Zhang, Linlin
There is an increasing interest regarding the use of electroencephalography (EEG) in social commerce and electronic commerce (e-commerce) research. There are several reviews in the field of social commerce or e-commerce; these have great potential value and mining them is fundamental and significant. To our knowledge, EEG is rarely applied to study these. In this study, we examined the neural correlates of social commerce reviews (SCRs) and e-commerce reviews (ECRs) by using them as stimuli to evoke event-related potentials. All SCRs were from friends through a social media platform, whereas ECRs were from strangers through an e-commerce platform. The experimental design was similar to that of a priming paradigm, and included 40 pairs of stimuli consisting of product information (prime stimulus) and reviews (target stimulus). The results showed that the P300 component was successfully evoked by SCR and ECR stimuli. Moreover, the P300 components elicited by SCRs had higher amplitudes than those elicited by ECRs. These findings indicate that participants paid more attention to SCRs than to ECRs. In addition, the associations between neural responses and reviews in social commerce have the potential to assist companies in studying consumer behaviors, thus permitting them to enhance their social commerce strategies.
Full Text Available Abstract Background Due to climate change, extreme weather events have an incremental impact on human health. Injuries and mental health disorders are a particular burden of disease, which is broadly investigated in high income countries. Most distressed populations are, however, those in developing countries. Therefore, this study investigates mental and physical health impacts arising from extreme weather events in these populations. Method Post-traumatic Stress Disorder (PTSD, injury [primary outcomes], anxiety and depressive disorders [secondary outcomes], caused by weather extremes were systematically analyzed in people of developing countries. A systematic review of observational studies was conducted searching six databases, complemented by hand search, and utilizing two search engines. Review processing was done independently by two reviewers. Prevalence rates were analyzed in a pre/post design; an additional semi-structured search was conducted, to provide reference data for studies not incorporating reference values. Results All 17 identified studies (70,842 individuals indicate a disease increase, compared to the reference data. Increase ranges from 0.7–52.6 % for PTSD, and from 0.3–37.3 % for injury. No studies on droughts and heatwaves were identified. All studies were conducted in South America and Asia. Conclusion There is an increased burden of psychological diseases and injury. This finding needs to be incorporated into activities of prevention, preparedness and general health care of those developing countries increasingly experiencing extreme weather events. There is also a gap in research in Africa (in quantity and quality of studies in this field and a predominant heterogeneity of health assessment tools. PROSPERO registration no.: CRD42014009109
Teodorczuk, Andrew; Welfare, Mark; Corbett, Sally; Mukaetova-Ladinska, Elizabeta
Deficiencies in the knowledge, skills and attitudes of all healthcare professionals working within the general hospital contribute towards the suboptimal care of older hospitalized patients with confusion. In the U.K., policy dictates that Liaison Old Age Psychiatry teams deliver effective education to general hospital clinical staff. The purpose of this paper is to review the literature concerning the learning needs of healthcare professionals in relation to managing confusion in the older patient in order to inform effective educational approaches for Liaison Old Age Psychiatry teams. A broad range of medical and educational databases were searched. Identified English language studies were selected for further analysis if they had a specific educational focus in the hospital setting and then further subdivided into intervention and naturalistic studies. The impact of intervention studies was evaluated by Kirkpatrick's system. Learning needs, as determined from the naturalistic studies, were mapped to identify themes. 13 intervention studies were identified. Despite a high level of effectiveness for educational interventions, it was unclear what the active components were. A further 23 naturalistic studies were identified; their findings focused on knowledge gaps, diagnostic behaviors and experiences, attitudes and training issues. Few studies specifically researched learning needs or the educational role of liaison teams. Conspicuous by its absence was reference to relevant educational theories. The findings of this review can be incorporated in the planning of local curricula by Liaison Teams in order to design educational strategies. There is a need for further research, especially studies exploring the learning needs of all healthcare professionals.
King, Allana; Long, Lesley; Lisy, Karolina
The organization of the work of nurses, according to recognized models of care, can have a significant impact on the wellbeing and performance of nurses and nursing teams. This review focuses on two models of nursing care delivery, namely, team and total patient care, and their effect on nurses' wellbeing. To examine the effectiveness of team nursing compared to total patient care on staff wellbeing when organizing nursing work in acute care wards. Participants were nurses working on wards in acute care hospitals.The intervention was the use of a team nursing model when organizing nursing work. The comparator was the use of a total patient care model.This review considered quantitative study designs for inclusion in the review.The outcome of interest was staff wellbeing which was measured by staff outcomes in relation to job satisfaction, turnover, absenteeism, stress levels and burnout. The search strategy aimed to find both published and unpublished studies from 1995 to April 21, 2014. Quantitative papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute. Data was extracted from papers included in the review using the standardized data extraction tool from the Joanna Briggs Institute. The data extracted included specific details about the interventions, populations, study methods and outcomes of significance to the review question and its specific objectives. Due to the heterogeneity of the included quantitative studies, meta-analysis was not possible. Results have been presented in a narrative form. The database search returned 10,067 records. Forty-three full text titles were assessed, and of these 40 were excluded, resulting in three studies being included in the review. Two of the studies were quasi experimental designs and the other was considered an uncontrolled before and after experimental study
Burgert, James M
The intraosseous (IO) route of vascular access has been increasingly used to administer resuscitative fluids and drugs to patients in whom reliable intravenous (IV) access could not be rapidly or easily obtained. It is unknown that to what extent the IO route has been used to gain vascular access during disasters and mass casualty events. The purpose of this review was to examine the existing literature to answer the research question, "What is the utility of the IO route compared to other routes for establishing vascular access in patients resulting from disasters and mass casualty events?" Keyword-based online database search of PubMed, CINAHL, and the Cochrane Database of Systematic Reviews. University-based academic research cell. Included evidence were randomized and nonrandomized trials, systematic reviews with and without meta-analysis, case series, and case reports. Excluded evidence included narrative reviews and expert opinion. Not applicable. Of 297 evidence sources located, 22 met inclusion criteria. Located evidence was organized into four categories including chemical agent poisoning, IO placement, while wearing chemical protective clothing (PPE), military trauma, and infectious disease outbreak. Evidence indicates that the IO route of infusion is pharmacokinetically equal to the IV route and superior to the intramuscular (IM) and endotracheal routes for the administration of antidotal drugs in animal models of chemical agent poisoning while wearing full chemical PPE. The IO route is superior to the IM route for antidote administration during hypovolemic shock. Civilian casualties of explosive attacks and mass shootings would likely benefit from expanded use of the IO route and military resuscitation strategies. The IO route is useful for fluid resuscitation in the management of diarrheal and hemorrhagic infectious disease outbreaks.
El-Kot, Ghada Awed Hassan
The literature has revealed few studies of management in Arab countries in general and particularly in Egypt. Many Egyptian organisations implemented the team concept a number of years ago, however, there do not appear to be any studies investicitaýt inc",D team work effectiveness in Egypt. The literature review and the findings of a pilot study emphasised the need for empirical research in team work in Egypt. Team effectiveness models are examined in order to identify the fact...
The term paper is to analyze the formation of the team and its - motyvation, and interviews from four different companies and find out the leaders in terms of your team, and what principle he tries to motivate her. The Tasks of this paper is to review the organization formed by a team; investigate the promotion of employees in enterprises; The four firms interviewed; Assess how you can work in different organizations. Methods used To analyze the topic, I decided to interview four different co...
Warhuus, Jan; Günzel-Jensen, Franziska; Robinson, Sarah
or pre-arranged at random. Therefore we investigate the importance of team formation in the entrepreneurial classroom and ask: (i) What are the underlying factors that influence outcomes of teamwork in student groups? (ii) How does team formation influence student perception of learning?, and (iii) Do...... different team formation strategies produce different teamwork and learning outcomes? Approach: We employed a multiple case study design comprising of 38 student teams to uncover potential links between team formation and student perception of learning. This research draws on data from three different....... A rigorous coding and inductive analysis process was undertaken. Pattern and relationship coding were used to reveal underlying factors, which helped to unveil important similarities and differences between student in different teams’ project progress and perception of learning. Results: When students...
individualistic culture , it is ‘Can you work with me?’ and for the collectivistic culture , it is ‘Can we work together’. These evidently have important...comparison of individualistic and collectivistic cultures , Academy of Management Review, 22: 730-757. Kiffin-Petersen, S.A., and Cordery, J.L. (2003...that when a team member is perceived as in-group, the collectivists evaluated him or her more generously as compared to individualists . Moreover
This report presents the results of the IAEA Operational Safety Review Team (OSART) review of Ignalina nuclear power plant in Lithuania. It describes recommendations and suggestions for improvements affecting operational safety provided to the responsible Lithuanian authorities for consideration and also describes a good practice for consideration by other nuclear power plants. Distribution of this OSART report is at the discretion of the Government of Lithuania and, until it is derestricted, the IAEA will make the report available to third parties only with the express permission of the Government of Lithuania. Any use of, or reference to, this report that may be made by the competent Lithuanian organizations is solely their responsibility
Timbie, Justin W; Ringel, Jeanne S; Fox, D Steven; Pillemer, Francesca; Waxman, Daniel A; Moore, Melinda; Hansen, Cynthia K; Knebel, Ann R; Ricciardi, Richard; Kellermann, Arthur L
Efficient management and allocation of scarce medical resources can improve outcomes for victims of mass casualty events. However, the effectiveness of specific strategies has never been systematically reviewed. We analyze published evidence on strategies to optimize the management and allocation of scarce resources across a wide range of mass casualty event contexts and study designs. Our literature search included MEDLINE, Scopus, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Global Health, Web of Science, and the Cochrane Database of Systematic Reviews, from 1990 through late 2011. We also searched the gray literature, using the New York Academy of Medicine's Grey Literature Report and key Web sites. We included both English- and foreign-language articles. We included studies that evaluated strategies used in actual mass casualty events or tested through drills, exercises, or computer simulations. We excluded studies that lacked a comparison group or did not report quantitative outcomes. Data extraction, quality assessment, and strength of evidence ratings were conducted by a single researcher and reviewed by a second; discrepancies were reconciled by the 2 reviewers. Because of heterogeneity in outcome measures, we qualitatively synthesized findings within categories of strategies. From 5,716 potentially relevant citations, 74 studies met inclusion criteria. Strategies included reducing demand for health care services (18 studies), optimizing use of existing resources (50), augmenting existing resources (5), implementing crisis standards of care (5), and multiple categories (4). The evidence was sufficient to form conclusions on 2 strategies, although the strength of evidence was rated as low. First, as a strategy to reduce demand for health care services, points of dispensing can be used to efficiently distribute biological countermeasures after a bioterrorism attack or influenza pandemic, and their organization influences speed of
Full Text Available How the race and gender diversity of team members is related to innovative science and technology outcomes is debated in the scholarly literature. Some studies find diversity is linked to creativity and productivity, other studies find that diversity has no effect or even negative effects on team outcomes. Based on a critical review of the literature, this paper explains the seemingly contradictory findings through careful attention to the organizational contexts of team diversity. We distinguish between representational diversity and full integration of minority scientists. Representational diversity, where organizations have workforces that match the pool of degree recipients in relevant fields, is a necessary but not sufficient condition for diversity to yield benefits. Full integration of minority scientists (i.e., including women and people of color in an interaction context that allows for more level information exchange, unimpeded by the asymmetrical power relationships that are common across many scientific organizations, is when the full potential for diversity to have innovative outcomes is realized. Under conditions of equitable and integrated work environments, diversity leads to creativity, innovation, productivity, and positive reputational (status effects. Thus, effective policies for diversity in science and engineering must also address integration in the organizational contexts in which diverse teams are embedded.
Virtual work teams scattered around the globe are becoming a feature of corporate workplaces. Although most people prefer face-to-face meetings and interactions, reality often requires telecommuting. (JOW)
Sasou, Kunihide; Reason, James
In error analysis or error management, the focus is usually upon individuals who have made errors. In large complex systems, however, most people work in teams or groups. Considering this working environment, insufficient emphasis has been given to 'team errors'. This paper discusses the definition of team errors and its taxonomy. These notions are also applied to events that have occurred in the nuclear power industry, aviation industry and shipping industry. The paper also discusses the relations between team errors and Performance Shaping Factors (PSFs). As a result, the proposed definition and taxonomy are found to be useful in categorizing team errors. The analysis also reveals that deficiencies in communication, resource/task management, excessive authority gradient, excessive professional courtesy will cause team errors. Handling human errors as team errors provides an opportunity to reduce human errors
Little, Charles M; McStay, Christopher; Oeth, Justin; Koehler, April; Bookman, Kelly
The use of after-action reviews (AARs) following major emergency events, such as a disaster, is common and mandated for hospitals and similar organizations. There is a recurrent challenge of identified problems not being resolved and repeated in subsequent events. A process improvement technique called a rapid improvement event (RIE) was used to conduct an AAR following a complete information technology (IT) outage at a large urban hospital. Using RIE methodology to conduct the AAR allowed for the rapid development and implementation of major process improvements to prepare for future IT downtime events. Thus, process improvement methodology, particularly the RIE, is suited for conducting AARs following disasters and holds promise for improving outcomes in emergency management. Little CM , McStay C , Oeth J , Koehler A , Bookman K . Using rapid improvement events for disaster after-action reviews: experience in a hospital information technology outage and response. Prehosp Disaster Med. 2018;33(1):98-100.
Manan, Norhafizah A.; Abidin, Basir
Five percent of patients who went through Percutaneous Coronary Intervention (PCI) experienced Major Adverse Cardiac Events (MACE) after PCI procedure. Risk prediction of MACE following a PCI procedure therefore is helpful. This work describes a review of such prediction models currently in use. Literature search was done on PubMed and SCOPUS database. Thirty literatures were found but only 4 studies were chosen based on the data used, design, and outcome of the study. Particular emphasis was given and commented on the study design, population, sample size, modeling method, predictors, outcomes, discrimination and calibration of the model. All the models had acceptable discrimination ability (C-statistics >0.7) and good calibration (Hosmer-Lameshow P-value >0.05). Most common model used was multivariate logistic regression and most popular predictor was age.
Samsa, M. E.; Baldwin, T. E.; Berry, M. S.; Guzowski, L. B.; Martinez-Moyano, I.; Nieves, A. L.; Ramarasad, A. (Decision and Information Sciences)
The terrorist attacks of September 11, 2001 (9/11), focused a great deal of interest and concern on how individual and social perceptions of risk change behavior and subsequently affect commercial sector venues. Argonne conducted a review of the literature to identify studies that quantify the direct and indirect economic consequences of avoidance behaviors that result from terrorist attacks. Despite a growing amount of literature addressing terrorism impacts, relatively little is known about the causal relationships between risk perception, human avoidance behaviors, and the economic effects on commercial venues. Nevertheless, the technical and academic literature does provide some evidence, both directly and by inference, of the level and duration of post-event avoidance behaviors on commercial venues. Key findings are summarized in this Executive Summary. Also included as an appendix is a more detailed summary table of literature findings reproduced from the full report.
ter Stege, Marloes H. P.; Dallinga, Joan M.; Benjaminse, Anne; Lemmink, Koen A. P. M.
Background Knee injuries are one of the most common types of injuries in team ball sports, and prevention is crucial because of health and economic implications. To set up effective prevention programs, these programs must be designed to target potential, modifiable risk factors. In addition, it is
Jones, Mary Lou Baker; Seybold, Paul G.
The widely acknowledged need to include chemical information competencies and communication skills in the undergraduate chemistry curriculum can be accommodated in a variety of ways. We describe a team-taught, semester-length course at Wright State University which combines chemical information literacy, written and oral communication skills,…
McGinley, Jennifer L; Dobson, Fiona; Ganeshalingam, Rekha; Shore, Benjamin J; Rutz, Erich; Graham, H Kerr
To conduct a systematic review of single-event multilevel surgery (SEMLS) for children with cerebral palsy, with the aim of evaluating the quality of the evidence and developing recommendations for future research. The systematic review was conducted using standard search and extraction methods in Medline, EMBASE, CINAHL, and Cochrane electronic databases. For the purposes of this review, SEMLS was defined as two or more soft-tissue or bony surgical procedures at two or more anatomical levels during one operative procedure, requiring only one hospital admission and one period of rehabilitation. Studies were included if: (1) the primary focus was to examine the effect of SEMLS in children with cerebral palsy; (2) the results focused on multiple anatomic levels and reported findings of one or more World Health Organization International Classification of Functioning, Disability and Health (ICF) domains. Studies that focused on a single intervention or level, or on the utility of a specific outcome measure were excluded. Study quality was appraised with the Methodological Index for Non-Randomized Studies (MINORS) and the Oxford Centre for Evidence-Based Medicine scale. The review also examined the reporting of surgery, adverse events, and rehabilitation. Thirty-one studies fulfilled the criteria for inclusion, over the period 1985 to October 2010. The MINORS score for these studies varied from 4 to 19, with marked variation in the quality of reporting. Study quality has improved over recent years. Valid measures of gait and function have been introduced and several of the most recent studies have addressed multiple dimensions of the ICF. A statistical synthesis of the outcome data was not conducted, although a trend towards favourable outcomes in gait was evident. Caution is advised with interpretation owing to the variable study quality. Uncontrolled studies may have resulted in an overestimation of treatment efficacy. The design and reporting of studies of SEMLS are
Westover Arthur N
Full Text Available Abstract Background There is increasing concern that prescription stimulants may be associated with adverse cardiovascular events such as stroke, myocardial infarction, and sudden death. Public health concerns are amplified by increasing use of prescription stimulants among adults. Methods The objective of this study was to conduct a systematic review of the evidence of an association between prescription stimulant use and adverse cardiovascular outcomes. PUBMED, MEDLINE, EMBASE and Google Scholar searches were conducted using key words related to these topics (MESH: ADHD; Adults; Amphetamine; Amphetamines; Arrhythmias, Cardiac; Cardiovascular Diseases; Cardiovascular System; Central Nervous Stimulants; Cerebrovascular; Cohort Studies; Case–control Studies; Death; Death, Sudden, Cardiac; Dextroamphetamine; Drug Toxicity; Methamphetamine; Methylphenidate; Myocardial Infarction; Stimulant; Stroke; Safety. Eligible studies were population-based studies of children, adolescents, or adults using prescription stimulant use as the independent variable and a hard cardiovascular outcome as the dependent variable. Results Ten population-based observational studies which evaluated prescription stimulant use with cardiovascular outcomes were reviewed. Six out of seven studies in children and adolescents did not show an association between stimulant use and adverse cardiovascular outcomes. In contrast, two out of three studies in adults found an association. Conclusions Findings of an association between prescription stimulant use and adverse cardiovascular outcomes are mixed. Studies of children and adolescents suggest that statistical power is limited in available study populations, and the absolute risk of an event is low. More suggestive of a safety signal, studies of adults found an increased risk for transient ischemic attack and sudden death/ventricular arrhythmia. Interpretation was limited due to differences in population, cardiovascular outcome
McEwan, Desmond; Ruissen, Geralyn R; Eys, Mark A; Zumbo, Bruno D; Beauchamp, Mark R
The objective of this study was to conduct a systematic review and meta-analysis of teamwork interventions that were carried out with the purpose of improving teamwork and team performance, using controlled experimental designs. A literature search returned 16,849 unique articles. The meta-analysis was ultimately conducted on 51 articles, comprising 72 (k) unique interventions, 194 effect sizes, and 8439 participants, using a random effects model. Positive and significant medium-sized effects were found for teamwork interventions on both teamwork and team performance. Moderator analyses were also conducted, which generally revealed positive and significant effects with respect to several sample, intervention, and measurement characteristics. Implications for effective teamwork interventions as well as considerations for future research are discussed.
McEwan, Desmond; Ruissen, Geralyn R.; Eys, Mark A.; Zumbo, Bruno D.; Beauchamp, Mark R.
The objective of this study was to conduct a systematic review and meta-analysis of teamwork interventions that were carried out with the purpose of improving teamwork and team performance, using controlled experimental designs. A literature search returned 16,849 unique articles. The meta-analysis was ultimately conducted on 51 articles, comprising 72 (k) unique interventions, 194 effect sizes, and 8439 participants, using a random effects model. Positive and significant medium-sized effects were found for teamwork interventions on both teamwork and team performance. Moderator analyses were also conducted, which generally revealed positive and significant effects with respect to several sample, intervention, and measurement characteristics. Implications for effective teamwork interventions as well as considerations for future research are discussed. PMID:28085922
Full Text Available The objective of this study was to conduct a systematic review and meta-analysis of teamwork interventions that were carried out with the purpose of improving teamwork and team performance, using controlled experimental designs. A literature search returned 16,849 unique articles. The meta-analysis was ultimately conducted on 51 articles, comprising 72 (k unique interventions, 194 effect sizes, and 8439 participants, using a random effects model. Positive and significant medium-sized effects were found for teamwork interventions on both teamwork and team performance. Moderator analyses were also conducted, which generally revealed positive and significant effects with respect to several sample, intervention, and measurement characteristics. Implications for effective teamwork interventions as well as considerations for future research are discussed.
Balogh, Lívia; Czobor, Pál
Error-related bioelectric signals constitute a special subgroup of event-related potentials. Researchers have identified two evoked potential components to be closely related to error processing, namely error-related negativity (ERN) and error-positivity (Pe), and they linked these to specific cognitive functions. In our article first we give a brief description of these components, then based on the available literature, we review differences in error-related evoked potentials observed in patients across psychiatric disorders. The PubMed and Medline search engines were used in order to identify all relevant articles, published between 2000 and 2009. For the purpose of the current paper we reviewed publications summarizing results of clinical trials. Patients suffering from schizophrenia, anorexia nervosa or borderline personality disorder exhibited a decrease in the amplitude of error-negativity when compared with healthy controls, while in cases of depression and anxiety an increase in the amplitude has been observed. Some of the articles suggest specific personality variables, such as impulsivity, perfectionism, negative emotions or sensitivity to punishment to underlie these electrophysiological differences. Research in the field of error-related electric activity has come to the focus of psychiatry research only recently, thus the amount of available data is significantly limited. However, since this is a relatively new field of research, the results available at present are noteworthy and promising for future electrophysiological investigations in psychiatric disorders.
Full Text Available Starting from the relationship between urban planning and mobility management, TeMA has gradually expanded the view of the covered topics, always remaining in the groove of rigorous scientific in-depth analysis. During the last two years a particular attention has been paid on the Smart Cities theme and on the different meanings that come with it. The last section of the journal is formed by the Review Pages. They have different aims: to inform on the problems, trends and evolutionary processes; to investigate on the paths by highlighting the advanced relationships among apparently distant disciplinary fields; to explore the interaction’s areas, experiences and potential applications; to underline interactions, disciplinary developments but also, if present, defeats and setbacks. Inside the journal the Review Pages have the task of stimulating as much as possible the circulation of ideas and the discovery of new points of view. For this reason the section is founded on a series of basic’s references, required for the identification of new and more advanced interactions. These references are the research, the planning acts, the actions and the applications, analysed and investigated both for their ability to give a systematic response to questions concerning the urban and territorial planning, and for their attention to aspects such as the environmental sustainability and the innovation in the practices. For this purpose the Review Pages are formed by five sections (Web Resources; Books; Laws; Urban Practices; News and Events, each of which examines a specific aspect of the broader information storage of interest for TeMA
Russell, Mark; West, Daniel J; Harper, Liam D; Cook, Christian J; Kilduff, Liam P
A number of intermittent team sports require that two consecutive periods of play (lasting for ~30-45 min) are separated by a 10-20 min half-time break. The half-time practices employed by team-sports players generally include returning to the changing rooms, temporarily relaxing from the cognitive and physical demands of the first half, rehydration and re-fuelling strategies, addressing injury or equipment concerns, and receiving tactical instruction and coach feedback. However, the typically passive nature of these actions has been associated with physiological changes that impair performance during the second half. Both physical and cognitive performances have been found to decline in the initial stages of subsequent exercise that follows half-time. An increased risk of injury has also been observed during this period. Therefore, half-time provides sports scientists and strength and conditioning coaches with an opportunity to optimise second-half performance. An overview of strategies thought to benefit team-sports athletes is presented; specifically, the efficacy of heat maintenance strategies (including passive and active methods), post-activation potentiation, hormonal priming, and modified hydro-nutritional practices are discussed. A theoretical model of applying these strategies in a manner that compliments current practice is also offered.
Shebby, S.; Cobb, W. H.; Buxner, S.; Shipp, S. S.
Each year, the National Aeronautics and Space Administration (NASA) sponsors a variety of educational events to share information with educators, students, and the general public. Intended outcomes of these events include increased interest in and awareness of the mission and goals of NASA. Events range in size from relatively small family science nights at a local school to large-scale mission and celestial event celebrations involving thousands of members of the general public. To support community members in designing event evaluations, the Science Mission Directorate (SMD) Planetary Science Forum sponsored the creation of a Best Practices Guide. The guide was generated by reviewing published large-scale event evaluation reports; however, the best practices described within are pertinent for all event organizers and evaluators regardless of event size. Each source included in the guide identified numerous challenges to conducting their event evaluation. These included difficulty in identifying extant instruments or items, collecting representative data, and disaggregating data to inform different evaluation questions. Overall, the guide demonstrates that evaluations of the large-scale events are generally done at a very basic level, with the types of data collected limited to observable demographic information and participant reactions collected via online survey. In addition to these findings, this presentation will describe evaluation best practices that will help practitioners move beyond these basic indicators and examine how to make the evaluation process an integral—and valuable—element of event planning, ultimately informing event outcomes and impacts. It will provide detailed information on five recommendations presented in the guide: 1) consider evaluation methodology, including data analysis, in advance; 2) design data collection instruments well in advance of the event; 3) collect data at different times and from multiple sources; 4) use
Timmermans, Olaf; Van Linge, Roland; Van Petegem, Peter; Elseviers, Monique; Denekens, Joke
Purpose: This study aims to explore team learning activities in nursing teams and to test the effect of team composition on team learning to extend conceptually an initial model of team learning and to examine empirically a new model of ambidextrous team learning in nursing. Design/methodology/approach: Quantitative research utilising exploratory…
D'Amour, Danielle; Dubois, Carl-Ardy; Tchouaket, Eric; Clarke, Sean; Blais, Régis
Ensuring the safety of hospitalized patients remains a major challenge for healthcare systems, and nursing services are at the center of hospital care. Yet our knowledge about safety of nursing care is quite limited. In fact, most earlier studies examined one, or at most two, indicators, thus presenting an incomplete picture of safety at an institutional or broader level. Furthermore, methodologies have differed from one study to another, making benchmarking difficult. The aim of this study was to describe the frequencies of six adverse events widely considered in the literature to be nursing-sensitive outcomes and to estimate the degree to which these events could be attributed to nursing care. Cross-sectional review of charts of 2699 patients hospitalized on 22 medical units in 11 hospitals in Quebec, Canada. The events included: pressure sores, falls, medication administration errors, pneumonias, urinary infections, and inappropriate use of restraints. Experienced nurse reviewers abstracted patients' charts based on a grid developed for the study. Patient-level risk for at least one of these six adverse events was 15.3%, ranging from 9% to 28% across units. Of the 412 patients who experienced an event, 30% experienced two or more, for a total of 568 events. The risk of experiencing an adverse event with consequences was 6.2%, with a unit-level range from 3.2% to 13.5%. Abstractors concluded that 76.8% of the events were attributable to nursing care. While the measurement approach adopted here has limitations stemming from reliance on review of documentation, it provided a practical means of assessing several nursing-sensitive adverse events simultaneously. Given that patient safety issues are so complex, tracking their prevalence and impact is important, as is finding means of evaluating progress in reducing them. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.
In order to properly assess safety culture, it is necessary to consider the contribution of all organizations which have an impact on it. Therefore, while assessing the safety culture in an operating organization it is necessary to address at least its interfaces with the local regulatory agency, utility corporate headquarters and supporting organizations. These guidelines are primarily intended for use by any organization wishing to conduct a self-assessment of safety culture. They should also serve as a basis for conducting an international peer review of the organization's self-assessment carried out by an ASCOT (Assessment of Safety Culture in Organizations Team) mission
Goparaju Purna SUDHAKAR
Popularity of teams is growing in 21st Century. Organizations are getting their work done through different types of teams. Teams have proved that the collective performance is more than the sum of the individual performances. Thus, the teams have got different dimensions such as quantitative dimensions and qualitative dimensions. The Quantitative dimensions of teams such as team performance, team productivity, team innovation, team effectiveness, team efficiency, team decision making and tea...
Levisen, Vinie; Haugaard, Lena
organisation som denne? Når teams i samtiden anses for at være en organisationsform, der fremmer organisatorisk læring, beror det på, at teamet antages at udgøre et ikke-hierarkisk arbejdsfællesskab, hvor erfaringer udveksles og problemer løses. Teamorganisering kan imidlertid udformes på mange forskellige...
Bentz, A; Buddemeier, B; Dombroski, M
Following the events of September 11, a litany of imaginable horribles was trotted out before an anxious and concerned public. To date, government agencies and academics are still grappling with how to best respond to such catastrophes, and as Senator Lieberman's quote says above, now is the time to plan and prepare for such events. One of the nation's worst fears is that terrorists might detonate an improvised nuclear device (IND) in an American city. With 9/11 serving as the catalyst, the government and many NGOs have invested money into research and development of response capabilities throughout the country. Yet, there is still much to learn about how to best respond to an IND event. Understanding the state of knowledge, identifying gaps, and making recommendations for how to fill those gaps, this paper will provide a framework under which past findings can be understood and future research can fit. The risk of an improvised nuclear device (IND) detonation may seem unlikely; and while this is hopefully true, due to its destructive capability, IND events must be prepared for. Many people still live under the Cold War mentality that if a city is attacked with a nuclear weapon, there is little chance of survival. This assumption, while perhaps true in the case of multiple, thermonuclear weapons exchanges, does not hold for the current threat. If a single IND were detonated in the United States, there would be many casualties at the point of impact; however, there would also be many survivors and the initial response by two major groups will mean the difference between life and death for many people. These groups are the first responders and the public. Understanding how these two groups prepare, react and interact will improve response to nuclear terrorism. Figure 1 provides a visualization of the response timeline of an IND event. For the purposes of this assessment, it is assumed that to accurately inform the public, three functions need to be
Oliveira, Andrea Carvalho de; Garcia, Paulo Carlos; Nogueira, Lilia de Souza
To identifyevidences of the influence of nursing workload on the occurrence of adverse events (AE) in adult patients admitted to the intensive care unit (ICU). A systematic literature review was conducted in the databases MEDLINE, CINAHL, LILACS, SciELO, BDENF, and Cochrane from studies in English, Portuguese, or Spanish, published by 2015. The analyzed AE were infection, pressure ulcer (PU), patient falls, and medication errors. Of 594 potential studies, eight comprised the final sample of the review. TheNursing Activities Score (NAS; 37.5%) and the Therapeutic Intervention Scoring System(TISS; 37.5%) were the instruments most frequently used for assessing nursing workload. Six studies (75.0%) identified the influence of work overload in events of infection, PU, and medicationerrors. An investigation found that the NAS was a protective factor for PU. The nursing workload required by patients in the ICU influenced the occurrence of AE, and nurses must monitor this variable daily to ensure proper sizing of staff and safety of care. Identificar evidências sobre a influência da carga de trabalho de enfermagem na ocorrência de eventos adversos (EA) em pacientes adultos internados em Unidade de Terapia Intensiva (UTI). Revisão sistemática da literatura realizada nas bases de dados MEDLINE, CINAHL, LILACS, SciELO, BDENF e Cochrane deestudosem inglês, português ou espanhol, publicados até 2015. Os EA analisados foram infecção, úlcera por pressão (UPP), quedas e erros associados a medicamentos. Das 594 pesquisas potenciais identificadas, oito compuseram a amostra final da revisão. O NursingActivities Score -NAS (37,5%) e o TherapeuticInterventionScoring System -TISS (37,5%) foram os instrumentos mais utilizados para avaliação da carga de trabalho de enfermagem. Seis pesquisas (75,0%) identificaram influência da sobrecarga de trabalho na ocorrência de infecção, UPP e uso de medicamentos. Uma investigação identificou que o NAS foi fator de prote
Full Text Available Work Team 2016 (Jan-Jul1. Editorial TeamChief-editorsBayardo Bapstista Torres, Instituto de Química (USP, BrasilEduardo Galembeck, Depto. Bioquímica, Instituto de Biologia, Universidade de Campinas (Unicamp, Brasil Co-editorsGabriel Gerber Hornink, Depto. Bioquímica, Instituto de Ciências Biomédicas, Universidade - Federal de Alfenas (Unifal-MG, BrasilVera Maria Treis Trindade, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS, Brasil Editorial BoardAdriana Cassina, Department of Biochemistry, Facultad de Medicina, Universidad de la República, UruguayAngel Herráez, Departamento de Bioquímica y Biología molecular, Universidad de Alcalá de Henares, Madrid, SpainAndré Amaral Gonçalves Bianco, Universidade Federal de São Paulo (Unifesp, BrasilDenise Vaz de Macedo, Depto. Bioquímica, Instituto de Biologia, Universidade Estadual de Campinas (Unicamp, BrasilEneida de Paula, Depto. Bioquímica, Instituto de Biologia, Universidade Estadual de Campinas (Unicamp, BrasilJose Antonio Martinez Oyanedel, Universidad de Concepción, ChileJosep Maria Fernández Novell, Department of Molecular Biology & Biochemistry, Universitat de Barcelona, SpainLeila Maria Beltramini, Instituto de Física de São Carlos, Universidade Estadual de São Paulo (USP, BrasilManuel João da Costa, Escola de Ciências da Saúde, Universidade do Minho, PortugalMaria Lucia Bianconi, Instituto de Bioquímica Médica, Universidade Federal do Rio de Janeiro (UFRJ, BrasilMaría Noel Alvarez, Department of Biochemistry, Facultad de Medicina, Universidad de la República, UruguayMiguel Ángel Medina Torres, Department of Molecular Biology & Biochemistry Faculty of Sciences University of Málaga, SpainNelma Regina Segnini Bossolan, Instituto de Física de São Carlos, Universidade de São Paulo (USP, BrasilPaulo De Avila Junior, Centro de Ciências Naturais e Humanas (CCNH Universidade Federal do ABC (UFABC
Neunert, C; Noroozi, N; Norman, G; Buchanan, G R; Goy, J; Nazi, I; Kelton, J G; Arnold, D M
The burden of severe bleeding in adults and children with immune thrombocytopenia (ITP) has not been established. To describe the frequency and severity of bleeding events in patients with ITP, and the methods used to measure bleeding in ITP studies. We performed a systematic review of all prospective ITP studies that enrolled 20 or more patients. Two reviewers searched Medline, Embase, CINAHL and the Cochrane registry up to May 2014. Overall weighted proportions were estimated using a random effects model. Measurement properties of bleeding assessment tools were evaluated. We identified 118 studies that reported bleeding (n = 10 908 patients). Weighted proportions for intracerebral hemorrhage (ICH) were 1.4% for adults (95% confidence interval [CI], 0.9-2.1%) and 0.4% for children (95% CI, 0.2-0.7%; P bleeding was 9.6% for adults (95% CI, 4.1-17.1%) and 20.2% for children (95% CI, 10.0-32.9%; P bleeding were highly variable in primary studies. Two bleeding assessment tools (Buchanan 2002 for children; Page 2007 for adults) demonstrated adequate inter-rater reliability and validity in independent assessments. ICH was more common in adults and tended to occur during chronic ITP; other severe bleeds were more common in children and occurred at all stages of disease. Reporting of non-ICH bleeding was variable across studies. Further attention to ITP-specific bleeding measurement in clinical trials is needed to improve standardization of this important outcome for patients. © 2014 International Society on Thrombosis and Haemostasis.
James S Leung
Full Text Available To systematically review the literature and determine frequencies of adverse drug events (ADE associated with pediatric asthma medications.Following PRISMA guidelines, we systematically searched six bibliographic databases between January 1991 and January 2017. Study eligibility, data extraction and quality assessment were independently completed and verified by two reviewers. We included randomized control trials (RCT, case-control, cohort, or quasi-experimental studies where the primary objective was identifying ADE in children 1 month- 18 years old exposed to commercial asthma medications. The primary outcome was ADE frequency.Our search identified 14,540 citations. 46 studies were included: 24 RCT, 15 cohort, 4 RCT pooled analyses, 1 case-control, 1 open-label trial and 1 quasi-experimental study. Studies examined the following drug classes: inhaled corticosteroids (ICS (n = 24, short-acting beta-agonists (n = 10, long-acting beta-agonists (LABA (n = 3, ICS + LABA (n = 3, Leukotriene Receptor Antagonists (n = 3 and others (n = 3. 29 studies occurred in North America, and 29 were industry funded. We report a detailed index of 406 ADE descriptions and frequencies organized by drug class. The majority of data focuses on ICS, with 174 ADE affecting 13 organ systems including adrenal and growth suppression. We observed serious ADE, although they were rare, with frequency ranging between 0.9-6% per drug. There were no confirmed deaths, except for 13 potential deaths in a LABA study including combined adult and pediatric participants. We identified substantial methodological concerns, particularly with identifying ADE and determining severity. No studies utilized available standardized causality, severity or preventability assessments.The majority of studies focus on ICS, with adrenal and growth suppression described. Serious ADE are relatively uncommon, with no confirmed pediatric deaths. We identify substantial methodological concerns
Business continuity management is often thought of as a proactive planning process for minimising impact from large-scale incidents and disasters. While this is true, and it is critical to plan for the worst, consistently validating plan effectiveness against smaller disruptions can enable an organisation to gain key insights about its business continuity readiness, drive programme improvements, reduce costs and provide an opportunity to quantitatively demonstrate the value of the programme to management. This paper describes a post mortem framework which is used as a continuous improvement mechanism for tracking, reviewing and learning from real-world events at Microsoft Customer Service & Support. This approach was developed and adopted because conducting regular business continuity exercises proved difficult and expensive in a complex and distributed operations environment with high availability requirements. Using a quantitative approach to measure response to incidents, and categorising outcomes based on such responses, enables business continuity teams to provide data-driven insights to leadership, change perceptions of incident root cause, and instil a higher level of confidence towards disaster response readiness and incident management. The scope of the framework discussed here is specific to reviewing and driving improvements from operational incidents. However, the concept can be extended to learning and evolving readiness plans for other types of incidents.
Morganti, Deena J.; Buckalew, Flora C.
Discussion of team teaching focuses on librarians team teaching a course on information search strategy at the Pennsylvania State Berks Campus Library. Course requirements are described, planning for the course is discussed, grading practices are reviewed, and course and instructor evaluations are described. (two references) (LRW)
This project included a literature review and summary that focused on subjects related to team building, team/committee member : motivational strategies, and tools for effective and efficient committee meetings. It also completed an online survey of ...
Lewis, Gillian M; Neville, Christine; Ashkanasy, Neal M
To investigate the current state of knowledge about emotional intelligence and affective events that arise during nursing students' clinical placement experiences. Narrative literature review. CINAHL, MEDLINE, PsycINFO, Scopus, Web of Science, ERIC and APAIS-Health databases published in English between 1990 and 2016. Data extraction from and constant comparative analysis of ten (10) research articles. We found four main themes: (1) emotional intelligence buffers stress; (2) emotional intelligence reduces anxiety associated with end of life care; (3) emotional intelligence promotes effective communication; and (4) emotional intelligence improves nursing performance. The articles we analysed adopted a variety of emotional intelligence models. Using the Ashkanasy and Daus "three-stream" taxonomy (Stream 1: ability models; 2: self-report; 3: mixed models), we found that Stream 2 self-report measures were the most popular followed by Stream 3 mixed model measures. None of the studies we surveyed used the Stream 1 approach. Findings nonetheless indicated that emotional intelligence was important in maintaining physical and psychological well-being. We concluded that developing emotional intelligence should be a useful adjunct to improve academic and clinical performance and to reduce the risk of emotional distress during clinical placement experiences. We call for more consistency in the use of emotional intelligence tests as a means to create an empirical evidence base in the field of nurse education. Copyright © 2017 Elsevier Ltd. All rights reserved.
Judith U. Cope
Full Text Available Background. Ewing sarcoma family of tumors (ESFT are rare but deadly cancers of unknown etiology. Few risk factors have been identified. This study was undertaken to ascertain any possible association between exposure to therapeutic drugs and ESFT. Methods. This is a retrospective, descriptive study. A query of the FDA Adverse Event Reporting System (FAERS was conducted for all reports of ESFT, January 1, 1998, through December 31, 2013. Report narratives were individually reviewed for patient characteristics, underlying conditions and drug exposures. Results. Over 16 years, 134 ESFT reports were identified, including 25 cases of ESFT following therapeutic drugs and biologics including immunosuppressive agents and hormones. Many cases were confounded by concomitant medications and other therapies. Conclusions. This study provides a closer look at medication use and underlying disorders in patients who later developed ESFT. While this study was not designed to demonstrate any clear causative association between ESFT and prior use of a single product or drug class, many drugs were used to treat immune-related disease and growth or hormonal disturbances. Further studies may be warranted to better understand possible immune or neuroendocrine abnormalities or exposure to specific classes of drugs that may predispose to the later development of ESFT.
Cashman, Patrick; Macartney, Kristine; Khandaker, Gulam; King, Catherine; Gold, Michael; Durrheim, David N
The importance of active, participant-centred monitoring of adverse events following immunisation (AEFI) is increasingly recognised as a valuable adjunct to traditional passive AEFI surveillance. The databases OVID Medline and OVID Embase were searched to identify all published articles referring to AEFI. Only studies which sought participant response after vaccination were included. A total of 6060 articles published since the year 2000 were identified. After the application of screening inclusion and exclusion criteria, 25 articles describing 23 post-marketing AEFI systems were identified. Most countries had a single system: Ghana, Japan, China, Korea, Netherlands, Singapore, Brazil, Cambodia, Sri Lanka, Turkey and Cameroon except the USA (2), Canada (4) and Australia (6). Data were collected from participants with and without AEFI in all studies reviewed with denominator data enabling AEFI rate calculations. All studies considered either a single vaccine or specified vaccines or were time limited except one Australian system, which provides continuous automated participant-centred active surveillance of all vaccines. Post-marketing surveillance systems using solicited patient feedback are emerging as a novel AEFI monitoring tool. A number of exploratory systems utilising e-technology have been developed and their potential for scaling up and application in low and middle income countries deserves further investigation. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
Full Text Available This article reviews the findings of event-related potentials (ERP in Parkinson's disease (PD published during the last 10 years. Basic principles and methods of ERP are briefly presented with particular regard to the auditory “odd-ball” paradigm almost uniquely employed for the ERP assessment in PD to date. The results of respective studies are overviewed and discussed with respect to three main axes: (1 The slowing down of cognitive processing in PD is reflected by the delays of N2 and P3 components of ERP which are more important in demented than in non-demented patients. The Nl component is delayed in demented patients with PD as well as in other dementias of presumed subcortical origin. (2 Various neuropsychological deficits observed in PD correlate with the delays of ERP evoking the implication of common subcortico-cortical cerebral mechanisms. (3 The variations of ERP under dopaminergic manipulation suggest conflicting effects of levodopa treatment on cognition, at least in certain categories of PD patients. These findings are discussed in the light of current knowledge on neurotransmitter brain systems and some hypothetic explanations are proposed. Finally, an attempt is made to outline further perspectives of clinical and research utilization of ERP in Parkinson's disease.
Chokshi, N.C.; Srinivasan, M.; Kupperman, D.S.; Krishnaswamy, P.
In response to the vessel head event at the Davis-Besse reactor, the U.S. Nuclear Regulatory Commission (NRC) formed a Lessons Learned Task Force (LLTF). Four action plans were formulated to respond to the recommendations of the LLTF. The action plans involved efforts on barrier integrity, stress corrosion cracking (SCC), operating experience, and inspection and program management. One part of the action plan on barrier integrity was an assessment to identify potential safety benefits from changes in requirements pertaining to leakage in the reactor coolant system (RCS). In this effort, experiments and models were reviewed to identify correlations between crack size, crack-tip-opening displacement (CTOD), and leak rate in the RCS. Sensitivity studies using the Seepage Quantification of Upsets In Reactor Tubes (SQUIRT) code were carried out to correlate crack parameters, such as crack size, with leak rate for various types of crack configurations in RCS components. A database that identifies the leakage source, leakage rate, and resulting actions from RCS leaks discovered in U.S. light water reactors was developed. Humidity monitoring systems for detecting leakage and acoustic emission crack monitoring systems for the detection of crack initiation and growth before a leak occurs were also considered. New approaches to the detection of a leak in the reactor head region by monitoring boric-acid aerosols were also considered. (authors)
Dietrich, Isa; Braga, Gustavo Arruda; de Melo, Fernanda Gomes; da Costa Silva Silva, Ana Carolina Calmon
This article reviewed very recent papers (2016) discussing or bringing clinical evidences of the possible common pathways leading to diabetic foot syndrome (DFS) and increased mortality rates. Diabetic patients with diabetic foot syndrome have a mortality rate greater than twofold when compared with non-ulcerated diabetics. In addition, the 5-year mortality rate following amputation is estimated at 39-68%, a life expectancy comparable to aggressive types of cancer or advanced congestive heart failure. The majority of patients with diabetic foot ulcer also present insulin resistance, central obesity, dyslipidemia, and hypertension that characterize the metabolic syndrome that, in turn, is associated with an elevated risk of major cardiovascular events. Sensory neuropathy is the primary cause of more the 60% of diabetic foot ulcer. Diabetic peripheral neuropathy is a microvascular complication of diabetes mellitus and in type 2 diabetes, not only hyperglycemia but also other metabolic alterations and persistent inflammatory status due to adiposity play a major role in axon injury. Elevated triglycerides have been showed to be an independent risk factor for lower extremity amputation in diabetic patients. Also, toxic adiposity, oxidative stress, mitochondrial dysfunction, activation of the polyol pathway, accumulation of advanced glycation end products (AGEs), and elevation of inflammatory markers are also implicated in diabetic vascular disease and neuropathy. The hypotheses that the association between DFS and increased rates of mortality reflects the progression of micro- and macrovascular complications are reinforced by the additional association of DFU to renal failure and retinopathy.
Title: The quantitative analysis of e team game performance made by men basketball teams at Olympis games 2008 Aims: Find reason successes and failures of teams in Olympis game play-off using quantitative (numerical) observation of selected game statistics. Method: The thesis was made on the basic a quantitative (numerical) observation of videorecordings using KVANTÝM. Results: Obtained selected statistic desribed the most essentials events for team winning or loss. Keywords: basketball, team...
Hernandez, H.; Gasca, C.; Beltran, F.; Salvat, M.; Pifarre, D.; Canadell, F.; Aleman, A.
Within the process of maintaining and updating the risk analysis of CN Vandellos II, results from the review of the study of vulnerability of the plant against severe accidents caused by external events (Individual Plant Examination on Extornal Events, IPEEE).
Beauchamp, Mark R; McEwan, Desmond; Waldhauser, Katrina J
Team building has been identified as an important method of improving the psychological climate in which teams operate, as well as overall team functioning. Within the context of sports, team building interventions have consistently been found to result in improvements in team effectiveness. In this paper we review the extant literature on team building in sport, and address a range of conceptual, methodological, and applied considerations that have the potential to advance theory, research, and applied intervention initiatives within the field. This involves expanding the scope of team building strategies that have, to date, primarily focused on developing group cohesion. Copyright © 2017 Elsevier Ltd. All rights reserved.
Goparaju Purna Sudhakar
Full Text Available This paper gives an exhaustive literature review of the techniques and models available tomeasure the productivity of software development teams. Definition of productivity, measuringindividual programmer’s productivity, and measuring software development team productivity arediscussed. Based on the literature review it was found that software productivity measurement canbe done using SLOC (Source Lines of Code, function points, use case points, object points, andfeature points. Secondary research findings indicate that the team size, response time, taskcomplexity, team climate and team cohesion have an impact on software development teamproductivity. List of factors affecting the software development team productivity are studied andreviewed.
Wood, Richard M.; Bauer, Steven X. S.; Hunter, Craig A.
A review of the linkage between knowledge, creativity, and design is presented and related to the best practices of multidisciplinary design teams. The discussion related to design and design teams is presented in the context of both the complete aerodynamic design community and specifically the work environment at the NASA Langley Research Center. To explore ways to introduce knowledge and creativity into the research and design environment at NASA Langley Research Center a creative design activity was executed within the context of a national product development activity. The success of the creative design team activity gave rise to a need to communicate the experience in a straightforward and managed approach. As a result the concept of creative potential its formulated and assessed with a survey of a small portion of the aeronautics research staff at NASA Langley Research Center. The final section of the paper provides recommendations for future creative organizations and work environments.
Grace I. Davies
Full Text Available Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia.
Davies, Grace I; McIver, Lachlan; Kim, Yoonhee; Hashizume, Masahiro; Iddings, Steven; Chan, Vibol
Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia.
Cortese, Samuele; Holtmann, Martin; Banaschewski, Tobias; Buitelaar, Jan; Coghill, David; Danckaerts, Marina; Dittmann, Ralf W.; Graham, John; Taylor, Eric; Sergeant, Joseph
Background: Medication is an important element of therapeutic strategies for ADHD. While medications for ADHD are generally well-tolerated, there are common, although less severe, as well as rare but severe adverse events AEs during treatment with ADHD drugs. The aim of this review is to provide
Thomas, Kyla H; Martin, Richard M; Knipe, Duleeka W; Higgins, Julian P T; Gunnell, David
To determine the risk of neuropsychiatric adverse events associated with use of varenicline compared with placebo in randomised controlled trials. Systematic review and meta-analysis comparing study effects using two summary estimates in fixed effects models, risk differences, and Peto odds ratios. Medline, Embase, PsycINFO, the Cochrane Central Register of Controlled Trials (CENTRAL), and clinicaltrials.gov. Randomised controlled trials with a placebo comparison group that reported on neuropsychiatric adverse events (depression, suicidal ideation, suicide attempt, suicide, insomnia, sleep disorders, abnormal dreams, somnolence, fatigue, anxiety) and death. Studies that did not involve human participants, did not use the maximum recommended dose of varenicline (1 mg twice daily), and were cross over trials were excluded. In the 39 randomised controlled trials (10,761 participants), there was no evidence of an increased risk of suicide or attempted suicide (odds ratio 1.67, 95% confidence interval 0.33 to 8.57), suicidal ideation (0.58, 0.28 to 1.20), depression (0.96, 0.75 to 1.22), irritability (0.98, 0.81 to 1.17), aggression (0.91, 0.52 to 1.59), or death (1.05, 0.47 to 2.38) in the varenicline users compared with placebo users. Varenicline was associated with an increased risk of sleep disorders (1.63, 1.29 to 2.07), insomnia (1.56, 1.36 to 1.78), abnormal dreams (2.38, 2.05 to 2.77), and fatigue (1.28, 1.06 to 1.55) but a reduced risk of anxiety (0.75, 0.61 to 0.93). Similar findings were observed when risk differences were reported. There was no evidence for a variation in depression and suicidal ideation by age group, sex, ethnicity, smoking status, presence or absence of psychiatric illness, and type of study sponsor (that is, pharmaceutical industry or other). This meta-analysis found no evidence of an increased risk of suicide or attempted suicide, suicidal ideation, depression, or death with varenicline. These findings provide some reassurance for users
Annual or biannual reviews of the operating history of the Advanced Test Reactor (ATR) at the Idaho National Engineering Laboratory (INEL) have been conducted for the purpose of reviewing and updating the ATR probabilistic safety assessment (PSA) for operating events and operating experience since the first compilation of plant- specific experience data for the ATR PSA which included data for operation from initial power operation in 1969 through 1988. This technical paper briefly discusses the means and some results of these periodic reviews of operating experience and their influence on the ATR PSA
Momsen, A.-M.; Nielsen, C.V.; Rasmussen, J.O.
Objectives: To systematically investigate current scientific evidence about the effectiveness of multidisciplinary team rehabilitation for different health problems. Data sources: A comprehensive literature search was conducted in Cochrane, Medline, DARE, Embase, and Cinahl databases, and research...... for adults, without restrictions in terms of study population or outcomes. The most recent reviews examining a study population were selected. Data extraction: Two reviewers independently extracted information about study populations, sample sizes, study designs, rehabilitation settings, the team...
Thomas, Roger E; Lorenzetti, Diane L; Spragins, Wendy; Jackson, Dave; Williamson, Tyler
To identify the rate of serious adverse events attributable to yellow fever vaccination with 17D and 17DD strains reported in active and passive surveillance data. We conducted a systematic review of published literature on adverse events associated with yellow fever. We searched 9 electronic databases for peer reviewed and grey literature in all languages. There were no restrictions on date of publication. Reference lists of key studies were also reviewed to identify additional studies. We identified 66 relevant studies: 24 used active, 17 a combination of passive and active (15 of which were pharmacovigilance databases), and 25 passive surveillance. ACTIVE SURVEILLANCE: A total of 2,660,929 patients in general populations were followed for adverse events after vaccination, heavily weighted (97.7%) by one large Brazilian study. There were no observed cases of viscerotropic or neurotropic disease, one of anaphylaxis and 26 cases of urticaria (hypersensitivity). We also identified four studies of infants and children (n=2199), four studies of women (n=1334), and one study of 174 HIV+, and no serious adverse events were observed. PHARMACOVIGILANCE DATABASES: 10 of the 15 databases contributed data to this review, with 107,621,154 patients, heavily weighted (94%) by the Brazilian database. The estimates for Australia were low at 0/210,656 for "severe neurological disease" and 1/210,656 for YEL-AVD, and also low for Brazil with 9 hypersensitivity events, 0.23 anaphylactic shock events, 0.84 neurologic syndrome events and 0.19 viscerotropic events cases/million doses. The five analyses of partly overlapping periods for the US VAERS database provided an estimate of 6.6 YEL-AVD and YEL-AND cases per million, and estimates between 11.1 and 15.6 of overall "serious adverse events" per million. The estimates for the UK were higher at 34 "serious adverse events" and also for Switzerland with 14.6 "neurologic events" and 40 "serious events not neurological"/million doses
The purpose of this task is to support asteroid research and the operation of an Asteroid Team within the Earth and Space Sciences Division at the Jet Propulsion Laboratory (JPL). The Asteroid Team carries out original research on asteroids in order to discover, better characterize and define asteroid properties. This information is needed for the planning and design of NASA asteroid flyby and rendezvous missions. The asteroid Team also provides scientific and technical advice to NASA and JPL on asteroid related programs. Work on asteroid classification continued and the discovery of two Earth-approaching M asteroids was published. In the asteroid photometry program researchers obtained N or Q photometry for more than 50 asteroids, including the two M-earth-crossers. Compositional analysis of infrared spectra (0.8 to 2.6 micrometer) of asteroids is continuing. Over the next year the work on asteroid classification and composition will continue with the analysis of the 60 reduced infrared spectra which we now have at hand. The radiometry program will continue with the reduction of the N and Q bandpass data for the 57 asteroids in order to obtain albedos and diameters. This year the emphasis will shift to IRAS follow-up observations; which includes objects not observed by IRAS and objects with poor or peculiar IRAS data. As in previous year, we plan to give top priority to any opportunities for observing near-Earth asteroids and the support (through radiometric lightcurve observations from the IRTF) of any stellar occultations by asteroids for which occultation observation expeditions are fielded. Support of preparing of IRAS data for publication and of D. Matson for his participation in the NASA Planetary Astronomy Management and Operations Working Group will continue
Matson, D. L.
The purpose of this task is to support asteroid research and the operation of an Asteroid Team within the Earth and Space Sciences Division at the Jet Propulsion Laboratory (JPL). The Asteroid Team carries out original research on asteroids in order to discover, better characterize and define asteroid properties. This information is needed for the planning and design of NASA asteroid flyby and rendezvous missions. The asteroid Team also provides scientific and technical advice to NASA and JPL on asteroid related programs. Work on asteroid classification continued and the discovery of two Earth-approaching M asteroids was published. In the asteroid photometry program researchers obtained N or Q photometry for more than 50 asteroids, including the two M-earth-crossers. Compositional analysis of infrared spectra (0.8 to 2.6 micrometer) of asteroids is continuing. Over the next year the work on asteroid classification and composition will continue with the analysis of the 60 reduced infrared spectra which we now have at hand. The radiometry program will continue with the reduction of the N and Q bandpass data for the 57 asteroids in order to obtain albedos and diameters. This year the emphasis will shift to IRAS follow-up observations; which includes objects not observed by IRAS and objects with poor or peculiar IRAS data. As in previous year, we plan to give top priority to any opportunities for observing near-Earth asteroids and the support (through radiometric lightcurve observations from the IRTF) of any stellar occultations by asteroids for which occultation observation expeditions are fielded. Support of preparing of IRAS data for publication and of D. Matson for his participation in the NASA Planetary Astronomy Management and Operations Working Group will continue.
Full Text Available Hamstring strain and anterior cruciate ligament injuries are, respectively, the most prevalent and serious non-contact occurring injuries in team sports. Specific biomechanical and neuromuscular variables have been used to estimate the risk of incurring a non-contact injury in athletes.The aim of this study was to systematically review the evidences for the effectiveness of injury prevention protocols to modify biomechanical and neuromuscular anterior cruciate and/or hamstring injuries associated risk factors in uninjured team sport athletes.PubMed, Science Direct, Web of Science, Cochrane Libraries, U.S. National Institutes of Health clinicaltrials.gov, Sport Discuss and Google Scholar databases were searched for relevant journal articles published until March 2015. A manual review of relevant articles, authors, and journals, including bibliographies was performed from identified articles.Nineteen studies were included in this review. Four assessment categories: i landing, ii side cutting, iii stop-jump, and iv muscle strength outcomes, were used to analyze the effectiveness of the preventive protocols. Eight studies using multifaceted interventions supported by video and/or technical feedback showed improvement in landing and/or stop-jump biomechanics, while no effects were observed on side-cutting maneuver. Additionally, multifaceted programs including hamstring eccentric exercises increased hamstring strength, hamstring to quadriceps functional ratio and/or promoted a shift of optimal knee flexion peak torque toward a more open angle position.Multifaceted programs, supported by proper video and/or technical feedback, including eccentric hamstring exercises would positively modify the biomechanical and or neuromuscular anterior cruciate and/or hamstring injury risk factors.
Monajati, Alireza; Larumbe-Zabala, Eneko; Goss-Sampson, Mark; Naclerio, Fernando
Hamstring strain and anterior cruciate ligament injuries are, respectively, the most prevalent and serious non-contact occurring injuries in team sports. Specific biomechanical and neuromuscular variables have been used to estimate the risk of incurring a non-contact injury in athletes. The aim of this study was to systematically review the evidences for the effectiveness of injury prevention protocols to modify biomechanical and neuromuscular anterior cruciate and/or hamstring injuries associated risk factors in uninjured team sport athletes. PubMed, Science Direct, Web of Science, Cochrane Libraries, U.S. National Institutes of Health clinicaltrials.gov, Sport Discuss and Google Scholar databases were searched for relevant journal articles published until March 2015. A manual review of relevant articles, authors, and journals, including bibliographies was performed from identified articles. Nineteen studies were included in this review. Four assessment categories: i) landing, ii) side cutting, iii) stop-jump, and iv) muscle strength outcomes, were used to analyze the effectiveness of the preventive protocols. Eight studies using multifaceted interventions supported by video and/or technical feedback showed improvement in landing and/or stop-jump biomechanics, while no effects were observed on side-cutting maneuver. Additionally, multifaceted programs including hamstring eccentric exercises increased hamstring strength, hamstring to quadriceps functional ratio and/or promoted a shift of optimal knee flexion peak torque toward a more open angle position. Multifaceted programs, supported by proper video and/or technical feedback, including eccentric hamstring exercises would positively modify the biomechanical and or neuromuscular anterior cruciate and/or hamstring injury risk factors.
McQueen, Carl; Crombie, Nicholas; Hulme, Jonathan; Cormack, Stef; Hussain, Nageena; Ludwig, Frank; Wheaton, Steve
In the West Midlands region of the UK, delivery of pre-hospital care has been remodelled through introduction of a 24 h Medical Emergency Response Incident Team (MERIT). Teams including physicians and critical care paramedics (CCP) are deployed to incidents on land-based and helicopter-based platforms. Clinical practice, including delivery of rapid sequence induction of anaesthesia (RSI), is underpinned by standard operating procedures (SOP). This study describes the first 12 months experience of prehospital RSI in the MERIT scheme in the West Midlands. Retrospective review of the MERIT clinical database for the 12 months following the launch of the scheme. Data was collected relating to the number of RSIs performed; indication for RSI; number of intubation attempts; grade of view on laryngoscopy and the base speciality/grade of the operator performing intubation. MERIT teams were activated 1619 times, attending scene in 1029 cases. RSI was performed 142 times (13.80% of scene attendances). There was one recorded case of failure to intubate requiring insertion of a supraglottic airway device (0.70%). In over a third of RSI cases, CCPs performed laryngoscopy and intubation (n=53, 37.32%). Proficiency of obtaining Grade I view at laryngoscopy was similar for physicians (74.70%) and CCPs (77.36%). Intubation was successful at the first attempt in over 90% of cases. This study demonstrates that operation within a system that provides high levels of exposure, underpinned by comprehensive and robust training and governance frameworks, promotes levels of performance in successful prehospital RSI regardless of base speciality or profession. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Denise J. Stokholm, Marianne
Future wellbeing is depending on human competences in order to strengthen a sustainable development. This requires system thinking and ability to deal with complexity, dynamic and a vast of information. `We need to move away from present principles of breaking down problems into components and gi...... thinking and communication in design. Trying to answer the question: How can visual system models facilitate learning in design thinking and team designing?......Future wellbeing is depending on human competences in order to strengthen a sustainable development. This requires system thinking and ability to deal with complexity, dynamic and a vast of information. `We need to move away from present principles of breaking down problems into components and give...... in relation to a design-engineering education at Aalborg University. It will exemplify how the model has been used in workshops on team designing, challenged design learning and affected design competence. In specific it will investigate the influence of visual models of the perception of design, design...
Cziraki, Karen; Lucas, Janie; Rogers, Toni; Page, Laura; Zimmerman, Rosanne; Hauer, Lois Ann; Daniels, Charlotte; Gregoroff, Susan
Rapid response teams (RRT) are an important safety strategy in the prevention of deaths in patients who are progressively failing outside of the intensive care unit. The goal is to intervene before a critical event occurs. Effective teamwork and communication skills are frequently cited as critical success factors in the implementation of these teams. However, there is very little literature that clearly provides an education strategy for the development of these skills. Training in simulation labs offers an opportunity to assess and build on current team skills; however, this approach does not address how to meet the gaps in team communication and relationship skill management. At Hamilton Health Sciences (HHS) a two-day program was developed in collaboration with the RRT Team Leads, Organizational Effectiveness and Patient Safety Leaders. Participants reflected on their conflict management styles and considered how their personality traits may contribute to team function. Communication and relationship theories were reviewed and applied in simulated sessions in the relative safety of off-site team sessions. The overwhelming positive response to this training has been demonstrated in the incredible success of these teams from the perspective of the satisfaction surveys of the care units that call the team, and in the multi-phased team evaluation of their application to practice. These sessions offer a useful approach to the development of the soft skills required for successful RRT implementation.
Apparent Life-Threatening Events (ALTEs) are a common presentation to paediatric hospitals and represent a significant cause of parental anxiety. Basic Life Support (BLS) training is recommended for all caregivers following ALTEs. This study aimed to assess the rate of caregiver BLS training and reviewed parents experience following discharge. Parents were interviewed by phone following discharge. Over the study period 25 children attended the Emergency Department with ALTE, 17\\/25 (68%) were trained and 13\\/17 (76%) were contactable for interview. All parents found training decreased their anxiety level and were interested in attending for re-training. BLS resuscitation was subsequently required by 2\\/13 (15%) of children. Non-medical grade monitors were in use by 10\\/13 (77%) of caregivers following discharge. Caregivers are eager to engage in BLS training and it effectively reduces their caregiver anxiety. We recommend an increase in instructor staff and use of group re-training post discharge
Macken, W L; Clarke, N; Nadeem, M; Coghlan, D
Apparent Life-Threatening Events (ALTEs) are a common presentation to paediatric hospitals and represent a significant cause of parental anxiety. Basic Life Support (BLS) training is recommended for all caregivers following ALTEs. This study aimed to assess the rate of caregiver BLS training and reviewed parents experience following discharge. Parents were interviewed by phone following discharge. Over the study period 25 children attended the Emergency Department with ALTE, 17/25 (68%) were trained and 13/17 (76%) were contactable for interview. All parents found training decreased their anxiety level and were interested in attending for re-training. BLS resuscitation was subsequently required by 2/13 (15%) of children. Non-medical grade monitors were in use by 10/13 (77%) of caregivers following discharge. Caregivers are eager to engage in BLS training and it effectively reduces their caregiver anxiety. We recommend an increase in instructor staff and use of group re-training post discharge.
Williams, Geraint; O'Malley, Michael; Nocera, Antony
The capacity for surgical teams to ensure their own safety when dealing with the consequences caused by the detonation of a radiological dirty bomb is primarily determined by prior knowledge, familiarity and training for this type of event. This review article defines the associated radiological terminology with an emphasis on the personal safety of surgical team members in respect to the principles of radiological protection. The article also describes a technique for use of hand held radiation monitors and will discuss the identification and management of radiologically contaminated patients who may pose a significant danger to the surgical team. 2010 Elsevier Ltd. All rights reserved.
Amaral, André Carlos Kajdacsy-Balla; Shojania, Kaveh G
Adverse events affect approximately 3% to 12% of hospitalized patients. At least a third, but as many as half, of such events are considered preventable. Detection of these events requires investments of time and money. A report in a recent issue of Critical Care used the medical emergency team activation as a trigger to perform a prospective standardized evaluation of charts. The authors observed that roughly one fourth of calls were related to a preventable adverse event, which is comparable to the previous literature. However, while previous studies relied on retrospective chart reviews, this study introduced the novel element of real-time characterization of events by the team at the moment of consultation. This methodology captures important opportunities for improvements in local care at a rate far higher than routine incident-reporting systems, but without requiring substantial investments of additional resources. Academic centers are increasingly recognizing engagement in quality improvement as a distinct career pathway. Involving such physicians in medical emergency teams will likely facilitate the dual roles of these as a clinical outreach arm of the intensive care unit and in identifying problems in care and leading to strategies to reduce them.
Trentzsch, H; Urban, B; Sandmeyer, B; Hammer, T; Strohm, P C; Lazarovici, M
Patient safety became paramount in medicine as well as in emergency medicine after it was recognized that preventable, adverse events significantly contributed to morbidity and mortality during hospital stay. The underlying errors cannot usually be explained by medical technical inadequacies only but are more due to difficulties in the transition of theoretical knowledge into tasks under the conditions of clinical reality. Crew Resource Management and Human Factors which determine safety and efficiency of humans in complex situations are suitable to control such sources of error. Simulation significantly improved safety in high reliability organizations, such as the aerospace industry.Thus, simulator-based team training has also been proposed for medical areas. As such training is consuming in cost, time and human resources, the question of the cost-benefit ratio obviously arises. This review outlines the effects of simulator-based team training on patient safety. Such course formats are not only capable of creating awareness and improvements in safety culture but also improve technical team performance and emphasize team performance as a clinical competence. A few studies even indicated improvement of patient-centered outcome, such as a reduced rate of adverse events but further studies are required in this respect. In summary, simulator-based team training should be accepted as a suitable strategy to improve patient safety.
Napier, Bruce A.
This article is a book review of a report from the International Atomic Energy Agency that was prepared by a team of scientists from Belarus, the Russian Federation, and Ukraine as an assessment of radiological contamination of the Dnieper River, which flows through these three countries. The topics covered begin with radioactive sources (actual and potential) including areas affected by the Chernobyl nuclear accident, nuclear power plants along the river and its tributaries, uranium mining and ore processing, radioactive waste storage and disposal sites, and non-power sources, such as medicine, industry, and research. The report continues with an assessment of human exposures to radiation from these sources. An additional area of consideration is radiological 'hot spots' in the region. The report finishes with conclusions and recommendations to the regional governments for a strategic action plan and individual government national plans.
Full Text Available This article reviews event-related potentials (ERPs the minute responses of the human brain that are elicited by external auditory stimuli and how the ERPs can be used to measure sleep disturbance. ERPs consist of a series of negative- and positive-going components. A negative component peaking at about 100 ms, N1, is thought to reflect the outcome of a transient detector system, activated by change in the transient energy in an acoustic stimulus. Its output and thus the amplitude of N1 increases as the intensity level of the stimulus is increased and when the rate of presentation is slowed. When the output reaches a certain critical level, operations of the central executive are interrupted and attention is switched to the auditory channel. This switching of attention is thought to be indexed by a later positivity, P3a, peaking between 250 and 300 ms. In order to sleep, consciousness for all but the most relevant of stimuli must be prevented. Thus, during sleep onset and definitive non-rapid eye movement (NREM sleep, the amplitude of N1 diminishes to near-baseline level. The amplitude of P2, peaking from 180 to 200 ms, is however larger in NREM sleep than in wakefulness. P2 is thought to reflect an inhibitory process protecting sleep from irrelevant disturbance. As stimulus input becomes increasingly obtrusive, the amplitude of P2 also increases. With increasing obtrusiveness particularly when stimuli are presented slowly, a later large negativity, peaking at about 350 ms, N350, becomes apparent. N350 is unique to sleep, its amplitude also increasing as the stimulus becomes more obtrusive. Many authors postulate that when the N350 reaches a critical amplitude, a very large amplitude N550, a component of the K-Complex is elicited. The K-Complex can only be elicited during NREM sleep. The P2, N350 and N550 processes are thus conceived as sleep protective mechanisms, activated sequentially as the risk for disturbance increases. During REM sleep
Pillay, Brindha; Wootten, Addie C; Crowe, Helen; Corcoran, Niall; Tran, Ben; Bowden, Patrick; Crowe, Jane; Costello, Anthony J
Conducting regular multidisciplinary team (MDT) meetings requires significant investment of time and finances. It is thus important to assess the empirical benefits of such practice. A systematic review was conducted to evaluate the literature regarding the impact of MDT meetings on patient assessment, management and outcomes in oncology settings. Relevant studies were identified by searching OVID MEDLINE, PsycINFO, and EMBASE databases from 1995 to April 2015, using the keywords: multidisciplinary team meeting* OR multidisciplinary discussion* OR multidisciplinary conference* OR case review meeting* OR multidisciplinary care forum* OR multidisciplinary tumour board* OR case conference* OR case discussion* AND oncology OR cancer. Studies were included if they assessed measurable outcomes, and used a comparison group and/or a pre- and post-test design. Twenty-seven articles met inclusion criteria. There was limited evidence for improved survival outcomes of patients discussed at MDT meetings. Between 4% and 45% of patients discussed at MDT meetings experienced changes in diagnostic reports following the meeting. Patients discussed at MDT meetings were more likely to receive more accurate and complete pre-operative staging, and neo-adjuvant/adjuvant treatment. Quality of studies was affected by selection bias and the use of historical cohorts impacted study quality. MDT meetings impact upon patient assessment and management practices. However, there was little evidence indicating that MDT meetings resulted in improvements in clinical outcomes. Future research should assess the impact of MDT meetings on patient satisfaction and quality of life, as well as, rates of cross-referral between disciplines. Copyright © 2015 Elsevier Ltd. All rights reserved.
Hakkarainen, Katja Marja; Andersson Sundell, Karolina; Petzold, Max; Hägg, Staffan
Preventable adverse drug events (ADEs) are common in both outpatient and inpatient settings. However, the proportion of preventable ADEs varies considerably in different studies, even when conducted in the same setting, and methods for assessing the preventability of ADEs are diverse. The aim of this article is to identify and systematically evaluate methods for assessing the preventability of ADEs. Seven databases (Cochrane, CINAHL, EMBASE, IPA, MEDLINE, PsycINFO and Web of Science) were searched in September 2010 utilizing the databases' index terms and other common terminology on preventable ADEs. No limits for the years of publication were set. Reference lists of included original articles and relevant review articles were also screened. After applying predetermined inclusion and exclusion criteria on 4161 unique citations, 142 (3.4%) original research articles were included in the review. One additional article was included from reference lists. Outcome measures of included studies had to include the frequency of ADEs and the assessment of their preventability. Studies were excluded if they focused on individuals with one specific type of treatment, medical condition, medical procedure or ADE. Measurement instruments for determining the preventability of ADEs in each article were extracted and unique instruments were compared. The process of assessing the preventability of ADEs was described based on reported actions taken to standardize and conduct the assessment, and on information about the reliability and validity of the assessment. Eighteen unique instruments for determining the preventability of ADEs were identified. They fell under the following four groups: (i) instruments using a definition of preventability only (n = 3); (ii) instruments with a definition of preventability and an assessment scale for determining preventability (n = 5); (iii) instruments with specific criteria for each preventability category (n = 3); and (iv) instruments
Budnitz, R.J.; Smith, P.
Within the scope of the TC Project RER/9/035, a review mission visited Ljubljana, Slovenia, 19-23 February 1996. Two outside experts, Messrs. R.J. Budnitz (USA) and Paul Smith (USA), as well as a staff member, A. Guerpinar (ESS-NSNI) took part in the review. The purpose of the mission was to assist the Slovenian Nuclear Safety Administration to review the external events PSA prepared by Krsko NPP consultants Westinghouse Energy Systems Europe and EQE International. Another seismic safety review was performed concurrently in Ljubljana involving the investigations in relation to the tectonic stability and reassessment of the design basis ground motion characterization for the Krsko NPP site
Olson, Joel D.; Ringhand, Darlene G.; Kalinski, Ray C.; Ziegler, James G.
What is the best way to assign graduate business students to online team-based projects? Team assignments are frequently made on the basis of alphabet, time zones or previous performance. This study reviews personality as an indicator of student online team performance. The personality assessment IDE (Insights Discovery Evaluator) was administered…
ultimately on the performance of the teams on the playing field and not so much ... However, travelling with a football team presents the team physician .... physician to determine the nutritional ..... diarrhoea in elite athletes: an audit of one team.
Sterrett, Emily C; Myer, Charles M; Oehler, Jennifer; Das, Bobby; Kerrey, Benjamin T
Objective Study the performance of a pediatric critical airway response team. Study Design Case series with chart review. Setting Freestanding academic children's hospital. Subjects and Methods A structured review of the electronic medical record was conducted for all activations of the critical airway team. Characteristics of the activations and patients are reported using descriptive statistics. Activation of the critical airway team occurred 196 times in 46 months (March 2012 to December 2015); complete data were available for 162 activations (83%). For 49 activations (30%), patients had diagnoses associated with difficult intubation; 45 (28%) had a history of difficult laryngoscopy. Results Activation occurred at least 4 times per month on average (vs 3 per month for hospital-wide codes). The most common reasons for team activation were anticipated difficult intubation (45%) or failed intubation attempt (20%). For 79% of activations, the team performed an airway procedure, most commonly direct laryngoscopy and tracheal intubation. Bronchoscopy was performed in 47% of activations. Surgical airway rescue was attempted 4 times. Cardiopulmonary resuscitation occurred in 41 activations (25%). Twenty-nine patients died during or following team activation (18%), including 10 deaths associated with the critical airway event. Conclusion Critical airway team activation occurred at least once per week on average. Direct laryngoscopy, tracheal intubation, and bronchoscopic procedures were performed frequently; surgical airway rescue was rare. Most patients had existing risk factors for difficult intubation. Given our rate of serious morbidity and mortality, primary prevention of critical airway events will be a focus of future efforts.
Wohlfeil, Markus; Whelan, Susan
As a result of significant changes in their marketing environments and in consumer behaviour, marketers are confronted with the decreasing effectiveness of their classic marketing communications (Kroeber-Riel 1984) and, consequently, in need of new ways to position their brands in consumers’ minds. Because nothing is more convincing than personal experiences (Nickel 1998), event-marketing creates new brand-related realities by staging marketing-events with which consumers interact. This would...
Sasou Kunihide; Ebisu, Mitsuhiro; Hirose, Ayako
Several studies have been done to evaluate or improve team performance in nuclear and aviation industries. Crew resource management is the typical example. In addition, team evaluation recently gathers interests in other teams of lawyers, medical staff, accountants, psychiatrics, executive, etc. However, the most evaluation methods focus on the results of team behavior that can be observed through training or actual business situations. What is expected team is not only resolving problems but also training younger members being destined to lead the next generation. Therefore, the authors set the final goal of this study establishing a series of methods to evaluate and improve teams inclusively such as decision making, motivation, staffing, etc. As the first step, this study develops team process model describing viewpoints for the evaluation. The team process is defined as some kinds of power that activate or inactivate competency of individuals that is the components of team's competency. To find the team process, the authors discussed the merits of team behavior with the experienced training instructors and shift supervisors of nuclear/thermal power plants. The discussion finds four team merits and many components to realize those team merits. Classifying those components into eight groups of team processes such as 'Orientation', 'Decision Making', 'Power and Responsibility', 'Workload Management', 'Professional Trust', 'Motivation', 'Training' and 'staffing', the authors propose Team Process Model with two to four sub processes in each team process. In the future, the authors will develop methods to evaluate some of the team processes for nuclear/thermal power plant operation teams. (author)
O'Hanlon, Claire E; Newberry, Sydne J; Booth, Marika; Grant, Sean; Motala, Aneesa; Maglione, Margaret A; FitzGerald, John D; Shekelle, Paul G
The prevalence of knee osteoarthritis (OA)/degenerative joint disease (DJD) is increasing in the USA. Systematic reviews of treatment efficacy and adverse events (AEs) of hyaluronic acid (HA) injections report conflicting evidence about the balance of benefits and harms. We review evidence on efficacy and AEs of intraarticular viscosupplementation with HA in older individuals with knee osteoarthritis and account for differences in these conclusions from another systematic review. We searched PubMed and eight other databases and gray literature sources from 1990 to December 12, 2014. Double-blind placebo-controlled randomized controlled trials (RCTs) reporting functional outcomes or quality-of-life; RCTs and observational studies on delay/avoidance of arthroplasty; RCTs, case reports, and large cohort studies and case series assessing safety; and systematic reviews reporting on knee pain were considered for inclusion. A standardized, pre-defined protocol was applied by two independent reviewers to screen titles and abstracts, review full text, and extract details on study design, interventions, outcomes, and quality. We compared our results with those of a prior systematic review and found them to be discrepant; our analysis of why this discrepancy occurred is the focus of this manuscript. Eighteen RCTs reported functional outcomes: pooled analysis of ten placebo-controlled, blinded trials showed a standardized mean difference of -0.23 (95 % confidence interval (CI) -0.45 to -0.01) favoring HA at 6 months. Studies reported few serious adverse events (SAEs) and no significant differences in non-serious adverse events (NSAEs) (relative risk (RR) [95 % CI] 1.03 [0.93-1.15] or SAEs (RR [95 % CI] 1.39 [0.78-2.47]). A recent prior systematic review reported similar functional outcomes, but significant SAE risk. Differences in SAE inclusion and synthesis accounted for the disparate conclusions. Trials show a small but significant effect of HA on function on which recent
Martínez-Lavín, Manuel; Amezcua-Guerra, Luis
This article critically reviews HPV vaccine serious adverse events described in pre-licensure randomized trials and in post-marketing case series. HPV vaccine randomized trials were identified in PubMed. Safety data were extracted. Post-marketing case series describing HPV immunization adverse events were reviewed. Most HPV vaccine randomized trials did not use inert placebo in the control group. Two of the largest randomized trials found significantly more severe adverse events in the tested HPV vaccine arm of the study. Compared to 2871 women receiving aluminum placebo, the group of 2881 women injected with the bivalent HPV vaccine had more deaths on follow-up (14 vs. 3, p = 0.012). Compared to 7078 girls injected with the 4-valent HPV vaccine, 7071 girls receiving the 9-valent dose had more serious systemic adverse events (3.3 vs. 2.6%, p = 0.01). For the 9-valent dose, our calculated number needed to seriously harm is 140 (95% CI, 79–653) [DOSAGE ERROR CORRECTED] . The number needed to vaccinate is 1757 (95% CI, 131 to infinity). Practically, none of the serious adverse events occurring in any arm of both studies were judged to be vaccine-related. Pre-clinical trials, post-marketing case series, and the global drug adverse reaction database (VigiBase) describe similar post-HPV immunization symptom clusters. Two of the largest randomized HPV vaccine trials unveiled more severe adverse events in the tested HPV vaccine arm of the study. Nine-valent HPV vaccine has a worrisome number needed to vaccinate/number needed to harm quotient. Pre-clinical trials and post-marketing case series describe similar post-HPV immunization symptoms.
Kovitz, K E; Dougan, P; Riese, R; Brummitt, J R
This paper advocates the need to move beyond interdisciplinary team composition as a minimum criterion for multidisciplinary functioning in child abuse treatment. Recent developments within the field reflect the practice of shared professional responsibility for detection, case management and treatment. Adherence to this particular model for intervention requires cooperative service planning and implementation as task related functions. Implicitly, this model also carries the potential to incorporate the supportive functioning essential to effective group process. However, explicit attention to the dynamics and process of small groups has been neglected in prescriptive accounts of multidisciplinary child abuse team organization. The present paper therefore focuses upon the maintenance and enhancement aspects of multidisciplinary group functioning. First, the development and philosophy of service for the Alberta Children's Hospital Child Abuse Program are reviewed. Second, composition of the team, it's mandate for service, and the population it serves are briefly described. Third, the conceptual framework within which the program functions is outlined. Strategies for effective group functioning are presented and the difficulties encountered with this model are highlighted. Finally, recommendations are offered for planning and implementing a multidisciplinary child abuse team and for maintaining its effective group functioning.
Bailiff, I.K.; Sholom, S.; McKeever, S.W.S.
This paper reviews recent research on the application of the physical dosimetry techniques of electron paramagnetic resonance (EPR) and luminescence (optically stimulated luminescence, OSL, and thermoluminescence, TL) to determine radiation dose following catastrophic, large-scale radiological events. Such data are used in dose reconstruction to obtain estimates of dose due to the exposure to external sources of radiation, primarily gamma radiation, by individual members of the public and by ...
Doorewaard, J.A.C.M.; Hootegem, G. van; Huys, R.
The purpose is to analyse the impact of team responsibility (the division of job regulation tasks between team leader and team members) on team performance. It bases an analysis on 36 case studies in The Netherlands which are known to have implemented team‐based work. The case studies were executed
Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events--a cross-sectional survey.
Van Bogaert, Peter; Timmermans, Olaf; Weeks, Susan Mace; van Heusden, Danny; Wouters, Kristien; Franck, Erik
To investigate the impact of nurse practice environment factors, nurse work characteristics, and burnout on nurse reported job outcomes, quality of care, and patient adverse events variables at the nursing unit level. Nurse practice environment studies show growing insights and knowledge about determining factors for nurse workforce stability, quality of care, and patient safety. Until now, international studies have primarily focused on variability at the hospital level; however, insights at the nursing unit level can reveal key factors in the nurse practice environment. A cross-sectional design with a survey. In a cross-sectional survey, a sample of 1108 nurses assigned to 96 nursing units completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality of care, and patient adverse events. Associations between the variables were examined using multilevel modelling techniques. Various unit-level associations (simple models) were identified between nurse practice environment factors, nurse work characteristics, burnout dimensions, and nurse reported outcome variables. Multiple multilevel models showed various independent variables such as nursing management at the unit level, social capital, emotional exhaustion, and depersonalization as important predictors of nurse reported outcome variables such job satisfaction, turnover intentions, quality of care (at the unit, the last shift, and in the hospital within the last year), patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medications errors. Results suggested a stable nurse work force, with the capability to achieve superior quality and patient safety outcomes, is associated with unit-level favourable perceptions of nurse work environment factors, workload, decision latitude, and social capital, as well low levels of burnout
Hospital staff should use more than one method to detect adverse events and potential adverse events: incident reporting, pharmacist surveillance and local real‐time record review may all have a place
Olsen, Sisse; Neale, Graham; Schwab, Kat; Psaila, Beth; Patel, Tejal; Chapman, E Jane; Vincent, Charles
Background Over the past five years, in most hospitals in England and Wales, incident reporting has become well established but it remains unclear how well reports match clinical adverse events. International epidemiological studies of adverse events are based on retrospective, multi‐hospital case record review. In this paper the authors describe the use of incident reporting, pharmacist surveillance and local real‐time record review for the recognition of clinical risks associated with hospital inpatient care. Methodology Data on adverse events were collected prospectively on 288 patients discharged from adult acute medical and surgical units in an NHS district general hospital using incident reports, active surveillance of prescription charts by pharmacists and record review at time of discharge. Results Record review detected 26 adverse events (AEs) and 40 potential adverse events (PAEs) occurring during the index admission. In contrast, in the same patient group, incident reporting detected 11 PAEs and no AEs. Pharmacy surveillance found 10 medication errors all of which were PAEs. There was little overlap in the nature of events detected by the three methods. Conclusion The findings suggest that incident reporting does not provide an adequate assessment of clinical adverse events and that this method needs to be supplemented with other more systematic forms of data collection. Structured record review, carried out by clinicians, provides an important component of an integrated approach to identifying risk in the context of developing a safety and quality improvement programme. PMID:17301203
Bai, Yan; Yao, Zhong; Cong, Fengyu; Zhang, Linlin
There is an increasing interest regarding the use of electroencephalography (EEG) in social commerce and electronic commerce (e-commerce) research. There are several reviews in the field of social commerce or e-commerce; these have great potential value and mining them is fundamental and significant. To our knowledge, EEG is rarely applied to study these. In this study, we examined the neural correlates of social commerce reviews (SCRs) and e-commerce reviews (ECRs) by using them as stimuli t...
Tillman, Benjamin F; Pauff, James M; Satyanarayana, Gowri; Talbott, Mahsa; Warner, Jeremy L
Ibrutinib is an irreversible inhibitor of Bruton tyrosine kinase (BTK) in B lymphocytes as well as other kinases including interleukin-2-inducible T-cell kinase (ITK) in CD4+ Th2 regulatory T cells. Increased infections have been observed in patients taking ibrutinib. The overall incidence has not been systematically evaluated. The published literature and conference abstracts of prospective clinical trials using ibrutinib in hematologic malignancies were identified and reviewed using PubMed, Google Scholar, and HemOnc.org per PRISMA guidelines. Infectious events with a focus on pneumonia were collated per the Common Terminology Criteria for Adverse Events Version 4.03 grading. Infectious complications are common, occurring in 56% of patients taking single-agent ibrutinib and 52% of those on combination therapy. Approximately one in 5 patients developed pneumonia, which was the major contributor to a 2% rate of death from infections. Many of the cases of pneumonia were due to opportunistic pathogens. Ibrutinib use requires prudent consideration of the impacts on host immunity. We identified a high rate of serious adverse infectious events within prospective clinical trials. Data suggest a role of both BTK and ITK inhibition for the increased events. There was considerable variability in the reporting of adverse events between trials, journals, and conference reports. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Halstead, L S; Rintala, D H; Kanellos, M; Griffin, B; Higgins, L; Rheinecker, S; Whiteside, W; Healy, J E
This article describes an effort by one rehabilitation team to create innovative approaches to team care in a medical rehabilitation hospital. The major arena for implementing change was the weekly patient rounds. We worked to increase patient involvement, developed a rounds coordinator role, used a structured format, and tried to integrate research findings into team decision making. Other innovations included use of a preadmission questionnaire, a discharge check list, and a rounds evaluation questionnaire. The impact of these changes was evaluated using the Group Environment Scale and by analyzing participation in rounds based on verbatim transcripts obtained prior to and 20 months after formation of the Innovative Rehabilitation Team (IRT). The results showed decreased participation by medical personnel during rounds, and increased participation by patients. The rounds coordinator role increased participation rates of staff from all disciplines and the group environment improved within the IRT. These data are compared with similar evaluations made of two other groups, which served as control teams. The problems inherent in making effective, lasting changes in interdisciplinary rehabilitation teams are reviewed, and a plea is made for other teams to explore additional ways to use the collective creativity and resources latent in the team membership.
Panagodage Perera, Nirmala Kanthi; Joseph, Corey; Kemp, Joanne Lyn; Finch, Caroline Frances
Team bat-or-stick sports, including cricket, softball and hockey, are popular among women. However, little is known about the injury profile in this population. The aim was to describe the incidence, nature and anatomical location of injuries in bat-or-stick sports played by women in a competitive league. This review was prospectively registered (PROSPERO CRD42015026715). CINAHL, MEDLINE, PsycINFO, PubMed, SPORTDiscus were systematically searched from January 2000 to September 2016, inclusive. Peer-reviewed original research articles reporting the incidence, nature and anatomical location of injuries sustained by women aged 18 + years in competitive bat-or-stick sports were included. Two meta-analyses based on injury incidence proportions (injury IP) and injury rates per 1000 person-days of athletic exposure (AE) were performed. A total of 37 studies satisfied the inclusion criteria, and five had low risk of bias. The weighted injury IP was 0.42 [95% confidence interval (CI) 0.39-0.45]. The weighted injury rate was 6.12 (95% CI 6.05-6.18) overall, and greater in games [15.79 (95% CI 15.65-15.93)] than in practice [3.07 (95% CI 2.99-3.15)]. The ankle was the most commonly injured anatomical location, followed by the hand (including wrist and fingers), knee and head. Soft tissue and ligament injuries were most common types of injuries. Injury prevention in women's sports is a novel and emerging field of research interest. This review highlights that injury incidence is high among female bat-or-stick players, but little information is known about direct causal mechanisms. This review clearly establishes the need for enhancements to injury data collection. Without this information, it will not be possible to develop evidence-based injury prevention interventions.
Teets, Maxwell; Tumin, Dmitry; Walia, Hina; Stevens, Jenna; Wrona, Sharon; Martin, David; Bhalla, Tarun; Tobias, Joseph D
Untreated pain or overly aggressive pain management may lead to adverse physiologic consequences and activation of the hospital's Rapid Response Team. This study is a quality improvement initiative that attempts to identify patient demographics and patterns associated with Rapid Response Team consultations for patients on the acute pain service. A retrospective review of all patients on the acute pain service from February 2011 until June 2015 was cross-referenced with inpatients requiring consultation from the Rapid Response Team. Two independent practitioners reviewed electronic medical records to determine which events were likely associated with pain management interventions. Over a 4-year period, 4872 patients were admitted to the acute pain service of whom 135 unique patients required Rapid Response Team consults. There were 159 unique Rapid Response Team activations among 6538 unique acute pain service consults. A subset of 27 pain management-related Rapid Response Team consultations was identified. The largest percentage of patients on the acute pain service were adolescents aged 12-17 (36%). Compared to this age group, the odds of Rapid Response Team activation were higher among infants Team consultations may help to identify patients at risk for clinical decompensation. © 2017 John Wiley & Sons Ltd.
Li, Jian; Zhang, Min; Loerbroks, Adrian; Angerer, Peter; Siegrist, Johannes
Though much evidence indicates that work stress increases the risk of incident of coronary heart disease (CHD), little is known about the role of work stress in the development of recurrent CHD events. The objective of this study was to review and synthesize the existing epidemiological evidence on whether work stress increases the risk of recurrent CHD events in patients with the first CHD. A systematic literature search in the PubMed database (January 1990 - December 2013) for prospective studies was performed. Inclusion criteria included: peer-reviewed English papers with original data, studies with substantial follow-up (> 3 years), end points defined as cardiac death or nonfatal myocardial infarction, as well as work stress assessed with reliable and valid instruments. Meta-analysis using random-effects modeling was conducted in order to synthesize the observed effects across the studies. Five papers derived from 4 prospective studies conducted in Sweden and Canada were included in this systematic review. The measurement of work stress was based on the Demand- Control model (4 papers) or the Effort-Reward Imbalance model (1 paper). According to the estimation by meta-analysis based on 4 papers, a significant effect of work stress on the risk of recurrent CHD events (hazard ratio: 1.65, 95% confidence interval: 1.23-2.22) was observed. Our findings suggest that, in patients with the first CHD, work stress is associated with an increased relative risk of recurrent CHD events by 65%. Due to the limited literature, more well-designed prospective research is needed to examine this association, in particular, from other than western regions of the world. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Sokol, Seth I; Tsang, Pansy; Aggarwal, Vikas; Melamed, Michal L; Srinivas, V S
Accumulating data linking hypovitaminosis D to cardiovascular (CV) events has contributed to large increases in vitamin D testing and supplementation. To evaluate the merits of this practice, we conducted a systematic review with meta-analysis providing a framework for interpreting the literature associating hypovitaminosis D with increased CV events. Prospective studies were identified by search of MEDLINE and EMBASE from inception to January 2010, restricted to English language publications. Two authors independently extracted data and graded study quality. Pooled relative risks (RR) were calculated using a random effects model. Ten studies met criteria for review and 7 were included in meta-analysis. Pooled RR for CV events using FAIR and GOOD quality studies was 1.67 (95% confidence interval, 1.23-2.28) during an average follow-up of 11.8 years. There was evidence of significant heterogeneity across studies (Q statistics = 16.6, P = 0.01, I = 63.8%), which was eliminated after omitting 2 studies identified by sensitivity analysis (RR, 1.34 [1.08-1.67]; P for heterogeneity =0.33). When restricting analysis to GOOD quality studies (RR, 1.27 [1.04-1.56]), no significant heterogeneity was found (P = 0.602). Systematic review identified significant shortcomings in the literature, including variability in defining vitamin D status, seasonal adjustments, defining and determining CV outcomes, and the use of baseline vitamin D levels. In conclusion, a modest increased risk of CV events associated with hypovitaminosis D is tempered by significant limitations within the current literature. These findings underscore the importance of critical appraisal of the literature, looking beyond reported risk estimates before translating results into clinical practice.
Mujika, Iñigo; Burke, Louise M
Team sports are based on intermittent high-intensity activity patterns, but the exact characteristics vary between and within codes, and from one game to the next. Despite the challenge of predicting exact game demands, performance in team sports is often dependent on nutritional factors. Chronic issues include achieving ideal levels of muscle mass and body fat, and supporting the nutrient needs of the training program. Acute issues, both for training and in games, include strategies that allow the player to be well fuelled and hydrated over the duration of exercise. Each player should develop a plan of consuming fluid and carbohydrate according to the needs of their activity patterns, within the breaks that are provided in their sport. In seasonal fixtures, competition varies from a weekly game in some codes to 2-3 games over a weekend road trip in others, and a tournament fixture usually involves 1-3 days between matches. Recovery between events is a major priority, involving rehydration, refuelling and repair/adaptation activities. Some sports supplements may be of value to the team athlete. Sports drinks, gels and liquid meals may be valuable in allowing nutritional goals to be met, while caffeine, creatine and buffering agents may directly enhance performance. Copyright © 2011 S. Karger AG, Basel.
The events in the nuclear industry are investigated from the license point of view and from the regulatory side too. It is well known the importance of the event investigation. One of the main goals of such investigation is to prevent the circumstances leading to the event and the consequences of the event. The protection of the nuclear workers against nuclear hazard, and the protection of general public against dangerous effects of an event could be achieved by systematic approach to the event investigation. Both, the nuclear safety regulatory body and the licensee shall ensure that operational significant events are investigated in a systematic and technically sound manner to gather information pertaining to the probable causes of the event. One of the results should be appropriate feedback regarding the lessons of the experience to the regulatory body, nuclear industry and general public. In the present paper a general description of systematic approach to the event investigation is presented. The systematic approach to the event investigation works best where cooperation is present among the different divisions of the nuclear facility or regulatory body. By involving management and supervisors the safety office can usually improve their efforts in the whole process. The end result shall be a program which serves to prevent events and reduce the time and efforts solving the root cause which initiated each event. Selection of the proper method for the investigation and an adequate review of the findings and conclusions lead to the higher level of the overall nuclear safety. (author)
Can hospital audit teams identify case management problems, analyse their causes, identify and implement improvements? A cross-sectional process evaluation of obstetric near-miss case reviews in Benin
Full Text Available Abstract Background Obstetric near-miss case reviews are being promoted as a quality assurance intervention suitable for hospitals in low income countries. We introduced such reviews in five district, regional and national hospitals in Benin, West Africa. In a cross-sectional study we analysed the extent to which the hospital audit teams were able to identify case management problems (CMPs, analyse their causes, agree on solutions and put these solutions into practice. Methods We analysed case summaries, women’s interview transcripts and audit minutes produced by the audit teams for 67 meetings concerning one woman with near-miss complications each. We compared the proportion of CMPs identified by an external assessment team to the number found by the audit teams. For the latter, we described the CMP causes identified, solutions proposed and implemented by the audit teams. Results Audit meetings were conducted regularly and were well attended. Audit teams identified half of the 714 CMPs; they were more likely to find managerial ones (71% than the ones relating to treatment (30%. Most identified CMPs were valid. Almost all causes of CMPs were plausible, but often too superficial to be of great value for directing remedial action. Audit teams suggested solutions, most of them promising ones, for 38% of the CMPs they had identified, but recorded their implementation only for a minority (8.5%. Conclusions The importance of following-up and documenting the implementation of solutions should be stressed in future audit interventions. Tools facilitating the follow-up should be made available. Near-miss case reviews hold promise, but their effectiveness to improve the quality of care sustainably and on a large scale still needs to be established.
Can hospital audit teams identify case management problems, analyse their causes, identify and implement improvements? A cross-sectional process evaluation of obstetric near-miss case reviews in Benin
Background Obstetric near-miss case reviews are being promoted as a quality assurance intervention suitable for hospitals in low income countries. We introduced such reviews in five district, regional and national hospitals in Benin, West Africa. In a cross-sectional study we analysed the extent to which the hospital audit teams were able to identify case management problems (CMPs), analyse their causes, agree on solutions and put these solutions into practice. Methods We analysed case summaries, women’s interview transcripts and audit minutes produced by the audit teams for 67 meetings concerning one woman with near-miss complications each. We compared the proportion of CMPs identified by an external assessment team to the number found by the audit teams. For the latter, we described the CMP causes identified, solutions proposed and implemented by the audit teams. Results Audit meetings were conducted regularly and were well attended. Audit teams identified half of the 714 CMPs; they were more likely to find managerial ones (71%) than the ones relating to treatment (30%). Most identified CMPs were valid. Almost all causes of CMPs were plausible, but often too superficial to be of great value for directing remedial action. Audit teams suggested solutions, most of them promising ones, for 38% of the CMPs they had identified, but recorded their implementation only for a minority (8.5%). Conclusions The importance of following-up and documenting the implementation of solutions should be stressed in future audit interventions. Tools facilitating the follow-up should be made available. Near-miss case reviews hold promise, but their effectiveness to improve the quality of care sustainably and on a large scale still needs to be established. PMID:23057707
M.A. Eisenbies; W.M. Aust; J.A. Burger; M.B. Adams
The connection between forests and water resources is well established, but the relationships among controlling factors are only partly understood. Concern over the effects of forestry operations, particularly harvesting, on extreme flooding events is a recurrent issue in forest and watershed management. Due to the complexity of the system, and the cost of installing...
Vermeer-de Bondt PE; Moorer-Lanser N; PHaff TAJ; Oostvogels B; Wesselo C; van der Maas NAT; LCI; cib
In 2010, 800,000 children received one or more vaccines on 1.3 million dates, with more than 7 million vaccine components. There is always some chance of adverse reactions but these are usually not severe, though sometimes frightening. This year, RIVM received 1380 reports of adverse events
Eisen, T.; Sternberg, C.N.; Robert, C.; Mulders, P.F.; Pyle, L.; Zbinden, S.; Izzedine, H.; Escudier, B.
With the advent of targeted agents for the treatment of renal cell carcinoma (RCC), overall survival has improved, and patients are being treated continuously for increasingly long periods of time. This has raised challenges in the management of adverse events (AEs) associated with the six targeted
Yamanaka, Kenya; Petrulionis, Marius; Lin, Shibo; Gao, Chao; Galli, Uwe; Richter, Susanne; Winkler, Susanne; Houben, Philipp; Schultze, Daniel; Hatano, Etsuro; Schemmer, Peter
Everolimus is an orally administrated mammalian target of rapamycin (mTOR) inhibitor. Several large-scale randomized controlled trials (RCTs) have demonstrated the survival benefits of everolimus at the dose of 10 mg/day for solid cancers. Furthermore, mTOR-inhibitor-based immunosuppression is associated with survival benefits for patients with hepatocellular carcinoma (HCC) who have received liver transplantation. However, a low rate of tumor reduction and some adverse events have been pointed out. This review summarizes the antitumor effects and adverse events of everolimus and evaluates its possible application in advanced HCC. For the meta-analysis of adverse events, we used the RCTs for solid cancers. The odds ratios of adverse events were calculated using the Peto method. Manypreclinical studies demonstrated that everolimus had antitumor effects such as antiproliferation and antiangiogenesis. However, some differences in the effects were observed among in vivo animal studies for HCC treatment. Meanwhile, clinical studies demonstrated that the response rate of single-agent everolimus was low, though survival benefits could be expected. The meta-analysis revealed the odds ratios (95% confidence interval [CI]) of stomatitis: 5.42 [4.31–6.73], hyperglycemia: 3.22 [2.37–4.39], anemia: 3.34 [2.37–4.67], pneumonitis: 6.02 [3.95–9.16], aspartate aminotransferase levels: 2.22 [1.37–3.62], and serum alanine aminotransferase levels: 2.94 [1.72–5.02], respectively. Everolimus at the dose of 10 mg/day significantly increased the risk of the adverse events. In order to enable its application to the standard conventional therapies of HCC, further studies are required to enhance the antitumor effects and manage the adverse events of everolimus
Carrascosa, J M; Del-Alcazar, E
Biologic drugs have revolutionized the treatment of moderate to severe psoriasis in recent years because of their high efficacy and low risk of toxicity. However, even within the group of biologic therapies, there are differences related to the different mechanisms of action. Areas covered: We review the main adverse events associated with the biologic agents currently available for the treatment of psoriasis and the new inhibitors targeting the p19 subunit of interleukin (IL) 23 and the IL-17A receptor. This review covers injection site reactions, infections, cardiovascular events, demyelinating disorders, tumours, class effects secondary adverse events, immunogenicity, safety in pregnancy and vaccines efficacy. Expert commentary: More than a decade after the first approval of biologic drugs for use in psoriasis, the good safety profile of these drugs is one of the main justifications and incentives for their long-term use. The emergence of new pharmacological groups has made it possible to avoid some of the class effects of first-generation biologic agents and the new therapies appear to pose less risk of reactivation of latent infections, such as hepatitis B virus and tuberculosis. However, they are associated with new adverse effects related to their mechanism of action, including candidiasis and the risk of exacerbation or onset of inflammatory bowel disease.
Hanan, N.A.; Ilberg, D.; Xue, D.; Youngblood, R.; Reed, J.W.; McCann, M.; Talwani, T.; Wreathall, J.; Kurth, P.D.; Bandyopadhyay, K.
A review of the Oconee-3 Probabilistic Risk Assessment (OPRA) was conducted with the broad objective of evaluating qualitatively and quantitatively (as much as possible) the OPRA assessment of the important sequences that are ''externally'' generated and lead to core damage. The review included a technical assessment of the assumptions and methods used in the OPRA within its stated objective and with the limited information available. Within this scope, BNL performed a detailed reevaluation of the accident sequences generated by internal floods and earthquakes and a less detailed review (in some cases a scoping review) for the accident sequences generated by fires, tornadoes, external floods, and aircraft impact. 12 refs., 24 figs., 31 tabs.
... and in the spirit of Executive Order 13563 on Improving Regulation and Regulatory Review, PBGC plans... indicate plan or employer financial problems. PBGC uses the information provided in determining what, if...
Hanan, N.A.; Ilberg, D.; Xue, D.
A review of the Oconee-3 Probabilistic Risk Assessment (OPRA) was conducted with the broad objective of evaluating qualitatively and quantitatively (as much as possible) the OPRA assessment of the important sequences that are ''externally'' generated and lead to core damage. The review included a technical assessment of the assumptions and methods used in the OPRA within its stated objective and with the limited information available. Within this scope, BNL performed a detailed reevaluation of the accident sequences generated by internal floods and earthquakes and a less detailed review (in some cases a scoping review) for the accident sequences generated by fires, tornadoes, external floods, and aircraft impact. 12 refs., 24 figs., 31 tabs
Shelley, P; Powney, B
Team building should not be a 'bolt-on' extra, it should be a well planned, integrated part of developing teams and assisting their leaders. When asked to facilitate team building by a group of NHS managers we developed a framework which enabled individual members of staff to become more effective in the way they communicated with each other, their teams and in turn within the organization. Facing the challenge posed by complex organizational changes, staff were able to use 3 training days to increase and develop their awareness of the principles of teamwork, better team management, and how a process of leadership and team building could help yield better patient care.
The meeting addressed the question how it is possible to make decision processes and risk assessment for deep repository development more transparent. The two dominant decision approaches used in Sweden and the UK, review/decide(r/d) and inquiry/decide(i/d), were discussed. The main conclusions from group discussions were: It was acknowledged that the concept of transparency includes three equally important aspects: factual issues, value issues, and stake holder's authenticity. There is a need in both countries to bring in the best aspects of both the r/d and the i/d approaches. Both approaches seem to offer possibilities and suffer limitations with respect to the segregation of facts, uncertainties and value judgements, and some sort of combination of the two may present a valuable development. However, neither the i/d nor the r/d approach seems to provide a good framework for clarification of the value issue. Experts have dominated the decision process in both countries. There is a need for a more genuine consultation process. The Swedish EIA is evolving in this direction. The regulator should take part in the process, also at an early stage. It is important that the integrity of the regulator is maintained. Rules and responsibilities of implementers, regulators, planning authorities and other decision-makers should be established early in the process. The public should know that they have access to a process that clarifies value judgements, facts, uncertainties and questions. It is necessary for the public to know what the technical issues are, and to have the means to evaluate the authenticity of the experts. It is important that political decisions are not taken without due consideration of scientific and technical arguments. There are factors beside safety assessments which are completely legitimate to consider. An approach with intense interaction between politicians, experts and the public is needed
Andersson, Kjell [ed.] [Karinta-Konsult, Taeby (Sweden)
The meeting addressed the question how it is possible to make decision processes and risk assessment for deep repository development more transparent. The two dominant decision approaches used in Sweden and the UK, review/decide(r/d) and inquiry/decide(i/d), were discussed. The main conclusions from group discussions were: It was acknowledged that the concept of transparency includes three equally important aspects: factual issues, value issues, and stake holder`s authenticity. There is a need in both countries to bring in the best aspects of both the r/d and the i/d approaches. Both approaches seem to offer possibilities and suffer limitations with respect to the segregation of facts, uncertainties and value judgements, and some sort of combination of the two may present a valuable development. However, neither the i/d nor the r/d approach seems to provide a good framework for clarification of the value issue. Experts have dominated the decision process in both countries. There is a need for a more genuine consultation process. The Swedish EIA is evolving in this direction. The regulator should take part in the process, also at an early stage. It is important that the integrity of the regulator is maintained. Rules and responsibilities of implementers, regulators, planning authorities and other decision-makers should be established early in the process. The public should know that they have access to a process that clarifies value judgements, facts, uncertainties and questions. It is necessary for the public to know what the technical issues are, and to have the means to evaluate the authenticity of the experts. It is important that political decisions are not taken without due consideration of scientific and technical arguments. There are factors beside safety assessments which are completely legitimate to consider. An approach with intense interaction between politicians, experts and the public is needed.
Ilberg, D.; Shiu, K.; Hanan, N.; Anavim, E.
A review of the Probabilistic Risk Assessment of the Shoreham Nuclear Power Station was conducted with the broad objective of evaluating its risks in relation to those identified in the Reactor Safety Study (WASH-1400). The scope of the review was limited to the ''front end'' part, i.e., to the evaluation of the frequencies of states in which core damage may occur. Furthermore, the review considered only internally generated accidents, consistent with the scope of the PRA. The review included an assessment of the assumptions and methods used in the Shoreham study. It also encompassed a reevaluation of the main results within the scope and general methodological framework of the Shoreham PRA, including both qualitative and quantitative analyses of accident initiators, data bases, and accident sequences which result in initiation of core damage. Specific comparisons are given between the Shoreham study, the results of the present review, and the WASH-1400 BWR, for the core damage frequency. The effect of modeling uncertainties was considered by a limited sensitivity study so as to show how the results would change if other assumptions were made. This review provides an independently assessed point value estimate of core damage frequency and describes the major contributors, by frontline systems and by accident sequences. 17 figs., 81 tabs
McKay, J; Murphy, D J; Bowie, P; Schmuck, M-L; Lough, M; Eva, K W
To establish the content validity and specific aspects of reliability for an assessment instrument designed to provide formative feedback to general practitioners (GPs) on the quality of their written analysis of a significant event. Content validity was quantified by application of a content validity index. Reliability testing involved a nested design, with 5 cells, each containing 4 assessors, rating 20 unique significant event analysis (SEA) reports (10 each from experienced GPs and GPs in training) using the assessment instrument. The variance attributable to each identified variable in the study was established by analysis of variance. Generalisability theory was then used to investigate the instrument's ability to discriminate among SEA reports. Content validity was demonstrated with at least 8 of 10 experts endorsing all 10 items of the assessment instrument. The overall G coefficient for the instrument was moderate to good (G>0.70), indicating that the instrument can provide consistent information on the standard achieved by the SEA report. There was moderate inter-rater reliability (G>0.60) when four raters were used to judge the quality of the SEA. This study provides the first steps towards validating an instrument that can provide educational feedback to GPs on their analysis of significant events. The key area identified to improve instrument reliability is variation among peer assessors in their assessment of SEA reports. Further validity and reliability testing should be carried out to provide GPs, their appraisers and contractual bodies with a validated feedback instrument on this aspect of the general practice quality agenda.
The United States Department of Energy (DOE) has a project for characterizing the site of a facility for disposing of radioactive waste located at Yucca Mountain Nevada, USA (the Yucca Mountain Site Characterization Project). This Project has developed an approach for assessing the future potential impact of any releases of radionuclides to the biosphere from a potential disposal facility sited at Yucca Mountain The DOE requested the International Atomic Energy Agency (IAEA) to organize an independent international expert review of the assessment methodology being used in its biosphere modelling programme. The IAEA accepted the request in the context of its statutory obligation to provide for the application of its established international standards of safety for the protection of health, at the request of a State, to any of that State's activities in the field of atomic energy. The terms of reference of the peer review were to review the biosphere assessment methodology being used for the total system performance assessment of the potential disposal facility. The main purpose was to analyze critically the proposed rationale and methodology and to identify consistencies and inconsistencies between methods being used in the frame of the Project and those established in international standards or in international programmes such as the IAEA's Biosphere Modelling and Assessment Programme (BIOMASS). This report presents the consensus view of the international experts convened by the IAEA for carrying out the review
Roberts, Nicole K; Williams, Reed G; Schwind, Cathy J; Sutyak, John A; McDowell, Christopher; Griffen, David; Wall, Jarrod; Sanfey, Hilary; Chestnut, Audra; Meier, Andreas H; Wohltmann, Christopher; Clark, Ted R; Wetter, Nathan
Communication breakdowns and care coordination problems often cause preventable adverse patient care events, which can be especially acute in the trauma setting, in which ad hoc teams have little time for advanced planning. Existing teamwork curricula do not address the particular issues associated with ad hoc emergency teams providing trauma care. Ad hoc trauma teams completed a preinstruction simulated trauma encounter and were provided with instruction on appropriate team behaviors and team communication. Teams completed a postinstruction simulated trauma encounter immediately afterward and 3 weeks later, then completed a questionnaire. Blinded raters rated videotapes of the simulations. Participants expressed high levels of satisfaction and intent to change practice after the intervention. Participants changed teamwork and communication behavior on the posttest, and changes were sustained after a 3-week interval, though there was some loss of retention. Brief training exercises can change teamwork and communication behaviors on ad hoc trauma teams. Copyright © 2014 Elsevier Inc. All rights reserved.
Dick, Charles G; White, Simon; Bopf, Daniel
Competitive and recreational motocross is an increasingly popular sport in Australia and worldwide. Children as young as 4-year-old can participate in this activity. It is recognised that this is a high risk sport despite the use of protective equipment and developments in course design. Injuries sustained range from minor contusions and fractures to severe life threatening spine and head injuries in adults and the paediatric population. In addition organised events can generate a surge of trauma that can burden small local hospitals, resulting in an unpredicted increase in the workload with subsequent delays to treatment. We present the trauma workload generated in a district hospital following a single motocross event. All patients attending a district hospital emergency department with injuries sustained during a single motocross event were identified through hospital and ambulance records. The nature of their injuries and the treatment required, the length of hospital stay and operative theatre time generated by their injuries were obtained from hospital and theatre records. 14 patients attended the emergency department over a 24-hour period, requiring 5 ambulances from the scene. 7 patients required hospital admission with 7 operations performed, consuming 12.2 h of operating theatre time and 21 days of hospital beds. 2 patients sustained head injuries requiring observation, one of which was transferred to a spinal unit for management of their spinal injuries. Motocross is a popular sport and at times has unacceptable risks of injury in organised competitions, especially with regards to paediatric injuries. Better course design, restrictions on participant age and limitations in vehicle speeds may help reduce the number of severe injuries. These events can also generate a sudden trauma burden to local hospital facilities with knock on effects on waiting times for theatre and potentially compromising not only treatment of the injured participants but also
Andreatta, Pamela; Marzano, David
Interdisciplinary team factors are significant contributors to clinical performance and associated patient outcomes. Quality of care and patient safety initiatives identify human factors associated with team performance as a prime improvement area for clinical patient care. The majority of references to interdisciplinary teams in obstetrics and gynecology in the literature recommends the use of multidisciplinary approaches when managing complex medical cases. The reviewed literature suggests that interdisciplinary team development is important for achieving optimally efficient and effective performance; however, few reports provide specific recommendations for how to optimally achieve these objectives in the process of providing interdisciplinary care to patients. The absence of these recommendations presents a significant challenge for those tasked with improving team performance in the workplace. The prescribed team development programs cited in the review are principally built around communication strategies and simulation-based training mechanisms. Few reports provide descriptions of optimal team-based competencies in the various contexts of obstetric and gynecology teams. However, team-based evaluation strategies and empirical data documenting the transfer of team training to applied clinical care are increasing in number and quality. Our findings suggest that research toward determining team factors that promote optimal performance in applied clinical practice requires definition of specific competencies for the variable teams serving obstetrics and gynecology.
Nixon, Howard L.
Contradictions in post research on the concepts of "cohesiveness" and team success seem to arise from the ways in which cohesiveness is measured and the nature of the teams investigated in each study. (MB)
Carron, Albert V; Bray, Steven R; Eys, Mark A
The main aim of this study was to examine the relationship between task cohesiveness and team success in elite teams using composite team estimates of cohesion. A secondary aim was to determine statistically the consistency (i.e. 'groupness') present in team members' perceptions of cohesion. Elite university basketball teams (n = 18) and club soccer teams (n = 9) were assessed for cohesiveness and winning percentages. Measures were recorded towards the end of each team's competitive season. Our results indicate that cohesiveness is a shared perception, thereby providing statistical support for the use of composite team scores. Further analyses indicated a strong relationship between cohesion and success (r = 0.55-0.67). Further research using multi-level statistical techniques is recommended.
Webb, J. T.
A new approach to the training, certification, recertification, and proficiency maintenance of the Shuttle launch team is proposed. Previous training approaches are first reviewed. Short term program goals include expanding current training methods, improving the existing simulation capability, and scheduling training exercises with the same priority as hardware tests. Long-term goals include developing user requirements which would take advantage of state-of-the-art tools and techniques. Training requirements for the different groups of people to be trained are identified, and future goals are outlined.
Dietz, Aaron S; Pronovost, Peter J; Mendez-Tellez, Pedro Alejandro; Wyskiel, Rhonda; Marsteller, Jill A; Thompson, David A; Rosen, Michael A
Teamwork is essential for ensuring the quality and safety of health care delivery in the intensive care unit (ICU). This article addresses what we know about teamwork, team tasks, and team improvement strategies in the ICU to identify the strengths and limitations of the existing knowledge base to guide future research. A keyword search of the PubMed database was conducted in February 2013. Keyword combinations focused on 3 areas: (1) teamwork, (2) the ICU, and (3) training/quality improvement interventions. All studies that investigated teamwork, team tasks, or team interventions within the ICU (ie, intradepartment) were selected for inclusion. Teamwork has been investigated across an array of research contexts and task types. The terminology used to describe team factors varied considerably across studies. The most common team tasks involved strategy and goal formulation. Team training and structured protocols were the most widely implemented quality improvement strategies. Team research is burgeoning in the ICU, yet low-hanging fruit remains that can further advance the science of teams in the ICU if addressed. Constructs must be defined, and theoretical frameworks should be referenced. The functional characteristics of tasks should also be reported to help determine the extent to which study results might generalize to other contexts of work. Copyright © 2014 Elsevier Inc. All rights reserved.
Stewart, Claire; Shoemaker, Jamie; Keller-Smith, Rachel; Edmunds, Katherine; Davis, Andrew; Tegtmeyer, Ken
Pediatric code blue activations are infrequent events with a high mortality rate despite the best effort of code teams. The best method for training these code teams is debatable; however, it is clear that training is needed to assure adherence to American Heart Association (AHA) Resuscitation Guidelines and to prevent the decay that invariably occurs after Pediatric Advanced Life Support training. The objectives of this project were to train a multidisciplinary, multidepartmental code team and to measure this team's adherence to AHA guidelines during code simulation. Multidisciplinary code team training sessions were held using high-fidelity, in situ simulation. Sessions were held several times per month. Each session was filmed and reviewed for adherence to 5 AHA guidelines: chest compression rate, ventilation rate, chest compression fraction, use of a backboard, and use of a team leader. After the first study period, modifications were made to the code team including implementation of just-in-time training and alteration of the compression team. Thirty-eight sessions were completed, with 31 eligible for video analysis. During the first study period, 1 session adhered to all AHA guidelines. During the second study period, after alteration of the code team and implementation of just-in-time training, no sessions adhered to all AHA guidelines; however, there was an improvement in percentage of sessions adhering to ventilation rate and chest compression rate and an improvement in median ventilation rate. We present a method for training a large code team drawn from multiple hospital departments and a method of assessing code team performance. Despite subjective improvement in code team positioning, communication, and role completion and some improvement in ventilation rate and chest compression rate, we failed to consistently demonstrate improvement in adherence to all guidelines.
The purpose of this manual is to provide professor's in engineering classes which the background necessary to use student team projects effectively. This manual describes some of the characteristics of student teams and how to use them in class. It provides a set of class activities and films which can be used to introduce and support student teams. Finally, a set of teaching modules used in freshmen, sophomore, and senior aeronautical engineering classes are presented. This manual was developed as part of a NASA sponsored project to improve the undergraduate education of aeronautical engineers. The project has helped to purchase a set of team work films which can be checked out from Cal Poly's Learning Resources Center in the Kennedy Library. Research for this project has included literature reviews on team work and cooperative learning; interviews, observations, and surveys of Cal Poly students from Industrial and Manufacturing Engineering, Aeronautical Engineering and Psychology; participation in the Aeronautical Engineering senior design lab; and interviews with engineering faculty. In addition to this faculty manual, there is a student team work manual which has been designed to help engineering students work better in teams.
Tozbikian, Gary; Gemignani, Mary L; Brogi, Edi
The consequences of patient identification errors due to specimen mislabeling can be deleterious. We describe two near-miss events involving mislabeled breast specimens from two patients who sought treatment at our institution. In both cases, microscopic review of the slides identified inconsistencies between the histologic findings and patient age, unveiling specimen identification errors. By correlating the clinical information with the microscopic findings, we identified mistakes that had occurred at the time of specimen accessioning at the original laboratories. In both cases, thanks to a timely reassignment of the specimens, the patients suffered no harm. These cases highlight the importance of routine clinical and pathologic correlation as a critical component of quality assurance and patient safety. A review of possible specimen identification errors in the anatomic pathology setting is presented. © 2017 Wiley Periodicals, Inc.
... gov/ency/patientinstructions/000929.htm Your cancer care team To use the sharing features on this page, ... help your body heal. Working with Your Care Team Each member of your care team plays an ...
Full Text Available The project team that is responsible for providing flexibility and innovation to this structure in order to enable organizations to remain successful (1. The very nature of the project team's work underpins a collective task much more complex than that assumed by other types of work teams. The aim of this paper is to explore the main factors that determine the project team effectiveness. The research methodology was the literature review. The main finding reveals that the organizational structure of projects and the project team should not be considered as a panacea for all problems of organizational effectiveness.
Objectives To assess non-health literature, identify key strategies in promoting more networked teams and groups, apply external ideas to healthcare, and build a model based on these strategies. Design A systematic review of the literature outside of healthcare. Method Searches guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) of ABI/INFORM Global, CINAHL, IBSS, MEDLINE and Psychinfo databases following a mind-mapping exercise generating key terms centred on the core construct of gaps across organisational social structures that uncovered 842 empirical articles of which 116 met the inclusion criteria. Data extraction and content analysis via data mining techniques were performed on these articles. Results The research involved subjects in 40 countries, with 32 studies enrolling participants in multiple countries. There were 40 studies conducted wholly or partly in the USA, 46 wholly or partly in continental Europe, 29 wholly or partly in Asia and 12 wholly or partly in Russia or Russian federated countries. Methods employed included 30 mixed or triangulated social science study designs, 39 qualitative studies, 13 experimental studies and 34 questionnaire-based studies, where the latter was mostly to gather data for social network analyses. Four recurring factors underpin a model for promoting networked behaviours and fortifying cross-group cooperation: appreciating the characteristics and nature of gaps between groups; using the leverage of boundary-spanners to bridge two or more groups; applying various mechanisms to stimulate interactive relationships; and mobilising those who can exert positive external influences to promote connections while minimising the impact of those who exacerbate divides. Conclusions The literature assessed is rich and varied. An evidence-oriented model and strategies for promoting more networked systems are now available for application to healthcare. While caution needs to be exercised in translating
Ostergaard, H; Ostergaard, D; Lippert, A
In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessme...
Canadell, F.; Aleman, A.; Beltran, F.; Pifarre, D.; Hernandez, H.; Gasca, C.
Within the process of maintaining and updating the risk analysis of the NPP Asco, results from the review of the vulnerability study of the plant against severe accidents caused by external success (Individual Plant Examination of External Events, IPEEE).
Sowden, M.; Mueller, U.; Blake, D.
The accurate measurements of natural and anthropogenic aerosol particulate matter (PM) is important in managing both environmental and health risks; however, limited monitoring in regional areas hinders accurate quantification. This article provides an overview of the ability of recently launched geostationary earth orbit (GEO) satellites, such as GOES-R (North America) and HIMAWARI (Asia and Oceania), to provide near real-time ground-level PM concentrations (GLCs). The review examines the literature relating to the spatial and temporal resolution required by air quality studies, the removal of cloud and surface effects, the aerosol inversion problem, and the computation of ground-level concentrations rather than columnar aerosol optical depth (AOD). Determining surface PM concentrations using remote sensing is complicated by differentiating intrinsic aerosol properties (size, shape, composition, and quantity) from extrinsic signal intensities, particularly as the number of unknown intrinsic parameters exceeds the number of known extrinsic measurements. The review confirms that development of GEO satellite products has led to improvements in the use of coupled products such as GEOS-CHEM, aerosol types have consolidated on model species rather than prior descriptive classifications, and forward radiative transfer models have led to a better understanding of predictive spectra interdependencies across different aerosol types, despite fewer wavelength bands. However, it is apparent that the aerosol inversion problem remains challenging because there are limited wavelength bands for characterising localised mineralogy. The review finds that the frequency of GEO satellite data exceeds the temporal resolution required for air quality studies, but the spatial resolution is too coarse for localised air quality studies. Continual monitoring necessitates using the less sensitive thermal infra-red bands, which also reduce surface absorption effects. However, given the
Radioactive waste safety appraisal. An international peer review of the licence application for the Australian near surface radioactive waste disposal facility. Report of the IAEA International Review Team
Radioactive waste has been generated in Australia for a number of decades from the production and use of radioactive materials in medicine and industry, from the processing of various minerals containing natural radionuclides and from various research activities. It has been decided in the overall interest of safety and security to develop a radioactive waste disposal facility to accommodate the low level and short lived intermediate level waste, which make up the bulk of the waste, other than mining and minerals processing residues. A site selection process has been undertaken and environmental impact statement report prepared and approved. A licence application has been submitted to the national nuclear regulatory authority, the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) for siting, construction and operation of the facility. In order to assist the CEO of ARPANSA with his deliberations in this regard a request was made to the IAEA, in terms of its statutory mandate to establish international safety standards for radioactive waste safety and to provide for their application, to undertake an international peer review of the licence application and to advise the CEO accordingly. The outcome and recommendations of this peer review are presented in the report
Elisa Theodora Adriana van Veldhuizen
Full Text Available The event took place from 3 till 8 July 2016 at Fazenda Monte Alto, Dourado, SP, Brazil. The aim of the course was to provide intensive knapping training in order to enhance analytical methods and procedures. This training was not only for students, but also professionals who were interested in the course. The course was given by Bruce Bradley (University of Exeter, who has extensive experience with Stone Age technologies and experimental archaeology. Mercedes Okumura (PPGArq, National Museum, Federal University of Rio de Janeiro and Astolfo G. M. Araujo (Museum of Archaeology and Ethnology, University of São Paulo organized the course, which was sponsored by Fazenda Monte Alto, Café Helena, and the British Academy, Newton Mobility Grants Scheme (NG140077. The workshop had 15 participants from Brazil, Uruguay, the Netherlands and Canada.
de Jager, Elzerie; McKenna, Chloe; Bartlett, Lynne; Gunnarsson, Ronny; Ho, Yik-Hong
The World Health Organization Surgical Safety Checklist (SSC) has been widely implemented in an effort to decrease surgical adverse events. This systematic literature review examined the effects of the SSC on postoperative outcomes. The review included 25 studies: two randomised controlled trials, 13 prospective and ten retrospective cohort trials. A meta-analysis was not conducted as combining observational studies of heterogeneous quality may be highly biased. The quality of the studies was largely suboptimal; only four studies had a concurrent control group, many studies were underpowered to examine specific postoperative outcomes and teamwork-training initiatives were often combined with the implementation of the checklist, confounding the results. The effects of the checklist were largely inconsistent. Postoperative complications were examined in 20 studies; complication rates significantly decreased in ten and increased in one. Eighteen studies examined postoperative mortality. Rates significantly decreased in four and increased in one. Postoperative mortality rates were not significantly decreased in any studies in developed nations, whereas they were significantly decreased in 75 % of studies conducted in developing nations. The checklist may be associated with a decrease in surgical adverse events and this effect seems to be greater in developing nations. With the observed incongruence between specific postoperative outcomes and the overall poor study designs, it is possible that many of the positive changes associated with the use of the checklist were due to temporal changes, confounding factors and publication bias.
Vangrieken, Katrien; Dochy, Filip; Raes, Elisabeth
This study aimed to investigate team learning in the context of teacher teams in higher vocational education. As teacher teams often do not meet all criteria included in theoretical team definitions, the construct "team entitativity" was introduced. Defined as the degree to which a group of individuals possesses the quality of being a…
Full Text Available Daniel A Hoffman,1 Charles DeBattista,2 Rob J Valuck,3 Dan V Iosifescu41Neuro-Therapy Clinic, Inc, Denver, CO, USA; 2Stanford University School of Medicine, Palo Alto, CA, USA; 3University of Colorado, SKAGES School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA; 4Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USAAbstract: We previously reported on an objective new tool that uses quantitative electroencephalography (QEEG normative- and referenced-electroencephalography sampling databases (currently called Psychiatric EEG Evaluation Registry [PEER], which may assist physicians in determining medication selection for optimal efficacy to overcome trial-and-error prescribing. The PEER test compares drug-free QEEG features for individual patients to a database of patients with similar EEG patterns and known outcomes after pharmacological interventions. Based on specific EEG data elements and historical outcomes, the PEER Report may also serve as a marker of future severe adverse events (eg, agitation, hostility, aggressiveness, suicidality, homicidality, mania, hypomania with specific medications. We used a retrospective chart review to investigate the clinical utility of such a registry in a naturalistic environment.Results: This chart review demonstrated significant improvement on the global assessment scales Clinical Global Impression – Improvement and Quality of Life Enjoyment and Satisfaction – Short Form as well as time to maximum medical improvement and decreased suicidality occurrences. The review also showed that 54.5% of previous medications causing a severe adverse event would have been raised as a caution had the PEER Report been available at the time the drug was prescribed. Finally, due to the significant amount of off-label prescribing of psychotropic medications, additional, objective, evidence-based data aided the prescriber toward better choices.Conclusion: The PEER Report may be
Witt, Emitt C.
Extreme emergency events of national significance that include manmade and natural disasters seem to have become more frequent during the past two decades. The Nation is becoming more resilient to these emergencies through better preparedness, reduced duplication, and establishing better communications so every response and recovery effort saves lives and mitigates the long-term social and economic impacts on the Nation. The National Response Framework (NRF) (http://www.fema.gov/NRF) was developed to provide the guiding principles that enable all response partners to prepare for and provide a unified national response to disasters and emergencies. The NRF provides five key principles for better preparation, coordination, and response: 1) engaged partnerships, 2) a tiered response, 3) scalable, flexible, and adaptable operations, 4) unity of effort, and 5) readiness to act. The NRF also describes how communities, tribes, States, Federal Government, privatesector, and non-governmental partners apply these principles for a coordinated, effective national response. The U.S. Geological Survey (USGS) has adopted the NRF doctrine by establishing several earth-sciences, discipline-level teams to ensure that USGS science, data, and individual expertise are readily available during emergencies. The Geospatial Information Response Team (GIRT) is one of these teams. The USGS established the GIRT to facilitate the effective collection, storage, and dissemination of geospatial data information and products during an emergency. The GIRT ensures that timely geospatial data are available for use by emergency responders, land and resource managers, and for scientific analysis. In an emergency and response capacity, the GIRT is responsible for establishing procedures for geospatial data acquisition, processing, and archiving; discovery, access, and delivery of data; anticipating geospatial needs; and providing coordinated products and services utilizing the USGS' exceptional pool of
Full Text Available The experience of childhood trauma (CT and stressful life events (SLEs is associated with subsequent development of a variety of mental health conditions, including psychotic illness. Recent research identifying adolescents and young adults at clinical high risk (CHR for psychosis allows for prospective evaluation of the impact of trauma and adverse life events on psychosis onset and other outcomes, addressing etiological questions that cannot be answered in studies of fully psychotic or non-clinical populations. This article provides a comprehensive review of the current emerging literature on trauma and adverse life events in the CHR population. Up to 80% of CHR youth endorse a lifetime history of childhood traumatic events and victimization (e.g., bullying. Several studies have shown that the experience of CT predicts psychosis onset among CHR individuals, while the literature on the influence of recent SLEs (e.g., death of a loved one remains inconclusive. Multiple models have been proposed to explain the link between trauma and psychosis, including the stress-vulnerability and stress-sensitivity hypotheses, with emphases on both cognitive processes and neurobiological mechanisms (e.g., the hypothalamic–pituitary–adrenal axis. Despite the preponderance of CHR individuals who endorse either CT or SLEs, no clinical trials have been conducted evaluating interventions for trauma in CHR youth to date. Furthermore, the current process of formal identification and assessment of trauma, SLEs, and their impact on CHR youth is inconsistent in research and clinical practice. Recommendations for improving trauma assessment, treatment, and future research directions in the CHR field are provided.
McCoy, Siobhán; Wakai, Abel; Blackburn, Carol; Barrett, Michael; Murphy, Adrian; Brenner, Maria; Larkin, Philip; Crispino-O'Connell, Gloria; Ratnapalan, Savithiri; O'Sullivan, Ronan
The use of procedural sedation outside the operating theatre has increased in hospital settings and has gained popularity among non-anesthesiologists. Sedative agents used for procedural pain, although effective, also pose significant risks to the patient if used incorrectly. There is currently no universally accepted program of education for practitioners using or introducing procedural sedation into their practice. There is emerging literature identifying structured procedural sedation programs (PSPs) as a method of ensuring a standardized level of competency among staff and reducing risks to the patient. We hypothesize that programs of education for healthcare professionals using procedural sedation outside the operating theatre are beneficial in improving patient care, safety, practitioner competence and reducing adverse event rates. Electronic databases will be systematically searched for studies (randomized and non-randomized) examining the effectiveness of structured PSPs from 1966 to present. Database searches will be supplemented by contact with experts, reference and citation checking, and a grey literature search. No language restriction will be imposed. Screening of titles and abstracts, and data extraction will be performed by two independent reviewers. All disagreements will be resolved by discussion with an independent third party. Data analysis will be completed adhering to procedures outlined in the Cochrane Handbook of Systematic Reviews of Interventions. If the data allows, a meta-analysis will be performed. This review will cohere evidence on the effectiveness of structured PSPs on sedation events and patient outcomes within the hospital and other acute care settings. In addition, it will examine key components identified within a PSP associated with patient safety and improved patient outcomes. PROSPERO registration number: CRD42013003851.
Suter, Esther; Mallinson, Sara; Misfeldt, Renee; Boakye, Omenaa; Nasmith, Louise; Wong, Sabrina T
We analyzed and compared primary health care (PHC) policies in British Columbia, Alberta and Saskatchewan to understand how they inform the design and implementation of team-based primary health care service delivery. The goal was to develop policy imperatives that can advance team-based PHC in Canada. We conducted comparative case studies (n = 3). The policy analysis included: Context review: We reviewed relevant information (2007 to 2014) from databases and websites. Policy review and comparative analysis: We compared and contrasted publically available PHC policies. Key informant interviews: Key informants (n = 30) validated narratives prepared from the comparative analysis by offering contextual information on potential policy imperatives. Advisory group and roundtable: An expert advisory group guided this work and a key stakeholder roundtable event guided prioritization of policy imperatives. The concept of team-based PHC varies widely across and within the three provinces. We noted policy gaps related to team configuration, leadership, scope of practice, role clarity and financing of team-based care; few policies speak explicitly to monitoring and evaluation of team-based PHC. We prioritized four policy imperatives: (1) alignment of goals and policies at different system levels; (2) investment of resources for system change; (3) compensation models for all members of the team; and (4) accountability through collaborative practice metrics. Policies supporting team-based PHC have been slow to emerge, lacking a systematic and coordinated approach. Greater alignment with specific consideration of financing, reimbursement, implementation mechanisms and performance monitoring could accelerate systemic transformation by removing some well-known barriers to team-based care.
Full Text Available Objective. The aim of this study is to systematically evaluate the evidence whether traditional Chinese herbal patches (TCHPs for osteoarthritis (OA are effective and safe and analyze their medication patterns. Methods. A systematic literature search was performed using all the possible Medical Subject Headings (MeSH and keywords from January 1979 to July 2013. Both randomized controlled trials (RCTs and observational studies were included. Estimated effects were analyzed using mean difference (MD or relative risk (RR with 95% confidence intervals (CI and meta-analysis. Results. 86 kinds of TCHPs were identified. RCTs and controlled clinical trials (CCTs which were mostly of low quality favored TCHPs for local pain and dysfunction relief. TCHPs, compared with diclofenac ointment, had significant effects on global effectiveness rate (RR = 0.50; 95% CI (0.29, 0.87. Components of formulae were mainly based on the compounds “Xiao Huo Luo Dan” (Minor collateral-freeing pill and “Du Huo Ji Sheng Tang” (Angelicae Pubescentis and Loranthi decoction. Ten kinds of adverse events (AEs, mainly consisting of itching and/or local skin rashes, were identified after 3-4 weeks of follow-up. Conclusions. TCHPs have certain evidence in improving global effectiveness rate for OA; however, more rigorous studies are warranted to support their use.
Lock, Sarah; Rubin, G. James; Murray, Virginia; Rogers, M. Brooke; Amlôt, Richard; Williams, Richard
Introduction Extreme events and disasters, such as earthquakes and floods, cause distress and are associated with some people developing mental disorders. Primary stressors inherent in many disasters can include injuries sustained or watching someone die. The literature recognises the distress which primary stressors cause and their association with mental disorders. Secondary stressors such as a lack of financial assistance, the gruelling process of submitting an insurance claim, parents’ worries about their children, and continued lack of infrastructure can manifest their effects shortly after a disaster and persist for extended periods of time. Secondary stressors, and their roles in affecting people’s longer-term mental health, should not be overlooked. We draw attention in this review to the nature of secondary stressors that are commonly identified in the literature, assess how they are measured, and develop a typology of these stressors that often affect people after extreme events. Methods We searched for relevant papers from 2010 and 2011 using MEDLINE®, Embase and PsycINFO®. We selected primary research papers that evaluated the associations between secondary stressors and distress or mental disorders following extreme events, and were published in English. We extracted information on which secondary stressors were assessed, and used thematic analysis to group the secondary stressors into a typology. Results Thirty-two relevant articles published in 2010 and 2011 were identified. Many secondary stressors were poorly defined and difficult to differentiate from primary stressors or other life events. We identified 11 categories of secondary stressors, though some extend over more than one category. The categories include: economic stressors such as problems with compensation, recovery of and rebuilding homes; loss of physical possessions and resources; health-related stressors; stress relating to education and schooling; stress arising from media
Fabiana Rossi Varallo
Full Text Available Objective: Identifying the main causes for underreporting of Adverse Drug Reaction (ADR by health professionals. Method: A systematic review carried out in the following databases: LILACS, PAHO, SciELO, EMBASE and PubMed in the period between 1992 and 2012. Descriptors were used in the search for articles, and the identified causes of underreporting were analyzed according to the classification of Inman. Results: In total, were identified 149 articles, among which 29 were selected. Most studies were carried out in hospitals (24/29 for physicians (22/29, and pharmacists (10/29. The main causes related to underreporting were ignorance (24/29, insecurity (24/29 and indifference (23/29. Conclusion: The data show the eighth sin in underreporting, which is the lack of training in pharmacovigilance. Therefore, continuing education can increase adherence of professionals to the service and improve knowledge and communication of risks due to drug use.
Edmondson, Amy; Bohmer, Richard; Pisano, Gary
A study of 16 cardiac surgery teams looked at how the teams adapted to new ways of working. The challenge of team management is to implement new processes as quickly as possible. Steps for creating a learning team include selecting a mix of skills and expertise, framing the challenge, and creating an environment of psychological safety. (JOW)
, maintaining team cohesiveness in multicultural teams to collaborate effectively presents a number of challenges. The present study employs the concept of trust to explore influences on team collaboration in high performing teams. The study is based on observation of teams in seven multinational corporations...... and interviews with managers from the US, Europe, China and Japan. The study presents a conceptual framework - a ‘trust buffer’ – which enables analysis and exemplification of the dynamics and challenges of teams as drivers of change. Each team has strategically important tasks, unique capacities and deal...... with change in particular ways: Each team is analyzed in relation to its global (HQ) mandate, local (national) stakeholders and organizational context. It is found that communication energy, resources and team mandate underscore the sense of trust in high performing teams. Diversity is understood...
Meijer, E.H.; Ben-Shakhar, G.; Verschuere, B.; Donchin, E.
In a recent issue of Cognitive Neurodynamics Farwell (Cogn Neurodyn 6:115-154, 2012) published a comprehensive tutorial review of the use of Event Related Brain Potentials (ERP) in the detection of concealed information. Farwell’s review covered much of his own work employing his ‘‘brain
Almost anyone has held various roles on a team, be it a family unit, sports team, or a project-oriented team. As an educator, one must make a conscious decision to build and invest in a team. Gathering the best team possible will help one achieve one's goals. This article explores some of the key reasons why it is important to focus on the team…
On July 9, 1999, pursuant to section 45.9(1)(b) of the Electric Utilities Act, the Independent Assessment Team (IAT) filed for approval with the Alberta Energy and Utilities Board (EUA/the Board) a report setting out its determinations on deregulation of electricity generation in Alberta. Included in the report were copies of the Power Purchase Arrangements (PPAs) for Regulated Generating Units listed in part 1 of the Schedule in the EUA. In filing its report, the IAT also advised the Board that, because of time pressures, the report might contain errors that would have to be corrected. The report did not include the Hydro PPA, which was subsequently filed on August 10,1999. Upon receipt of the IAT's filing, the Board reviewed its legislative authority under section 45.91 of the EUA and concluded that the section lends itself to the consideration of two questions, and, as a result, the Board developed a two phase approach to dealing with a request for variance. In phase 1, the Board would address the question of whether it should have had a variance hearing for the power purchase arrangements or other determinations made by the IAT. The Board considered that at this stage an applicant would need to satisfy the Board that there was a concern about the PPAs of sufficient importance that to require a formal process of review. If the first question was answered affirmatively, then in phase 2 the Board would address the second question of whether it should vary the power purchase arrangements and other determinations made by the ITA. Having regard to the evidence and argument presented and considered and having regard to its own knowledge and findings therein, the Board was not satisfied by those parties making the requests that the ITA did not carry out its duties in accordance with the EUA or that the PPAs and relevant determinations of the ITA are obviously unreasonable, and are not supported adequately by economic analysis, or are not in the public interest. The
Dehghani, Mahsa; Moftian, Nazila; Rezaei-Hachesu, Peyman; Samad-Soltani, Taha
To systematically review the current literature of simulation in healthcare including the structured steps in the emergency healthcare sector by proposing a framework for simulation in the emergency department. For the purpose of collecting the data, PubMed and ACM databases were used between the years 2003 and 2013. The inclusion criteria were to select English-written articles available in full text with the closest objectives from among a total of 54 articles retrieved from the databases. Subsequently, 11 articles were selected for further analysis. The studies focused on the reduction of waiting time and patient stay, optimization of resources allocation, creation of crisis and maximum demand scenarios, identification of overcrowding bottlenecks, investigation of the impact of other systems on the existing system, and improvement of the system operations and functions. Subsequently, 10 simulation steps were derived from the relevant studies after an expert's evaluation. The 10-steps approach proposed on the basis of the selected studies provides simulation and planning specialists with a structured method for both analyzing problems and choosing best-case scenarios. Moreover, following this framework systematically enables the development of design processes as well as software implementation of simulation problems.
Full Text Available Abstract Compounds derived from biologic sources, or biologicals, are increasingly utilized as therapeutic agents in malignancy. Development of anti-cancer targeted therapies from biologics is increasingly being utilized. Cetuximab, a chimeric monoclonal antibody, is one such anti-cancer targeted therapeutic that has shown efficacy in quelling the rate of patient decline in colorectal, head/neck, and non-small cell lung cancer. However, due to the relatively recent addition of biologic compounds to the therapeutic arsenal, information related to adverse reactions is less well known than those seen in traditional chemotherapeutics. Dermatologic reactions have been demonstrated as the most frequent side effect cited during cetuximab therapy for malignancy; however, other effects may lead to greater morbidity. In general, pulmonary complications of therapeutics can lead to significant morbidity and mortality. The purpose of this review is to compile the various pulmonary side effects seen in patients treated with cetuximab for various malignancies, and to compare the incidence of these adverse reactions to standard therapies.
Kim, Hyunah; Hughes, Peter J; Hawes, Emily M
This study was performed to review studies carried out in Korea reporting toxic reactions to traditional Chinese medicines (TCMs) as a result of heavy metal contamination. PubMed (1966-August 2013) and International Pharmaceutical Abstracts (1965-August 2013) were searched using the medical subject heading terms of "Medicine, Chinese Traditional," "Medicine, Korean Traditional," "Medicine, Traditional," "Metals, Heavy," and "Drug Contamination". For Korean literature, Korea Med (http://www.koreamed.org), the Korean Medical Database (http://kmbase.medric.or.kr), National Discovery for Science Leaders (www.ndsl.kr), Research Information Sharing Service (http://www.riss.kr), and Google Scholar were searched using the terms "Chinese medicine," "Korean medicine," "herbal medicine," and "metallic contamination" in Korean. Bibliographies of case reports and case series, identified using secondary resources, were also utilized. Only literature describing cases or studies performed in Korea were included. Case reports identified clear issues with heavy metal, particularly lead, contamination of TCMs utilized in Korea. No international standardization guidelines for processing, manufacturing and marketing of herbal products exist. Unacceptably high levels of toxic metals can be present in TCM preparations. Health care providers and patients should be educated on the potential risks associated with TCMs. International advocacy for stricter standardization procedures for production of TCMs is warranted.
Thomsen, Linda Aagaard; Winterstein, Almut G; Søndergaard, Birthe
studies, health services research, and follow-up studies. Additional articles were found in the reference sections of retrieved articles. STUDY SELECTION AND DATA EXTRACTION: Peer-reviewed articles assessing pADEs in ambulatory care, with detailed descriptions/frequency distributions of (1) ADE....../pADE incidence, (2) clinical outcomes, (3) associated drug groups, and/or (4) underlying medication errors were included. Study country, year and design, sample size, follow-up time, ADE/pADE identification method, proportion of ADEs/pADEs and ADEs/pADEs requiring hospital admission, and frequency distribution......-months, and the pADE incidence was 5.6 per 1000 person-months (1.1-10.1). The median ADE preventability rate was 21% (11-38%). The median incidence of ADEs requiring hospital admission was 0.45 (0.10-13.1) per 1000 person-months, and the median incidence of pADEs requiring hospital admission was 4.5 per 1000 person...
Choi, Minkyoung; Mesa-Frias, Marco; Nuesch, Eveline; Hargreaves, James; Prieto-Merino, David; Bowling, Ann; Snith, G Davey; Ebrahim, Shah; Dale, Caroline; Casas, Juan P
Social capital is considered to be an important determinant of life expectancy and cardiovascular health. Evidence on the association between social capital and all-cause mortality, cardiovascular disease (CVD) and cancer was systematically reviewed. Prospective studies examining the association of social capital with these outcomes were systematically sought in Medline, Embase and PsycInfo, all from inception to 8 October 2012. We categorized the findings from studies according to seven dimensions of social capital, including social participation, social network, civic participation,social support, trust, norm of reciprocity and sense of community, and pooled the estimates across studies to obtain summary relative risks of the health outcomes for each social capital dimension. We excluded studies focusing on children, refugees or immigrants and studies conducted in the former Soviet Union. Fourteen prospective studies were identified. The pooled estimates showed no association between most social capital dimensions and all-cause mortality, CVD or cancer. Limited evidence was found for association of increased mortality with social participation and civic participation when comparing the most extreme risk comparisons. Evidence to support an association between social capital and health outcomes is limited. Lack of consensus on measurements for social capital hinders the comparability of studies and weakens the evidence base.
Zhang, Ling; Gallagher, Robyn; Ding, Ding; Neubeck, Lis
Health outcomes and impact of cardiovascular disease vary between populations, where ethnic minorities and immigrant groups are more likely to be disadvantaged. Compared with the majority residents, health outcomes, especially short-term mortality from coronary heart disease event are worse in people of Chinese ethnicity, potentially due to poor self-management and experiences with the healthcare system in host countries. A scoping review was conducted. Four overarching themes were found: (1) understanding of heart disease, risk factors and symptom recognition, (2) adherence to medication and lifestyle modification, (3) health service/information choice, and (4) family role in disease self-management and decision making. All themes were greatly influenced by English language proficiency and cultural practices. English language proficiency and cultural practices should be taken into consideration when providing healthcare services for people of Chinese ethnicity, as it plays an important role in self-management and experiences with the healthcare system.
Full Text Available Epilepsy is one of the most serious chronical neurological disorders, affecting more than 50 million people worldwide. It can be defined as a spectrum disorder, and patients with epilepsy possess abnormalities in cognitive functions. A number of factors can cause cognitive dysfunctions in epileptic syndromes, including etiology, the age of onset, type of seizure and severity, duration, and antiepileptic drugs. Event-related potentials (ERPs are very useful clinical and research instruments to evaluate cognitive function in patients with neuropsychiatry disorders. Event-related potentials directly reflect cortical neuronal activity and provide a particular level of temporal resolution. Among various ERP components, the P300 is the most important component for assessing cognitive processes such as attention, working memory, and concentration. Numerous studies have reported the abnormalities in amplitude or latency of P300 component of ERP in epileptic patients, and these abnormalities are indicative of cognitive dysfunction. Therefore, the purpose of this review is to consolidate the existing literature in connection with the use of P300 in epileptic patients.
Leach, Linda Searle; Mayo, Ann M
Multidisciplinary rapid response teams focus on patients' emergent needs and manage critical situations to prevent avoidable deaths. Although research has focused primarily on outcomes, studies of the actual team effectiveness within the teams from multiple perspectives have been limited. To describe effectiveness of rapid response teams in a large teaching hospital in California that had been using such teams for 5 years. The grounded-theory method was used to discover if substantive theory might emerge from interview and/or observational data. Purposeful sampling was used to conduct in-person semistructured interviews with 17 key informants. Convenience sampling was used for the 9 observed events that involved a rapid response team. Analysis involved use of a concept or indicator model to generate empirical results from the data. Data were coded, compared, and contrasted, and, when appropriate, relationships between concepts were formed. Results Dimensions of effective team performance included the concepts of organizational culture, team structure, expertise, communication, and teamwork. Professionals involved reported that rapid response teams functioned well in managing patients at risk or in crisis; however, unique challenges were identified. Teams were loosely coupled because of the inconsistency of team members from day to day. Team members had little opportunity to develop relationships or team skills. The need for team training may be greater than that among teams that work together regularly under less time pressure to perform. Communication between team members and managing a crisis were critical aspects of an effective response team.
Fransen, Jos; Weinberger, Armin; Kirschner, Paul A.
There is a wealth of research on computer-supported cooperative work (CSCW) that is neglected in computer-supported collaborative learning (CSCL) research. CSCW research is concerned with contextual factors, however, that may strongly influence collaborative learning processes as well, such as task characteristics, team formation, team members'…
Red Teaming is used across both public and private sectors and is not the sole domain of the military. Red Team Consulting (2011) notes that “the use...open for review. Consider also the context of application. Oh (2009) explains how globalisation , the rise of emerging powers, environmental
Chalker-Scott, Linda; Daniels, Catherine H.; Martini, Nicole
The Garden Team at Washington State University is a transdisciplinary group of faculty, staff, and students with expertise in applied plant and soil sciences and an interest in Extension education. The team's primary mission is to create current, relevant, and peer-reviewed materials as Extension publications for home gardeners. The average yearly…
Sims, Henry P., Jr.; Dean, James W., Jr.
This article reviews the quality circle concept, shows why its characteristics appeal to American executives, and examines some of its limitations. It looks at self-managing teams and discusses the reasons that adoptions have been relatively few. It then shows what organizational conditions are necessary for quality circles to evolve into teams.…
Wildman, Jessica L; Thayer, Amanda L; Pavlas, Davin; Salas, Eduardo; Stewart, John E; Howse, William R
This article provides a systematic review of the team knowledge literature and guidance for further research. Recent research has called attention to the need for the improved study and understanding of team knowledge. Team knowledge refers to the higher level knowledge structures that emerge from the interactions of individual team members. We conducted a systematic review of the team knowledge literature, focusing on empirical work that involves the measurement of team knowledge constructs. For each study, we extracted author degree area, study design type, study setting, participant type, task type, construct type, elicitation method, aggregation method, measurement timeline, and criterion domain. Our analyses demonstrate that many of the methodological characteristics of team knowledge research can be linked back to the academic training of the primary author and that there are considerable gaps in our knowledge with regard to the relationships between team knowledge constructs, the mediating mechanisms between team knowledge and performance, and relationships with criteria outside of team performance, among others. We also identify categories of team knowledge not yet examined based on an organizing framework derived from a synthesis of the literature. There are clear opportunities for expansion in the study of team knowledge; the science of team knowledge would benefit from a more holistic theoretical approach. Human factors researchers are increasingly involved in the study of teams. This review and the resulting organizing framework provide researchers with a summary of team knowledge research over the past 10 years and directions for improving further research.
Full Text Available BACKGROUND: Low Molecular Weight Heparins (LMWH are at least as effective antithrombotic drugs as Unfractionated Heparin (UFH. However, it is still unclear whether the safety profiles of LMWH and UFH differ. We performed a systematic review to compare the bleeding risk of fixed dose subcutaneous LMWH and adjusted dose UFH for treatment of venous thromboembolism (VTE or acute coronary syndromes (ACS. Major bleeding was the primary end point. METHODS: Electronic databases (MEDLINE, EMBASE, and the Cochrane Library were searched up to May 2010 with no language restrictions. Randomized controlled trials in which subcutaneous LMWH were compared to intravenous UFH for the treatment of acute thrombotic events were selected. Two reviewers independently screened studies and extracted data on study design, study quality, incidence of major bleeding, patients' characteristics, type, dose and number of daily administrations of LMWH, co-treatments, study end points and efficacy outcome. Pooled odds ratios (OR and 95% confidence intervals (CI were calculated using the random effects model. RESULTS: Twenty-seven studies were included. A total of 14,002 patients received UFH and 14,635 patients LMWH. Overall, no difference in major bleeding was observed between LMWH patients and UFH (OR = 0.79, 95% CI 0.60-1.04. In patients with VTE LMWH appeared safer than UFH, (OR = 0.68, 95% CI 0.47-1.00. CONCLUSION: The results of our systematic review suggest that the use of LMWH in the treatment of VTE might be associated with a reduction in major bleeding compared with UFH. The choice of which heparin to use to minimize bleeding risk must be based on the single patient, taking into account the bleeding profile of different heparins in different settings.
Davis, Bradley; Welch, Katherine; Walsh-Hart, Sharon; Hanseman, Dennis; Petro, Michael; Gerlach, Travis; Dorlac, Warren; Collins, Jocelyn; Pritts, Timothy
Critical Care Air Transport Teams (CCATTs) are a critical component of the United States Air Force evacuation paradigm. This study was conducted to assess the incidence of task saturation in simulated CCATT missions and to determine if there are predictable performance domains. Sixteen CCATTs were studied over a 6-month period. Performance was scored using a tool assessing eight domains of performance. Teams were also assessed during critical events to determine the presence or absence of task saturation and its impact on patient care. Sixteen simulated missions were reviewed and 45 crisis events identified. Task saturation was present in 22/45 (49%) of crisis events. Scoring demonstrated that task saturation was associated with poor performance in teamwork (odds ratio [OR] = 1.96), communication (OR = 2.08), and mutual performance monitoring (OR = 1.9), but not maintenance of guidelines, task management, procedural skill, and equipment management. We analyzed the effect of task saturation on adverse patient outcomes during crisis events. Adverse outcomes occurred more often when teams were task saturated as compared to non-task-saturated teams (91% vs. 23%; RR 4.1, p < 0.0001). Task saturation is observed in simulated CCATT missions. Nontechnical skills correlate with task saturation. Task saturation is associated with worsening physiologic derangements in simulated patients. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
Emergency department case management: the dyad team of nurse case manager and social worker improve discharge planning and patient and staff satisfaction while decreasing inappropriate admissions and costs: a literature review.
Bristow, Darlene P; Herrick, Charlotte A
A model of emergency department (ED) case management consisting of a social worker and a nurse case manager can prevent inappropriate admissions, improve discharge planning, decrease cost, and enhance patient satisfaction. The individual and combined roles of the dyad team of social worker and nurse case manager are discussed. A literature review includes how a case management dyad team of social worker and nurse case manager in the ED can decrease utilization of the ED for nonemergent visits, promote the use of community resources, and improve discharge planning to avoid excessive costs. The importance of the dyad team working with the interdisciplinary team in the ED, the primary care physician (PCP), and other community health care providers in order to provide a holistic approach to care is addressed. A discussion about the improvement of both patient and staff satisfaction demonstrates the results of case management strategies that support and advocate for patients to receive quality, cost-effective care across the health care continuum, while decreasing the use of the ED for nonemergent care.
Ogiwara, Miyoko; Irino, Hiromi; Yamaoka, Keita; Fujimaki, Yoko; Watanabe, Mutsuko; Yamamoto, Takeshi; Hirohara, Masayoshi; Kushida, Kazuki
Due to the rising number of patients at the terminal stage or with high dependence on medical care, the cooperation of 2 teams, the hospital discharge support team and the home support team, has become very important. The recent spread of the Internet has enabled both patients and their families who have chosen home care to obtain a wide range of information about home services, as well as diseases, and form a picture of what will happen. However, there are actually many cases in which patients and families find that things are not as they imagined, and they are uneasy and unsure of what to do. Here, we report a case in which the mismatch between the patient's and family's expectations created an unsatisfactory care situation.
This paper will address the purpose, scope, and approach of the Department of Energy Tiger Team Assessments. It will use the Tiger Team Assessment experience of Sandia National Laboratories at Albuquerque, New Mexico, as illustration
Investigating virtual team collaboration in industry using grounded theory this paper presents the in-dept analysis of empirical work conducted in a global organization of 100.000 employees where a global virtual team with participants from Sweden, United Kingdom, Canada, and North America were...... studied. The research question investigated is how collaboration is negotiated within virtual teams? This paper presents findings concerning how collaboration is negotiated within a virtual team and elaborate the difficulties due to invisible articulation work and managing multiple communities...... in transforming the virtual team into a community. It is argued that translucence in communication structures within the virtual team and between team and management is essential for engaging in a positive transformation process of trustworthiness supporting the team becoming a community, managing the immanent...
Leadership Team Leadership Team Learn more about the expertise and technical skills of the wind Initiative and provides leadership in the focus areas of high-fidelity modeling, wind power plant controls
Fransen, J. (2012). Teaming up for learning: Team effectiveness in collaborative learning in higher education (Doctoral dissertation). November, 16, 2012, Open University in the Netherlands (CELSTEC), Heerlen, The Netherlands.
... A to Z Health Guide Your Dialysis Care Team Tweet Share Print Email Good health care is ... dialyzers (artificial kidneys) for reuse. Vascular Access Care Team If you are a hemodialysis patient, another group ...
Gaddy, C.D.; Koontz, J.L.
Although team training has received considerable attention throughout industry, a systematic approach to team skills training has only recently been proposed for control room crews. One important step of the approach to team skills training is evaluation of team skills. This paper describes methods and resources, and program considerations in team skills evaluation. The three areas pertaining to methods and resources are: development of evaluation criteria, preparation of event scenarios, and instructor training and additional resources. The program considerations include sequencing and coordination of team skills evaluation in the context of an overall operator training program
Kim, Ji Tae; Lee, Dhong Hoon; Choi, Young Sung [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)
Event investigation is one of the key means of enhancing nuclear safety deriving effective measures and preventing recurrences. However, it is difficult to analyze organizational factors and safety culture. This paper tries to review human error-related events from perspectives of organizational factors and safety culture, and to derive insights and lessons learned in developing the regulatory infrastructure of plant oversight on safety culture.
Kim, Ji Tae; Lee, Dhong Hoon; Choi, Young Sung
Event investigation is one of the key means of enhancing nuclear safety deriving effective measures and preventing recurrences. However, it is difficult to analyze organizational factors and safety culture. This paper tries to review human error-related events from perspectives of organizational factors and safety culture, and to derive insights and lessons learned in developing the regulatory infrastructure of plant oversight on safety culture
Aleman, A.; Canadell, F.; Beltran, F.; Pifarre, D.; Hernandez, H.; Gasca, C.
During the risk analysis update of Asco PP (2010), it has been carried out a review of the vulnerabilities against severe accidents caused by external events (individual Plant Examination of external Events, IPEEE). The assessment has included analysis of accidents in industrial and military facilities nearby and transportation accidents (i.e., rail, road and aircraft impact) release of hazardous materials on site, external flooding, turbine missiles and strong winds. (Author)
Bailiff, I.K.; Sholom, S.; McKeever, S.W.S.
This paper reviews recent research on the application of the physical dosimetry techniques of electron paramagnetic resonance (EPR) and luminescence (optically stimulated luminescence, OSL, and thermoluminescence, TL) to determine radiation dose following catastrophic, large-scale radiological events. Such data are used in dose reconstruction to obtain estimates of dose due to the exposure to external sources of radiation, primarily gamma radiation, by individual members of the public and by populations. The EPR and luminescence techniques have been applied to a wide range of radiological studies, including nuclear bomb detonation (e.g., Hiroshima and Nagasaki), nuclear power plant accidents (e.g., Chernobyl), radioactive pollution (e.g., Mayak plutonium facility), and in the future could include terrorist events involving the dispersal of radioactive materials. In this review we examine the application of these techniques in ‘emergency’ and ‘retrospective’ modes of operation that are conducted on two distinct timescales. For emergency dosimetry immediate action to evaluate dose to individuals following radiation exposure is required to assess deterministic biological effects and to enable rapid medical triage. Retrospective dosimetry, on the other hand, contributes to the reconstruction of doses to populations and individuals following external exposure, and contributes to the long-term study of stochastic processes and the consequential epidemiological effects. Although internal exposure, via ingestion of radionuclides for example, can be a potentially significant contributor to dose, this review is confined to those dose components arising from exposure to external radiation, which in most studies is gamma radiation. The nascent emergency dosimetry measurement techniques aim to perform direct dose evaluations for individuals who, as members of the public, are most unlikely to be carrying a dosimeter issued for radiation monitoring purposes in the event
Kaeding, Christopher C; Borchers, James
This article outlines the value of having the team physician traveling with athletes to away venues for competitions or training sessions. At present, this travel presents several issues for the team physician who crosses state lines for taking care of the athletes. In this article, these issues and their possible remedies are discussed. A concern for the travelling team physician is practicing medicine while caring for the team in a state where the physician is not licensed. Another issue can be the transportation of controlled substances in the course of providing optimal care for the team athletes. These two issues are regulatory and legislative issues at both the state and federal levels. On the practical side of being a team physician, the issues of emergency action plans, supplies, and when to transport injured or ill patients are also reviewed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Dyson, C.J.; Winte, N.C.
This paper is a description of an approach to managing Exploration and Production assets through the operation of multidisciplinary business teams. The business team approach can assist in improved asset performance in terms of efficiency, motivation and business results, compared with more traditional matrix style hierarchies. Within this paper certain critical success factors for the long term success of multidiscipline teams are outlined, together with some of the risk of business team operation
Hoda, Rashina; Babb, Jeff; Nørbjerg, Jacob
to sacrifice learning-focused practices. Effective learning under pressure involves conscious efforts to implement original agile practices such as retrospectives and adapted strategies such as learning spikes. Teams, their management, and customers must all recognize the importance of creating learning teams......Today's software development challenges require learning teams that can continuously apply new engineering and management practices, new and complex technical skills, cross-functional skills, and experiential lessons learned. The pressure of delivering working software often forces software teams...
This paper is divided to practical and theoretical part. Theoretical part defines essential background of personality and work psychology which are pillars for using the personality and roles typology in practical part. I also define conceptions such as group, team, procedures of making the team. Practical part is focused at making the repertoary grid which outlines proximity of team roles, anchored in the repertoary grids upon personal atributes basis and picked team positions.
Trager, E. A.
The purpose of this paper is to describe several aspects of a Human Performance Event Database (HPED) that is being developed by the Nuclear Regulatory Commission. These include the background, the database structure and basis for the structure, the process for coding and entering event records, the results of preliminary analyses of information in the database, and plans for the future. In 1992, the Office for Analysis and Evaluation of Operational Data (AEOD) within the NRC decided to develop a database for information on human performance during operating events. The database was needed to help classify and categorize the information to help feedback operating experience information to licensees and others. An NRC interoffice working group prepared a list of human performance information that should be reported for events and the list was based on the Human Performance Investigation Process (HPIP) that had been developed by the NRC as an aid in investigating events. The structure of the HPED was based on that list. The HPED currently includes data on events described in augmented inspection team (AIT) and incident investigation team (IIT) reports from 1990 through 1996, AEOD human performance studies from 1990 through 1993, recent NRR special team inspections, and licensee event reports (LERs) that were prepared for the events. (author)
Kallini, Joseph Ralph; Gabr, Ahmed; Thorlund, Kristian; Balijepalli, Chakrapani; Ayres, Dieter; Kanters, Steve; Ebrahim, Shanil; Mills, Edward; Lewandowski, Robert J; Salem, Riad
To compare the safety profiles of TheraSphere ® (glass) and SIR-Spheres ® (resin) Y90 microspheres for the treatment of hepatocellular carcinoma. A systematic review was conducted using the databases MEDLINE, Embase, and Cochrane Trials Register to identify all relevant studies. Baseline characteristics and adverse events of all grades related to gastrointestinal, hepatobiliary, and respiratory systems were collected along with commonly reported outcomes related to post-embolization syndrome. For all outcomes, data from each study were tabulated for each intervention. Adverse events and patients were summed across studies on TheraSphere ® and SIR-Spheres ® , respectively, and the resulting proportion of patients experiencing an outcome for both interventions was calculated. Thirty-one observational studies were included in the review. In the adverse events of all grades, more patients treated with resin microspheres reported gastric ulcers, hepatic encephalopathy, cholecystitis, hepatic failure, and pleural effusion. Patients treated with resin microspheres also had more hepatobiliary adverse events of grade 3 or higher. In the events related to post-embolization syndrome, glass microspheres exhibited a similar safety profile compared to resin microspheres. Ascites and nausea grade 3 or higher were recorded more frequently with glass microsphere treatment. Based on this review of the published literature, glass microspheres exhibit a safety profile with fewer gastrointestinal and pulmonary adverse events compared to resin microspheres in the treatment of hepatocellular carcinoma.
Nancarrow, Susan A; Booth, Andrew; Ariss, Steven; Smith, Tony; Enderby, Pam; Roots, Alison
Interdisciplinary team work is increasingly prevalent, supported by policies and practices that bring care closer to the patient and challenge traditional professional boundaries. To date, there has been a great deal of emphasis on the processes of team work, and in some cases, outcomes. This study draws on two sources of knowledge to identify the attributes of a good interdisciplinary team; a published systematic review of the literature on interdisciplinary team work, and the perceptions of over 253 staff from 11 community rehabilitation and intermediate care teams in the UK. These data sources were merged using qualitative content analysis to arrive at a framework that identifies characteristics and proposes ten competencies that support effective interdisciplinary team work. Ten characteristics underpinning effective interdisciplinary team work were identified: positive leadership and management attributes; communication strategies and structures; personal rewards, training and development; appropriate resources and procedures; appropriate skill mix; supportive team climate; individual characteristics that support interdisciplinary team work; clarity of vision; quality and outcomes of care; and respecting and understanding roles. We propose competency statements that an effective interdisciplinary team functioning at a high level should demonstrate.
Dickson, Ellen L.
Experience with student teams working on policy analysis projects indicates the need for faculty supervision of teams in the process of addressing complex issues. The problem-solving approach adopted in one policy analysis course is described, including assignments and tasks, issues and sponsors, team dynamics, conflict management, and the…
Bouwmans, Machiel; Runhaar, Piety; Wesselink, Renate; Mulder, Martin
The implementation of educational innovations by teachers seems to benefit from a team approach and team learning. The study's goal is to examine to what extent transformational leadership is associated with team learning, and to investigate the mediating roles of participative decision-making,
De Rooij, J.P.G.
The aim of this dissertation was to study the little examined, yet important issue of leadership for distributed teams. Distributed teams are defined as: “teams of which members are geographically distributed and are therefore working predominantly via mediated communication means on an
Norton-Westwood, Deborah; Pearson, Alan; Robertson-Malt, Suzanne
Background Children's' hospitals are by definition hospitals specialized in all aspects of children's care, but are they and if so, how is that achieved? Are healthcare facilities more than a 'space' in which to ask medical questions, seek answers and obtain treatment? Some suggest that the very design of a space can positively or negatively impact healing, hence the term referred to by those in the architectural community as 'healing spaces'. To date empirical studies to provide evidence to this effect, although growing in number, are still few. What is known is that hospitals, doctor's offices and dental offices alike unintentionally create an atmosphere, particularly for children, that add to an already heightened level of anxiety and fear. Designing a children's hospital, unlike a generalist facility, presents a unique and significant challenge. Those involved in designing such hospitals are faced with the opportunity and responsibility to care for and respond to the needs of children across the age spectrum; infants to toddlers, school aged children to adolescents. As healthcare professionals and architects, it is our responsibility to create healthcare facilities that are of purposeful design; anticipating and alleviating children's anxiety and fear wherever possible.Objectives The objective of this systematic review is to evaluate the effects of environmental design strategies in healthcare institutions such as hospitals and dental offices on event-related anxiety in the paediatric population.Inclusion Criteria This comprehensive systematic review involved children from the age of 1 to 18 years of age admitted to a healthcare facility with the primary outcomes of interest being four key design strategies: positive distraction; elimination of environmental stressors; access to social support and choice (control); and connection to nature.Search Strategy Using the Joanna Briggs defined three step search strategy, both published and unpublished studies were
Saleh, Joseph H.; Saltmarsh, Elizabeth A.; Favarò, Francesca M.; Brevault, Loïc
An important consideration in safety analysis and accident prevention is the identification of and response to accident precursors. These off-nominal events are opportunities to recognize potential accident pathogens, identify overlooked accident sequences, and make technical and organizational decisions to address them before further escalation can occur. When handled properly, the identification of precursors provides an opportunity to interrupt an accident sequence from unfolding; when ignored or missed, precursors may only provide tragic proof after the fact that an accident was preventable. In this work, we first provide a critical review of the concept of precursor, and we highlight important features that ought to be distinguished whenever accident precursors are discussed. We address for example the notion of ex-ante and ex-post precursors, identified for postulated and instantiated (occurred) accident sequences respectively, and we discuss the feature of transferability of precursors. We then develop a formal (mathematical) definition of accident precursors as truncated accident sequences within the modeling framework of Discrete Event Systems. Additionally, we examine the related notions of “accident pathogens” as static or lurking adverse conditions that can contribute to or aggravate an accident, as well as “near misses”, “warning signs” and the novel concept of “accident pathway”. While these terms are within the same linguistic neighborhood as “accident precursors”, we argue that there are subtle but important differences between them and recommend that they not be used interchangeably for the sake of accuracy and clarity of communication within the risk and safety community. We also propose venues for developing quantitative importance measures for accident precursors, similar to component importance measures in reliability engineering. Our objective is to establish a common understanding and clear delineation of these terms, and
Full Text Available The American College of Surgeons' National Surgical Quality Improvement Program (NSQIP is the first nationally validated, risk-adjusted, outcomes-based program to measure and compare the quality of surgical care across North America. Participation in this program may provide an opportunity to reduce the incidence of adverse events related to surgery.A systematic review of the literature was performed. MedLine, EMBASE and PubMed were searched for studies relevant to NSQIP. Patient characteristics, intervention, and primary outcome measures were abstracted. The intervention was participation in NSQIP and monitoring of Individual Site Summary Reports with or without implementation of a quality improvement program. The outcomes of interest were change in peri-operative adverse events and mortality represented by pooled risk ratios (pRR and 95% confidence intervals (CI.Eleven articles reporting on 35 health care institutions were included. Nine (82% of the eleven studies implemented a quality improvement program. Minimal improvements in superficial (pRR 0.81; 95% CI 0.72-0.91, deep (pRR 0.82; 95% CI0.64-1.05 and organ space (pRR 1.15; 95% CI 0.96-1.37 infections were observed at centers that did not institute a quality improvement program. However, centers that reported formal interventions for the prevention and treatment of infections observed substantial improvements (superficial pRR 0.55, 95% CI 0.39-0.77; deep pRR 0.61, 95% CI 0.50-0.75, and organ space pRR 0.60, 95% CI 0.50-0.71. Studies evaluating other adverse events noted decreased incidence following NSQIP participation and implementation of a formal quality improvement program.These data suggest that NSQIP is effective in reducing surgical morbidity. Improvement in surgical quality appears to be more marked at centers that implemented a formal quality improvement program directed at the reduction of specific morbidities.
Kain, Daniel L.
Teams are incompatible with the scientific management philosophy underlying traditional curricular and organizational theory. This article examines J. R. Hackman's book "Groups That Work (and Those That Don't): Creating Conditions for Effective Teamwork" (1990), as it illuminates the experience of teaching on a middle school…
Sieweke, Jost; Zhao, B.
To explore the dynamics involved in team coordination, we examine the impact of team familiarity and team leader experience on team coordination errors (TCEs). We argue that team familiarity has a U-shaped effect on TCEs. We study the moderating effects of team leader prior experience and team
Rosenman, Elizabeth D.; Branzetti, Jeremy B.; Fernandez, Rosemarie
Background Team leadership is a critical skill for emergency medicine physicians that directly affects team performance and the quality of patient care. There exists a robust body of team science research supporting team leadership conceptual models and behavioral skill sets. However, to date, this work has not been widely incorporated into health care team leadership education. Objective This narrative review has 3 aims: (1) to synthesize the team science literature and to translate important concepts and models to health care team leadership; (2) to describe how team leadership is currently represented in the health care literature and in the Accreditation Council for Graduate Medical Education Milestones for emergency medicine; and (3) to propose a novel, evidence-based framework for the assessment of team leadership in emergency medicine. Methods We conducted a narrative review of the team science and health care literature. We summarized our findings and identified a list of team leadership behaviors that were then used to create a framework for team leadership assessment. Results Current health care team leadership measurement tools do not incorporate evidence-based models of leadership concepts from other established domains. The emergency medicine milestones include several team leadership behaviors as part of a larger resident evaluation program. However, they do not offer a comprehensive or cohesive representation of the team leadership construct. Conclusions Despite the importance of team leadership to patient care, there is no standardized approach to team leadership assessment in emergency medicine. Based on the results of our review, we propose a novel team leadership assessment framework that is supported by the team science literature. PMID:27413434
Rosenman, Elizabeth D; Branzetti, Jeremy B; Fernandez, Rosemarie
Team leadership is a critical skill for emergency medicine physicians that directly affects team performance and the quality of patient care. There exists a robust body of team science research supporting team leadership conceptual models and behavioral skill sets. However, to date, this work has not been widely incorporated into health care team leadership education. This narrative review has 3 aims: (1) to synthesize the team science literature and to translate important concepts and models to health care team leadership; (2) to describe how team leadership is currently represented in the health care literature and in the Accreditation Council for Graduate Medical Education Milestones for emergency medicine; and (3) to propose a novel, evidence-based framework for the assessment of team leadership in emergency medicine. We conducted a narrative review of the team science and health care literature. We summarized our findings and identified a list of team leadership behaviors that were then used to create a framework for team leadership assessment. Current health care team leadership measurement tools do not incorporate evidence-based models of leadership concepts from other established domains. The emergency medicine milestones include several team leadership behaviors as part of a larger resident evaluation program. However, they do not offer a comprehensive or cohesive representation of the team leadership construct. Despite the importance of team leadership to patient care, there is no standardized approach to team leadership assessment in emergency medicine. Based on the results of our review, we propose a novel team leadership assessment framework that is supported by the team science literature.
Francis Char DeCroos
Conclusion: Neovascular events occur in eyes with CRVO undergoing serial anti-VEGF therapy, and these events may be delayed compared to the natural history of CRVO-associated neovascularization. Iris neovascularization occurred most frequently.
Danna, Paolo; Sagone, Antonio; Proietti, Riccardo; Arensi, Andrea; Viecca, Maurizio; Santangeli, Pasquale; Di Biase, Luigi; Natale, Andrea
Atrial fibrillation (AF) is the most common cardiac arrhythmia. The mortality rate of patients with AF is doubled as compared to non-fibrillating controls. The most relevant complication of AF is a major increase in the risk of stroke. The gold standard in reducing cerebrovascular events in AF is warfarin therapy, which is not free from contraindications and limitations. The left atrial appendage (LAA) is the main source of emboli causing stroke in AF. LAA closure is a seducing approach to stroke risk reduction in AF without anticoagulation. Since 1949, heart surgeons have performed LAA closure or amputation in patients with AF. Percutaneous endovascular LAA closure is a new, less invasive, technique to reach the goal. Several devices have been used to perform this intervention, and the results of published trials are encouraging in terms of effectiveness and relative safety of this attractive technique. In this review we examine the published trials and data on percutaneous LAA closure, with particular attention to the risks and benefits of this procedure.
Peters, Sanne A E; den Ruijter, Hester M; Bots, Michiel L
Abstract Adequate risk assessment for cardiovascular disease (CVD) is essential as a guide to initiate drug treatment. Current methods based on traditional risk factors could be improved considerably. Although brachial flow-mediated dilation (FMD) predicts subsequent cardiovascular events, its predictive value on top of traditional risk factors is unknown. We performed a systematic review to evaluate the incremental predictive value of FMD on top of traditional risk factors in asymptomatic individuals. Using PubMed and reference tracking, three studies were identified that reported on the incremental value of FMD using change in the area under the curve (AUC). Two large cohort studies found no improvement in AUC when FMD was added to traditional risk prediction models, whereas one small case-control study found an improvement. One study used the net reclassification improvement (NRI) to assess whether FMD measurement leads to correct risk stratification in risk categories. Although this study did not find an improvement in AUC, the NRI was statistically significant. Based on the reclassification results of this study, FMD measurement might be helpful in risk prediction. Evidence supporting the use of FMD measurement in clinical practice for risk stratification for CVD on top of traditional risk factors is limited, and future studies are needed.
The 600-km Mentawai megathrust had produced two giant historical earthquakes generating big tsunamies in 1797 and 1833. The SuGAr (Sumatran GPS continuous Array) network, first deployed in 2002, shows that the subduction interface underlying Mentawai Islands and the neighboring Nias section in the north are fully locked, thus confirming their potential hazards. Outreach activities to warn people about earthquake and tsunamies had been started since 4 months prior to the 26 December 2004 in Aceh-Andaman earthquake (Mw 9.15). Later in March 2005, the expected megathrust earthquake (Mw 8.7) hit Nias-Simelue area and killed about 2000 people, releasing the accumulated strain since the previous 1861 event (~Mw 8.5). After then many Mw 7s and smaller events occured in Sumatra, filling areas between and around two giant ruptures and heighten seismicities in neighboring areas. In March 2007, the twin earthquake disaster (Mw 6.3 and Mw 6.4) broke two consecutive segments of the transcurrent Sumatran fault in the Singkarak lake area. Only six month later, in September 2007, the rapid-fire-failures of three consecutive megathrust patches (Mw 8.5, Mw 7.9 and Mw 7.0) ruptured a 250-km-section of the southern part of the Mentawai. It was a big surprise since this particular section is predicted as a very-low coupled section from modelling the SuGAr data, and hence, bypassing the more potential fully coupled section of the Mentawai in between the 2005 and 2007 ruptures. In September 2009, a rare unexpected event (Mw 7.6) suddenly ruptured an intracrustal fault in the subducted slab down under Padang City and killed about 500 people. Padang had been in preparation for the next tsunami but not for strong shakes from near by major earthquake. This event seems to have remotely triggered another Mw 6.7 on the Sumatran fault near kerinci Lake, a few hundred kilometers south of Padang, in less than a day. Just a year later, in November 2010, again an unexpected large slow-slip event of
Desaulniers, David R.
As part of its regulatory activities, the U.S. Nuclear Regulatory Commission (NRC) reviews events and routine activities at commercial nuclear power facilities throughout the United States. Frequently, these reviews have highlighted team performance as an important factor in either the initiation or mitigation of significant events and conditions at these facilities. This paper summarizes operating experience relevant to the understanding of teamwork at U.S. nuclear power plants during recent years, describes the specific behaviors that were considered detrimental to team performance, and discusses the conditions that were identified as contributing to these behaviors. (author)
Ogletree, Billy T.; Bull, Jeannette; Drew, Ruby; Lunnen, Karen Y.
This article reviews the assessment procedures, treatment procedures, and the advantages and disadvantages of three professional-family team models: multidisciplinary teams, interdisciplinary teams, and transdisciplinary teams. Guidelines for optimal team participation are provided. The importance of mission statements, communication, trust,…
Piza, Felipe Maia de Toledo; Celi, Leo Anthony; Deliberato, Rodrigo Octavio; Bulgarelli, Lucas; de Carvalho, Fabricio Rodrigues Torres; Filho, Roberto Rabello; de La Hoz, Miguel Angel Armengol; Kesselheim, Jennifer Cohn
Datathons are increasingly organized in the healthcare field. The goal is to assemble people with different backgrounds to work together as a team and engage in clinically relevant research or develop algorithms using health-related datasets. Criteria to assess the return of investment on such events have traditionally included publications produced, patents for prediction, classification, image recognition and other types of software, and start-up companies around the application of machine learning in healthcare. Previous studies have not evaluated whether a datathon can promote affective learning and effective teamwork. Fifty participants of a health datathon event in São Paulo, Brazil at Hospital Israelita Albert Einstein (HIAE) were divided into 8 groups. A survey with 25 questions, using the Affective Learning Scale and Team-Review Questionnaire, was administered to assess team effectiveness and affective learning during the event. Multivariate regression models and Pearson's correlation tests were performed to evaluate the effect of affective learning on teamwork. Majority of the participants were male 76% (37/49); 32% (16/49) were physicians. The mean score for learning (scale from 1 to 10) was 8.38, while that for relevance of the perceived teamwork was 1.20 (scale from 1 to 5; "1" means most relevant). Pearson's correlation between the learning score and perception of teamwork showed moderate association (r = 0.36, p = 0.009). Five learning and 10 teamwork variables were on average positively graded in the event. The final regression model includes all learning and teamwork variables. Effective leadership was strongly correlated with affective learning (β = -0.27, p Effective leadership, team accomplishment, criticism, individual development and creativity were the variables significantly associated with higher levels of affective learning. It is feasible to enhance affective knowledge and the skill to work in a team during a datathon. We
accident has been exemplary, particularly illustrated by the dedicated, determined and expert staff working under exceptional circumstances; Japan's long-term response, including the evacuation of the area around stricken reactors, has been impressive and well organized. A suitable and timely follow-up programme on public and worker exposures and health monitoring would be beneficial; The tsunami hazard for several sites was underestimated. Nuclear plant designers and operators should appropriately evaluate and protect against the risks of all natural hazards, and should periodically update those assessments and assessment methodologies; Nuclear regulatory systems should address extreme events adequately, including their periodic review, and should ensure that regulatory independence and clarity of roles are preserved; and The Japanese accident demonstrates the value of hardened on-site Emergency Response Centres with adequate provisions for handling all necessary emergency roles, including communications. ''I appreciate the high level of cooperation and access that our team has received from Japan, as the devastating natural events and subsequent accident at TEPCO's Fukushima Daiichi have provided a unique opportunity for learning,'' Weightman said. ''It is of fundamental importance for all with responsibility for nuclear safety across the world to seek to learn from this unique event.'' (IAEA)
Team-based learning was selected as a strategy to help engage pre-registration undergraduate nursing students in a second-year evidence-informed decision making course. To detail the preparatory work required to deliver a team-based learning course; and to explore the perceptions of the teaching team of their first experience using team-based learning. Descriptive evaluation. Information was extracted from a checklist and process document developed by the course leader to document the work required prior to and during implementation. Members of the teaching team were interviewed by a research assistant at the end of the course using a structured interview schedule to explore perceptions of first time implementation. There were nine months between the time the decision was made to use team-based learning and the first day of the course. Approximately 60days were needed to reconfigure the course for team-based learning delivery, develop the knowledge and expertise of the teaching team, and develop and review the resources required for the students and the teaching team. This reduced to around 12days for the subsequent delivery. Interview data indicated that the teaching team were positive about team-based learning, felt prepared for the course delivery and did not identify any major problems during this first implementation. Implementation of team-based learning required time and effort to prepare the course materials and the teaching team. The teaching team felt well prepared, were positive about using team-based learning and did not identify any major difficulties. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.
Mickan, Sharon M
While it is recognised that effective health care teams are associated with quality patient care, the literature is comparatively sparse in defining the outcomes of effective teamwork. This literature review of the range of organisational, team and individual benefits of teamwork complements an earlier article which summarised the antecedent conditions for (input) and team processes (throughput) of effective teams. This article summarises the evidence for a range of outcome measures of effective teams. Organisational benefits of teamwork include reduced hospitalisation time and costs, reduced unanticipated admissions, better accessibility for patients, and improved coordination of care. Team benefits include efficient use of health care services, enhanced communication and professional diversity. Patients report benefits of enhanced satisfaction, acceptance of treatment and improved health outcomes. Finally, team members report enhanced job satisfaction, greater role clarity and enhanced well-being. Due to the inherent complexity of teamwork, a constituency model of team evaluation is supported where key stakeholders identify and measure the intended benefits of a team.
Misfeldt, Renée; Suter, Esther; Mallinson, Sara; Boakye, Omenaa; Wong, Sabrina; Nasmith, Louise
This paper discusses findings from a high-level scan of the contextual factors and actors that influenced policies on team-based primary healthcare in three Canadian provinces: British Columbia, Alberta and Saskatchewan. The team searched diverse sources (e.g., news reports, press releases, discussion papers) for contextual information relevant to primary healthcare teams. We also conducted qualitative interviews with key health system informants from the three provinces. Data from documents and interviews were analyzed qualitatively using thematic analysis. We then wrote narrative summaries highlighting pivotal policy and local system events and the influence of actors and context. Our overall findings highlight the value of reviewing the context, relationships and power dynamics, which come together and create "policy windows" at different points in time. We observed physician-centric policy processes with some recent moves to rebalance power and be inclusive of other actors and perspectives. The context review also highlighted the significant influence of changes in political leadership and prioritization in driving policies on team-based care. While this existed in different degrees in the three provinces, the push and pull of political and professional power dynamics shaped Canadian provincial policies governing team-based care. If we are to move team-based primary healthcare forward in Canada, the provinces need to review the external factors and the complex set of relationships and trade-offs that underscore the policy process. Copyright © 2017 Longwoods Publishing.
The purpose of this research is to (1) show the effectiveness and success of self-directed work teams within the organization, (2) emphasize the importance of team building in the success of the team, and (3) assist organizations in building self-directed work teams. The researcher used a direct survey and studied the following team building techniques: (1) Is the team`s mission clearly defined to each team member? (2) Are the goals clearly defined and achievable by all team members? (3) Will empowerment (decision-making power) be given equally to all team members? (4) Will open and honest communication be allowed among team members? (5) Will each team member be respected and valued for his/her position on the team? (6) Are self-directed work teams effectively rewarded for accomplishments? (7) Have team members received adequate training to effectively complete their job tasks? Upon completion of the literature review and statistical data, and after analyzing the seven areas of team building techniques, it was determined three of the four teams were successful and effective. The only area of concern to the organization is that the participants felt they did not have true ownership of their teams; that is, team members were not given full empowerment. According to this study and the review of literature, full empowerment must be given to achieve successful and effective teams. If true empowerment is not given, the team will suffer in other areas of team building, and the organization will lose a valuable tool.
Van Hooft, Edwin A J; Van Mierlo, Heleen
Models of team development have indicated that teams typically engage in task delay during the first stages of the team's life cycle. An important question is to what extent this equally applies to all teams, or whether there is variation across teams in the amount of task delay. The present study introduces the concept of team procrastination as a lens through which we can examine whether teams collectively engage in unplanned, voluntary, and irrational delay of team tasks. Based on theory and research on self-regulation, team processes, and team motivation we developed a conceptual multilevel model of predictors and outcomes of team procrastination. In a sample of 209 student debating teams, we investigated whether and why teams engage in collective procrastination as a team, and what consequences team procrastination has in terms of team member well-being and team performance. The results supported the existence of team procrastination as a team-level construct that has some stability over time. The teams' composition in terms of individual-level trait procrastination, as well as the teams' motivational states (i.e., team learning goal orientation, team performance-approach goal orientation in interaction with team efficacy) predicted team procrastination. Team procrastination related positively to team members' stress levels, especially for those low on trait procrastination. Furthermore, team procrastination had an indirect negative relationship with team performance, through teams' collective stress levels. These findings add to the theoretical understanding of self-regulatory processes of teams, and highlight the practical importance of paying attention to team-level states and processes such as team goal orientation and team procrastination.
To say that a team leader's job is a tough one is certainly not saying enough. It is up to the team leader to manage a group of people to be individuals but yet work as a team. The team leader must keep the peace and yet create a revolution with this group all at the same time. The good leader will require a lot of education, training, and tons of practical application to be a success. The good news, however, is that the team leader's job is a rewarding one, one that they'll always feel good about if they do it right. How many of us get the opportunity to take a group of wonderful, thinking individual minds and pull from them ideas that a whole team can take to success? Yes, the job is indeed tough, but the paybacks are many.
Raman, Shanti; Maiese, Michelle; Vasquez, Viviana; Gordon, Paola; Jones, Jennifer M
Child abuse and neglect (CAN) cases presenting to health-services may be complex; when things go seriously wrong such as a child death or near miss, cases are reviewed and health-services and professionals subject to intense scrutiny. While there are a variety of mechanisms to review critical incidents in health-services no formal process for the review of cases where child protection is the primary concern exists in Australia. We aimed to develop a systematic process to review serious events in cases of suspected CAN across two health districts in Sydney, so that shared learnings could fuel system change. Drawing upon mapping, case review, literature findings and using quality improvement methodology, we developed a model named Review of Serious Events (RoSE), in suspected cases of CAN. The RoSE model has the key features of: being child focused; seeking to examine care over a period of time; using child protection staff as lead reviewers; involving health professionals/services in the review who have been involved with the child; and actioning systems change at local levels. The RoSE model was trialled through 2014-2015. Eight cases were reviewed using RoSE; cases were similar to those reviewed prior to having a model. Participant feedback from RoSE group processes was overwhelmingly positive; outputs were transparent and accessible to key stakeholders, there was mixed progress with implementation. The RoSE model is a serious case review process that is strongly child-focused, is both investigative and reflective, led by child protection experts; and can be adapted to other settings and systems. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
O'Horo, John C; Sevilla Berrios, Ronaldo A; Elmer, Jennifer L; Velagapudi, Venu; Caples, Sean M; Kashyap, Rahul; Jensen, Jeffrey B
The purpose of the study is to evaluate the impact of primary service involvement on rapid response team (RRT) evaluations. The study is a combination of retrospective chart review and prospective survey-based evaluation. Data included when and where the activations occurred and the patient's code status, primary service, and ultimate disposition. These data were correlated with survey data from each event. A prospective survey evaluated the primary team's involvement in decision making and the overall subjective quality of the interaction with primary service through a visual analog scale. We analyzed 4408 RRTs retrospectively and an additional 135 prospectively. The primary team's involvement by telephone or in person was associated with significantly more transfers to higher care levels in retrospective (P team involvement, with more frequent changes seen in the retrospective analysis (P = .01). Subjective ratings of communication by the RRT leader were significantly higher when the primary service was involved (P team involvement influences RRT activation processes of care. The RRT role should be an adjunct to, but not a substitute for, an engaged and present primary care team. Copyright © 2014 Elsevier Inc. All rights reserved.
Brett, Jeanne; Behfar, Kristin; Kern, Mary C
Multicultural teams offer a number of advantages to international firms, including deep knowledge of different product markets, culturally sensitive customer service, and 24-hour work rotations. But those advantages may be outweighed by problems stemming from cultural differences, which can seriously impair the effectiveness of a team or even bring itto a stalemate. How can managers best cope with culture-based challenges? The authors conducted in-depth interviews with managers and members of multicultural teams from all over the world. Drawing on their extensive research on dispute resolution and teamwork and those interviews, they identify four problem categories that can create barriers to a team's success: direct versus indirect communication, trouble with accents and fluency, differing attitudes toward hierarchy and authority, and conflicting norms for decision making. If a manager--or a team member--can pinpoint the root cause of the problem, he or she is likelier to select an appropriate strategy for solving it. The most successful teams and managers, the authors found, dealt with multicultural challenges in one of four ways: adaptation (acknowledging cultural gaps openly and working around them), structural intervention (changing the shape or makeup of the team), managerial intervention (setting norms early or bringing in a higher-level manager), and exit (removing a team member when other options have failed). Which strategy is best depends on the particular circumstances--and each has potential complications. In general, though, managers who intervene early and set norms; teams and managers who try to engage everyone on the team; and teams that can see challenges as stemming from culture, not personality, succeed in solving culture-based problems with good humor and creativity. They are the likeliest to harvest the benefits inherent in multicultural teams.
Taylor, Katherine L; Parshuram, Christopher S; Ferri, Susan; Mema, Briseida
Communication during resuscitation is essential for the provision of coordinated, effective care. Previously, we observed 44% of resuscitation communication originated from participants other than the physician team leader; 65% of which was directed to the team, exclusive of the team leader. We called this outer-loop communication. This institutional review board-approved qualitative study used grounded theory analysis of focus groups and interviews to describe and define outer-loop communication and the role of "event manager" as an additional "leader." Participants were health care staff involved in the medical management of resuscitations in a quaternary pediatric academic hospital. The following 3 domains were identified: the existence and rationale of outer-loop communication; the functions fulfilled by outer-loop communication; and the leadership and learning of event manager skills. The role was recognized by all team members and evolved organically as resuscitation complexity increased. A "good" manager has similar qualities to a "good team leader" with strong nontechnical skills. Event managers were not formally identified and no specific training had occurred. "Outer-loop" communication supports resuscitation activities. An event manager gives direction to the team, coordinates activities, and supports the team leader. We describe a new role in resuscitation in light of structural organizational theory and cognitive load with a view to incorporating this structure into resuscitation training. Copyright © 2017 Elsevier Inc. All rights reserved.
Ma, Zheng; Lin, Chih-Cheng; Tanev, Stoyan
elaborates on the role of culture diversity and geographical dispersion in NPD team conflict. A simulation is conducted where organizations may be regarded as complex systems to affect the team conflict with a variety of influences. The results firstly indicate that there are two dimensions of NPD team...... conflict: stable and unstable dimensions with four elements: task characteristics, group members’ relationship, cultural diversity and geographical dispersion; secondly, there are two phenomena whereby the geographical dispersion influences the NPD team interaction, and the influence between cultural...
... over and over again Know the Signs of Post-traumatic Stress Disorder (PTSD) Half of the children who survive traumatic events ... team. Related MedlinePlus Health Topics Child Mental Health Post-Traumatic Stress Disorder Browse the Encyclopedia A.D.A.M., Inc. ...
Full Text Available Objective – To discover how library Web teams’ staffing, backgrounds, tools, and professional development differ among various types of academic libraries.Design – Survey.Setting – Academic libraries in the United States.Subjects – Academic library Web team members.Methods – A systematic sample of every twelfth institution on The Carnegie Classification of Institutions of Higher Education list was used to establish a sample group. A Web search was carriedout to identify each institution’s library Web site and contact information for the Web site designer or most appropriate alternative person. Institutions were excluded from the sample if they had no Web site at all, had no library Web site, had a Web site that did not mention a library, or had a Spanish language Web site. In September 2006 an e-mail was sent to the contact for each institution in the sample group asking them to participate in an online survey. A follow up e-mail was sent two weeks later and the survey closed after one month. The survey respondents were asked to identify their institutions so that analysis of the results in relation to the sizeand type of institution could be carried out. The researchers used a simplified version of the Carnegie classification to sort the responding institutions into five main groups.Main Results – The systematic sample consisted of 288 institutions (sample size 6.5%. The profile of the responding institutions was as follows: associate’s colleges (35.5%, baccalaureate colleges (18.2%, master’s colleges and universities (20.9%, doctorate-granting universities (9% and special focus institutions (15.5%. A total of 110 institutions completed the survey, yielding a response rate of 38.19%, although not all respondents answered all the survey questions. The final sample of 110 was 2.5% of the total 4384 institutions on the Carnegielist. Seventy-one per cent of institutions with multiple libraries shared Web teams, with two
Mellor, M Joanna; Solomon, Renee
Geriatric health care requires the services of an interdisciplinary health care team to assess, treat and order the social service needs of the older person, and this concept needs to be included in geriatric social work education. But while the necessity of interdisciplinary team care is recognized, little focus has been placed on the actual process of developing a functional team. The issues that arise-disparate terminologies, organizational and administrative differentials, turf-and the steps needed for a team to become viable are described, using an interdisciplinary team based in academia as a case model. The academic interdisciplinary team may easily become a forum for 'hot air' rather than a catalyst for good practice. This danger is reviewed with reference to stages in the interdisciplinary team development-- goal development group affiliation; team awareness; and goal evaluation. The chapter concludes with a discussion on the impact of the interdisciplinary team on faculty, students and the academic setting.
Østergaard, H T; Østergaard, D; Lippert, A
In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessment, learning objectives, educational methods including full-scale simulation and evaluations strategies. The use of this framework is illustrated by the present multiprofessional team training in advanced cardiac life support, trauma team training and neonatal resuscitation in Denmark. The challenges of addressing all aspects of team skills, the education of the facilitators, and establishment of evaluation strategies to document the effect of the different types of training on patient safety are discussed.
Østergaard, H T; Østergaard, Ditte; Lippert, A
In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type...... of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessment, learning objectives, educational methods including full-scale simulation and evaluations strategies. The use...... of this framework is illustrated by the present multiprofessional team training in advanced cardiac life support, trauma team training and neonatal resuscitation in Denmark. The challenges of addressing all aspects of team skills, the education of the facilitators, and establishment of evaluation strategies...
Littlepage, Glenn E; Hein, Michael B; Moffett, Richard G; Craig, Paul A; Georgiou, Andrea M
This study evaluates the effectiveness of a training program designed to improve cross-functional coordination in airline operations. Teamwork across professional specializations is essential for safe and efficient airline operations, but aviation education primarily emphasizes positional knowledge and skill. Although crew resource management training is commonly used to provide some degree of teamwork training, it is generally focused on specific specializations, and little training is provided in coordination across specializations. The current study describes and evaluates a multifaceted training program designed to enhance teamwork and team performance of cross-functional teams within a simulated airline flight operations center. The training included a variety of components: orientation training, position-specific declarative knowledge training, position-specific procedural knowledge training, a series of high-fidelity team simulations, and a series of after-action reviews. Following training, participants demonstrated more effective teamwork, development of transactive memory, and more effective team performance. Multifaceted team training that incorporates positional training and team interaction in complex realistic situations and followed by after-action reviews can facilitate teamwork and team performance. Team training programs, such as the one described here, have potential to improve the training of aviation professionals. These techniques can be applied to other contexts where multidisciplinary teams and multiteam systems work to perform highly interdependent activities. © 2016, Human Factors and Ergonomics Society.
Kraan, T.; Velthorst, E.; Smit, H.F.E.; de Haan, L.; van der Gaag, M.
Background: Childhood trauma and recent life-events have been related to psychotic disorders. The aim of the present study was to examine whether childhood trauma and recent life-events are significantly more prevalent in patients at Ultra High Risk (UHR) of developing a psychotic disorder compared
The effect of an active on-ward participation of hospital pharmacists in Internal Medicine teams on preventable Adverse Drug Events in elderly inpatients: protocol of the WINGS study (Ward-oriented pharmacy in newly admitted geriatric seniors)
Klopotowska, J.E.; Wierenga, P.C.; de Rooij, S.E.; Stuijt, C.C.; Arisz, L.; Kuks, P.F.; Dijkgraaf, M.G.; Lie-A-Huen, L.; Smorenburg, S.M.
The potential of clinical interventions, aiming at reduction of pre