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Sample records for human error taxonomy

  1. Human Errors - A Taxonomy for Describing Human Malfunction in Industrial Installations

    DEFF Research Database (Denmark)

    Rasmussen, Jens

    1982-01-01

    This paper describes the definition and the characteristics of human errors. Different types of human behavior are classified, and their relation to different error mechanisms are analyzed. The effect of conditioning factors related to affective, motivating aspects of the work situation as well...... as physiological factors are also taken into consideration. The taxonomy for event analysis, including human malfunction, is presented. Possibilities for the prediction of human error are discussed. The need for careful studies in actual work situations is expressed. Such studies could provide a better...

  2. Using HET taxonomy to help stop human error

    OpenAIRE

    Li, Wen-Chin; Harris, Don; Stanton, Neville A.; Hsu, Yueh-Ling; Chang, Danny; Wang, Thomas; Young, Hong-Tsu

    2010-01-01

    Flight crews make positive contributions to the safety of aviation operations. Pilots have to assess continuously changing situations, evaluate potential risks, and make quick decisions. However, even well-trained and experienced pilots make errors. Accident investigations have identified that pilots’ performance is influenced significantly by the design of the flightdeck interface. This research applies hierarchical task analysis (HTA) and utilizes the Human Error Template (HET) taxonomy to ...

  3. Team errors: definition and taxonomy

    International Nuclear Information System (INIS)

    Sasou, Kunihide; Reason, James

    1999-01-01

    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

  4. Evaluating a medical error taxonomy.

    OpenAIRE

    Brixey, Juliana; Johnson, Todd R.; Zhang, Jiajie

    2002-01-01

    Healthcare has been slow in using human factors principles to reduce medical errors. The Center for Devices and Radiological Health (CDRH) recognizes that a lack of attention to human factors during product development may lead to errors that have the potential for patient injury, or even death. In response to the need for reducing medication errors, the National Coordinating Council for Medication Errors Reporting and Prevention (NCC MERP) released the NCC MERP taxonomy that provides a stand...

  5. A human error taxonomy for analysing healthcare incident reports: assessing reporting culture and its effects on safety perfomance

    DEFF Research Database (Denmark)

    Itoh, Kenji; Omata, N.; Andersen, Henning Boje

    2009-01-01

    The present paper reports on a human error taxonomy system developed for healthcare risk management and on its application to evaluating safety performance and reporting culture. The taxonomy comprises dimensions for classifying errors, for performance-shaping factors, and for the maturity...

  6. FRamework Assessing Notorious Contributing Influences for Error (FRANCIE): Perspective on Taxonomy Development to Support Error Reporting and Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lon N. Haney; David I. Gertman

    2003-04-01

    Beginning in the 1980s a primary focus of human reliability analysis was estimation of human error probabilities. However, detailed qualitative modeling with comprehensive representation of contextual variables often was lacking. This was likely due to the lack of comprehensive error and performance shaping factor taxonomies, and the limited data available on observed error rates and their relationship to specific contextual variables. In the mid 90s Boeing, America West Airlines, NASA Ames Research Center and INEEL partnered in a NASA sponsored Advanced Concepts grant to: assess the state of the art in human error analysis, identify future needs for human error analysis, and develop an approach addressing these needs. Identified needs included the need for a method to identify and prioritize task and contextual characteristics affecting human reliability. Other needs identified included developing comprehensive taxonomies to support detailed qualitative modeling and to structure meaningful data collection efforts across domains. A result was the development of the FRamework Assessing Notorious Contributing Influences for Error (FRANCIE) with a taxonomy for airline maintenance tasks. The assignment of performance shaping factors to generic errors by experts proved to be valuable to qualitative modeling. Performance shaping factors and error types from such detailed approaches can be used to structure error reporting schemes. In a recent NASA Advanced Human Support Technology grant FRANCIE was refined, and two new taxonomies for use on space missions were developed. The development, sharing, and use of error taxonomies, and the refinement of approaches for increased fidelity of qualitative modeling is offered as a means to help direct useful data collection strategies.

  7. A human error taxonomy and its application to an automatic method accident analysis

    International Nuclear Information System (INIS)

    Matthews, R.H.; Winter, P.W.

    1983-01-01

    Commentary is provided on the quantification aspects of human factors analysis in risk assessment. Methods for quantifying human error in a plant environment are discussed and their application to system quantification explored. Such a programme entails consideration of the data base and a taxonomy of factors contributing to human error. A multi-levelled approach to system quantification is proposed, each level being treated differently drawing on the advantages of different techniques within the fault/event tree framework. Management, as controller of organization, planning and procedure, is assigned a dominant role. (author)

  8. An error taxonomy system for analysis of haemodialysis incidents.

    Science.gov (United States)

    Gu, Xiuzhu; Itoh, Kenji; Suzuki, Satoshi

    2014-12-01

    This paper describes the development of a haemodialysis error taxonomy system for analysing incidents and predicting the safety status of a dialysis organisation. The error taxonomy system was developed by adapting an error taxonomy system which assumed no specific specialty to haemodialysis situations. Its application was conducted with 1,909 incident reports collected from two dialysis facilities in Japan. Over 70% of haemodialysis incidents were reported as problems or complications related to dialyser, circuit, medication and setting of dialysis condition. Approximately 70% of errors took place immediately before and after the four hours of haemodialysis therapy. Error types most frequently made in the dialysis unit were omission and qualitative errors. Failures or complications classified to staff human factors, communication, task and organisational factors were found in most dialysis incidents. Device/equipment/materials, medicine and clinical documents were most likely to be involved in errors. Haemodialysis nurses were involved in more incidents related to medicine and documents, whereas dialysis technologists made more errors with device/equipment/materials. This error taxonomy system is able to investigate incidents and adverse events occurring in the dialysis setting but is also able to estimate safety-related status of an organisation, such as reporting culture. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  9. A taxonomy for human reliability analysis

    International Nuclear Information System (INIS)

    Beattie, J.D.; Iwasa-Madge, K.M.

    1984-01-01

    A human interaction taxonomy (classification scheme) was developed to facilitate human reliability analysis in a probabilistic safety evaluation of a nuclear power plant, being performed at Ontario Hydro. A human interaction occurs, by definition, when operators or maintainers manipulate, or respond to indication from, a plant component or system. The taxonomy aids the fault tree analyst by acting as a heuristic device. It helps define the range and type of human errors to be identified in the construction of fault trees, while keeping the identification by different analysts consistent. It decreases the workload associated with preliminary quantification of the large number of identified interactions by including a category called 'simple interactions'. Fault tree analysts quantify these according to a procedure developed by a team of human reliability specialists. The interactions which do not fit into this category are called 'complex' and are quantified by the human reliability team. The taxonomy is currently being used in fault tree construction in a probabilistic safety evaluation. As far as can be determined at this early stage, the potential benefits of consistency and completeness in identifying human interactions and streamlining the initial quantification are being realized

  10. Threat and error management for anesthesiologists: a predictive risk taxonomy

    Science.gov (United States)

    Ruskin, Keith J.; Stiegler, Marjorie P.; Park, Kellie; Guffey, Patrick; Kurup, Viji; Chidester, Thomas

    2015-01-01

    Purpose of review Patient care in the operating room is a dynamic interaction that requires cooperation among team members and reliance upon sophisticated technology. Most human factors research in medicine has been focused on analyzing errors and implementing system-wide changes to prevent them from recurring. We describe a set of techniques that has been used successfully by the aviation industry to analyze errors and adverse events and explain how these techniques can be applied to patient care. Recent findings Threat and error management (TEM) describes adverse events in terms of risks or challenges that are present in an operational environment (threats) and the actions of specific personnel that potentiate or exacerbate those threats (errors). TEM is a technique widely used in aviation, and can be adapted for the use in a medical setting to predict high-risk situations and prevent errors in the perioperative period. A threat taxonomy is a novel way of classifying and predicting the hazards that can occur in the operating room. TEM can be used to identify error-producing situations, analyze adverse events, and design training scenarios. Summary TEM offers a multifaceted strategy for identifying hazards, reducing errors, and training physicians. A threat taxonomy may improve analysis of critical events with subsequent development of specific interventions, and may also serve as a framework for training programs in risk mitigation. PMID:24113268

  11. Fail Better: Toward a Taxonomy of E-Learning Error

    Science.gov (United States)

    Priem, Jason

    2010-01-01

    The study of student error, important across many fields of educational research, has begun to attract interest in the field of e-learning, particularly in relation to usability. However, it remains unclear when errors should be avoided (as usability failures) or embraced (as learning opportunities). Many domains have benefited from taxonomies of…

  12. A preliminary taxonomy of medical errors in family practice.

    Science.gov (United States)

    Dovey, S M; Meyers, D S; Phillips, R L; Green, L A; Fryer, G E; Galliher, J M; Kappus, J; Grob, P

    2002-09-01

    To develop a preliminary taxonomy of primary care medical errors. Qualitative analysis to identify categories of error reported during a randomized controlled trial of computer and paper reporting methods. The National Network for Family Practice and Primary Care Research. Family physicians. Medical error category, context, and consequence. Forty two physicians made 344 reports: 284 (82.6%) arose from healthcare systems dysfunction; 46 (13.4%) were errors due to gaps in knowledge or skills; and 14 (4.1%) were reports of adverse events, not errors. The main subcategories were: administrative failure (102; 30.9% of errors), investigation failures (82; 24.8%), treatment delivery lapses (76; 23.0%), miscommunication (19; 5.8%), payment systems problems (4; 1.2%), error in the execution of a clinical task (19; 5.8%), wrong treatment decision (14; 4.2%), and wrong diagnosis (13; 3.9%). Most reports were of errors that were recognized and occurred in reporters' practices. Affected patients ranged in age from 8 months to 100 years, were of both sexes, and represented all major US ethnic groups. Almost half the reports were of events which had adverse consequences. Ten errors resulted in patients being admitted to hospital and one patient died. This medical error taxonomy, developed from self-reports of errors observed by family physicians during their routine clinical practice, emphasizes problems in healthcare processes and acknowledges medical errors arising from shortfalls in clinical knowledge and skills. Patient safety strategies with most effect in primary care settings need to be broader than the current focus on medication errors.

  13. Human error mechanisms in complex work environments

    International Nuclear Information System (INIS)

    Rasmussen, J.

    1988-01-01

    Human error taxonomies have been developed from analysis of industrial incident reports as well as from psychological experiments. In this paper the results of the two approaches are reviewed and compared. It is found, in both cases, that a fairly small number of basic psychological mechanisms will account for most of the action errors observed. In addition, error mechanisms appear to be intimately related to the development of high skill and know-how in a complex work context. This relationship between errors and human adaptation is discussed in detail for individuals and organisations. The implications for system safety and briefly mentioned, together with the implications for system design. (author)

  14. Human error mechanisms in complex work environments

    International Nuclear Information System (INIS)

    Rasmussen, Jens; Danmarks Tekniske Hoejskole, Copenhagen)

    1988-01-01

    Human error taxonomies have been developed from analysis of industrial incident reports as well as from psychological experiments. In this paper the results of the two approaches are reviewed and compared. It is found, in both cases, that a fairly small number of basic psychological mechanisms will account for most of the action errors observed. In addition, error mechanisms appear to be intimately related to the development of high skill and know-how in a complex work context. This relationship between errors and human adaptation is discussed in detail for individuals and organisations. The implications for system safety are briefly mentioned, together with the implications for system design. (author)

  15. A methodology for collection and analysis of human error data based on a cognitive model: IDA

    International Nuclear Information System (INIS)

    Shen, S.-H.; Smidts, C.; Mosleh, A.

    1997-01-01

    This paper presents a model-based human error taxonomy and data collection. The underlying model, IDA (described in two companion papers), is a cognitive model of behavior developed for analysis of the actions of nuclear power plant operating crew during abnormal situations. The taxonomy is established with reference to three external reference points (i.e. plant status, procedures, and crew) and four reference points internal to the model (i.e. information collected, diagnosis, decision, action). The taxonomy helps the analyst: (1) recognize errors as such; (2) categorize the error in terms of generic characteristics such as 'error in selection of problem solving strategies' and (3) identify the root causes of the error. The data collection methodology is summarized in post event operator interview and analysis summary forms. The root cause analysis methodology is illustrated using a subset of an actual event. Statistics, which extract generic characteristics of error prone behaviors and error prone situations are presented. Finally, applications of the human error data collection are reviewed. A primary benefit of this methodology is to define better symptom-based and other auxiliary procedures with associated training to minimize or preclude certain human errors. It also helps in design of control rooms, and in assessment of human error probabilities in the probabilistic risk assessment framework. (orig.)

  16. Basic considerations in predicting error probabilities in human task performance

    International Nuclear Information System (INIS)

    Fleishman, E.A.; Buffardi, L.C.; Allen, J.A.; Gaskins, R.C. III

    1990-04-01

    It is well established that human error plays a major role in the malfunctioning of complex systems. This report takes a broad look at the study of human error and addresses the conceptual, methodological, and measurement issues involved in defining and describing errors in complex systems. In addition, a review of existing sources of human reliability data and approaches to human performance data base development is presented. Alternative task taxonomies, which are promising for establishing the comparability on nuclear and non-nuclear tasks, are also identified. Based on such taxonomic schemes, various data base prototypes for generalizing human error rates across settings are proposed. 60 refs., 3 figs., 7 tabs

  17. Selection of the important performance influencing factors for the assessment of human error under accident management situations in nuclear power plants

    International Nuclear Information System (INIS)

    Kim, J. H.; Jung, W. J.

    1999-01-01

    This paper introduces the process and final results of selection of the important Performance Influencing Factors (PIFs) under emergency operation and accident management situations in nuclear power plants for use in the assessment of human errors. We collected two types of PIF taxonomies, one is the full set PIF list mainly developed for human error analysis, and the other is the PIFs for human reliability analysis (HRA) in probabilistic safety assessment (PSA). 5 PIF taxonomies among the full set PIF list and 10 PIF taxonomies among HRA methodologies (CREAM, SLIM, INTENT, were collected in this research. By reviewing and analyzing PIFs selected for HRA methodologies, the criterion could be established for the selection of appropriate PIFs under emergency operation and accident management situations. Based on this selection criteria, a new PIF taxonomy was proposed for the assessment of human error under emergency operation and accident management situations in nuclear power plants

  18. A Taxonomy of Human Translation Styles

    DEFF Research Database (Denmark)

    Carl, Michael; Dragsted, Barbara; Lykke Jakobsen, Arnt

    2011-01-01

    on the translators' activity data, we develop a taxonomy of translation styles. The taxonomy could serve to inform the development of advanced translation assistance tools and provide a basis for a felicitous and grounded integration of human machine interaction in translation.......While the translation profession becomes increasingly technological, we are still far from understanding how humans actually translate and how they could be best supported by machines. In this paper we outline a method which helps to uncover characteristics of human translation processes. Based...

  19. Human error identification for laparoscopic surgery: Development of a motion economy perspective.

    Science.gov (United States)

    Al-Hakim, Latif; Sevdalis, Nick; Maiping, Tanaphon; Watanachote, Damrongpan; Sengupta, Shomik; Dissaranan, Charuspong

    2015-09-01

    This study postulates that traditional human error identification techniques fail to consider motion economy principles and, accordingly, their applicability in operating theatres may be limited. This study addresses this gap in the literature with a dual aim. First, it identifies the principles of motion economy that suit the operative environment and second, it develops a new error mode taxonomy for human error identification techniques which recognises motion economy deficiencies affecting the performance of surgeons and predisposing them to errors. A total of 30 principles of motion economy were developed and categorised into five areas. A hierarchical task analysis was used to break down main tasks of a urological laparoscopic surgery (hand-assisted laparoscopic nephrectomy) to their elements and the new taxonomy was used to identify errors and their root causes resulting from violation of motion economy principles. The approach was prospectively tested in 12 observed laparoscopic surgeries performed by 5 experienced surgeons. A total of 86 errors were identified and linked to the motion economy deficiencies. Results indicate the developed methodology is promising. Our methodology allows error prevention in surgery and the developed set of motion economy principles could be useful for training surgeons on motion economy principles. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  20. Classifying and quantifying human error in routine tasks in nuclear power plants

    International Nuclear Information System (INIS)

    Pederson, O.M.; Rasmussen, J.; Carnino, A.; Gagnolet, P.; Griffon, M.; Mancini, G.

    1982-01-01

    This paper results from the work of the OECD/NEA-CSNI Group of Experts on Human Error Data and Assessment. It proposes a classification system (or taxonomy) for use in reporting events involving human malfunction, especially those occurring during the execution of routine tasks. A set of data collection sheets based on this taxonomy has been designed. They include the information needed in order to ensure adequate quality and coherence of the raw data. The sources from which the various data should be obtainable are identified, as are the persons who should analyze them. Improving data collection systems is an iterative process. Therefore Group members are currently making trial applications of the taxonomy to previously analysed real incidents. Results from the initial round of trials are presented and discussed

  1. Exploring human error in military aviation flight safety events using post-incident classification systems.

    Science.gov (United States)

    Hooper, Brionny J; O'Hare, David P A

    2013-08-01

    Human error classification systems theoretically allow researchers to analyze postaccident data in an objective and consistent manner. The Human Factors Analysis and Classification System (HFACS) framework is one such practical analysis tool that has been widely used to classify human error in aviation. The Cognitive Error Taxonomy (CET) is another. It has been postulated that the focus on interrelationships within HFACS can facilitate the identification of the underlying causes of pilot error. The CET provides increased granularity at the level of unsafe acts. The aim was to analyze the influence of factors at higher organizational levels on the unsafe acts of front-line operators and to compare the errors of fixed-wing and rotary-wing operations. This study analyzed 288 aircraft incidents involving human error from an Australasian military organization occurring between 2001 and 2008. Action errors accounted for almost twice (44%) the proportion of rotary wing compared to fixed wing (23%) incidents. Both classificatory systems showed significant relationships between precursor factors such as the physical environment, mental and physiological states, crew resource management, training and personal readiness, and skill-based, but not decision-based, acts. The CET analysis showed different predisposing factors for different aspects of skill-based behaviors. Skill-based errors in military operations are more prevalent in rotary wing incidents and are related to higher level supervisory processes in the organization. The Cognitive Error Taxonomy provides increased granularity to HFACS analyses of unsafe acts.

  2. In-plant reliability data base for nuclear plant components: a feasibility study on human error information

    International Nuclear Information System (INIS)

    Borkowski, R.J.; Fragola, J.R.; Schurman, D.L.; Johnson, J.W.

    1984-03-01

    This report documents the procedure and final results of a feasibility study which examined the usefulness of nuclear plant maintenance work requests in the IPRDS as tools for understanding human error and its influence on component failure and repair. Developed in this study were (1) a set of criteria for judging the quality of a plant maintenance record set for studying human error; (2) a scheme for identifying human errors in the maintenance records; and (3) two taxonomies (engineering-based and psychology-based) for categorizing and coding human error-related events

  3. Beyond human error taxonomies in assessment of risk in sociotechnical systems: a new paradigm with the EAST 'broken-links' approach.

    Science.gov (United States)

    Stanton, Neville A; Harvey, Catherine

    2017-02-01

    Risk assessments in Sociotechnical Systems (STS) tend to be based on error taxonomies, yet the term 'human error' does not sit easily with STS theories and concepts. A new break-link approach was proposed as an alternative risk assessment paradigm to reveal the effect of information communication failures between agents and tasks on the entire STS. A case study of the training of a Royal Navy crew detecting a low flying Hawk (simulating a sea-skimming missile) is presented using EAST to model the Hawk-Frigate STS in terms of social, information and task networks. By breaking 19 social links and 12 task links, 137 potential risks were identified. Discoveries included revealing the effect of risk moving around the system; reducing the risks to the Hawk increased the risks to the Frigate. Future research should examine the effects of compounded information communication failures on STS performance. Practitioner Summary: The paper presents a step-by-step walk-through of EAST to show how it can be used for risk assessment in sociotechnical systems. The 'broken-links' method takes a systemic, rather than taxonomic, approach to identify information communication failures in social and task networks.

  4. Human reliability analysis—Taxonomy and praxes of human entropy boundary conditions for marine and offshore applications

    International Nuclear Information System (INIS)

    El-Ladan, S.B.; Turan, O.

    2012-01-01

    This is the first stage towards the development of a human reliability model called human entropy (HENT). The paper presents qualitative and quantitative taxonomies and praxes of performance shaping factors (PSF) for Marine and Offshore operations. Three structured and guided expert elicitation methods were used in this study. The experts interrogated accident reports and databases from which the generic root causes of failures/accidents in operations are determined. The elicitations led to the development of 9 qualitative and quantitative human influencing factors, which are called Human Entropy Boundary Conditions (HEBC). Further explications of the 9 HEBC gave birth to 137 quantifiable explanatory variables, which are called hypothetical constructs (HyC). The HyCs are used to identify potential risks due to shrinkages in safety standards. Human entropy is a detour from traditional human error and was used as a result of tripartite human failure modes; error, local rationality and extraneous acts, all of which signify disorderliness and are seemingly inevitable in maritime operations. The praxes and scaling of HEBC was developed as guidance towards a practical oriented HRA and provide inputs for measuring human disorderliness in maritime operations.

  5. Information Management System Development for the Characterization and Analysis of Human Error in Naval Aviation Maintenance Related Mishaps

    National Research Council Canada - National Science Library

    Wood, Brian

    2000-01-01

    .... The Human Factors Analysis and Classification System-Maintenance Extension taxonomy, an effective framework for classifying and analyzing the presence of maintenance errors that lead to mishaps...

  6. A Taxonomy of Human-Agent Team Collaborations

    NARCIS (Netherlands)

    Neef, R.M.

    2006-01-01

    Future command teams will be heavily supported by artificial actors. This paper introduces a taxonomy of collaboration types in human – agent teams. Using two classifying dimensions, coordination type and collaboration type, eight different classes of human – agent collaborations transpire. These

  7. Web-Based Information Management System for the Investigation, Reporting, and Analysis of Human Error in Naval Aviation Maintenance

    National Research Council Canada - National Science Library

    Boex, Anthony

    2001-01-01

    .... The Human Factors Analysis and Classification System-Maintenance Extension (HFACS-ME) taxonomy, a framework for classifying and analyzing the presence of maintenance errors that lead to mishaps, is the foundation of this tool...

  8. SCHEME (Soft Control Human error Evaluation MEthod) for advanced MCR HRA

    International Nuclear Information System (INIS)

    Jang, Inseok; Jung, Wondea; Seong, Poong Hyun

    2015-01-01

    The Technique for Human Error Rate Prediction (THERP), Korean Human Reliability Analysis (K-HRA), Human Error Assessment and Reduction Technique (HEART), A Technique for Human Event Analysis (ATHEANA), Cognitive Reliability and Error Analysis Method (CREAM), and Simplified Plant Analysis Risk Human Reliability Assessment (SPAR-H) in relation to NPP maintenance and operation. Most of these methods were developed considering the conventional type of Main Control Rooms (MCRs). They are still used for HRA in advanced MCRs even though the operating environment of advanced MCRs in NPPs has been considerably changed by the adoption of new human-system interfaces such as computer-based soft controls. Among the many features in advanced MCRs, soft controls are an important feature because the operation action in NPP advanced MCRs is performed by soft controls. Consequently, those conventional methods may not sufficiently consider the features of soft control execution human errors. To this end, a new framework of a HRA method for evaluating soft control execution human error is suggested by performing the soft control task analysis and the literature reviews regarding widely accepted human error taxonomies. In this study, the framework of a HRA method for evaluating soft control execution human error in advanced MCRs is developed. First, the factors which HRA method in advanced MCRs should encompass are derived based on the literature review, and soft control task analysis. Based on the derived factors, execution HRA framework in advanced MCRs is developed mainly focusing on the features of soft control. Moreover, since most current HRA database deal with operation in conventional type of MCRs and are not explicitly designed to deal with digital HSI, HRA database are developed under lab scale simulation

  9. Human errors and violations in computer and information security: the viewpoint of network administrators and security specialists.

    Science.gov (United States)

    Kraemer, Sara; Carayon, Pascale

    2007-03-01

    This paper describes human errors and violations of end users and network administration in computer and information security. This information is summarized in a conceptual framework for examining the human and organizational factors contributing to computer and information security. This framework includes human error taxonomies to describe the work conditions that contribute adversely to computer and information security, i.e. to security vulnerabilities and breaches. The issue of human error and violation in computer and information security was explored through a series of 16 interviews with network administrators and security specialists. The interviews were audio taped, transcribed, and analyzed by coding specific themes in a node structure. The result is an expanded framework that classifies types of human error and identifies specific human and organizational factors that contribute to computer and information security. Network administrators tended to view errors created by end users as more intentional than unintentional, while errors created by network administrators as more unintentional than intentional. Organizational factors, such as communication, security culture, policy, and organizational structure, were the most frequently cited factors associated with computer and information security.

  10. Representing cognitive activities and errors in HRA trees

    International Nuclear Information System (INIS)

    Gertman, D.I.

    1992-01-01

    This paper discusses development of a means by which to present cognitive information in human reliability assessment (HRA) event trees. The descriptions found in probabilistic risk assessments (PRAs) regarding the demands on, and the resulting performance of, nuclear power plant (NPP) crews often make use of the technique for human error rate prediction (THERP), which provides a mechanism, the HRA event tree, for presenting the analyst's conceptualization of the activities underlying performance and the errors associated with that performance. When using THERP, analysts have often omitted the more complex elements of human cognition from these trees. There has yet to be a concerted effort to take theory, principles, and data from cognitive psychology and wed it to the logic structure of the HRA event tree. This paper attempts to do so. The COGENT modeling scheme (cognitively based HRA event trees) adds two taxonomies to the HRA event tree proposed by Swain and Guttman. The first taxonomy, the one proposed by Norman and Reason, describes the type of error committed and implies something about the underlying cognition as well. The second of these, the Rasmussen taxonomy, provides description regarding the skill-based, rule-based, or knowledge-based behavior underlying the execution of tasks. It is not apparent and must be deduced from the pattern of errors exhibited by personnel

  11. The use of the SACADA taxonomy to analyze simulation records: Insights and suggestions

    International Nuclear Information System (INIS)

    Park, J.; Chang, Y.J.; Kim, Y.; Choi, S.; Kim, S.; Jung, W.

    2017-01-01

    It is evident that diverse human reliability analysis (HRA) methods are effective for enhancing the safety of socio-technical systems through identifying the most vulnerable tasks to human errors with the associated human error probabilities. This means that reliable human performance data is an important factor affecting HRA quality. Therefore, many researchers have developed technical underpinnings (such as guidelines and taxonomies) that specify what and how HRA data can be collected from simulator experiments. Here, SACADA (Scenario Authoring, Characterization, and Debriefing Application) taxonomy recently developed by US NRC (Nuclear Regulatory Commission) is worth emphasizing, because it is constructed on the basis of a cognitive model (i.e., a top-down approach) while most of the technical underpinnings are developed by a bottom-up approach (i.e., the intensive review of existing literature). For this reason, in this study, the SACADA taxonomy is used to analyze several audio-visual records collected from the full scope simulators of nuclear power plants in the Republic of Korea. The results indicate that the SACADA taxonomy is useful to collect operator performance data in simulator training for HRA. Certain human performance information that can be provided by SACADA data provided are difficult to be covered by the bottom-up approach. - Highlights: • HRA is important for enhancing the safety of socio-technical systems. • HRA quality is largely dependent on the availability of HRA data. • One of the HRA data sources is to use a full-scope simulator. • Data contents to be collected from the full-scope simulator should be clarified. • SACADA is helpful for clarifying data contents from the cognitive perspective.

  12. Evaluation of near-miss and adverse events in radiation oncology using a comprehensive causal factor taxonomy.

    Science.gov (United States)

    Spraker, Matthew B; Fain, Robert; Gopan, Olga; Zeng, Jing; Nyflot, Matthew; Jordan, Loucille; Kane, Gabrielle; Ford, Eric

    Incident learning systems (ILSs) are a popular strategy for improving safety in radiation oncology (RO) clinics, but few reports focus on the causes of errors in RO. The goal of this study was to test a causal factor taxonomy developed in 2012 by the American Association of Physicists in Medicine and adopted for use in the RO: Incident Learning System (RO-ILS). Three hundred event reports were randomly selected from an institutional ILS database and Safety in Radiation Oncology (SAFRON), an international ILS. The reports were split into 3 groups of 100 events each: low-risk institutional, high-risk institutional, and SAFRON. Three raters retrospectively analyzed each event for contributing factors using the American Association of Physicists in Medicine taxonomy. No events were described by a single causal factor (median, 7). The causal factor taxonomy was found to be applicable for all events, but 4 causal factors were not described in the taxonomy: linear accelerator failure (n = 3), hardware/equipment failure (n = 2), failure to follow through with a quality improvement intervention (n = 1), and workflow documentation was misleading (n = 1). The most common causal factor categories contributing to events were similar in all event types. The most common specific causal factor to contribute to events was a "slip causing physical error." Poor human factors engineering was the only causal factor found to contribute more frequently to high-risk institutional versus low-risk institutional events. The taxonomy in the study was found to be applicable for all events and may be useful in root cause analyses and future studies. Communication and human behaviors were the most common errors affecting all types of events. Poor human factors engineering was found to specifically contribute to high-risk more than low-risk institutional events, and may represent a strategy for reducing errors in all types of events. Copyright © 2017 American Society for Radiation Oncology

  13. Toward a comprehensive taxonomy of human motives

    Science.gov (United States)

    Talevich, Jennifer R.; Walsh, David A.; Iyer, Ravi; Chopra, Gurveen

    2017-01-01

    A major success in personality has been the development of a consensual structure of traits. However, much less progress has been made on the structure of an equally important aspect of human psychology: motives. We present an empirically and theoretically structured hierarchical taxonomy of 161 motives gleaned from a literature review from McDougall to the present and based on the cluster analysis of similarity judgments among these 161 motives, a broader sampling of motives than previous work. At the broadest level were: Meaning, Communion, and Agency. These divided into nine clusters: Morality & Virtue, Religion & Spirituality, Self-Actualization, Avoidance, Social Relating, Family, Health, Mastery & Competence, and Financial & Occupational Success. Each divided into more concrete clusters to form 5 levels. We discuss contributions to research on motives, especially recent work on goal systems, and the aiding of communication and systematization of research. Finally, we compare the taxonomy to other motive organizations. PMID:28231252

  14. Task types and error types involved in the human-related unplanned reactor trip events

    International Nuclear Information System (INIS)

    Kim, Jae Whan; Park, Jin Kyun

    2008-01-01

    In this paper, the contribution of task types and error types involved in the human-related unplanned reactor trip events that have occurred between 1986 and 2006 in Korean nuclear power plants are analysed in order to establish a strategy for reducing the human-related unplanned reactor trips. Classification systems for the task types, error modes, and cognitive functions are developed or adopted from the currently available taxonomies, and the relevant information is extracted from the event reports or judged on the basis of an event description. According to the analyses from this study, the contributions of the task types are as follows: corrective maintenance (25.7%), planned maintenance (22.8%), planned operation (19.8%), periodic preventive maintenance (14.9%), response to a transient (9.9%), and design/manufacturing/installation (6.9%). According to the analysis of the error modes, error modes such as control failure (22.2%), wrong object (18.5%), omission (14.8%), wrong action (11.1%), and inadequate (8.3%) take up about 75% of the total unplanned trip events. The analysis of the cognitive functions involved in the events indicated that the planning function had the highest contribution (46.7%) to the human actions leading to unplanned reactor trips. This analysis concludes that in order to significantly reduce human-induced or human-related unplanned reactor trips, an aide system (in support of maintenance personnel) for evaluating possible (negative) impacts of planned actions or erroneous actions as well as an appropriate human error prediction technique, should be developed

  15. Task types and error types involved in the human-related unplanned reactor trip events

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Whan; Park, Jin Kyun [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2008-12-15

    In this paper, the contribution of task types and error types involved in the human-related unplanned reactor trip events that have occurred between 1986 and 2006 in Korean nuclear power plants are analysed in order to establish a strategy for reducing the human-related unplanned reactor trips. Classification systems for the task types, error modes, and cognitive functions are developed or adopted from the currently available taxonomies, and the relevant information is extracted from the event reports or judged on the basis of an event description. According to the analyses from this study, the contributions of the task types are as follows: corrective maintenance (25.7%), planned maintenance (22.8%), planned operation (19.8%), periodic preventive maintenance (14.9%), response to a transient (9.9%), and design/manufacturing/installation (6.9%). According to the analysis of the error modes, error modes such as control failure (22.2%), wrong object (18.5%), omission (14.8%), wrong action (11.1%), and inadequate (8.3%) take up about 75% of the total unplanned trip events. The analysis of the cognitive functions involved in the events indicated that the planning function had the highest contribution (46.7%) to the human actions leading to unplanned reactor trips. This analysis concludes that in order to significantly reduce human-induced or human-related unplanned reactor trips, an aide system (in support of maintenance personnel) for evaluating possible (negative) impacts of planned actions or erroneous actions as well as an appropriate human error prediction technique, should be developed.

  16. Collection and classification of human error and human reliability data from Indian nuclear power plants for use in PSA

    International Nuclear Information System (INIS)

    Subramaniam, K.; Saraf, R.K.; Sanyasi Rao, V.V.S.; Venkat Raj, V.; Venkatraman, R.

    2000-01-01

    Complex systems such as NPPs involve a large number of Human Interactions (HIs) in every phase of plant operations. Human Reliability Analysis (HRA) in the context of a PSA, attempts to model the HIs and evaluate/predict their impact on safety and reliability using human error/human reliability data. A large number of HRA techniques have been developed for modelling and integrating HIs into PSA but there is a significant lack of HAR data. In the face of insufficient data, human reliability analysts have had to resort to expert judgement methods in order to extend the insufficient data sets. In this situation, the generation of data from plant operating experience assumes importance. The development of a HRA data bank for Indian nuclear power plants was therefore initiated as part of the programme of work on HRA. Later, with the establishment of the coordinated research programme (CRP) on collection of human reliability data and use in PSA by IAEA in 1994-95, the development was carried out under the aegis of the IAEA research contract No. 8239/RB. The work described in this report covers the activities of development of a data taxonomy and a human error reporting form (HERF) based on it, data structuring, review and analysis of plant event reports, collection of data on human errors, analysis of the data and calculation of human error probabilities (HEPs). Analysis of plant operating experience does yield a good amount of qualitative data but obtaining quantitative data on human reliability in the form of HEPs is seen to be more difficult. The difficulties have been highlighted and some ways to bring about improvements in the data situation have been discussed. The implementation of a data system for HRA is described and useful features that can be incorporated in future systems are also discussed. (author)

  17. Human errors and mistakes

    International Nuclear Information System (INIS)

    Wahlstroem, B.

    1993-01-01

    Human errors have a major contribution to the risks for industrial accidents. Accidents have provided important lesson making it possible to build safer systems. In avoiding human errors it is necessary to adapt the systems to their operators. The complexity of modern industrial systems is however increasing the danger of system accidents. Models of the human operator have been proposed, but the models are not able to give accurate predictions of human performance. Human errors can never be eliminated, but their frequency can be decreased by systematic efforts. The paper gives a brief summary of research in human error and it concludes with suggestions for further work. (orig.)

  18. Analysis of gross error rates in operation of commercial nuclear power stations

    International Nuclear Information System (INIS)

    Joos, D.W.; Sabri, Z.A.; Husseiny, A.A.

    1979-01-01

    Experience in operation of US commercial nuclear power plants is reviewed over a 25-month period. The reports accumulated in that period on events of human error and component failure are examined to evaluate gross operator error rates. The impact of such errors on plant operation and safety is examined through the use of proper taxonomies of error, tasks and failures. Four categories of human errors are considered; namely, operator, maintenance, installation and administrative. The computed error rates are used to examine appropriate operator models for evaluation of operator reliability. Human error rates are found to be significant to a varying degree in both BWR and PWR. This emphasizes the import of considering human factors in safety and reliability analysis of nuclear systems. The results also indicate that human errors, and especially operator errors, do indeed follow the exponential reliability model. (Auth.)

  19. The role of error in organizing behaviour

    DEFF Research Database (Denmark)

    Rasmussen, Jens

    2003-01-01

    information technology. Consequently, the topic of the present contribution is not a definition of the concept or a proper taxonomy. Instead, a review is given of two professional contexts for which the concept of error is important. Three cases of analysis of human-system interaction are reviewed: (1...... be cognitive control of behaviour in complex environments....

  20. The role of error in organizing behaviour

    DEFF Research Database (Denmark)

    Rasmussen, Jens

    1990-01-01

    information technology. Consequently, the topic of the present contribution is not a definition of the concept or a proper taxonomy. Instead, a review is given of two professional contexts for which the concept of error is important. Three cases of analysis of human-system interaction are reviewed: (1...... of study should be cognitive control of behaviour in complex environments....

  1. Taxonomy Icon Data: [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Phaeodactylum tricornutum Phaeodactylum_tricornutum_L.png Phaeodactylum_tricornutum..._NL.png Phaeodactylum_tricornutum_S.png Phaeodactylum_tricornutum_NS.png http://biosciencedbc.jp/taxonomy_ic...on/icon.cgi?i=Phaeodactylum+tricornutum&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Phaeodactylum+tricorn...utum&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Phaeodactylum+tricorn...utum&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Phaeodactylum+tricornutum&t=NS http://togodb.biosciencedbc.jp/togodb/view/taxonomy_icon_comment_en?species_id=213 ...

  2. Human Errors in Decision Making

    OpenAIRE

    Mohamad, Shahriari; Aliandrina, Dessy; Feng, Yan

    2005-01-01

    The aim of this paper was to identify human errors in decision making process. The study was focused on a research question such as: what could be the human error as a potential of decision failure in evaluation of the alternatives in the process of decision making. Two case studies were selected from the literature and analyzed to find the human errors contribute to decision fail. Then the analysis of human errors was linked with mental models in evaluation of alternative step. The results o...

  3. A theory of human error

    Science.gov (United States)

    Mcruer, D. T.; Clement, W. F.; Allen, R. W.

    1981-01-01

    Human errors tend to be treated in terms of clinical and anecdotal descriptions, from which remedial measures are difficult to derive. Correction of the sources of human error requires an attempt to reconstruct underlying and contributing causes of error from the circumstantial causes cited in official investigative reports. A comprehensive analytical theory of the cause-effect relationships governing propagation of human error is indispensable to a reconstruction of the underlying and contributing causes. A validated analytical theory of the input-output behavior of human operators involving manual control, communication, supervisory, and monitoring tasks which are relevant to aviation, maritime, automotive, and process control operations is highlighted. This theory of behavior, both appropriate and inappropriate, provides an insightful basis for investigating, classifying, and quantifying the needed cause-effect relationships governing propagation of human error.

  4. Developing a Gap Taxonomy to Address Crew Health Risks in NASA's Human Research Program

    Science.gov (United States)

    Kundrot, Craig E.; Edwards, J. Michelle

    2009-01-01

    The mission of NASA's Human Research Program (HRP) is to understand and reduce the risk to crew health and performance in exploration missions. The HRP addresses 27 specific risks by identifying and then filling gaps in understanding the risks and in the ability to disposition the risks. The primary bases for identifying gaps have been past experience and requirements definition. This approach has been very effective in identifying some important, relevant gaps, but may be inadequate for identifying gaps outside the past experience base. We are exploring the use of a gap taxonomy as a comprehensive, underlying conceptual framework that allows a more systematic identification of gaps. The taxonomy is based on these stages in medical care: prediction, prevention, detection/diagnosis, treatment, monitoring, rehabilitation, and lifetime surveillance. This gap taxonomy approach identifies new gaps in HRP health risks. Many of the new gaps suggest risk reduction approaches that are more cost effective than present approaches. A major benefit of the gap taxonomy approach is to identify new, economical approaches that reduce the likelihood and/or consequence of a risk.

  5. A taxonomy and discussion of software attack technologies

    Science.gov (United States)

    Banks, Sheila B.; Stytz, Martin R.

    2005-03-01

    Software is a complex thing. It is not an engineering artifact that springs forth from a design by simply following software coding rules; creativity and the human element are at the heart of the process. Software development is part science, part art, and part craft. Design, architecture, and coding are equally important activities and in each of these activities, errors may be introduced that lead to security vulnerabilities. Therefore, inevitably, errors enter into the code. Some of these errors are discovered during testing; however, some are not. The best way to find security errors, whether they are introduced as part of the architecture development effort or coding effort, is to automate the security testing process to the maximum extent possible and add this class of tools to the tools available, which aids in the compilation process, testing, test analysis, and software distribution. Recent technological advances, improvements in computer-generated forces (CGFs), and results in research in information assurance and software protection indicate that we can build a semi-intelligent software security testing tool. However, before we can undertake the security testing automation effort, we must understand the scope of the required testing, the security failures that need to be uncovered during testing, and the characteristics of the failures. Therefore, we undertook the research reported in the paper, which is the development of a taxonomy and a discussion of software attacks generated from the point of view of the security tester with the goal of using the taxonomy to guide the development of the knowledge base for the automated security testing tool. The representation for attacks and threat cases yielded by this research captures the strategies, tactics, and other considerations that come into play during the planning and execution of attacks upon application software. The paper is organized as follows. Section one contains an introduction to our research

  6. Taxonomy Icon Data: Planaria [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Planaria Dugesia japonica Platyhelminthes Dugesia_japonica_L.png Dugesia_japonica_NL.png Dugesia_jap...onica_S.png Dugesia_japonica_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Dugesia+jap...onica&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Dugesia+japonica&t=NL http://biosciencedbc.j...p/taxonomy_icon/icon.cgi?i=Dugesia+japonica&t=S http://biosciencedbc.jp/taxonomy_...icon/icon.cgi?i=Dugesia+japonica&t=NS http://togodb.biosciencedbc.jp/togodb/view/taxonomy_icon_comment_en?species_id=124 ...

  7. Understanding human management of automation errors

    Science.gov (United States)

    McBride, Sara E.; Rogers, Wendy A.; Fisk, Arthur D.

    2013-01-01

    Automation has the potential to aid humans with a diverse set of tasks and support overall system performance. Automated systems are not always reliable, and when automation errs, humans must engage in error management, which is the process of detecting, understanding, and correcting errors. However, this process of error management in the context of human-automation interaction is not well understood. Therefore, we conducted a systematic review of the variables that contribute to error management. We examined relevant research in human-automation interaction and human error to identify critical automation, person, task, and emergent variables. We propose a framework for management of automation errors to incorporate and build upon previous models. Further, our analysis highlights variables that may be addressed through design and training to positively influence error management. Additional efforts to understand the error management process will contribute to automation designed and implemented to support safe and effective system performance. PMID:25383042

  8. A qualitative description of human error

    International Nuclear Information System (INIS)

    Li Zhaohuan

    1992-11-01

    The human error has an important contribution to risk of reactor operation. The insight and analytical model are main parts in human reliability analysis. It consists of the concept of human error, the nature, the mechanism of generation, the classification and human performance influence factors. On the operating reactor the human error is defined as the task-human-machine mismatch. The human error event is focused on the erroneous action and the unfavored result. From the time limitation of performing a task, the operation is divided into time-limited and time-opened. The HCR (human cognitive reliability) model is suited for only time-limited. The basic cognitive process consists of the information gathering, cognition/thinking, decision making and action. The human erroneous action may be generated in any stage of this process. The more natural ways to classify human errors are presented. The human performance influence factors including personal, organizational and environmental factors are also listed

  9. A qualitative description of human error

    Energy Technology Data Exchange (ETDEWEB)

    Zhaohuan, Li [Academia Sinica, Beijing, BJ (China). Inst. of Atomic Energy

    1992-11-01

    The human error has an important contribution to risk of reactor operation. The insight and analytical model are main parts in human reliability analysis. It consists of the concept of human error, the nature, the mechanism of generation, the classification and human performance influence factors. On the operating reactor the human error is defined as the task-human-machine mismatch. The human error event is focused on the erroneous action and the unfavored result. From the time limitation of performing a task, the operation is divided into time-limited and time-opened. The HCR (human cognitive reliability) model is suited for only time-limited. The basic cognitive process consists of the information gathering, cognition/thinking, decision making and action. The human erroneous action may be generated in any stage of this process. The more natural ways to classify human errors are presented. The human performance influence factors including personal, organizational and environmental factors are also listed.

  10. Taxonomy Icon Data: [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Amborella trichopoda Amborella_trichopoda_L.png Amborella_trichopoda_NL.png Amborella..._trichopoda_S.png Amborella_trichopoda_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Amborella+t...richopoda&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Amborella+trichopoda&t=NL http://biosciencedb...c.jp/taxonomy_icon/icon.cgi?i=Amborella+trichopoda&t=S http://biosciencedbc.jp/ta...xonomy_icon/icon.cgi?i=Amborella+trichopoda&t=NS http://togodb.biosciencedbc.jp/togodb/view/taxonomy_icon_comment_en?species_id=13 ...

  11. A strategy to the development of a human error analysis method for accident management in nuclear power plants using industrial accident dynamics

    International Nuclear Information System (INIS)

    Lee, Yong Hee; Kim, Jae Whan; Jung, Won Dae; Ha, Jae Ju

    1998-06-01

    This technical report describes the early progress of he establishment of a human error analysis method as a part of a human reliability analysis(HRA) method for the assessment of the human error potential in a given accident management strategy. At first, we review the shortages and limitations of the existing HRA methods through an example application. In order to enhance the bias to the quantitative aspect of the HRA method, we focused to the qualitative aspect, i.e., human error analysis(HEA), during the proposition of a strategy to the new method. For the establishment of a new HEA method, we discuss the basic theories and approaches to the human error in industry, and propose three basic requirements that should be maintained as pre-requisites for HEA method in practice. Finally, we test IAD(Industrial Accident Dynamics) which has been widely utilized in industrial fields, in order to know whether IAD can be so easily modified and extended to the nuclear power plant applications. We try to apply IAD to the same example case and develop new taxonomy of the performance shaping factors in accident management and their influence matrix, which could enhance the IAD method as an HEA method. (author). 33 refs., 17 tabs., 20 figs

  12. A Taxonomy for In-depth Evaluation of Normalization for User Generated Content

    NARCIS (Netherlands)

    van der Goot, Rob; van Noord, Rik; van Noord, Gertjan

    2018-01-01

    In this work we present a taxonomy of error categories for lexical normalization, which is the task of translating user generated content to canonical language. We annotate a recent normalization dataset to test the practical use of the taxonomy and read a near-perfect agreement. This annotated

  13. Taxonomy Icon Data: potato [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available potato Solanum tuberosum Solanum_tuberosum_L.png Solanum_tuberosum_NL.png Solanum_tuber...osum_S.png Solanum_tuberosum_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Solanum+tuberosum&t...=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Solanum+tuberosum&t=NL http://biosciencedbc.jp/taxonomy_...icon/icon.cgi?i=Solanum+tuberosum&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Solanum+tuberosum&t=NS ...

  14. Human Errors and Bridge Management Systems

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle; Nowak, A. S.

    on basis of reliability profiles for bridges without human errors are extended to include bridges with human errors. The first rehabilitation distributions for bridges without and with human errors are combined into a joint first rehabilitation distribution. The methodology presented is illustrated...... for reinforced concrete bridges....

  15. Taxonomy Icon Data: sorghum [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available sorghum Sorghum bicolor Sorghum_bicolor_L.png Sorghum_bicolor_NL.png Sorghum_bicolor_S.png Sorg...hum_bicolor_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Sorghum+bicolor&t=L http://b...iosciencedbc.jp/taxonomy_icon/icon.cgi?i=Sorghum+bicolor&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Sorg...hum+bicolor&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Sorghum+bicolor&t=NS ...

  16. Taxonomy Icon Data: mandrill [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available mandrill Mandrillus sphinx Chordata/Vertebrata/Mammalia/Theria/Eutheria/Primate Mandrillus_sphinx..._L.png Mandrillus_sphinx_NL.png Mandrillus_sphinx_S.png Mandrillus_sphinx_NS.png http://biosci...encedbc.jp/taxonomy_icon/icon.cgi?i=Mandrillus+sphinx&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Mandrillus+sphinx...&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Mandrillus+sphinx...&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Mandrillus+sphinx&t=NS ...

  17. Taxonomy Icon Data: coelacanth [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available coelacanth Latimeria chalumnae Chordata/Vertebrata/Pisciformes Latimeria_chalumnae_L.png Latime...ria_chalumnae_NL.png Latimeria_chalumnae_S.png Latimeria_chalumnae_NS.png http://biosciencedbc.j...p/taxonomy_icon/icon.cgi?i=Latimeria+chalumnae&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Latimeri...a+chalumnae&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Latimeria+chalu...mnae&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Latimeria+chalumnae&t=NS ...

  18. Game Design Principles based on Human Error

    Directory of Open Access Journals (Sweden)

    Guilherme Zaffari

    2016-03-01

    Full Text Available This paper displays the result of the authors’ research regarding to the incorporation of Human Error, through design principles, to video game design. In a general way, designers must consider Human Error factors throughout video game interface development; however, when related to its core design, adaptations are in need, since challenge is an important factor for fun and under the perspective of Human Error, challenge can be considered as a flaw in the system. The research utilized Human Error classifications, data triangulation via predictive human error analysis, and the expanded flow theory to allow the design of a set of principles in order to match the design of playful challenges with the principles of Human Error. From the results, it was possible to conclude that the application of Human Error in game design has a positive effect on player experience, allowing it to interact only with errors associated with the intended aesthetics of the game.

  19. Human errors in NPP operations

    International Nuclear Information System (INIS)

    Sheng Jufang

    1993-01-01

    Based on the operational experiences of nuclear power plants (NPPs), the importance of studying human performance problems is described. Statistical analysis on the significance or frequency of various root-causes and error-modes from a large number of human-error-related events demonstrate that the defects in operation/maintenance procedures, working place factors, communication and training practices are primary root-causes, while omission, transposition, quantitative mistake are the most frequent among the error-modes. Recommendations about domestic research on human performance problem in NPPs are suggested

  20. Human errors, countermeasures for their prevention and evaluation

    International Nuclear Information System (INIS)

    Kohda, Takehisa; Inoue, Koichi

    1992-01-01

    The accidents originated in human errors have occurred as ever in recent large accidents such as the TMI accident and the Chernobyl accident. The proportion of the accidents originated in human errors is unexpectedly high, therefore, the reliability and safety of hardware are improved hereafter, but the improvement of human reliability cannot be expected. Human errors arise by the difference between the function required for men and the function actually accomplished by men, and the results exert some adverse effect to systems. Human errors are classified into design error, manufacture error, operation error, maintenance error, checkup error and general handling error. In terms of behavior, human errors are classified into forget to do, fail to do, do that must not be done, mistake in order and do at improper time. The factors in human error occurrence are circumstantial factor, personal factor and stress factor. As the method of analyzing and evaluating human errors, system engineering method such as probabilistic risk assessment is used. The technique for human error rate prediction, the method for human cognitive reliability, confusion matrix and SLIM-MAUD are also used. (K.I.)

  1. Taxonomy Icon Data: Trypanosoma brucei [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Trypanosoma brucei Trypanosoma brucei Trypanosoma_brucei_L.png Trypanosoma_brucei_NL.png Trypanoso...ma_brucei_S.png Trypanosoma_brucei_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Trypanoso...ma+brucei&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Trypanosoma+brucei&t=NL http://bioscie...ncedbc.jp/taxonomy_icon/icon.cgi?i=Trypanosoma+brucei&t=S http://biosciencedbc.jp.../taxonomy_icon/icon.cgi?i=Trypanosoma+brucei&t=NS http://togodb.biosciencedbc.jp/togodb/view/taxonomy_icon_comment_en?species_id=121 ...

  2. Taxonomy Icon Data: Toxoplasma gondii [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Toxoplasma gondii Toxoplasma gondii Toxoplasma_gondii_L.png Toxoplasma_gondii_NL.png Toxoplasma..._gondii_S.png Toxoplasma_gondii_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Toxoplasma...+gondii&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Toxoplasma+gondii&t=NL http://biosciencedbc.j...p/taxonomy_icon/icon.cgi?i=Toxoplasma+gondii&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Toxoplas...ma+gondii&t=NS http://togodb.biosciencedbc.jp/togodb/view/taxonomy_icon_comment_en?species_id=113 ...

  3. Research trend on human error reduction

    International Nuclear Information System (INIS)

    Miyaoka, Sadaoki

    1990-01-01

    Human error has been the problem in all industries. In 1988, the Bureau of Mines, Department of the Interior, USA, carried out the worldwide survey on the human error in all industries in relation to the fatal accidents in mines. There was difference in the results according to the methods of collecting data, but the proportion that human error took in the total accidents distributed in the wide range of 20∼85%, and was 35% on the average. The rate of occurrence of accidents and troubles in Japanese nuclear power stations is shown, and the rate of occurrence of human error is 0∼0.5 cases/reactor-year, which did not much vary. Therefore, the proportion that human error took in the total tended to increase, and it has become important to reduce human error for lowering the rate of occurrence of accidents and troubles hereafter. After the TMI accident in 1979 in USA, the research on man-machine interface became active, and after the Chernobyl accident in 1986 in USSR, the problem of organization and management has been studied. In Japan, 'Safety 21' was drawn up by the Advisory Committee for Energy, and also the annual reports on nuclear safety pointed out the importance of human factors. The state of the research on human factors in Japan and abroad and three targets to reduce human error are reported. (K.I.)

  4. Taxonomy Icon Data: okapi [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available okapi Okapia johnstoni Chordata/Vertebrata/Mammalia/Theria/Eutheria/Artiodactyla Okapi...a_johnstoni_L.png Okapia_johnstoni_NL.png Okapia_johnstoni_S.png Okapia_johnstoni_NS.png http://bioscienc...edbc.jp/taxonomy_icon/icon.cgi?i=Okapia+johnstoni&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Okapi...a+johnstoni&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Okapia+johnston...i&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Okapia+johnstoni&t=NS ...

  5. Taxonomy Icon Data: Japanese Ratsnake [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Japanese Ratsnake Elaphe climacophora Chordata/Vertebrata/Reptilia/etc Elaphe_climacophora_L.png Elaphe_clim...acophora_NL.png Elaphe_climacophora_S.png Elaphe_climacophora_NS.png http://bioscie...ncedbc.jp/taxonomy_icon/icon.cgi?i=Elaphe+climacophora&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Elaphe+clima...cophora&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Elaphe+clima...cophora&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Elaphe+climacophora&t=NS http://togodb.biosciencedbc.jp/togodb/view/taxonomy_icon_comment_en?species_id=3 ...

  6. Taxonomy Icon Data: Schistosoma japonicum [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Schistosoma japonicum Schistosoma japonicum Platyhelminthes Schistosoma_japonicum_L.png Schistoso...ma_japonicum_NL.png Schistosoma_japonicum_S.png Schistosoma_japonicum_NS.png http://bioscience...dbc.jp/taxonomy_icon/icon.cgi?i=Schistosoma+japonicum&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Schistoso...ma+japonicum&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Schistoso...ma+japonicum&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Schistosoma+japonicum&t=NS http://togodb.biosciencedbc.jp/togodb/view/taxonomy_icon_comment_en?species_id=132 ...

  7. Taxonomy Icon Data: Anopheles stephensi [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Anopheles stephensi Anopheles stephensi Arthropoda Anopheles_stephensi_L.png Anopheles_stephen...si_NL.png Anopheles_stephensi_S.png Anopheles_stephensi_NS.png http://biosciencedbc.jp/taxonomy_i...con/icon.cgi?i=Anopheles+stephensi&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Anopheles+stephensi&...t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Anopheles+stephensi&t=S htt...p://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Anopheles+stephensi&t=NS http://togodb.biosciencedbc.jp/togodb/view/taxonomy_icon_comment_en?species_id=149 ...

  8. ICTV Virus Taxonomy Profile: Pneumoviridae.

    Science.gov (United States)

    Rima, Bert; Collins, Peter; Easton, Andrew; Fouchier, Ron; Kurath, Gael; Lamb, Robert A; Lee, Benhur; Maisner, Andrea; Rota, Paul; Wang, Linfa; Ictv Report Consortium

    2017-12-01

    The family Pneumoviridae comprises large enveloped negative-sense RNA viruses. This taxon was formerly a subfamily within the Paramyxoviridae, but was reclassified in 2016 as a family with two genera, Orthopneumovirus and Metapneumovirus. Pneumoviruses infect a range of mammalian species, while some members of the Metapneumovirus genus may also infect birds. Some viruses are specific and pathogenic for humans, such as human respiratory syncytial virus and human metapneumovirus. There are no known vectors for pneumoviruses and transmission is thought to be primarily by aerosol droplets and contact. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the taxonomy of the Pneumoviridae, which is available at www.ictv.global/report/pneumoviridae.

  9. A taxonomy of inductive problems.

    Science.gov (United States)

    Kemp, Charles; Jern, Alan

    2014-02-01

    Inductive inferences about objects, features, categories, and relations have been studied for many years, but there are few attempts to chart the range of inductive problems that humans are able to solve. We present a taxonomy of inductive problems that helps to clarify the relationships between familiar inductive problems such as generalization, categorization, and identification, and that introduces new inductive problems for psychological investigation. Our taxonomy is founded on the idea that semantic knowledge is organized into systems of objects, features, categories, and relations, and we attempt to characterize all of the inductive problems that can arise when these systems are partially observed. Recent studies have begun to address some of the new problems in our taxonomy, and future work should aim to develop unified theories of inductive reasoning that explain how people solve all of the problems in the taxonomy.

  10. Collection of offshore human error probability data

    International Nuclear Information System (INIS)

    Basra, Gurpreet; Kirwan, Barry

    1998-01-01

    Accidents such as Piper Alpha have increased concern about the effects of human errors in complex systems. Such accidents can in theory be predicted and prevented by risk assessment, and in particular human reliability assessment (HRA), but HRA ideally requires qualitative and quantitative human error data. A research initiative at the University of Birmingham led to the development of CORE-DATA, a Computerised Human Error Data Base. This system currently contains a reasonably large number of human error data points, collected from a variety of mainly nuclear-power related sources. This article outlines a recent offshore data collection study, concerned with collecting lifeboat evacuation data. Data collection methods are outlined and a selection of human error probabilities generated as a result of the study are provided. These data give insights into the type of errors and human failure rates that could be utilised to support offshore risk analyses

  11. Spumaretroviruses: Updated taxonomy and nomenclature.

    Science.gov (United States)

    Khan, Arifa S; Bodem, Jochen; Buseyne, Florence; Gessain, Antoine; Johnson, Welkin; Kuhn, Jens H; Kuzmak, Jacek; Lindemann, Dirk; Linial, Maxine L; Löchelt, Martin; Materniak-Kornas, Magdalena; Soares, Marcelo A; Switzer, William M

    2018-03-01

    Spumaretroviruses, commonly referred to as foamy viruses, are complex retroviruses belonging to the subfamily Spumaretrovirinae, family Retroviridae, which naturally infect a variety of animals including nonhuman primates (NHPs). Additionally, cross-species transmissions of simian foamy viruses (SFVs) to humans have occurred following exposure to tissues of infected NHPs. Recent research has led to the identification of previously unknown exogenous foamy viruses, and to the discovery of endogenous spumaretrovirus sequences in a variety of host genomes. Here, we describe an updated spumaretrovirus taxonomy that has been recently accepted by the International Committee on Taxonomy of Viruses (ICTV) Executive Committee, and describe a virus nomenclature that is generally consistent with that used for other retroviruses, such as lentiviruses and deltaretroviruses. This taxonomy can be applied to distinguish different, but closely related, primate (e.g., human, ape, simian) foamy viruses as well as those from other hosts. This proposal accounts for host-virus co-speciation and cross-species transmission. Published by Elsevier Inc.

  12. Taxonomy Icon Data: honey bee [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available honey bee Apis mellifera Arthropoda Apis_mellifera_L.png Apis_mellifera_NL.png Apis_mellife...ra_S.png Apis_mellifera_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Apis+mellifera&t=L h...ttp://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Apis+mellifera&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Apis+mellife...ra&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Apis+mellifera&t=NS ...

  13. Taxonomy Icon Data: thale cress [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available thale cress Arabidopsis thaliana Arabidopsis_thaliana_L.png Arabidopsis_thaliana_NL.png Arabidopsis_thal...iana_S.png Arabidopsis_thaliana_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Arabidopsis+thal...iana&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Arabidopsis+thaliana&t=NL http://...biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Arabidopsis+thaliana&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Arabidopsis+thaliana&t=NS ...

  14. Taxonomy Icon Data: Lotus corniculatus [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Lotus corniculatus Lotus corniculatus Lotus_corniculatus_L.png Lotus_corniculatus_NL.png Lotus_corn...iculatus_S.png Lotus_corniculatus_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Lotus+corn...iculatus&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Lotus+corniculatus&t=NL http://bioscie...ncedbc.jp/taxonomy_icon/icon.cgi?i=Lotus+corniculatus&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Lotus+corniculatus&t=NS ...

  15. Taxonomy Icon Data: fission yeast [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available fission yeast Schizosaccharomyces pombe Schizosaccharomyces_pombe_L.png Schizosaccharomyce...s_pombe_NL.png Schizosaccharomyces_pombe_S.png Schizosaccharomyces_pombe_NS.png http://biosciencedbc....jp/taxonomy_icon/icon.cgi?i=Schizosaccharomyces+pombe&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Schizosaccharomyce...s+pombe&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Schizosaccharomyce...s+pombe&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Schizosaccharomyces+pombe&t=NS

  16. Taxonomy Icon Data: barrel medic [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available barrel medic Medicago truncatula Medicago_truncatula_L.png Medicago_truncatula_NL.png Medi...cago_truncatula_S.png Medicago_truncatula_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Medi...cago+truncatula&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Medicago+truncatula&t=NL http://biosci...encedbc.jp/taxonomy_icon/icon.cgi?i=Medicago+truncatula&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Medicago+truncatula&t=NS ...

  17. Taxonomy Icon Data: fruit fly [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available fruit fly Drosophila melanogaster Arthropoda Drosophila_melanogaster_L.png Drosophila_mela...nogaster_NL.png Drosophila_melanogaster_S.png Drosophila_melanogaster_NS.png http://biosciencedbc.jp/...taxonomy_icon/icon.cgi?i=Drosophila+melanogaster&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Drosophila+mela...nogaster&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Drosophila+mela...nogaster&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Drosophila+melanogaster&t=NS ...

  18. Taxonomy Icon Data: Lotus japonicus [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Lotus japonicus Lotus japonicus Lotus_japonicus_L.png Lotus_japonicus_NL.png Lotus_japonicus_S.png Lotus_jap...onicus_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Lotus+japonicus&t=L ...http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Lotus+japonicus&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Lotus+jap...onicus&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Lotus+japonicus&t=NS ...

  19. Taxonomy Icon Data: Asiatic tapir [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Asiatic tapir Tapirus indicus Chordata/Vertebrata/Mammalia/Theria/Eutheria/etc. Tapirus_indicus_L.png Tapi...rus_indicus_NL.png Tapirus_indicus_S.png Tapirus_indicus_NS.png http://biosciencedbc....jp/taxonomy_icon/icon.cgi?i=Tapirus+indicus&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Tapirus+ind...icus&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Tapirus+indicus&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Tapirus+indicus&t=NS ...

  20. Taxonomy Icon Data: fathead minnow [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available fathead minnow Pimephales promelas Chordata/Vertebrata/Pisciformes Pimephales_promela...s_L.png Pimephales_promelas_NL.png Pimephales_promelas_S.png Pimephales_promelas_NS.png http://bioscienced...bc.jp/taxonomy_icon/icon.cgi?i=Pimephales+promelas&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Pimephales+promela...s&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Pimephales+promela...s&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Pimephales+promelas&t=NS ...

  1. Taxonomy Icon Data: white shark [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available white shark Carcharodon carcharias Chordata/Vertebrata/Pisciformes Carcharodon_carcharias_L.png Carcharo...don_carcharias_NL.png Carcharodon_carcharias_S.png Carcharodon_carcharias_NS.png http:/.../biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Carcharodon+carcharias&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Carcharo...don+carcharias&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Carcharo...don+carcharias&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Carcharodon+carcharias&t=NS ...

  2. Study on a new framework of Human Reliability Analysis to evaluate soft control execution error in advanced MCRs of NPPs

    International Nuclear Information System (INIS)

    Jang, Inseok; Kim, Ar Ryum; Jung, Wondea; Seong, Poong Hyun

    2016-01-01

    Highlights: • The operation environment of MCRs in NPPs has changed by adopting new HSIs. • The operation action in NPP Advanced MCRs is performed by soft control. • New HRA framework should be considered in the HRA for advanced MCRs. • HRA framework for evaluation of soft control execution human error is suggested. • Suggested method will be helpful to analyze human reliability in advance MCRs. - Abstract: Since the Three Mile Island (TMI)-2 accident, human error has been recognized as one of the main causes of Nuclear Power Plant (NPP) accidents, and numerous studies related to Human Reliability Analysis (HRA) have been carried out. Most of these methods were developed considering the conventional type of Main Control Rooms (MCRs). However, the operating environment of MCRs in NPPs has changed with the adoption of new Human-System Interfaces (HSIs) that are based on computer-based technologies. The MCRs that include these digital technologies, such as large display panels, computerized procedures, and soft controls, are called advanced MCRs. Among the many features of advanced MCRs, soft controls are a particularly important feature because operating actions in NPP advanced MCRs are performed by soft control. Due to the differences in interfaces between soft control and hardwired conventional type control, different Human Error Probabilities (HEPs) and a new HRA framework should be considered in the HRA for advanced MCRs. To this end, a new framework of a HRA method for evaluating soft control execution human error is suggested by performing a soft control task analysis and the literature regarding widely accepted human error taxonomies is reviewed. Moreover, since most current HRA databases deal with operation in conventional MCRs and are not explicitly designed to deal with digital HSIs, empirical analysis of human error and error recovery considering soft controls under an advanced MCR mockup are carried out to collect human error data, which is

  3. Taxonomy Icon Data: Old world swallowtail [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Old world swallowtail Papilio machaon Arthropoda Papilio_machaon_L.png Papilio_machaon_NL.png Papilio_machao...n_S.png Papilio_machaon_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Papilio+machao...n&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Papilio+machaon&t=NL http://biosciencedbc....jp/taxonomy_icon/icon.cgi?i=Papilio+machaon&t=S http://biosciencedbc.jp/taxonomy_...icon/icon.cgi?i=Papilio+machaon&t=NS http://togodb.biosciencedbc.jp/togodb/view/taxonomy_icon_comment_en?species_id=47 ...

  4. Taxonomy Icon Data: sperm whale [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available sperm whale Physeter macrocephalus Chordata/Vertebrata/Mammalia/Theria/Eutheria/Cetacea Physeter_macrocephal...us_L.png Physeter_macrocephalus_NL.png Physeter_macrocephalus_S.png Physeter_macrocephal...us_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Physeter+macrocephalus&t=L http://bioscience...dbc.jp/taxonomy_icon/icon.cgi?i=Physeter+macrocephalus&t=NL http://biosciencedbc....jp/taxonomy_icon/icon.cgi?i=Physeter+macrocephalus&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Physeter+macrocephalus&t=NS ...

  5. Taxonomy Icon Data: Asiatic elephant [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Asiatic elephant Elephas maximus Chordata/Vertebrata/Mammalia/Theria/Eutheria/etc. Elephas_maxim...us_L.png Elephas_maximus_NL.png Elephas_maximus_S.png Elephas_maximus_NS.png http://bioscienced...bc.jp/taxonomy_icon/icon.cgi?i=Elephas+maximus&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Elephas+maxim...us&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Elephas+maximus&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Elephas+maximus&t=NS ...

  6. Taxonomy Icon Data: giant panda [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available giant panda Ailuropoda melanoleuca Chordata/Vertebrata/Mammalia/Theria/Eutheria/Carnivora Ailuropoda_mela...noleuca_L.png Ailuropoda_melanoleuca_NL.png Ailuropoda_melanoleuca_S.png Ailuropoda_mela...noleuca_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Ailuropoda+melanoleuca&t=L http://bioscien...cedbc.jp/taxonomy_icon/icon.cgi?i=Ailuropoda+melanoleuca&t=NL http://biosciencedb...c.jp/taxonomy_icon/icon.cgi?i=Ailuropoda+melanoleuca&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Ailuropoda+melanoleuca&t=NS ...

  7. Taxonomy Icon Data: Guinea baboon [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Guinea baboon Papio papio Chordata/Vertebrata/Mammalia/Theria/Eutheria/Primate Papio_papio_L.png Papio_papi...o_NL.png Papio_papio_S.png Papio_papio_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Papio+papi...o&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Papio+papio&t=NL http://bioscien...cedbc.jp/taxonomy_icon/icon.cgi?i=Papio+papio&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Papio+papio&t=NS ...

  8. Analysis of Employee's Survey for Preventing Human-Errors

    International Nuclear Information System (INIS)

    Sung, Chanho; Kim, Younggab; Joung, Sanghoun

    2013-01-01

    Human errors in nuclear power plant can cause large and small events or incidents. These events or incidents are one of main contributors of reactor trip and might threaten the safety of nuclear plants. To prevent human-errors, KHNP(nuclear power plants) introduced 'Human-error prevention techniques' and have applied the techniques to main parts such as plant operation, operation support, and maintenance and engineering. This paper proposes the methods to prevent and reduce human-errors in nuclear power plants through analyzing survey results which includes the utilization of the human-error prevention techniques and the employees' awareness of preventing human-errors. With regard to human-error prevention, this survey analysis presented the status of the human-error prevention techniques and the employees' awareness of preventing human-errors. Employees' understanding and utilization of the techniques was generally high and training level of employee and training effect on actual works were in good condition. Also, employees answered that the root causes of human-error were due to working environment including tight process, manpower shortage, and excessive mission rather than personal negligence or lack of personal knowledge. Consideration of working environment is certainly needed. At the present time, based on analyzing this survey, the best methods of preventing human-error are personal equipment, training/education substantiality, private mental health check before starting work, prohibit of multiple task performing, compliance with procedures, and enhancement of job site review. However, the most important and basic things for preventing human-error are interests of workers and organizational atmosphere such as communication between managers and workers, and communication between employees and bosses

  9. Taxonomy Icon Data: Oryzias javanicus [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Oryzias javanicus Oryzias javanicus Chordata/Vertebrata/Pisciformes Oryzias_javanicus_L.png Oryzias_java...nicus_NL.png Oryzias_javanicus_S.png Oryzias_javanicus_NS.png http://biosciencedbc.jp/t...axonomy_icon/icon.cgi?i=Oryzias+javanicus&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Oryzias+javan...icus&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Oryzias+javanicus&t=S ...http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Oryzias+javanicus&t=NS http://togodb.biosciencedbc.jp/togodb/view/taxonomy_icon_comment_en?species_id=77 ...

  10. Taxonomy Icon Data: Japanese tree frog [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Japanese tree frog Hyla japonica Chordata/Vertebrata/Amphibia Hyla_japonica_L.png Hyla_jap...onica_NL.png Hyla_japonica_S.png Hyla_japonica_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Hyla+jap...onica&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Hyla+japonica&t=NL http://biosciencedbc....jp/taxonomy_icon/icon.cgi?i=Hyla+japonica&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Hyla+jap

  11. A 2 × 2 taxonomy of multilevel latent contextual models: accuracy-bias trade-offs in full and partial error correction models.

    Science.gov (United States)

    Lüdtke, Oliver; Marsh, Herbert W; Robitzsch, Alexander; Trautwein, Ulrich

    2011-12-01

    In multilevel modeling, group-level variables (L2) for assessing contextual effects are frequently generated by aggregating variables from a lower level (L1). A major problem of contextual analyses in the social sciences is that there is no error-free measurement of constructs. In the present article, 2 types of error occurring in multilevel data when estimating contextual effects are distinguished: unreliability that is due to measurement error and unreliability that is due to sampling error. The fact that studies may or may not correct for these 2 types of error can be translated into a 2 × 2 taxonomy of multilevel latent contextual models comprising 4 approaches: an uncorrected approach, partial correction approaches correcting for either measurement or sampling error (but not both), and a full correction approach that adjusts for both sources of error. It is shown mathematically and with simulated data that the uncorrected and partial correction approaches can result in substantially biased estimates of contextual effects, depending on the number of L1 individuals per group, the number of groups, the intraclass correlation, the number of indicators, and the size of the factor loadings. However, the simulation study also shows that partial correction approaches can outperform full correction approaches when the data provide only limited information in terms of the L2 construct (i.e., small number of groups, low intraclass correlation). A real-data application from educational psychology is used to illustrate the different approaches.

  12. ICTV Virus Taxonomy Profile: Hepeviridae.

    Science.gov (United States)

    Purdy, Michael A; Harrison, Tim J; Jameel, S; Meng, X-J; Okamoto, H; Van der Poel, W H M; Smith, Donald B; Ictv Report Consortium

    2017-11-01

    The family Hepeviridae includes enterically transmitted small non-enveloped positive-sense RNA viruses. It includes the genera Piscihepevirus, whose members infect fish, and Orthohepevirus, whose members infect mammals and birds. Members of the genus Orthohepevirus include hepatitis E virus, which is responsible for self-limiting acute hepatitis in humans and several mammalian species; the infection may become chronic in immunocompromised individuals. Extrahepatic manifestations of Guillain-Barré syndrome, neuralgic amyotrophy, glomerulonephritis and pancreatitis have been described in humans. Avian hepatitis E virus causes hepatitis-splenomegaly syndrome in chickens. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the taxonomy of the Hepeviridae, which is available at www.ictv.global/report/hepeviridae.

  13. Human error in remote Afterloading Brachytherapy

    International Nuclear Information System (INIS)

    Quinn, M.L.; Callan, J.; Schoenfeld, I.; Serig, D.

    1994-01-01

    Remote Afterloading Brachytherapy (RAB) is a medical process used in the treatment of cancer. RAB uses a computer-controlled device to remotely insert and remove radioactive sources close to a target (or tumor) in the body. Some RAB problems affecting the radiation dose to the patient have been reported and attributed to human error. To determine the root cause of human error in the RAB system, a human factors team visited 23 RAB treatment sites in the US. The team observed RAB treatment planning and delivery, interviewed RAB personnel, and performed walk-throughs, during which staff demonstrated the procedures and practices used in performing RAB tasks. Factors leading to human error in the RAB system were identified. The impact of those factors on the performance of RAB was then evaluated and prioritized in terms of safety significance. Finally, the project identified and evaluated alternative approaches for resolving the safety significant problems related to human error

  14. Human Error Assessmentin Minefield Cleaning Operation Using Human Event Analysis

    Directory of Open Access Journals (Sweden)

    Mohammad Hajiakbari

    2015-12-01

    Full Text Available Background & objective: Human error is one of the main causes of accidents. Due to the unreliability of the human element and the high-risk nature of demining operations, this study aimed to assess and manage human errors likely to occur in such operations. Methods: This study was performed at a demining site in war zones located in the West of Iran. After acquiring an initial familiarity with the operations, methods, and tools of clearing minefields, job task related to clearing landmines were specified. Next, these tasks were studied using HTA and related possible errors were assessed using ATHEANA. Results: de-mining task was composed of four main operations, including primary detection, technical identification, investigation, and neutralization. There were found four main reasons for accidents occurring in such operations; walking on the mines, leaving mines with no action, error in neutralizing operation and environmental explosion. The possibility of human error in mine clearance operations was calculated as 0.010. Conclusion: The main causes of human error in de-mining operations can be attributed to various factors such as poor weather and operating conditions like outdoor work, inappropriate personal protective equipment, personality characteristics, insufficient accuracy in the work, and insufficient time available. To reduce the probability of human error in de-mining operations, the aforementioned factors should be managed properly.

  15. Taxonomy Icon Data: llama [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available llama Lama glama Chordata/Vertebrata/Mammalia/Theria/Eutheria/Artiodactyla Lama_glama_L.png Lama_glama_NL.png Lama_glama_S.png Lama_glama..._NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Lama+glam...a&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Lama+glama&t=NL http://biosciencedbc.jp/t...axonomy_icon/icon.cgi?i=Lama+glama&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Lama+glama&t=NS ...

  16. Taxonomy Icon Data: Pacific electric ray [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Pacific electric ray Torpedo californica Chordata/Vertebrata/Pisciformes Torpedo_californica_L.png Torpedo..._californica_NL.png Torpedo_californica_S.png Torpedo_californica_NS.png http://biosc...iencedbc.jp/taxonomy_icon/icon.cgi?i=Torpedo+californica&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Torpedo...+californica&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Torpedo...+californica&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Torpedo+californica&t=NS ...

  17. Taxonomy Icon Data: Japanese giant salamander [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Japanese giant salamander Andrias japonicus Chordata/Vertebrata/Amphibia Andrias_japonicus_L.png Andrias_jap...onicus_NL.png Andrias_japonicus_S.png Andrias_japonicus_NS.png http://biosciencedbc....jp/taxonomy_icon/icon.cgi?i=Andrias+japonicus&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Andrias+jap...onicus&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Andrias+japonicus...&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Andrias+japonicus&t=NS ...

  18. Diagnosis - the limiting focus of taxonomy.

    Science.gov (United States)

    Sturmberg, Joachim P; Martin, Carmel M

    2016-02-01

    The focus on the diagnosis is a pivotal aspect of medical practice since antiquity. Diagnostic taxonomy helped to categorize ailments to improve medical care, and in its social sense resulted in validation of the sick role for some, but marginalization or stigmatization for others. In the medical industrial complex, diagnostic taxonomy structured health care financing, management and practitioner remuneration. However, with increasing demands from multiple agencies, there are increasing unintended and unwarranted consequences of our current taxonomies and diagnostic processes resulting from the conglomeration of underpinning concepts, theories, information and motivations. We argue that the increasing focus on the diagnosis resulted in excessive compartmentalization - 'partialism' - of medical practice, diminishing medical care and being naively simplistic in light of the emerging understanding of the interconnected nature of the diseasome. The human is a complex organic system of interconnecting dynamics and feedback loops responding to internal and external forces including genetic, epigenetic and environmental attractors, rather than the sum of multiple discrete organs which can develop isolated diseases or multiple morbidities. Solutions to these unintended consequences of many contemporary health system processes involve revisiting the nature of diagnostic taxonomies and the processes of their construction. A dynamic taxonomic framework would shift to more relevant attractors at personal, clinical and health system levels recognizing the non-linear nature of health and disease. Human health at an individual, group and population level is the ability to adapt to internal and external stressors with resilience throughout the life course, yet diagnostic taxonomies are increasingly constructed around fixed anchors. Understanding diagnosis as dissecting, pigeonholing or bean counting (learning by dividing) is no longer useful, the challenge for the future is to

  19. Taxonomy Icon Data: Javan tree shrew [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Javan tree shrew Tupaia javanica Chordata/Vertebrata/Mammalia/Theria/Eutheria/etc. Tupaia_java...nica_L.png Tupaia_javanica_NL.png Tupaia_javanica_S.png Tupaia_javanica_NS.png http://bioscienced...bc.jp/taxonomy_icon/icon.cgi?i=Tupaia+javanica&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Tupaia+java...nica&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Tupaia+javanica&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Tupaia+javanica&t=NS ...

  20. Taxonomy Icon Data: wild Bactrian camel [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available wild Bactrian camel Camelus ferus Chordata/Vertebrata/Mammalia/Theria/Eutheria/Artiodactyla Camel...us_ferus_L.png Camelus_ferus_NL.png Camelus_ferus_S.png Camelus_ferus_NS.png http://bioscience...dbc.jp/taxonomy_icon/icon.cgi?i=Camelus+ferus&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Camelus+f...erus&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Camelus+ferus&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Camelus+ferus&t=NS ...

  1. Taxonomy Icon Data: Diplazium tomitaroanum Masam [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Diplazium tomitaroanum Masam Diplazium tomitaroanum Masam Diplazium_tomitaroanum_Masam_L.png Diplazium_tomit...aroanum_Masam_NL.png Diplazium_tomitaroanum_Masam_S.png Diplazium_tomitaroanum_Masa...m_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Diplazium+tomitaroanum+Masam&t=L http://bioscience...dbc.jp/taxonomy_icon/icon.cgi?i=Diplazium+tomitaroanum+Masam&t=NL http://bioscien...cedbc.jp/taxonomy_icon/icon.cgi?i=Diplazium+tomitaroanum+Masam&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Diplazium+tomitaroanum+Masam&t=NS ...

  2. Taxonomy Icon Data: moss [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available moss Physcomitrella patens subsp. patens. Physcomitrella_patens_subsp_patens_L.png Physcomitrella_patens..._subsp_patens_NL.png Physcomitrella_patens_subsp_patens_S.png Physcomitrella_patens_subsp_patens..._NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Physcomitrella+patens+subsp%2e+patens%2e&t...=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Physcomitrella+patens+subsp%2e+patens...%2e&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Physcomitrella+patens+subsp%2e+patens%2e&t

  3. Taxonomy Icon Data: dog [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available dog Canis lupus familiaris Chordata/Vertebrata/Mammalia/Theria/Eutheria/Carnivora Canis_lupus..._familiaris_L.png Canis_lupus_familiaris_NL.png Canis_lupus_familiaris_S.png Canis_lupus_familiari...s_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Canis+lupus+familiaris&t=L http://biosciencedbc.jp.../taxonomy_icon/icon.cgi?i=Canis+lupus+familiaris&t=NL http://biosciencedbc.jp/tax...onomy_icon/icon.cgi?i=Canis+lupus+familiaris&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Canis+lupus+familiaris&t=NS ...

  4. Can human error theory explain non-adherence?

    Science.gov (United States)

    Barber, Nick; Safdar, A; Franklin, Bryoney D

    2005-08-01

    To apply human error theory to explain non-adherence and examine how well it fits. Patients who were taking chronic medication were telephoned and asked whether they had been adhering to their medicine, and if not the reasons were explored and analysed according to a human error theory. Of 105 patients, 87 were contacted by telephone and they took part in the study. Forty-two recalled being non-adherent, 17 of them in the last 7 days; 11 of the 42 were intentionally non-adherent. The errors could be described by human error theory, and it explained unintentional non-adherence well, however, the application of 'rules' was difficult when considering mistakes. The consideration of error producing conditions and latent failures also revealed useful contributing factors. Human error theory offers a new and valuable way of understanding non-adherence, and could inform interventions. However, the theory needs further development to explain intentional non-adherence.

  5. Taxonomy Icon Data: Japanese Bush Warbler [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Japanese Bush Warbler Cettia diphone Chordata/Vertebrata/Aves Cettia_diphone_L.png Cettia_diphone..._NL.png Cettia_diphone_S.png Cettia_diphone_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Cettia+diphone...&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Cettia+diphone&t=NL http://bioscie...ncedbc.jp/taxonomy_icon/icon.cgi?i=Cettia+diphone&t=S http://biosciencedbc.jp/tax...onomy_icon/icon.cgi?i=Cettia+diphone&t=NS http://togodb.biosciencedbc.jp/togodb/view/taxonomy_icon_comment_en?species_id=26 ...

  6. Taxonomy Icon Data: aye-aye [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available aye-aye Daubentonia madagascariensis Chordata/Vertebrata/Mammalia/Theria/Eutheria/Primate Daubentonia_madaga...scariensis_L.png Daubentonia_madagascariensis_NL.png Daubentonia_madagascariensis_S.png Daubentonia_madagasc...ariensis_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Daubentonia+madagascar...iensis&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Daubentonia+madagascar...iensis&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Daubentonia+madagascariensis&t=S http://bi

  7. Human errors in operation - what to do with them?

    International Nuclear Information System (INIS)

    Michalek, J.

    2009-01-01

    'It is human to make errors!' This saying of our predecessors is still current and will continue to be valid also in the future, until human is a human. Errors cannot be completely eliminated from human activities. In average human makes two simple errors in one hour. For example, how many typing errors do we make while typing on the computer keyboard? How many times we make mistakes in writing the date in the first days of a new year? These errors have no major consequences, however, in certain situations errors of humans are very unpleasant and may be also very costly, they may even endanger human lives. (author)

  8. SHERPA: A systematic human error reduction and prediction approach

    International Nuclear Information System (INIS)

    Embrey, D.E.

    1986-01-01

    This paper describes a Systematic Human Error Reduction and Prediction Approach (SHERPA) which is intended to provide guidelines for human error reduction and quantification in a wide range of human-machine systems. The approach utilizes as its basic current cognitive models of human performance. The first module in SHERPA performs task and human error analyses, which identify likely error modes, together with guidelines for the reduction of these errors by training, procedures and equipment redesign. The second module uses a SARAH approach to quantify the probability of occurrence of the errors identified earlier, and provides cost benefit analyses to assist in choosing the appropriate error reduction approaches in the third module

  9. Human Error and Organizational Management

    Directory of Open Access Journals (Sweden)

    Alecxandrina DEACONU

    2009-01-01

    Full Text Available The concern for performance is a topic that raises interest in the businessenvironment but also in other areas that – even if they seem distant from thisworld – are aware of, interested in or conditioned by the economy development.As individual performance is very much influenced by the human resource, wechose to analyze in this paper the mechanisms that generate – consciously or not–human error nowadays.Moreover, the extremely tense Romanian context,where failure is rather a rule than an exception, made us investigate thephenomenon of generating a human error and the ways to diminish its effects.

  10. Human errors related to maintenance and modifications

    International Nuclear Information System (INIS)

    Laakso, K.; Pyy, P.; Reiman, L.

    1998-01-01

    The focus in human reliability analysis (HRA) relating to nuclear power plants has traditionally been on human performance in disturbance conditions. On the other hand, some studies and incidents have shown that also maintenance errors, which have taken place earlier in plant history, may have an impact on the severity of a disturbance, e.g. if they disable safety related equipment. Especially common cause and other dependent failures of safety systems may significantly contribute to the core damage risk. The first aim of the study was to identify and give examples of multiple human errors which have penetrated the various error detection and inspection processes of plant safety barriers. Another objective was to generate numerical safety indicators to describe and forecast the effectiveness of maintenance. A more general objective was to identify needs for further development of maintenance quality and planning. In the first phase of this operational experience feedback analysis, human errors recognisable in connection with maintenance were looked for by reviewing about 4400 failure and repair reports and some special reports which cover two nuclear power plant units on the same site during 1992-94. A special effort was made to study dependent human errors since they are generally the most serious ones. An in-depth root cause analysis was made for 14 dependent errors by interviewing plant maintenance foremen and by thoroughly analysing the errors. A more simple treatment was given to maintenance-related single errors. The results were shown as a distribution of errors among operating states i.a. as regards the following matters: in what operational state the errors were committed and detected; in what operational and working condition the errors were detected, and what component and error type they were related to. These results were presented separately for single and dependent maintenance-related errors. As regards dependent errors, observations were also made

  11. A classification scheme of erroneous behaviors for human error probability estimations based on simulator data

    International Nuclear Information System (INIS)

    Kim, Yochan; Park, Jinkyun; Jung, Wondea

    2017-01-01

    Because it has been indicated that empirical data supporting the estimates used in human reliability analysis (HRA) is insufficient, several databases have been constructed recently. To generate quantitative estimates from human reliability data, it is important to appropriately sort the erroneous behaviors found in the reliability data. Therefore, this paper proposes a scheme to classify the erroneous behaviors identified by the HuREX (Human Reliability data Extraction) framework through a review of the relevant literature. A case study of the human error probability (HEP) calculations is conducted to verify that the proposed scheme can be successfully implemented for the categorization of the erroneous behaviors and to assess whether the scheme is useful for the HEP quantification purposes. Although continuously accumulating and analyzing simulator data is desirable to secure more reliable HEPs, the resulting HEPs were insightful in several important ways with regard to human reliability in off-normal conditions. From the findings of the literature review and the case study, the potential and limitations of the proposed method are discussed. - Highlights: • A taxonomy of erroneous behaviors is proposed to estimate HEPs from a database. • The cognitive models, procedures, HRA methods, and HRA databases were reviewed. • HEPs for several types of erroneous behaviors are calculated as a case study.

  12. Taxonomy Icon Data: Japanese serow [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Japanese serow Capricornis crispus Chordata/Vertebrata/Mammalia/Theria/Eutheria/Artiodactyla Capricorn...is_crispus_L.png Capricornis_crispus_NL.png Capricornis_crispus_S.png Capricornis_crispus..._NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Capricornis+crispus&t=L http://biosciencedbc.jp/tax...onomy_icon/icon.cgi?i=Capricornis+crispus&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Capricorn...is+crispus&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Capricornis+crispus&t=NS ...

  13. Taxonomy Icon Data: Arabian camel [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Arabian camel Camelus dromedarius Chordata/Vertebrata/Mammalia/Theria/Eutheria/Artiodactyla Camel...us_dromedarius_L.png Camelus_dromedarius_NL.png Camelus_dromedarius_S.png Camelus_dromedarius_...NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Camelus+dromedarius&t=L http://biosciencedbc.jp/taxo...nomy_icon/icon.cgi?i=Camelus+dromedarius&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Camel...us+dromedarius&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Camelus+dromedarius&t=NS ...

  14. Notes on human error analysis and prediction

    International Nuclear Information System (INIS)

    Rasmussen, J.

    1978-11-01

    The notes comprise an introductory discussion of the role of human error analysis and prediction in industrial risk analysis. Following this introduction, different classes of human errors and role in industrial systems are mentioned. Problems related to the prediction of human behaviour in reliability and safety analysis are formulated and ''criteria for analyzability'' which must be met by industrial systems so that a systematic analysis can be performed are suggested. The appendices contain illustrative case stories and a review of human error reports for the task of equipment calibration and testing as found in the US Licensee Event Reports. (author)

  15. Human Error Analysis by Fuzzy-Set

    International Nuclear Information System (INIS)

    Situmorang, Johnny

    1996-01-01

    In conventional HRA the probability of Error is treated as a single and exact value through constructing even tree, but in this moment the Fuzzy-Set Theory is used. Fuzzy set theory treat the probability of error as a plausibility which illustrate a linguistic variable. Most parameter or variable in human engineering been defined verbal good, fairly good, worst etc. Which describe a range of any value of probability. For example this analysis is quantified the human error in calibration task, and the probability of miscalibration is very low

  16. The probability and the management of human error

    International Nuclear Information System (INIS)

    Dufey, R.B.; Saull, J.W.

    2004-01-01

    Embedded within modern technological systems, human error is the largest, and indeed dominant contributor to accident cause. The consequences dominate the risk profiles for nuclear power and for many other technologies. We need to quantify the probability of human error for the system as an integral contribution within the overall system failure, as it is generally not separable or predictable for actual events. We also need to provide a means to manage and effectively reduce the failure (error) rate. The fact that humans learn from their mistakes allows a new determination of the dynamic probability and human failure (error) rate in technological systems. The result is consistent with and derived from the available world data for modern technological systems. Comparisons are made to actual data from large technological systems and recent catastrophes. Best estimate values and relationships can be derived for both the human error rate, and for the probability. We describe the potential for new approaches to the management of human error and safety indicators, based on the principles of error state exclusion and of the systematic effect of learning. A new equation is given for the probability of human error (λ) that combines the influences of early inexperience, learning from experience (ε) and stochastic occurrences with having a finite minimum rate, this equation is λ 5.10 -5 + ((1/ε) - 5.10 -5 ) exp(-3*ε). The future failure rate is entirely determined by the experience: thus the past defines the future

  17. The Bootstrap, the Jackknife, and the Randomization Test: A Sampling Taxonomy.

    Science.gov (United States)

    Rodgers, J L

    1999-10-01

    A simple sampling taxonomy is defined that shows the differences between and relationships among the bootstrap, the jackknife, and the randomization test. Each method has as its goal the creation of an empirical sampling distribution that can be used to test statistical hypotheses, estimate standard errors, and/or create confidence intervals. Distinctions between the methods can be made based on the sampling approach (with replacement versus without replacement) and the sample size (replacing the whole original sample versus replacing a subset of the original sample). The taxonomy is useful for teaching the goals and purposes of resampling schemes. An extension of the taxonomy implies other possible resampling approaches that have not previously been considered. Univariate and multivariate examples are presented.

  18. The SACADA database for human reliability and human performance

    International Nuclear Information System (INIS)

    James Chang, Y.; Bley, Dennis; Criscione, Lawrence; Kirwan, Barry; Mosleh, Ali; Madary, Todd; Nowell, Rodney; Richards, Robert; Roth, Emilie M.; Sieben, Scott; Zoulis, Antonios

    2014-01-01

    Lack of appropriate and sufficient human performance data has been identified as a key factor affecting human reliability analysis (HRA) quality especially in the estimation of human error probability (HEP). The Scenario Authoring, Characterization, and Debriefing Application (SACADA) database was developed by the U.S. Nuclear Regulatory Commission (NRC) to address this data need. An agreement between NRC and the South Texas Project Nuclear Operating Company (STPNOC) was established to support the SACADA development with aims to make the SACADA tool suitable for implementation in the nuclear power plants' operator training program to collect operator performance information. The collected data would support the STPNOC's operator training program and be shared with the NRC for improving HRA quality. This paper discusses the SACADA data taxonomy, the theoretical foundation, the prospective data to be generated from the SACADA raw data to inform human reliability and human performance, and the considerations on the use of simulator data for HRA. Each SACADA data point consists of two information segments: context and performance results. Context is a characterization of the performance challenges to task success. The performance results are the results of performing the task. The data taxonomy uses a macrocognitive functions model for the framework. At a high level, information is classified according to the macrocognitive functions of detecting the plant abnormality, understanding the abnormality, deciding the response plan, executing the response plan, and team related aspects (i.e., communication, teamwork, and supervision). The data are expected to be useful for analyzing the relations between context, error modes and error causes in human performance

  19. Intervention strategies for the management of human error

    Science.gov (United States)

    Wiener, Earl L.

    1993-01-01

    This report examines the management of human error in the cockpit. The principles probably apply as well to other applications in the aviation realm (e.g. air traffic control, dispatch, weather, etc.) as well as other high-risk systems outside of aviation (e.g. shipping, high-technology medical procedures, military operations, nuclear power production). Management of human error is distinguished from error prevention. It is a more encompassing term, which includes not only the prevention of error, but also a means of disallowing an error, once made, from adversely affecting system output. Such techniques include: traditional human factors engineering, improvement of feedback and feedforward of information from system to crew, 'error-evident' displays which make erroneous input more obvious to the crew, trapping of errors within a system, goal-sharing between humans and machines (also called 'intent-driven' systems), paperwork management, and behaviorally based approaches, including procedures, standardization, checklist design, training, cockpit resource management, etc. Fifteen guidelines for the design and implementation of intervention strategies are included.

  20. Estimation of the human error probabilities in the human reliability analysis

    International Nuclear Information System (INIS)

    Liu Haibin; He Xuhong; Tong Jiejuan; Shen Shifei

    2006-01-01

    Human error data is an important issue of human reliability analysis (HRA). Using of Bayesian parameter estimation, which can use multiple information, such as the historical data of NPP and expert judgment data to modify the human error data, could get the human error data reflecting the real situation of NPP more truly. This paper, using the numeric compute program developed by the authors, presents some typical examples to illustrate the process of the Bayesian parameter estimation in HRA and discusses the effect of different modification data on the Bayesian parameter estimation. (authors)

  1. Generalizing human error rates: A taxonomic approach

    International Nuclear Information System (INIS)

    Buffardi, L.; Fleishman, E.; Allen, J.

    1989-01-01

    It is well established that human error plays a major role in malfunctioning of complex, technological systems and in accidents associated with their operation. Estimates of the rate of human error in the nuclear industry range from 20-65% of all system failures. In response to this, the Nuclear Regulatory Commission has developed a variety of techniques for estimating human error probabilities for nuclear power plant personnel. Most of these techniques require the specification of the range of human error probabilities for various tasks. Unfortunately, very little objective performance data on error probabilities exist for nuclear environments. Thus, when human reliability estimates are required, for example in computer simulation modeling of system reliability, only subjective estimates (usually based on experts' best guesses) can be provided. The objective of the current research is to provide guidelines for the selection of human error probabilities based on actual performance data taken in other complex environments and applying them to nuclear settings. A key feature of this research is the application of a comprehensive taxonomic approach to nuclear and non-nuclear tasks to evaluate their similarities and differences, thus providing a basis for generalizing human error estimates across tasks. In recent years significant developments have occurred in classifying and describing tasks. Initial goals of the current research are to: (1) identify alternative taxonomic schemes that can be applied to tasks, and (2) describe nuclear tasks in terms of these schemes. Three standardized taxonomic schemes (Ability Requirements Approach, Generalized Information-Processing Approach, Task Characteristics Approach) are identified, modified, and evaluated for their suitability in comparing nuclear and non-nuclear power plant tasks. An agenda for future research and its relevance to nuclear power plant safety is also discussed

  2. Subject-verb agreement: Error production by Tourism undergraduate students

    Directory of Open Access Journals (Sweden)

    Ana Paula Correia

    2014-11-01

    Full Text Available The aim of this paper, which is part of a more extensive research on verb tense errors, is to investigate the subject-verb agreement errors in the simple present in the texts of a group of Tourism undergraduate students. Based on the concept of interlanguage and following the error analysis model, this descriptive non-experimental study applies qualitative and quantitative procedures. Three types of instruments were used to collect data: a sociolinguistic questionnaire (to define the learners’ profile; the Dialang test (to establish their proficiency level in English; and our own learner corpus (140 texts. Errors were identified and classified by an expert panel in accordance with a verb error taxonomy developed for this study based on the taxonomy established by the Cambridge Learner Corpus. The Markin software was used to code errors in the corpus and the Wordsmith Tools software to analyze the data. Subject-verb agreement errors and their relation with the learners’ proficiency levels are described.

  3. Taxonomy Icon Data: Synechocystis sp.PCC 6803 [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Synechocystis sp.PCC 6803 Synechocystis sp.PCC 6803 Synechocystis_sp_PCC_6803_L.png Synecho...cystis_sp_PCC_6803_NL.png Synechocystis_sp_PCC_6803_S.png Synechocystis_sp_PCC_6803_NS.png http://bi...osciencedbc.jp/taxonomy_icon/icon.cgi?i=Synechocystis+sp%2ePCC+6803&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Synecho...cystis+sp%2ePCC+6803&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Synecho...cystis+sp%2ePCC+6803&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Synechocystis

  4. The introduction of an acute physiological support service for surgical patients is an effective error reduction strategy.

    Science.gov (United States)

    Clarke, D L; Kong, V Y; Naidoo, L C; Furlong, H; Aldous, C

    2013-01-01

    Acute surgical patients are particularly vulnerable to human error. The Acute Physiological Support Team (APST) was created with the twin objectives of identifying high-risk acute surgical patients in the general wards and reducing both the incidence of error and impact of error on these patients. A number of error taxonomies were used to understand the causes of human error and a simple risk stratification system was adopted to identify patients who are particularly at risk of error. During the period November 2012-January 2013 a total of 101 surgical patients were cared for by the APST at Edendale Hospital. The average age was forty years. There were 36 females and 65 males. There were 66 general surgical patients and 35 trauma patients. Fifty-six patients were referred on the day of their admission. The average length of stay in the APST was four days. Eleven patients were haemo-dynamically unstable on presentation and twelve were clinically septic. The reasons for referral were sepsis,(4) respiratory distress,(3) acute kidney injury AKI (38), post-operative monitoring (39), pancreatitis,(3) ICU down-referral,(7) hypoxia,(5) low GCS,(1) coagulopathy.(1) The mortality rate was 13%. A total of thirty-six patients experienced 56 errors. A total of 143 interventions were initiated by the APST. These included institution or adjustment of intravenous fluids (101), blood transfusion,(12) antibiotics,(9) the management of neutropenic sepsis,(1) central line insertion,(3) optimization of oxygen therapy,(7) correction of electrolyte abnormality,(8) correction of coagulopathy.(2) CONCLUSION: Our intervention combined current taxonomies of error with a simple risk stratification system and is a variant of the defence in depth strategy of error reduction. We effectively identified and corrected a significant number of human errors in high-risk acute surgical patients. This audit has helped understand the common sources of error in the general surgical wards and will inform

  5. Analysis of Employee's Survey for Preventing Human-Errors

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Chanho; Kim, Younggab; Joung, Sanghoun [KHNP Central Research Institute, Daejeon (Korea, Republic of)

    2013-10-15

    Human errors in nuclear power plant can cause large and small events or incidents. These events or incidents are one of main contributors of reactor trip and might threaten the safety of nuclear plants. To prevent human-errors, KHNP(nuclear power plants) introduced 'Human-error prevention techniques' and have applied the techniques to main parts such as plant operation, operation support, and maintenance and engineering. This paper proposes the methods to prevent and reduce human-errors in nuclear power plants through analyzing survey results which includes the utilization of the human-error prevention techniques and the employees' awareness of preventing human-errors. With regard to human-error prevention, this survey analysis presented the status of the human-error prevention techniques and the employees' awareness of preventing human-errors. Employees' understanding and utilization of the techniques was generally high and training level of employee and training effect on actual works were in good condition. Also, employees answered that the root causes of human-error were due to working environment including tight process, manpower shortage, and excessive mission rather than personal negligence or lack of personal knowledge. Consideration of working environment is certainly needed. At the present time, based on analyzing this survey, the best methods of preventing human-error are personal equipment, training/education substantiality, private mental health check before starting work, prohibit of multiple task performing, compliance with procedures, and enhancement of job site review. However, the most important and basic things for preventing human-error are interests of workers and organizational atmosphere such as communication between managers and workers, and communication between employees and bosses.

  6. Taxonomy Icon Data: African savanna elephant [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available African savanna elephant Loxodonta africana Chordata/Vertebrata/Mammalia/Theria/Eutheria/etc. Loxodonta_afri...cana_L.png Loxodonta_africana_NL.png Loxodonta_africana_S.png Loxodonta_africana_NS....png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Loxodonta+africana&t=L http://biosciencedbc.jp/taxonom...y_icon/icon.cgi?i=Loxodonta+africana&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Loxodonta+afric...ana&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Loxodonta+africana&t=NS ...

  7. ICTV Virus Taxonomy Profile: Rhabdoviridae.

    Science.gov (United States)

    Walker, Peter J; Blasdell, Kim R; Calisher, Charles H; Dietzgen, Ralf G; Kondo, Hideki; Kurath, Gael; Longdon, Ben; Stone, David M; Tesh, Robert B; Tordo, Noël; Vasilakis, Nikos; Whitfield, Anna E; Nbsp Ictv Report Consortium

    2018-04-01

    The family Rhabdoviridae comprises viruses with negative-sense (-) single-stranded RNA genomes of 10.8-16.1 kb. Virions are typically enveloped with bullet-shaped or bacilliform morphology but can also be non-enveloped filaments. Rhabdoviruses infect plants and animals including mammals, birds, reptiles and fish, as well as arthropods which serve as single hosts or act as biological vectors for transmission to animals or plants. Rhabdoviruses include important pathogens of humans, livestock, fish and agricultural crops. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the taxonomy of Rhabdoviridae, which is available at www.ictv.global/report/rhabdoviridae.

  8. Taxonomy Icon Data: Ptychodera flava Eschscholtz (Acorn worm) [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Ptychodera flava Eschscholtz (Acorn worm) Ptychodera flava Hemichordata Ptychodera_flava_L.png Ptycho...dera_flava_NL.png Ptychodera_flava_S.png Ptychodera_flava_NS.png http://biosciencedbc.jp/t...axonomy_icon/icon.cgi?i=Ptychodera+flava&t=L http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Ptychodera+fla...va&t=NL http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Ptychodera+flava&t=S htt...p://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Ptychodera+flava&t=NS http://togodb.biosciencedbc.jp/togodb/view/taxonomy_icon_comment_en?species_id=161 ...

  9. The contributions of human factors on human error in Malaysia aviation maintenance industries

    Science.gov (United States)

    Padil, H.; Said, M. N.; Azizan, A.

    2018-05-01

    Aviation maintenance is a multitasking activity in which individuals perform varied tasks under constant pressure to meet deadlines as well as challenging work conditions. These situational characteristics combined with human factors can lead to various types of human related errors. The primary objective of this research is to develop a structural relationship model that incorporates human factors, organizational factors, and their impact on human errors in aviation maintenance. Towards that end, a questionnaire was developed which was administered to Malaysian aviation maintenance professionals. Structural Equation Modelling (SEM) approach was used in this study utilizing AMOS software. Results showed that there were a significant relationship of human factors on human errors and were tested in the model. Human factors had a partial effect on organizational factors while organizational factors had a direct and positive impact on human errors. It was also revealed that organizational factors contributed to human errors when coupled with human factors construct. This study has contributed to the advancement of knowledge on human factors effecting safety and has provided guidelines for improving human factors performance relating to aviation maintenance activities and could be used as a reference for improving safety performance in the Malaysian aviation maintenance companies.

  10. Taxonomies of Educational Objective Domain

    OpenAIRE

    Eman Ghanem Nayef; Nik Rosila Nik Yaacob; Hairul Nizam Ismail

    2013-01-01

    This paper highlights an effort to study the educational objective domain taxonomies including Bloom’s taxonomy, Lorin Anderson’s taxonomy, and Wilson’s taxonomy. In this study a comparison among these three taxonomies have been done. Results show that Bloom’s taxonomy is more suitable as an analysis tool to Educational Objective domain.

  11. Technique for human-error sequence identification and signification

    International Nuclear Information System (INIS)

    Heslinga, G.

    1988-01-01

    The aim of the present study was to investigate whether the event-tree technique can be used for the analysis of sequences of human errors that could cause initiating events. The scope of the study was limited to a consideration of the performance of procedural actions. The event-tree technique was modified to adapt it for this study and will be referred to as the 'Technique for Human-Error-Sequence Identification and Signification' (THESIS). The event trees used in this manner, i.e. THESIS event trees, appear to present additional problems if they are applied to human performance instead of technical systems. These problems, referred to as the 'Man-Related Features' of THESIS, are: the human capability to choose among several procedures, the ergonomics of the panel layout, human actions of a continuous nature, dependence between human errors, human capability to recover possible errors, the influence of memory during the recovery attempt, variability in human performance and correlations between human;erropr probabilities. The influence of these problems on the applicability of THESIS was assessed by means of mathematical analysis, field studies and laboratory experiments (author). 130 refs.; 51 figs.; 24 tabs

  12. Human decision error (HUMDEE) trees

    International Nuclear Information System (INIS)

    Ostrom, L.T.

    1993-01-01

    Graphical presentations of human actions in incident and accident sequences have been used for many years. However, for the most part, human decision making has been underrepresented in these trees. This paper presents a method of incorporating the human decision process into graphical presentations of incident/accident sequences. This presentation is in the form of logic trees. These trees are called Human Decision Error Trees or HUMDEE for short. The primary benefit of HUMDEE trees is that they graphically illustrate what else the individuals involved in the event could have done to prevent either the initiation or continuation of the event. HUMDEE trees also present the alternate paths available at the operator decision points in the incident/accident sequence. This is different from the Technique for Human Error Rate Prediction (THERP) event trees. There are many uses of these trees. They can be used for incident/accident investigations to show what other courses of actions were available and for training operators. The trees also have a consequence component so that not only the decision can be explored, also the consequence of that decision

  13. Effects of human errors on the determination of surveillance test interval

    International Nuclear Information System (INIS)

    Chung, Dae Wook; Koo, Bon Hyun

    1990-01-01

    This paper incorporates the effects of human error relevant to the periodic test on the unavailability of the safety system as well as the component unavailability. Two types of possible human error during the test are considered. One is the possibility that a good safety system is inadvertently left in a bad state after the test (Type A human error) and the other is the possibility that bad safety system is undetected upon the test (Type B human error). An event tree model is developed for the steady-state unavailability of safety system to determine the effects of human errors on the component unavailability and the test interval. We perform the reliability analysis of safety injection system (SIS) by applying aforementioned two types of human error to safety injection pumps. Results of various sensitivity analyses show that; 1) the appropriate test interval decreases and steady-state unavailability increases as the probabilities of both types of human errors increase, and they are far more sensitive to Type A human error than Type B and 2) the SIS unavailability increases slightly as the probability of Type B human error increases, and significantly as the probability of Type A human error increases. Therefore, to avoid underestimation, the effects of human error should be incorporated in the system reliability analysis which aims at the relaxations of the surveillance test intervals, and Type A human error has more important effect on the unavailability and surveillance test interval

  14. ICTV Virus Taxonomy Profile: Picornaviridae.

    Science.gov (United States)

    Zell, R; Delwart, E; Gorbalenya, A E; Hovi, T; King, A M Q; Knowles, N J; Lindberg, A M; Pallansch, M A; Palmenberg, A C; Reuter, G; Simmonds, P; Skern, T; Stanway, G; Yamashita, T; Ictv Report Consortium

    2017-10-01

    The family Picornaviridae comprises small non-enveloped viruses with RNA genomes of 6.7 to 10.1 kb, and contains >30 genera and >75 species. Most of the known picornaviruses infect mammals and birds, but some have also been detected in reptiles, amphibians and fish. Many picornaviruses are important human and veterinary pathogens and may cause diseases of the central nervous system, heart, liver, skin, gastrointestinal tract or upper respiratory tract. Most picornaviruses are transmitted by the faecal-oral or respiratory routes. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the taxonomy of the Picornaviridae, which is available at www.ictv.global/report/picornaviridae.

  15. Taxonomy Icon Data: North Pacific right whale [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available North Pacific right whale Eubalaena japonica Chordata/Vertebrata/Mammalia/Theria/Eu...theria/Cetacea Eubalaena_japonica_L.png Eubalaena_japonica_NL.png Eubalaena_japonica_S.png Eubalaena_japonic...a_NS.png http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Eubalaena+japonica&t=L http://biosciencedbc.jp/tax...onomy_icon/icon.cgi?i=Eubalaena+japonica&t=NL http://biosciencedbc.jp/taxonomy_ic...on/icon.cgi?i=Eubalaena+japonica&t=S http://biosciencedbc.jp/taxonomy_icon/icon.cgi?i=Eubalaena+japonica&t=NS ...

  16. Human Error Mechanisms in Complex Work Environments

    DEFF Research Database (Denmark)

    Rasmussen, Jens

    1988-01-01

    will account for most of the action errors observed. In addition, error mechanisms appear to be intimately related to the development of high skill and know-how in a complex work context. This relationship between errors and human adaptation is discussed in detail for individuals and organisations...

  17. The cost of human error intervention

    International Nuclear Information System (INIS)

    Bennett, C.T.; Banks, W.W.; Jones, E.D.

    1994-03-01

    DOE has directed that cost-benefit analyses be conducted as part of the review process for all new DOE orders. This new policy will have the effect of ensuring that DOE analysts can justify the implementation costs of the orders that they develop. We would like to argue that a cost-benefit analysis is merely one phase of a complete risk management program -- one that would more than likely start with a probabilistic risk assessment. The safety community defines risk as the probability of failure times the severity of consequence. An engineering definition of failure can be considered in terms of physical performance, as in mean-time-between-failure; or, it can be thought of in terms of human performance, as in probability of human error. The severity of consequence of a failure can be measured along any one of a number of dimensions -- economic, political, or social. Clearly, an analysis along one dimension cannot be directly compared to another but, a set of cost-benefit analyses, based on a series of cost-dimensions, can be extremely useful to managers who must prioritize their resources. Over the last two years, DOE has been developing a series of human factors orders, directed a lowering the probability of human error -- or at least changing the distribution of those errors. The following discussion presents a series of cost-benefit analyses using historical events in the nuclear industry. However, we would first like to discuss some of the analytic cautions that must be considered when we deal with human error

  18. Effects of digital human-machine interface characteristics on human error in nuclear power plants

    International Nuclear Information System (INIS)

    Li Pengcheng; Zhang Li; Dai Licao; Huang Weigang

    2011-01-01

    In order to identify the effects of digital human-machine interface characteristics on human error in nuclear power plants, the new characteristics of digital human-machine interface are identified by comparing with the traditional analog control systems in the aspects of the information display, user interface interaction and management, control systems, alarm systems and procedures system, and the negative effects of digital human-machine interface characteristics on human error are identified by field research and interviewing with operators such as increased cognitive load and workload, mode confusion, loss of situation awareness. As to the adverse effects related above, the corresponding prevention and control measures of human errors are provided to support the prevention and minimization of human errors and the optimization of human-machine interface design. (authors)

  19. Human factors in nuclear power plant operation

    International Nuclear Information System (INIS)

    Sabri, Z.A.; Husseiny, A.A.

    1980-01-01

    An extensive effort is being devoted to developing a comprehensive human factor program that encompasses establishment of a data base for human error prediction using past operation experience in commercial nuclear power plants. Some of the main results of such an effort are reported including data retrieval and classification systems which have been developed to assist in estimation of operator error rates. Also, statistical methods are developed to relate operator error data to reactor type, age, and specific technical design features. Results reported in this paper are based on an analysis of LER's covering a six-year period for LWR's. Developments presently include a computer data management program, statistical model, and detailed error taxonomy

  20. Understanding and Confronting Our Mistakes: The Epidemiology of Error in Radiology and Strategies for Error Reduction.

    Science.gov (United States)

    Bruno, Michael A; Walker, Eric A; Abujudeh, Hani H

    2015-10-01

    Arriving at a medical diagnosis is a highly complex process that is extremely error prone. Missed or delayed diagnoses often lead to patient harm and missed opportunities for treatment. Since medical imaging is a major contributor to the overall diagnostic process, it is also a major potential source of diagnostic error. Although some diagnoses may be missed because of the technical or physical limitations of the imaging modality, including image resolution, intrinsic or extrinsic contrast, and signal-to-noise ratio, most missed radiologic diagnoses are attributable to image interpretation errors by radiologists. Radiologic interpretation cannot be mechanized or automated; it is a human enterprise based on complex psychophysiologic and cognitive processes and is itself subject to a wide variety of error types, including perceptual errors (those in which an important abnormality is simply not seen on the images) and cognitive errors (those in which the abnormality is visually detected but the meaning or importance of the finding is not correctly understood or appreciated). The overall prevalence of radiologists' errors in practice does not appear to have changed since it was first estimated in the 1960s. The authors review the epidemiology of errors in diagnostic radiology, including a recently proposed taxonomy of radiologists' errors, as well as research findings, in an attempt to elucidate possible underlying causes of these errors. The authors also propose strategies for error reduction in radiology. On the basis of current understanding, specific suggestions are offered as to how radiologists can improve their performance in practice. © RSNA, 2015.

  1. A taxonomy of dignity: a grounded theory study

    Directory of Open Access Journals (Sweden)

    Jacobson Nora

    2009-02-01

    Full Text Available Abstract Background This paper has its origins in Jonathan Mann's insight that the experience of dignity may explain the reciprocal relationships between health and human rights. It follows his call for a taxonomy of dignity: "a coherent vocabulary and framework to characterize dignity." Methods Grounded theory procedures were use to analyze literature pertaining to dignity and to conduct and analyze 64 semi-structured interviews with persons marginalized by their health or social status, individuals who provide health or social services to these populations, and people working in the field of health and human rights. Results The taxonomy presented identifies two main forms of dignity–human dignity and social dignity–and describes several elements of these forms, including the social processes that violate or promote them, the conditions under which such violations and promotions occur, the objects of violation and promotion, and the consequences of dignity violation. Together, these forms and elements point to a theory of dignity as a quality of individuals and collectives that is constituted through interaction and interpretation and structured by conditions pertaining to actors, relationships, settings, and the broader social order. Conclusion The taxonomy has several implications for work in health and human rights. It suggests a map to possible points of intervention and provides a language in which to talk about dignity.

  2. SHEAN (Simplified Human Error Analysis code) and automated THERP

    International Nuclear Information System (INIS)

    Wilson, J.R.

    1993-01-01

    One of the most widely used human error analysis tools is THERP (Technique for Human Error Rate Prediction). Unfortunately, this tool has disadvantages. The Nuclear Regulatory Commission, realizing these drawbacks, commissioned Dr. Swain, the author of THERP, to create a simpler, more consistent tool for deriving human error rates. That effort produced the Accident Sequence Evaluation Program Human Reliability Analysis Procedure (ASEP), which is more conservative than THERP, but a valuable screening tool. ASEP involves answering simple questions about the scenario in question, and then looking up the appropriate human error rate in the indicated table (THERP also uses look-up tables, but four times as many). The advantages of ASEP are that human factors expertise is not required, and the training to use the method is minimal. Although not originally envisioned by Dr. Swain, the ASEP approach actually begs to be computerized. That WINCO did, calling the code SHEAN, for Simplified Human Error ANalysis. The code was done in TURBO Basic for IBM or IBM-compatible MS-DOS, for fast execution. WINCO is now in the process of comparing this code against THERP for various scenarios. This report provides a discussion of SHEAN

  3. Using a structured morbidity and mortality meeting to understand the contribution of human error to adverse surgical events in a South African regional hospital.

    Science.gov (United States)

    Clarke, Damian L; Furlong, Heidi; Laing, Grant L; Aldous, Colleen; Thomson, Sandie Rutherford

    2013-10-22

    Several authors have suggested that the traditional surgical morbidity and mortality meeting be developed as a tool to identify surgical errors and turn them into learning opportunities for staff. We report our experience with these meetings. A structured template was developed for each morbidity and mortality meeting. We used a grid to analyse mortality and classify the death as: (i) death expected/death unexpected; and (ii) death unpreventable/death preventable. Individual cases were then analysed using a combination of error taxonomies. During the period June - December 2011, a total of 400 acute admissions (195 trauma and 205 non-trauma) were managed at Edendale Hospital, Pietermaritzburg, South Africa. During this period, 20 morbidity and mortality meetings were held, at which 30 patients were discussed. There were 10 deaths, of which 5 were unexpected and potentially avoidable. A total of 43 errors were recognised, all in the domain of the acute admissions ward. There were 33 assessment failures, 5 logistical failures, 5 resuscitation failures, 16 errors of execution and 27 errors of planning. Seven patients experienced a number of errors, of whom 5 died. Error theory successfully dissected out the contribution of error to adverse events in our institution. Translating this insight into effective strategies to reduce the incidence of error remains a challenge. Using the examples of error identified at the meetings as educational cases may help with initiatives that directly target human error in trauma care.

  4. Human error theory: relevance to nurse management.

    Science.gov (United States)

    Armitage, Gerry

    2009-03-01

    Describe, discuss and critically appraise human error theory and consider its relevance for nurse managers. Healthcare errors are a persistent threat to patient safety. Effective risk management and clinical governance depends on understanding the nature of error. This paper draws upon a wide literature from published works, largely from the field of cognitive psychology and human factors. Although the content of this paper is pertinent to any healthcare professional; it is written primarily for nurse managers. Error is inevitable. Causation is often attributed to individuals, yet causation in complex environments such as healthcare is predominantly multi-factorial. Individual performance is affected by the tendency to develop prepacked solutions and attention deficits, which can in turn be related to local conditions and systems or latent failures. Blame is often inappropriate. Defences should be constructed in the light of these considerations and to promote error wisdom and organizational resilience. Managing and learning from error is seen as a priority in the British National Health Service (NHS), this can be better achieved with an understanding of the roots, nature and consequences of error. Such an understanding can provide a helpful framework for a range of risk management activities.

  5. Applying lessons learned to enhance human performance and reduce human error for ISS operations

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, W.R.

    1998-09-01

    A major component of reliability, safety, and mission success for space missions is ensuring that the humans involved (flight crew, ground crew, mission control, etc.) perform their tasks and functions as required. This includes compliance with training and procedures during normal conditions, and successful compensation when malfunctions or unexpected conditions occur. A very significant issue that affects human performance in space flight is human error. Human errors can invalidate carefully designed equipment and procedures. If certain errors combine with equipment failures or design flaws, mission failure or loss of life can occur. The control of human error during operation of the International Space Station (ISS) will be critical to the overall success of the program. As experience from Mir operations has shown, human performance plays a vital role in the success or failure of long duration space missions. The Department of Energy`s Idaho National Engineering and Environmental Laboratory (INEEL) is developed a systematic approach to enhance human performance and reduce human errors for ISS operations. This approach is based on the systematic identification and evaluation of lessons learned from past space missions such as Mir to enhance the design and operation of ISS. This paper describes previous INEEL research on human error sponsored by NASA and how it can be applied to enhance human reliability for ISS.

  6. Guidelines for system modeling: pre-accident human errors, rev.0

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Dae Il; Jung, W. D.; Lee, Y. H.; Hwang, M. J.; Yang, J. E

    2004-01-01

    The evaluation results of Human Reliability Analysis (HRA) of pre-accident human errors in the probabilistic safety assessment (PSA) for the Korea Standard Nuclear Power Plant (KSNP) using the ASME PRA standard show that more than 50% of 10 items to be improved are related to the identification and screening analysis for them. Thus, we developed a guideline for modeling pre-accident human errors for the system analyst to resolve some items to be improved for them. The developed guideline consists of modeling criteria for the pre-accident human errors (identification, qualitative screening, and common restoration errors) and detailed guidelines for pre-accident human errors relating to testing, maintenance, and calibration works of nuclear power plants (NPPs). The system analyst use the developed guideline and he or she applies it to the system which he or she takes care of. The HRA analyst review the application results of the system analyst. We applied the developed guideline to the auxiliary feed water system of the KSNP to show the usefulness of it. The application results of the developed guideline show that more than 50% of the items to be improved for pre-accident human errors of auxiliary feed water system are resolved. The guideline for modeling pre-accident human errors developed in this study can be used for other NPPs as well as the KSNP. It is expected that both use of the detailed procedure, to be developed in the future, for the quantification of pre-accident human errors and the guideline developed in this study will greatly enhance the PSA quality in the HRA of pre-accident human errors.

  7. Guidelines for system modeling: pre-accident human errors, rev.0

    International Nuclear Information System (INIS)

    Kang, Dae Il; Jung, W. D.; Lee, Y. H.; Hwang, M. J.; Yang, J. E.

    2004-01-01

    The evaluation results of Human Reliability Analysis (HRA) of pre-accident human errors in the probabilistic safety assessment (PSA) for the Korea Standard Nuclear Power Plant (KSNP) using the ASME PRA standard show that more than 50% of 10 items to be improved are related to the identification and screening analysis for them. Thus, we developed a guideline for modeling pre-accident human errors for the system analyst to resolve some items to be improved for them. The developed guideline consists of modeling criteria for the pre-accident human errors (identification, qualitative screening, and common restoration errors) and detailed guidelines for pre-accident human errors relating to testing, maintenance, and calibration works of nuclear power plants (NPPs). The system analyst use the developed guideline and he or she applies it to the system which he or she takes care of. The HRA analyst review the application results of the system analyst. We applied the developed guideline to the auxiliary feed water system of the KSNP to show the usefulness of it. The application results of the developed guideline show that more than 50% of the items to be improved for pre-accident human errors of auxiliary feed water system are resolved. The guideline for modeling pre-accident human errors developed in this study can be used for other NPPs as well as the KSNP. It is expected that both use of the detailed procedure, to be developed in the future, for the quantification of pre-accident human errors and the guideline developed in this study will greatly enhance the PSA quality in the HRA of pre-accident human errors

  8. Risk Management and the Concept of Human Error

    DEFF Research Database (Denmark)

    Rasmussen, Jens

    1995-01-01

    by a stochastic coincidence of faults and human errors, but by a systemic erosion of the defenses due to decision making under competitive pressure in a dynamic environment. The presentation will discuss the nature of human error and the risk management problems found in a dynamic, competitive society facing...

  9. Selection of anchor values for human error probability estimation

    International Nuclear Information System (INIS)

    Buffardi, L.C.; Fleishman, E.A.; Allen, J.A.

    1989-01-01

    There is a need for more dependable information to assist in the prediction of human errors in nuclear power environments. The major objective of the current project is to establish guidelines for using error probabilities from other task settings to estimate errors in the nuclear environment. This involves: (1) identifying critical nuclear tasks, (2) discovering similar tasks in non-nuclear environments, (3) finding error data for non-nuclear tasks, and (4) establishing error-rate values for the nuclear tasks based on the non-nuclear data. A key feature is the application of a classification system to nuclear and non-nuclear tasks to evaluate their similarities and differences in order to provide a basis for generalizing human error estimates across tasks. During the first eight months of the project, several classification systems have been applied to a sample of nuclear tasks. They are discussed in terms of their potential for establishing task equivalence and transferability of human error rates across situations

  10. PERANCANGAN COMPUTER AIDED SYSTEM DALAM MENGANALISA HUMAN ERROR DI PERKERETAAPIAN INDONESIA

    Directory of Open Access Journals (Sweden)

    Wiwik Budiawan

    2013-06-01

    Full Text Available Kecelakaan kereta api (KA yang terjadi secara beruntun di Indonesia sudah berada pada tingkat kritis. Berdasarkan data dari Direktorat Jendral Perkeretaapian, dalam kurun 5 tahun terakhir (2005-2009 total terdapat 611 kecelakaan KA.  Banyak faktor yang berkontribusi menyebabkan terjadinya kecelakaan, antara lain: sarana, prasarana, SDM operator (human error, eksternal, dan alam.  Kegagalan manusia (Human error merupakan salah satu faktor yang berpotensi menyebabkan terjadinya suatu kecelakaan KA dan dinyatakan sebagai faktor utama penyebab terjadinya suatu kecelakaan kereta api di Indonesia. Namun, tidak jelas bagaimana teknik analisis ini dilakukan. Kajian human error yang dilakukan Komite Nasional Keselamatan Transportasi (KNKT masih relatif terbatas, tidak dilengkapi dengan metode yang sistematis. Terdapat beberapa metode yang telah dikembangkan saat ini, tetapi untuk moda transportasi kereta api masih belum banyak dikembangkan. Human Factors Analysis and Classification System (HFACS merupakan metode analisis human error yang dikembangkan dan disesuaikan dengan sistem perkeretaapian Indonesia. Guna meningkatkan keandalan dalam analisis human error, HFACS kemudian dikembangkan dalam bentuk aplikasi berbasis web yang dapat diakses di komputer maupun smartphone. Hasil penelitian ini dapat dimanfaatkan oleh KNKT sebagai metode analisis kecelakaan kereta api khususnya terkait dengan human error. Kata kunci : human error, HFACS, CAS, kereta api   Abstract Train wreck (KA which occurred in quick succession in Indonesia already at a critical level. Based on data from the Directorate General of Railways, during the last 5 years (2005-2009 there were a total of 611 railway accidents. Many factors contribute to cause accidents, such as: facilities, infrastructure, human operator (human error, external, and natural. Human failure (Human error is one of the factors that could potentially cause a train accident and expressed as the main factors causing

  11. Applying modern error theory to the problem of missed injuries in trauma.

    Science.gov (United States)

    Clarke, D L; Gouveia, J; Thomson, S R; Muckart, D J J

    2008-06-01

    Modern theory of human error has helped reduce the incidence of adverse events in commercial aviation. It remains unclear whether these lessons are applicable to adverse events in trauma surgery. Missed injuries in a large metropolitan surgical service were prospectively audited and analyzed using a modern error taxonomy to define its applicability to trauma. A prospective database of all patients who experienced a missed injury during a 6-month period in a busy surgical service was maintained from July 2006. A missed injury was defined as one that escaped detection from primary assessment to operative exploration. Each missed injury was recorded and categorized. The clinical significance of the error and the level of physician responsible was documented. Errors were divided into planning or execution errors, acts of omission or commission, or violations, slips, and lapses. A total of 1,024 trauma patients were treated by the surgical services over the 6-month period from July to December 2006 in Pietermaritzburg. Thirty-four patients (2.5%) with missed injuries were identified during this period. There were 29 men and 5 women with an average age of 29 years (range: 21-67 years). In 14 patients, errors were related to inadequate clinical assessment. In 11 patients errors involved the misinterpretation of, or failure to respond to radiological imaging. There were 9 cases in which an injury was missed during surgical exploration. Overall mortality was 27% (9 patients). In 5 cases death was directly attributable to the missed injury. The level of the physicians making the error was consultant surgeon (4 cases), resident in training (15 cases), career medical officer (2 cases), referring doctor (6 cases). Missed injuries are uncommon and are made by all grades of staff. They are associated with increased morbidity and mortality. Understanding the pattern of these errors may help develop error-reduction strategies. Current taxonomies help in understanding the error

  12. A chance to avoid mistakes human error

    International Nuclear Information System (INIS)

    Amaro, Pablo; Obeso, Eduardo; Gomez, Ruben

    2010-01-01

    Trying to give an answer to the lack of public information in the industry, in relationship with the different tools that are managed in the nuclear industry for minimizing the human error, a group of workers from different sections of the St. Maria de Garona NPP (Quality Assurance/ Organization and Human Factors) decided to embark on a challenging and exciting project: 'Write a book collecting all the knowledge accumulated during their daily activities, very often during lecture time of external information received from different organizations within the nuclear industry (INPO, WANO...), but also visiting different NPP's, maintaining meetings and participating in training courses related de Human and Organizational Factors'. Main objective of the book is presenting to the industry in general, the different tools that are used and fostered in the nuclear industry, in a practical way. In this way, the assimilation and implementation in others industries could be possible and achievable in and efficient context. One year of work, and our project is a reality. We have presented and abstract during the last Spanish Nuclear Society meeting in Sevilla, last October...and the best, the book is into the market for everybody in web-site: www.bubok.com. The book is structured in the following areas: 'Errare humanum est': Trying to present what is the human error to the reader, its origin and the different barriers. The message is that the reader see the error like something continuously present in our lives... even more frequently than we think. Studying its origin can be established aimed at barriers to avoid or at least minimize it. 'Error's bitter face': Shows the possible consequences of human errors. What better that presenting real experiences that have occurred in the industry. In the book, accidents in the nuclear industry, like Tree Mile Island NPP, Chernobyl NPP, and incidents like Davis Besse NPP in the past, helps to the reader to make a reflection about the

  13. Let's rise up to unite taxonomy and technology.

    Science.gov (United States)

    Bik, Holly M

    2017-08-01

    What do you think of when you think of taxonomy? An 18th century gentlemen in breeches? Or perhaps botany drawings hung on the walls of a boutique hotel? Such old-fashioned conceptions to the contrary, taxonomy is alive today although constantly struggling for survival and recognition. The scientific community is losing valuable resources as taxonomy experts age and retire, and funding for morphological studies and species descriptions remains stagnant. At the same time, organismal knowledge (morphology, ecology, physiology) has never been more important: genomic studies are becoming more taxon focused, the scientific community is recognizing the limitations of traditional "model" organisms, and taxonomic expertise is desperately needed to fight against global biodiversity declines resulting from human impacts. There has never been a better time for a taxonomic renaissance.

  14. Let's rise up to unite taxonomy and technology.

    Directory of Open Access Journals (Sweden)

    Holly M Bik

    2017-08-01

    Full Text Available What do you think of when you think of taxonomy? An 18th century gentlemen in breeches? Or perhaps botany drawings hung on the walls of a boutique hotel? Such old-fashioned conceptions to the contrary, taxonomy is alive today although constantly struggling for survival and recognition. The scientific community is losing valuable resources as taxonomy experts age and retire, and funding for morphological studies and species descriptions remains stagnant. At the same time, organismal knowledge (morphology, ecology, physiology has never been more important: genomic studies are becoming more taxon focused, the scientific community is recognizing the limitations of traditional "model" organisms, and taxonomic expertise is desperately needed to fight against global biodiversity declines resulting from human impacts. There has never been a better time for a taxonomic renaissance.

  15. Nursing Errors in Intensive Care Unit by Human Error Identification in Systems Tool: A Case Study

    Directory of Open Access Journals (Sweden)

    Nezamodini

    2016-03-01

    Full Text Available Background Although health services are designed and implemented to improve human health, the errors in health services are a very common phenomenon and even sometimes fatal in this field. Medical errors and their cost are global issues with serious consequences for the patients’ community that are preventable and require serious attention. Objectives The current study aimed to identify possible nursing errors applying human error identification in systems tool (HEIST in the intensive care units (ICUs of hospitals. Patients and Methods This descriptive research was conducted in the intensive care unit of a hospital in Khuzestan province in 2013. Data were collected through observation and interview by nine nurses in this section in a period of four months. Human error classification was based on Rose and Rose and Swain and Guttmann models. According to HEIST work sheets the guide questions were answered and error causes were identified after the determination of the type of errors. Results In total 527 errors were detected. The performing operation on the wrong path had the highest frequency which was 150, and the second rate with a frequency of 136 was doing the tasks later than the deadline. Management causes with a frequency of 451 were the first rank among identified errors. Errors mostly occurred in the system observation stage and among the performance shaping factors (PSFs, time was the most influencing factor in occurrence of human errors. Conclusions Finally, in order to prevent the occurrence and reduce the consequences of identified errors the following suggestions were proposed : appropriate training courses, applying work guidelines and monitoring their implementation, increasing the number of work shifts, hiring professional workforce, equipping work space with appropriate facilities and equipment.

  16. An Optimized Player Taxonomy Model for Mobile MMORPGs with Millions of Users

    Directory of Open Access Journals (Sweden)

    Fang You

    2011-01-01

    Full Text Available Massively multiplayer online role-playing games (MMORPGs have great potential as sites for research within the social and human-computer interaction. In the MMORPGs, a stability player taxonomy model is very important for game design. It helps to balance different types of players and improve business strategy of the game. The players in mobile MMORPGs are also connected with social networks; many studies only use the player's own attributes statistics or questionnaire survey method to predict player taxonomy, so lots of social network relations' information will be lost. In this paper, by analyzing the impacts of player's social network, commercial operating data from mobile MMORPGs is used to establish our player taxonomy model (SN model. From the model results, social network-related information in mobile MMORPGs will be considered as important factors to pose this optimized player taxonomy model. As experimental results showed, compared with another player taxonomy model (RA model, our proposed player taxonomy model can achieve good results: classification is more stable.

  17. Normalization of Deviation: Quotation Error in Human Factors.

    Science.gov (United States)

    Lock, Jordan; Bearman, Chris

    2018-05-01

    Objective The objective of this paper is to examine quotation error in human factors. Background Science progresses through building on the work of previous research. This requires accurate quotation. Quotation error has a number of adverse consequences: loss of credibility, loss of confidence in the journal, and a flawed basis for academic debate and scientific progress. Quotation error has been observed in a number of domains, including marine biology and medicine, but there has been little or no previous study of this form of error in human factors, a domain that specializes in the causes and management of error. Methods A study was conducted examining quotation accuracy of 187 extracts from 118 published articles that cited a control article (Vaughan's 1996 book: The Challenger Launch Decision: Risky Technology, Culture, and Deviance at NASA). Results Of extracts studied, 12.8% ( n = 24) were classed as inaccurate, with 87.2% ( n = 163) being classed as accurate. A second dimension of agreement was examined with 96.3% ( n = 180) agreeing with the control article and only 3.7% ( n = 7) disagreeing. The categories of accuracy and agreement form a two by two matrix. Conclusion Rather than simply blaming individuals for quotation error, systemic factors should also be considered. Vaughan's theory, normalization of deviance, is one systemic theory that can account for quotation error. Application Quotation error is occurring in human factors and should receive more attention. According to Vaughan's theory, the normal everyday systems that promote scholarship may also allow mistakes, mishaps, and quotation error to occur.

  18. Applications of human error analysis to aviation and space operations

    International Nuclear Information System (INIS)

    Nelson, W.R.

    1998-01-01

    For the past several years at the Idaho National Engineering and Environmental Laboratory (INEEL) we have been working to apply methods of human error analysis to the design of complex systems. We have focused on adapting human reliability analysis (HRA) methods that were developed for Probabilistic Safety Assessment (PSA) for application to system design. We are developing methods so that human errors can be systematically identified during system design, the potential consequences of each error can be assessed, and potential corrective actions (e.g. changes to system design or procedures) can be identified. These applications lead to different requirements when compared with HR.As performed as part of a PSA. For example, because the analysis will begin early during the design stage, the methods must be usable when only partial design information is available. In addition, the ability to perform numerous ''what if'' analyses to identify and compare multiple design alternatives is essential. Finally, since the goals of such human error analyses focus on proactive design changes rather than the estimate of failure probabilities for PRA, there is more emphasis on qualitative evaluations of error relationships and causal factors than on quantitative estimates of error frequency. The primary vehicle we have used to develop and apply these methods has been a series of prqjects sponsored by the National Aeronautics and Space Administration (NASA) to apply human error analysis to aviation operations. The first NASA-sponsored project had the goal to evaluate human errors caused by advanced cockpit automation. Our next aviation project focused on the development of methods and tools to apply human error analysis to the design of commercial aircraft. This project was performed by a consortium comprised of INEEL, NASA, and Boeing Commercial Airplane Group. The focus of the project was aircraft design and procedures that could lead to human errors during airplane maintenance

  19. Simulator data on human error probabilities

    International Nuclear Information System (INIS)

    Kozinsky, E.J.; Guttmann, H.E.

    1982-01-01

    Analysis of operator errors on NPP simulators is being used to determine Human Error Probabilities (HEP) for task elements defined in NUREG/CR 1278. Simulator data tapes from research conducted by EPRI and ORNL are being analyzed for operator error rates. The tapes collected, using Performance Measurement System software developed for EPRI, contain a history of all operator manipulations during simulated casualties. Analysis yields a time history or Operational Sequence Diagram and a manipulation summary, both stored in computer data files. Data searches yield information on operator errors of omission and commission. This work experimentally determines HEPs for Probabilistic Risk Assessment calculations. It is the only practical experimental source of this data to date

  20. Simulator data on human error probabilities

    International Nuclear Information System (INIS)

    Kozinsky, E.J.; Guttmann, H.E.

    1981-01-01

    Analysis of operator errors on NPP simulators is being used to determine Human Error Probabilities (HEP) for task elements defined in NUREG/CR-1278. Simulator data tapes from research conducted by EPRI and ORNL are being analyzed for operator error rates. The tapes collected, using Performance Measurement System software developed for EPRI, contain a history of all operator manipulations during simulated casualties. Analysis yields a time history or Operational Sequence Diagram and a manipulation summary, both stored in computer data files. Data searches yield information on operator errors of omission and commission. This work experimentally determined HEP's for Probabilistic Risk Assessment calculations. It is the only practical experimental source of this data to date

  1. Savannah River Site human error data base development for nonreactor nuclear facilities

    International Nuclear Information System (INIS)

    Benhardt, H.C.; Held, J.E.; Olsen, L.M.; Vail, R.E.; Eide, S.A.

    1994-01-01

    As part of an overall effort to upgrade and streamline methodologies for safety analyses of nonreactor nuclear facilities at the Savannah River Site (SRS), a human error data base has been developed and is presented in this report. The data base fulfills several needs of risk analysts supporting safety analysis report (SAR) development. First, it provides a single source for probabilities or rates for a wide variety of human errors associated with the SRS nonreactor nuclear facilities. Second, it provides a documented basis for human error probabilities or rates. And finally, it provides actual SRS-specific human error data to support many of the error probabilities or rates. Use of a single, documented reference source for human errors, supported by SRS-specific human error data, will improve the consistency and accuracy of human error modeling by SRS risk analysts. It is envisioned that SRS risk analysts will use this report as both a guide to identifying the types of human errors that may need to be included in risk models such as fault and event trees, and as a source for human error probabilities or rates. For each human error in this report, ffime different mean probabilities or rates are presented to cover a wide range of conditions and influencing factors. The ask analysts must decide which mean value is most appropriate for each particular application. If other types of human errors are needed for the risk models, the analyst must use other sources. Finally, if human enors are dominant in the quantified risk models (based on the values obtained fmm this report), then it may be appropriate to perform detailed human reliability analyses (HRAS) for the dominant events. This document does not provide guidance for such refined HRAS; in such cases experienced human reliability analysts should be involved

  2. Demonstration Integrated Knowledge-Based System for Estimating Human Error Probabilities

    Energy Technology Data Exchange (ETDEWEB)

    Auflick, Jack L.

    1999-04-21

    Human Reliability Analysis (HRA) is currently comprised of at least 40 different methods that are used to analyze, predict, and evaluate human performance in probabilistic terms. Systematic HRAs allow analysts to examine human-machine relationships, identify error-likely situations, and provide estimates of relative frequencies for human errors on critical tasks, highlighting the most beneficial areas for system improvements. Unfortunately, each of HRA's methods has a different philosophical approach, thereby producing estimates of human error probabilities (HEPs) that area better or worse match to the error likely situation of interest. Poor selection of methodology, or the improper application of techniques can produce invalid HEP estimates, where that erroneous estimation of potential human failure could have potentially severe consequences in terms of the estimated occurrence of injury, death, and/or property damage.

  3. BAYES-HEP: Bayesian belief networks for estimation of human error probability

    International Nuclear Information System (INIS)

    Karthick, M.; Senthil Kumar, C.; Paul, Robert T.

    2017-01-01

    Human errors contribute a significant portion of risk in safety critical applications and methods for estimation of human error probability have been a topic of research for over a decade. The scarce data available on human errors and large uncertainty involved in the prediction of human error probabilities make the task difficult. This paper presents a Bayesian belief network (BBN) model for human error probability estimation in safety critical functions of a nuclear power plant. The developed model using BBN would help to estimate HEP with limited human intervention. A step-by-step illustration of the application of the method and subsequent evaluation is provided with a relevant case study and the model is expected to provide useful insights into risk assessment studies

  4. ERROR ANALYSIS IN THE TRAVEL WRITING MADE BY THE STUDENTS OF ENGLISH STUDY PROGRAM

    Directory of Open Access Journals (Sweden)

    Vika Agustina

    2015-05-01

    Full Text Available This study was conducted to identify the kinds of errors in surface strategy taxonomy and to know the dominant type of errors made by the fifth semester students of English Department of one State University in Malang-Indonesia in producing their travel writing. The type of research of this study is document analysis since it analyses written materials, in this case travel writing texts. The analysis finds that the grammatical errors made by the students based on surface strategy taxonomy theory consist of four types. They are (1 omission, (2 addition, (3 misformation and (4 misordering. The most frequent errors occuring in misformation are in the use of tense form. Secondly, the errors are in omission of noun/verb inflection. The next error, there are many clauses that contain unnecessary phrase added there.

  5. Detailed semantic analyses of human error incidents occurring at nuclear power plant in USA (interim report). Characteristics of human error incidents occurring in the period from 1992 to 1996

    International Nuclear Information System (INIS)

    Hirotsu, Yuko; Tsuge, Tadashi; Sano, Toshiaki; Takano, Kenichi; Gouda, Hidenori

    2001-01-01

    CRIEPI has been conducting detailed analyses of all human error incidents at domestic nuclear power plants (NPPs) collected from Japanese Licensee Event Reports (LERs) using J-HPES (Japanese version of HPES) as an analysis method. Results obtained by the analyses have been stored in J-HPES database. Since 1999, human error incidents have been selected from U.S. LERs, and they are analyzed using J-HPES. In this report, the results, which classified error action, cause, and preventive measure, are summarized for U.S. human error cases occurring in the period from 1992 to 1996. It was suggested as a result of classification that the categories of error action were almost the same as those of Japanese human error cases. Therefore, problems in the process of error action and checkpoints for preventing errors will be extracted by analyzing both U.S. and domestic human error cases. It was also suggested that the interrelations between error actions, causes, and organizational factors could be identified. While taking these suggestions into consideration, we will continue to analyze U.S. human error cases. (author)

  6. A systems perspective of managing error recovery and tactical re-planning of operating teams in safety critical domains.

    Science.gov (United States)

    Kontogiannis, Tom

    2011-04-01

    Research in human error has provided useful tools for designing procedures, training, and intelligent interfaces that trap errors at an early stage. However, this "error prevention" policy may not be entirely successful because human errors will inevitably occur. This requires that the error management process (e.g., detection, diagnosis and correction) must also be supported. Research has focused almost exclusively on error detection; little is known about error recovery, especially in the context of safety critical systems. The aim of this paper is to develop a research framework that integrates error recovery strategies employed by experienced practitioners in handling their own errors. A control theoretic model of human performance was used to integrate error recovery strategies assembled from reviews of the literature, analyses of near misses from aviation and command & control domains, and observations of abnormal situations training at air traffic control facilities. The method of system dynamics has been used to analyze and compare error recovery strategies in terms of patterns of interaction, system affordances, and types of recovery plans. System dynamics offer a promising basis for studying the nature of error recovery management in the context of team interactions and system characteristics. The proposed taxonomy of error recovery strategies can help human factors and safety experts to develop resilient system designs and training solutions for managing human errors in unforeseen situations; it may also help incident investigators to explore why people's actions and assessments were not corrected at the time. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Chernobyl - system accident or human error?

    International Nuclear Information System (INIS)

    Stang, E.

    1996-01-01

    Did human error cause the Chernobyl disaster? The standard point of view is that operator error was the root cause of the disaster. This was also the view of the Soviet Accident Commission. The paper analyses the operator errors at Chernobyl in a system context. The reactor operators committed errors that depended upon a lot of other failures that made up a complex accident scenario. The analysis is based on Charles Perrow's analysis of technological disasters. Failure possibility is an inherent property of high-risk industrial installations. The Chernobyl accident consisted of a chain of events that were both extremely improbable and difficult to predict. It is not reasonable to put the blame for the disaster on the operators. (author)

  8. Automation of Commanding at NASA: Reducing Human Error in Space Flight

    Science.gov (United States)

    Dorn, Sarah J.

    2010-01-01

    Automation has been implemented in many different industries to improve efficiency and reduce human error. Reducing or eliminating the human interaction in tasks has been proven to increase productivity in manufacturing and lessen the risk of mistakes by humans in the airline industry. Human space flight requires the flight controllers to monitor multiple systems and react quickly when failures occur so NASA is interested in implementing techniques that can assist in these tasks. Using automation to control some of these responsibilities could reduce the number of errors the flight controllers encounter due to standard human error characteristics. This paper will investigate the possibility of reducing human error in the critical area of manned space flight at NASA.

  9. Let’s rise up to unite taxonomy and technology

    Science.gov (United States)

    2017-01-01

    What do you think of when you think of taxonomy? An 18th century gentlemen in breeches? Or perhaps botany drawings hung on the walls of a boutique hotel? Such old-fashioned conceptions to the contrary, taxonomy is alive today although constantly struggling for survival and recognition. The scientific community is losing valuable resources as taxonomy experts age and retire, and funding for morphological studies and species descriptions remains stagnant. At the same time, organismal knowledge (morphology, ecology, physiology) has never been more important: genomic studies are becoming more taxon focused, the scientific community is recognizing the limitations of traditional “model” organisms, and taxonomic expertise is desperately needed to fight against global biodiversity declines resulting from human impacts. There has never been a better time for a taxonomic renaissance. PMID:28820884

  10. An Approach to Human Error Hazard Detection of Unexpected Situations in NPPs

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sangjun; Oh, Yeonju; Shin, Youmin; Lee, Yong-Hee [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    Fukushima accident is a typical complex event including the extreme situations induced by the succeeding earthquake, tsunami, explosion, and human errors. And it is judged with incomplete cause of system build-up same manner, procedure as a deficiency of response manual, education and training, team capability and the discharge of operator from human engineering point of view. Especially, the guidelines of current operating NPPs are not enough including countermeasures to the human errors at the extreme situations. Therefore, this paper describes a trial to detect the hazards of human errors at extreme situation, and to define the countermeasures that can properly response to the human error hazards when an individual, team, organization, and working entities that encounter the extreme situation in NPPs. In this paper we try to propose an approach to analyzing and extracting human error hazards for suggesting additional countermeasures to the human errors in unexpected situations. They might be utilized to develop contingency guidelines, especially for reducing the human error accident in NPPs. But the trial application in this study is currently limited since it is not easy to find accidents cases in detail enough to enumerate the proposed steps. Therefore, we will try to analyze as more cases as possible, and consider other environmental factors and human error conditions.

  11. An Approach to Human Error Hazard Detection of Unexpected Situations in NPPs

    International Nuclear Information System (INIS)

    Park, Sangjun; Oh, Yeonju; Shin, Youmin; Lee, Yong-Hee

    2015-01-01

    Fukushima accident is a typical complex event including the extreme situations induced by the succeeding earthquake, tsunami, explosion, and human errors. And it is judged with incomplete cause of system build-up same manner, procedure as a deficiency of response manual, education and training, team capability and the discharge of operator from human engineering point of view. Especially, the guidelines of current operating NPPs are not enough including countermeasures to the human errors at the extreme situations. Therefore, this paper describes a trial to detect the hazards of human errors at extreme situation, and to define the countermeasures that can properly response to the human error hazards when an individual, team, organization, and working entities that encounter the extreme situation in NPPs. In this paper we try to propose an approach to analyzing and extracting human error hazards for suggesting additional countermeasures to the human errors in unexpected situations. They might be utilized to develop contingency guidelines, especially for reducing the human error accident in NPPs. But the trial application in this study is currently limited since it is not easy to find accidents cases in detail enough to enumerate the proposed steps. Therefore, we will try to analyze as more cases as possible, and consider other environmental factors and human error conditions

  12. Human Error Probability Assessment During Maintenance Activities of Marine Systems

    Directory of Open Access Journals (Sweden)

    Rabiul Islam

    2018-03-01

    Full Text Available Background: Maintenance operations on-board ships are highly demanding. Maintenance operations are intensive activities requiring high man–machine interactions in challenging and evolving conditions. The evolving conditions are weather conditions, workplace temperature, ship motion, noise and vibration, and workload and stress. For example, extreme weather condition affects seafarers' performance, increasing the chances of error, and, consequently, can cause injuries or fatalities to personnel. An effective human error probability model is required to better manage maintenance on-board ships. The developed model would assist in developing and maintaining effective risk management protocols. Thus, the objective of this study is to develop a human error probability model considering various internal and external factors affecting seafarers' performance. Methods: The human error probability model is developed using probability theory applied to Bayesian network. The model is tested using the data received through the developed questionnaire survey of >200 experienced seafarers with >5 years of experience. The model developed in this study is used to find out the reliability of human performance on particular maintenance activities. Results: The developed methodology is tested on the maintenance of marine engine's cooling water pump for engine department and anchor windlass for deck department. In the considered case studies, human error probabilities are estimated in various scenarios and the results are compared between the scenarios and the different seafarer categories. The results of the case studies for both departments are also compared. Conclusion: The developed model is effective in assessing human error probabilities. These probabilities would get dynamically updated as and when new information is available on changes in either internal (i.e., training, experience, and fatigue or external (i.e., environmental and operational conditions

  13. Quantitative estimation of the human error probability during soft control operations

    International Nuclear Information System (INIS)

    Lee, Seung Jun; Kim, Jaewhan; Jung, Wondea

    2013-01-01

    Highlights: ► An HRA method to evaluate execution HEP for soft control operations was proposed. ► The soft control tasks were analyzed and design-related influencing factors were identified. ► An application to evaluate the effects of soft controls was performed. - Abstract: In this work, a method was proposed for quantifying human errors that can occur during operation executions using soft controls. Soft controls of advanced main control rooms have totally different features from conventional controls, and thus they may have different human error modes and occurrence probabilities. It is important to identify the human error modes and quantify the error probability for evaluating the reliability of the system and preventing errors. This work suggests an evaluation framework for quantifying the execution error probability using soft controls. In the application result, it was observed that the human error probabilities of soft controls showed both positive and negative results compared to the conventional controls according to the design quality of advanced main control rooms

  14. Article Errors in the English Writing of Saudi EFL Preparatory Year Students

    Science.gov (United States)

    Alhaisoni, Eid; Gaudel, Daya Ram; Al-Zuoud, Khalid M.

    2017-01-01

    This study aims at providing a comprehensive account of the types of errors produced by Saudi EFL students enrolled in the preparatory year programe in their use of articles, based on the Surface Structure Taxonomies (SST) of errors. The study describes the types, frequency and sources of the definite and indefinite article errors in writing…

  15. The HCBS Taxonomy- A New Language for Classifying Home...

    Data.gov (United States)

    U.S. Department of Health & Human Services — The home- and community-based services (HCBS) taxonomy provides a common language for describing and categorizing HCBS across Medicaid programs. Prior to the...

  16. Sensitivity of risk parameters to human errors for a PWR

    International Nuclear Information System (INIS)

    Samanta, P.; Hall, R.E.; Kerr, W.

    1980-01-01

    Sensitivities of the risk parameters, emergency safety system unavailabilities, accident sequence probabilities, release category probabilities and core melt probability were investigated for changes in the human error rates within the general methodological framework of the Reactor Safety Study for a Pressurized Water Reactor (PWR). Impact of individual human errors were assessed both in terms of their structural importance to core melt and reliability importance on core melt probability. The Human Error Sensitivity Assessment of a PWR (HESAP) computer code was written for the purpose of this study

  17. ADVANCED MMIS TOWARD SUBSTANTIAL REDUCTION IN HUMAN ERRORS IN NPPS

    Directory of Open Access Journals (Sweden)

    POONG HYUN SEONG

    2013-04-01

    Full Text Available This paper aims to give an overview of the methods to inherently prevent human errors and to effectively mitigate the consequences of such errors by securing defense-in-depth during plant management through the advanced man-machine interface system (MMIS. It is needless to stress the significance of human error reduction during an accident in nuclear power plants (NPPs. Unexpected shutdowns caused by human errors not only threaten nuclear safety but also make public acceptance of nuclear power extremely lower. We have to recognize there must be the possibility of human errors occurring since humans are not essentially perfect particularly under stressful conditions. However, we have the opportunity to improve such a situation through advanced information and communication technologies on the basis of lessons learned from our experiences. As important lessons, authors explained key issues associated with automation, man-machine interface, operator support systems, and procedures. Upon this investigation, we outlined the concept and technical factors to develop advanced automation, operation and maintenance support systems, and computer-based procedures using wired/wireless technology. It should be noted that the ultimate responsibility of nuclear safety obviously belongs to humans not to machines. Therefore, safety culture including education and training, which is a kind of organizational factor, should be emphasized as well. In regard to safety culture for human error reduction, several issues that we are facing these days were described. We expect the ideas of the advanced MMIS proposed in this paper to lead in the future direction of related researches and finally supplement the safety of NPPs.

  18. Advanced MMIS Toward Substantial Reduction in Human Errors in NPPs

    Energy Technology Data Exchange (ETDEWEB)

    Seong, Poong Hyun; Kang, Hyun Gook [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Na, Man Gyun [Chosun Univ., Gwangju (Korea, Republic of); Kim, Jong Hyun [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of); Heo, Gyunyoung [Kyung Hee Univ., Yongin (Korea, Republic of); Jung, Yoensub [Korea Hydro and Nuclear Power Co., Ltd., Daejeon (Korea, Republic of)

    2013-04-15

    This paper aims to give an overview of the methods to inherently prevent human errors and to effectively mitigate the consequences of such errors by securing defense-in-depth during plant management through the advanced man-machine interface system (MMIS). It is needless to stress the significance of human error reduction during an accident in nuclear power plants (NPPs). Unexpected shutdowns caused by human errors not only threaten nuclear safety but also make public acceptance of nuclear power extremely lower. We have to recognize there must be the possibility of human errors occurring since humans are not essentially perfect particularly under stressful conditions. However, we have the opportunity to improve such a situation through advanced information and communication technologies on the basis of lessons learned from our experiences. As important lessons, authors explained key issues associated with automation, man-machine interface, operator support systems, and procedures. Upon this investigation, we outlined the concept and technical factors to develop advanced automation, operation and maintenance support systems, and computer-based procedures using wired/wireless technology. It should be noted that the ultimate responsibility of nuclear safety obviously belongs to humans not to machines. Therefore, safety culture including education and training, which is a kind of organizational factor, should be emphasized as well. In regard to safety culture for human error reduction, several issues that we are facing these days were described. We expect the ideas of the advanced MMIS proposed in this paper to lead in the future direction of related researches and finally supplement the safety of NPPs.

  19. Advanced MMIS Toward Substantial Reduction in Human Errors in NPPs

    International Nuclear Information System (INIS)

    Seong, Poong Hyun; Kang, Hyun Gook; Na, Man Gyun; Kim, Jong Hyun; Heo, Gyunyoung; Jung, Yoensub

    2013-01-01

    This paper aims to give an overview of the methods to inherently prevent human errors and to effectively mitigate the consequences of such errors by securing defense-in-depth during plant management through the advanced man-machine interface system (MMIS). It is needless to stress the significance of human error reduction during an accident in nuclear power plants (NPPs). Unexpected shutdowns caused by human errors not only threaten nuclear safety but also make public acceptance of nuclear power extremely lower. We have to recognize there must be the possibility of human errors occurring since humans are not essentially perfect particularly under stressful conditions. However, we have the opportunity to improve such a situation through advanced information and communication technologies on the basis of lessons learned from our experiences. As important lessons, authors explained key issues associated with automation, man-machine interface, operator support systems, and procedures. Upon this investigation, we outlined the concept and technical factors to develop advanced automation, operation and maintenance support systems, and computer-based procedures using wired/wireless technology. It should be noted that the ultimate responsibility of nuclear safety obviously belongs to humans not to machines. Therefore, safety culture including education and training, which is a kind of organizational factor, should be emphasized as well. In regard to safety culture for human error reduction, several issues that we are facing these days were described. We expect the ideas of the advanced MMIS proposed in this paper to lead in the future direction of related researches and finally supplement the safety of NPPs

  20. The Relationship between Human Operators' Psycho-physiological Condition and Human Errors in Nuclear Power Plants

    International Nuclear Information System (INIS)

    Kim, Arryum; Jang, Inseok; Kang, Hyungook; Seong, Poonghyun

    2013-01-01

    The safe operation of nuclear power plants (NPPs) is substantially dependent on the performance of the human operators who operate the systems. In this environment, human errors caused by inappropriate performance of operator have been considered to be critical since it may lead serious problems in the safety-critical plants. In order to provide meaningful insights to prevent human errors and enhance the human performance, operators' physiological conditions such as stress and workload have been investigated. Physiological measurements were considered as reliable tools to assess the stress and workload. T. Q. Tran et al. and J. B. Brooking et al pointed out that operators' workload can be assessed using eye tracking, galvanic skin response, electroencephalograms (EEGs), heart rate, respiration and other measurements. The purpose of this study is to investigate the effect of the human operators' tense level and knowledge level to the number of human errors. For this study, the experiments were conducted in the mimic of the main control rooms (MCR) in NPP. It utilized the compact nuclear simulator (CNS) which is modeled based on the three loop Pressurized Water Reactor, 993MWe, Kori unit 3 and 4 in Korea and the subjects were asked to follow the tasks described in the emergency operating procedures (EOP). During the simulation, three kinds of physiological measurement were utilized; Electrocardiogram (ECG), EEG and nose temperature. Also, subjects were divided into three groups based on their knowledge of the plant operation. The result shows that subjects who are tense make fewer errors. In addition, subjects who are in higher knowledge level tend to be tense and make fewer errors. For the ECG data, subjects who make fewer human errors tend to be located in higher tense level area of high SNS activity and low PSNS activity. The results of EEG data are also similar to ECG result. Beta power ratio of subjects who make fewer errors was higher. Since beta power ratio is

  1. Quantification of human errors in level-1 PSA studies in NUPEC/JINS

    International Nuclear Information System (INIS)

    Hirano, M.; Hirose, M.; Sugawara, M.; Hashiba, T.

    1991-01-01

    THERP (Technique for Human Error Rate Prediction) method is mainly adopted to evaluate the pre-accident and post-accident human error rates. Performance shaping factors are derived by taking Japanese operational practice into account. Several examples of human error rates with calculational procedures are presented. The important human interventions of typical Japanese NPPs are also presented. (orig./HP)

  2. AGAPE-ET for human error analysis of emergency tasks and its application

    International Nuclear Information System (INIS)

    Kim, J. H.; Jeong, W. D.

    2002-01-01

    The paper presents a proceduralised human reliability analysis (HRA) methodology, AGAPE-ET (A Guidance And Procedure for Human Error Analysis for Emergency Tasks), covering both qualitative error analysis and quantification of human error probability (HEP) of emergency tasks in nuclear power plants. The AGAPE-ET method is based on the simplified cognitive model. By each cognitive function, error causes or error-likely situations have been identified considering the characteristics of the performance of each cognitive function and influencing mechanism of the performance influencing factors (PIFs) on the cognitive function. Then, error analysis items have been determined from the identified error causes or error-likely situations and a human error analysis procedure based on the error analysis items is organised to help the analysts cue or guide overall human error analysis. The basic scheme for the quantification of HEP consists in the multiplication of the BHEP assigned by the error analysis item and the weight from the influencing factors decision tree (IFDT) constituted by cognitive function. The method can be characterised by the structured identification of the weak points of the task required to perform and the efficient analysis process that the analysts have only to carry out with the necessary cognitive functions. The paper also presents the application of AGAPE-ET to 31 nuclear emergency tasks and its results

  3. Teaching Taxonomy: How Many Kingdoms?

    Science.gov (United States)

    Case, Emily

    2008-01-01

    Taxonomy, the identification, naming, and classification of living things, is an indispensable unit in any biology curriculum and indeed, an integral part of biological science. Taxonomy catalogues life's diversity and is an essential tool for communication. Textbook discussions of taxonomy range anywhere from three to eight domains of kingdoms.…

  4. Modeling Human Error Mechanism for Soft Control in Advanced Control Rooms (ACRs)

    Energy Technology Data Exchange (ETDEWEB)

    Aljneibi, Hanan Salah Ali [Khalifa Univ., Abu Dhabi (United Arab Emirates); Ha, Jun Su; Kang, Seongkeun; Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of)

    2015-10-15

    To achieve the switch from conventional analog-based design to digital design in ACRs, a large number of manual operating controls and switches have to be replaced by a few common multi-function devices which is called soft control system. The soft controls in APR-1400 ACRs are classified into safety-grade and non-safety-grade soft controls; each was designed using different and independent input devices in ACRs. The operations using soft controls require operators to perform new tasks which were not necessary in conventional controls such as navigating computerized displays to monitor plant information and control devices. These kinds of computerized displays and soft controls may make operations more convenient but they might cause new types of human error. In this study the human error mechanism during the soft controls is studied and modeled to be used for analysis and enhancement of human performance (or human errors) during NPP operation. The developed model would contribute to a lot of applications to improve human performance (or reduce human errors), HMI designs, and operators' training program in ACRs. The developed model of human error mechanism for the soft control is based on assumptions that a human operator has certain amount of capacity in cognitive resources and if resources required by operating tasks are greater than resources invested by the operator, human error (or poor human performance) is likely to occur (especially in 'slip'); good HMI (Human-machine Interface) design decreases the required resources; operator's skillfulness decreases the required resources; and high vigilance increases the invested resources. In this study the human error mechanism during the soft controls is studied and modeled to be used for analysis and enhancement of human performance (or reduction of human errors) during NPP operation.

  5. Modeling Human Error Mechanism for Soft Control in Advanced Control Rooms (ACRs)

    International Nuclear Information System (INIS)

    Aljneibi, Hanan Salah Ali; Ha, Jun Su; Kang, Seongkeun; Seong, Poong Hyun

    2015-01-01

    To achieve the switch from conventional analog-based design to digital design in ACRs, a large number of manual operating controls and switches have to be replaced by a few common multi-function devices which is called soft control system. The soft controls in APR-1400 ACRs are classified into safety-grade and non-safety-grade soft controls; each was designed using different and independent input devices in ACRs. The operations using soft controls require operators to perform new tasks which were not necessary in conventional controls such as navigating computerized displays to monitor plant information and control devices. These kinds of computerized displays and soft controls may make operations more convenient but they might cause new types of human error. In this study the human error mechanism during the soft controls is studied and modeled to be used for analysis and enhancement of human performance (or human errors) during NPP operation. The developed model would contribute to a lot of applications to improve human performance (or reduce human errors), HMI designs, and operators' training program in ACRs. The developed model of human error mechanism for the soft control is based on assumptions that a human operator has certain amount of capacity in cognitive resources and if resources required by operating tasks are greater than resources invested by the operator, human error (or poor human performance) is likely to occur (especially in 'slip'); good HMI (Human-machine Interface) design decreases the required resources; operator's skillfulness decreases the required resources; and high vigilance increases the invested resources. In this study the human error mechanism during the soft controls is studied and modeled to be used for analysis and enhancement of human performance (or reduction of human errors) during NPP operation

  6. The Concept of Human Error and the Design of Reliable Human-Machine Systems

    DEFF Research Database (Denmark)

    Rasmussen, Jens

    1995-01-01

    The concept of human error is unreliable as a basis for design of reliable human-machine systems. Humans are basically highly adaptive and 'errors' are closely related to the process of adaptation and learning. Therefore, reliability of system operation depends on an interface that is not designed...... so as to support a pre-conceived operating procedure, but, instead, makes visible the deep, functional structure of the system together with the boundaries of acceptable operation in away that allows operators to 'touch' the boundaries and to learn to cope with the effects of errors in a reversible...... way. The concepts behind such 'ecological' interfaces are discussed, an it is argued that a 'typology' of visualization concepts is a pressing research need....

  7. Dynamic taxonomies applied to a web-based relational database for geo-hydrological risk mitigation

    Science.gov (United States)

    Sacco, G. M.; Nigrelli, G.; Bosio, A.; Chiarle, M.; Luino, F.

    2012-02-01

    In its 40 years of activity, the Research Institute for Geo-hydrological Protection of the Italian National Research Council has amassed a vast and varied collection of historical documentation on landslides, muddy-debris flows, and floods in northern Italy from 1600 to the present. Since 2008, the archive resources have been maintained through a relational database management system. The database is used for routine study and research purposes as well as for providing support during geo-hydrological emergencies, when data need to be quickly and accurately retrieved. Retrieval speed and accuracy are the main objectives of an implementation based on a dynamic taxonomies model. Dynamic taxonomies are a general knowledge management model for configuring complex, heterogeneous information bases that support exploratory searching. At each stage of the process, the user can explore or browse the database in a guided yet unconstrained way by selecting the alternatives suggested for further refining the search. Dynamic taxonomies have been successfully applied to such diverse and apparently unrelated domains as e-commerce and medical diagnosis. Here, we describe the application of dynamic taxonomies to our database and compare it to traditional relational database query methods. The dynamic taxonomy interface, essentially a point-and-click interface, is considerably faster and less error-prone than traditional form-based query interfaces that require the user to remember and type in the "right" search keywords. Finally, dynamic taxonomy users have confirmed that one of the principal benefits of this approach is the confidence of having considered all the relevant information. Dynamic taxonomies and relational databases work in synergy to provide fast and precise searching: one of the most important factors in timely response to emergencies.

  8. The treatment of commission errors in first generation human reliability analysis methods

    Energy Technology Data Exchange (ETDEWEB)

    Alvarengga, Marco Antonio Bayout; Fonseca, Renato Alves da, E-mail: bayout@cnen.gov.b, E-mail: rfonseca@cnen.gov.b [Comissao Nacional de Energia Nuclear (CNEN) Rio de Janeiro, RJ (Brazil); Melo, Paulo Fernando Frutuoso e, E-mail: frutuoso@nuclear.ufrj.b [Coordenacao dos Programas de Pos-Graduacao de Engenharia (PEN/COPPE/UFRJ), RJ (Brazil). Programa de Engenharia Nuclear

    2011-07-01

    Human errors in human reliability analysis can be classified generically as errors of omission and commission errors. Omission errors are related to the omission of any human action that should have been performed, but does not occur. Errors of commission are those related to human actions that should not be performed, but which in fact are performed. Both involve specific types of cognitive error mechanisms, however, errors of commission are more difficult to model because they are characterized by non-anticipated actions that are performed instead of others that are omitted (omission errors) or are entered into an operational task without being part of the normal sequence of this task. The identification of actions that are not supposed to occur depends on the operational context that will influence or become easy certain unsafe actions of the operator depending on the operational performance of its parameters and variables. The survey of operational contexts and associated unsafe actions is a characteristic of second-generation models, unlike the first generation models. This paper discusses how first generation models can treat errors of commission in the steps of detection, diagnosis, decision-making and implementation, in the human information processing, particularly with the use of THERP tables of errors quantification. (author)

  9. A Human Error Analysis Procedure for Identifying Potential Error Modes and Influencing Factors for Test and Maintenance Activities

    International Nuclear Information System (INIS)

    Kim, Jae Whan; Park, Jin Kyun

    2010-01-01

    Periodic or non-periodic test and maintenance (T and M) activities in large, complex systems such as nuclear power plants (NPPs) are essential for sustaining stable and safe operation of the systems. On the other hand, it also has been raised that human erroneous actions that might occur during T and M activities has the possibility of incurring unplanned reactor trips (RTs) or power derate, making safety-related systems unavailable, or making the reliability of components degraded. Contribution of human errors during normal and abnormal activities of NPPs to the unplanned RTs is known to be about 20% of the total events. This paper introduces a procedure for predictively analyzing human error potentials when maintenance personnel perform T and M tasks based on a work procedure or their work plan. This procedure helps plant maintenance team prepare for plausible human errors. The procedure to be introduced is focusing on the recurrent error forms (or modes) in execution-based errors such as wrong object, omission, too little, and wrong action

  10. The recovery factors analysis of the human errors for research reactors

    International Nuclear Information System (INIS)

    Farcasiu, M.; Nitoi, M.; Apostol, M.; Turcu, I.; Florescu, Ghe.

    2006-01-01

    The results of many Probabilistic Safety Assessment (PSA) studies show a very significant contribution of human errors to systems unavailability of the nuclear installations. The treatment of human interactions is considered one of the major limitations in the context of PSA. To identify those human actions that can have an effect on system reliability or availability applying the Human Reliability Analysis (HRA) is necessary. The recovery factors analysis of the human action is an important step in HRA. This paper presents how can be reduced the human errors probabilities (HEP) using those elements that have the capacity to recovery human error. The recovery factors modeling is marked to identify error likelihood situations or situations that conduct at development of the accident. This analysis is realized by THERP method. The necessary information was obtained from the operating experience of the research reactor TRIGA of the INR Pitesti. The required data were obtained from generic databases. (authors)

  11. Knowledge-base for the new human reliability analysis method, A Technique for Human Error Analysis (ATHEANA)

    International Nuclear Information System (INIS)

    Cooper, S.E.; Wreathall, J.; Thompson, C.M., Drouin, M.; Bley, D.C.

    1996-01-01

    This paper describes the knowledge base for the application of the new human reliability analysis (HRA) method, a ''A Technique for Human Error Analysis'' (ATHEANA). Since application of ATHEANA requires the identification of previously unmodeled human failure events, especially errors of commission, and associated error-forcing contexts (i.e., combinations of plant conditions and performance shaping factors), this knowledge base is an essential aid for the HRA analyst

  12. A Human Reliability Analysis of Post- Accident Human Errors in the Low Power and Shutdown PSA of KSNP

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Daeil; Kim, J. H.; Jang, S. C

    2007-03-15

    Korea Atomic Energy Research Institute, using the ANS low power and shutdown (LPSD) probabilistic risk assessment (PRA) Standard, evaluated the LPSD PSA model of the KSNP, Yonggwang Units 5 and 6, and identified the items to be improved. The evaluation results of human reliability analysis (HRA) of the post-accident human errors in the LPSD PSA model for the KSNP showed that 10 items among 19 items of supporting requirements for those in the ANS PRA Standard were identified as them to be improved. Thus, we newly carried out a HRA for post-accident human errors in the LPSD PSA model for the KSNP. Following tasks are the improvements in the HRA of post-accident human errors of the LPSD PSA model for the KSNP compared with the previous one: Interviews with operators in the interpretation of the procedure, modeling of operator actions, and the quantification results of human errors, site visit. Applications of limiting value to the combined post-accident human errors. Documentation of information of all the input and bases for the detailed quantifications and the dependency analysis using the quantification sheets The assessment results for the new HRA results of post-accident human errors using the ANS LPSD PRA Standard show that above 80% items of its supporting requirements for post-accident human errors were graded as its Category II. The number of the re-estimated human errors using the LPSD Korea Standard HRA method is 385. Among them, the number of individual post-accident human errors is 253. The number of dependent post-accident human errors is 135. The quantification results of the LPSD PSA model for the KSNP with new HEPs show that core damage frequency (CDF) is increased by 5.1% compared with the previous baseline CDF It is expected that this study results will be greatly helpful to improve the PSA quality for the domestic nuclear power plants because they have sufficient PSA quality to meet the Category II of Supporting Requirements for the post

  13. A Human Reliability Analysis of Post- Accident Human Errors in the Low Power and Shutdown PSA of KSNP

    International Nuclear Information System (INIS)

    Kang, Daeil; Kim, J. H.; Jang, S. C.

    2007-03-01

    Korea Atomic Energy Research Institute, using the ANS low power and shutdown (LPSD) probabilistic risk assessment (PRA) Standard, evaluated the LPSD PSA model of the KSNP, Yonggwang Units 5 and 6, and identified the items to be improved. The evaluation results of human reliability analysis (HRA) of the post-accident human errors in the LPSD PSA model for the KSNP showed that 10 items among 19 items of supporting requirements for those in the ANS PRA Standard were identified as them to be improved. Thus, we newly carried out a HRA for post-accident human errors in the LPSD PSA model for the KSNP. Following tasks are the improvements in the HRA of post-accident human errors of the LPSD PSA model for the KSNP compared with the previous one: Interviews with operators in the interpretation of the procedure, modeling of operator actions, and the quantification results of human errors, site visit. Applications of limiting value to the combined post-accident human errors. Documentation of information of all the input and bases for the detailed quantifications and the dependency analysis using the quantification sheets The assessment results for the new HRA results of post-accident human errors using the ANS LPSD PRA Standard show that above 80% items of its supporting requirements for post-accident human errors were graded as its Category II. The number of the re-estimated human errors using the LPSD Korea Standard HRA method is 385. Among them, the number of individual post-accident human errors is 253. The number of dependent post-accident human errors is 135. The quantification results of the LPSD PSA model for the KSNP with new HEPs show that core damage frequency (CDF) is increased by 5.1% compared with the previous baseline CDF It is expected that this study results will be greatly helpful to improve the PSA quality for the domestic nuclear power plants because they have sufficient PSA quality to meet the Category II of Supporting Requirements for the post

  14. Error detection in spoken human-machine interaction

    NARCIS (Netherlands)

    Krahmer, E.J.; Swerts, M.G.J.; Theune, M.; Weegels, M.F.

    2001-01-01

    Given the state of the art of current language and speech technology, errors are unavoidable in present-day spoken dialogue systems. Therefore, one of the main concerns in dialogue design is how to decide whether or not the system has understood the user correctly. In human-human communication,

  15. Error detection in spoken human-machine interaction

    NARCIS (Netherlands)

    Krahmer, E.; Swerts, M.; Theune, Mariet; Weegels, M.

    Given the state of the art of current language and speech technology, errors are unavoidable in present-day spoken dialogue systems. Therefore, one of the main concerns in dialogue design is how to decide whether or not the system has understood the user correctly. In human-human communication,

  16. Interruption of People in Human-Computer Interaction: A General Unifying Definition of Human Interruption and Taxonomy

    National Research Council Canada - National Science Library

    McFarlane, Daniel

    1997-01-01

    .... This report asserts that a single unifying definition of user-interruption and the accompanying practical taxonomy would be useful theoretical tools for driving effective investigation of this crucial...

  17. Evaluation of human error estimation for nuclear power plants

    International Nuclear Information System (INIS)

    Haney, L.N.; Blackman, H.S.

    1987-01-01

    The dominant risk for severe accident occurrence in nuclear power plants (NPPs) is human error. The US Nuclear Regulatory Commission (NRC) sponsored an evaluation of Human Reliability Analysis (HRA) techniques for estimation of human error in NPPs. Twenty HRA techniques identified by a literature search were evaluated with criteria sets designed for that purpose and categorized. Data were collected at a commercial NPP with operators responding in walkthroughs of four severe accident scenarios and full scope simulator runs. Results suggest a need for refinement and validation of the techniques. 19 refs

  18. Towards the Development of a Taxonomy for Visualisation of Streamed Geospatial Data

    Science.gov (United States)

    Sibolla, B. H.; Van Zyl, T.; Coetzee, S.

    2016-06-01

    Geospatial data has very specific characteristics that need to be carefully captured in its visualisation, in order for the user and the viewer to gain knowledge from it. The science of visualisation has gained much traction over the last decade as a response to various visualisation challenges. During the development of an open source based, dynamic two-dimensional visualisation library, that caters for geospatial streaming data, it was found necessary to conduct a review of existing geospatial visualisation taxonomies. The review was done in order to inform the design phase of the library development, such that either an existing taxonomy can be adopted or extended to fit the needs at hand. The major challenge in this case is to develop dynamic two dimensional visualisations that enable human interaction in order to assist the user to understand the data streams that are continuously being updated. This paper reviews the existing geospatial data visualisation taxonomies that have been developed over the years. Based on the review, an adopted taxonomy for visualisation of geospatial streaming data is presented. Example applications of this taxonomy are also provided. The adopted taxonomy will then be used to develop the information model for the visualisation library in a further study.

  19. A Human Error Analysis with Physiological Signals during Utilizing Digital Devices

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee; Oh, Yeon Ju; Shin, Kwang Hyeon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2011-10-15

    The introduction of advanced MCR is accompanied with lots of changes and different forms and features through the virtue of new digital technologies. There are various kinds of digital devices such as flat panel displays, touch screens, and so on. The characteristics of these digital devices give many chances to the interface management, and can be integrated into a compact single workstation in an advanced MCR so that workers can operate the plant with minimum burden during any operating condition. However, these devices may introduce new types of human errors, and thus we need a means to evaluate and prevent such error, especially those related to the digital devices. Human errors have been retrospectively assessed for accident reviews and quantitatively evaluated through HRA for PSA. However, the ergonomic verification and validation is an important process to defend all human error potential in the NPP design. HRA is a crucial part of a PSA, and helps in preparing a countermeasure for design by drawing potential human error items that affect the overall safety of NPPs. Various HRA techniques are available however: they reveal shortages of the HMI design in the digital era. - HRA techniques depend on PSFs: this means that the scope dealing with human factors is previously limited, and thus all attributes of new digital devices may not be considered in HRA. - The data used to HRA are not close to the evaluation items. So, human error analysis is not easy to apply to design by several individual experiments and cases. - The results of HRA are not statistically meaningful because accidents including human errors in NPPs are rare and have been estimated as having an extremely low probability

  20. Human errors evaluation for muster in emergency situations applying human error probability index (HEPI, in the oil company warehouse in Hamadan City

    Directory of Open Access Journals (Sweden)

    2012-12-01

    Full Text Available Introduction: Emergency situation is one of the influencing factors on human error. The aim of this research was purpose to evaluate human error in emergency situation of fire and explosion at the oil company warehouse in Hamadan city applying human error probability index (HEPI. . Material and Method: First, the scenario of emergency situation of those situation of fire and explosion at the oil company warehouse was designed and then maneuver against, was performed. The scaled questionnaire of muster for the maneuver was completed in the next stage. Collected data were analyzed to calculate the probability success for the 18 actions required in an emergency situation from starting point of the muster until the latest action to temporary sheltersafe. .Result: The result showed that the highest probability of error occurrence was related to make safe workplace (evaluation phase with 32.4 % and lowest probability of occurrence error in detection alarm (awareness phase with 1.8 %, probability. The highest severity of error was in the evaluation phase and the lowest severity of error was in the awareness and recovery phase. Maximum risk level was related to the evaluating exit routes and selecting one route and choosy another exit route and minimum risk level was related to the four evaluation phases. . Conclusion: To reduce the risk of reaction in the exit phases of an emergency situation, the following actions are recommended, based on the finding in this study: A periodic evaluation of the exit phase and modifying them if necessary, conducting more maneuvers and analyzing this results along with a sufficient feedback to the employees.

  1. The Relationship between Human Operators' Psycho-physiological Condition and Human Errors in Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Arryum; Jang, Inseok; Kang, Hyungook; Seong, Poonghyun [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2013-05-15

    The safe operation of nuclear power plants (NPPs) is substantially dependent on the performance of the human operators who operate the systems. In this environment, human errors caused by inappropriate performance of operator have been considered to be critical since it may lead serious problems in the safety-critical plants. In order to provide meaningful insights to prevent human errors and enhance the human performance, operators' physiological conditions such as stress and workload have been investigated. Physiological measurements were considered as reliable tools to assess the stress and workload. T. Q. Tran et al. and J. B. Brooking et al pointed out that operators' workload can be assessed using eye tracking, galvanic skin response, electroencephalograms (EEGs), heart rate, respiration and other measurements. The purpose of this study is to investigate the effect of the human operators' tense level and knowledge level to the number of human errors. For this study, the experiments were conducted in the mimic of the main control rooms (MCR) in NPP. It utilized the compact nuclear simulator (CNS) which is modeled based on the three loop Pressurized Water Reactor, 993MWe, Kori unit 3 and 4 in Korea and the subjects were asked to follow the tasks described in the emergency operating procedures (EOP). During the simulation, three kinds of physiological measurement were utilized; Electrocardiogram (ECG), EEG and nose temperature. Also, subjects were divided into three groups based on their knowledge of the plant operation. The result shows that subjects who are tense make fewer errors. In addition, subjects who are in higher knowledge level tend to be tense and make fewer errors. For the ECG data, subjects who make fewer human errors tend to be located in higher tense level area of high SNS activity and low PSNS activity. The results of EEG data are also similar to ECG result. Beta power ratio of subjects who make fewer errors was higher. Since beta

  2. GEM Building Taxonomy (Version 2.0)

    Science.gov (United States)

    Brzev, S.; Scawthorn, C.; Charleson, A.W.; Allen, L.; Greene, M.; Jaiswal, Kishor; Silva, V.

    2013-01-01

    This report documents the development and applications of the Building Taxonomy for the Global Earthquake Model (GEM). The purpose of the GEM Building Taxonomy is to describe and classify buildings in a uniform manner as a key step towards assessing their seismic risk, Criteria for development of the GEM Building Taxonomy were that the Taxonomy be relevant to seismic performance of different construction types; be comprehensive yet simple; be collapsible; adhere to principles that are familiar to the range of users; and ultimately be extensible to non-buildings and other hazards. The taxonomy was developed in conjunction with other GEM researchers and builds on the knowledge base from other taxonomies, including the EERI and IAEE World Housing Encyclopedia, PAGER-STR, and HAZUS. The taxonomy is organized as a series of expandable tables, which contain information pertaining to various building attributes. Each attribute describes a specific characteristic of an individual building or a class of buildings that could potentially affect their seismic performance. The following 13 attributes have been included in the GEM Building Taxonomy Version 2.0 (v2.0): 1.) direction, 2.)material of the lateral load-resisting system, 3.) lateral load-resisting system, 4.) height, 5.) date of construction of retrofit, 6.) occupancy, 7.) building position within a block, 8.) shape of the building plan, 9.) structural irregularity, 10.) exterior walls, 11.) roof, 12.) floor, 13.) foundation system. The report illustrates the pratical use of the GEM Building Taxonomy by discussing example case studies, in which the building-specific characteristics are mapped directly using GEM taxonomic attributes and the corresponding taxonomic string is constructed for that building, with "/" slash marks separating attributes. For example, for the building shown to the right, the GEM Taxonomy string is: DX1/MUR+CLBRS+MOCL2/LWAL3/

  3. A system engineer's Perspective on Human Errors For a more Effective Management of Human Factors in Nuclear Power Plants

    International Nuclear Information System (INIS)

    Lee, Yong-Hee; Jang, Tong-Il; Lee, Soo-Kil

    2007-01-01

    The management of human factors in nuclear power plants (NPPs) has become one of the burden factors during their operating period after the design and construction period. Almost every study on the major accidents emphasizes the prominent importance of the human errors. Regardless of the regulatory requirements such as Periodic Safety Review, the management of human factors would be a main issue to reduce the human errors and to enhance the performance of plants. However, it is not easy to find out a more effective perspective on human errors to establish the engineering implementation plan for preventing them. This paper describes a system engineer's perspectives on human errors and discusses its application to the recent study on the human error events in Korean NPPs

  4. Towards a Future Reallocation of Work between Humans and Machines – Taxonomy of Tasks and Interaction Types in the Context of Machine Learning

    OpenAIRE

    Traumer, Fabian; Oeste-Reiß, Sarah; Leimeister, Jan Marco

    2017-01-01

    In today’s race for competitive advantages, more and more companies implement innovations in artificial intelligence and machine learning (ML). Although these machines take over tasks that have been executed by humans, they will not make human workforce obsolete. To leverage the potentials of ML, collaboration between humans and machines is necessary. Before collaboration processes can be developed, a classification of tasks in the field of ML is needed. Therefore, we present a taxonomy for t...

  5. A stochastic dynamic model for human error analysis in nuclear power plants

    Science.gov (United States)

    Delgado-Loperena, Dharma

    Nuclear disasters like Three Mile Island and Chernobyl indicate that human performance is a critical safety issue, sending a clear message about the need to include environmental press and competence aspects in research. This investigation was undertaken to serve as a roadmap for studying human behavior through the formulation of a general solution equation. The theoretical model integrates models from two heretofore-disassociated disciplines (behavior specialists and technical specialists), that historically have independently studied the nature of error and human behavior; including concepts derived from fractal and chaos theory; and suggests re-evaluation of base theory regarding human error. The results of this research were based on comprehensive analysis of patterns of error, with the omnipresent underlying structure of chaotic systems. The study of patterns lead to a dynamic formulation, serving for any other formula used to study human error consequences. The search for literature regarding error yielded insight for the need to include concepts rooted in chaos theory and strange attractors---heretofore unconsidered by mainstream researchers who investigated human error in nuclear power plants or those who employed the ecological model in their work. The study of patterns obtained from the rupture of a steam generator tube (SGTR) event simulation, provided a direct application to aspects of control room operations in nuclear power plant operations. In doing so, the conceptual foundation based in the understanding of the patterns of human error analysis can be gleaned, resulting in reduced and prevent undesirable events.

  6. The Distributed Wind Cost Taxonomy

    Energy Technology Data Exchange (ETDEWEB)

    Forsyth, Trudy; Jimenez, Tony; Preus, Robert; Tegen, Suzanne; Baring-Gould, Ian

    2017-03-28

    To date, there has been no standard method or tool to analyze the installed and operational costs for distributed wind turbine systems. This report describes the development of a classification system, or taxonomy, for distributed wind turbine project costs. The taxonomy establishes a framework to help collect, sort, and compare distributed wind cost data that mirrors how the industry categorizes information. The taxonomy organizes costs so they can be aggregated from installers, developers, vendors, and other sources without losing cost details. Developing a peer-reviewed taxonomy is valuable to industry stakeholders because a common understanding the details of distributed wind turbine costs and balance of station costs is a first step to identifying potential high-value cost reduction opportunities. Addressing cost reduction potential can help increase distributed wind's competitiveness and propel the U.S. distributed wind industry forward. The taxonomy can also be used to perform cost comparisons between technologies and track trends for distributed wind industry costs in the future. As an initial application and piloting of the taxonomy, preliminary cost data were collected for projects of different sizes and from different regions across the contiguous United States. Following the methods described in this report, these data are placed into the established cost categories.

  7. Operator error and emotions. Operator error and emotions - a major cause of human failure

    International Nuclear Information System (INIS)

    Patterson, B.K.; Bradley, M.; Artiss, W.G.

    2000-01-01

    This paper proposes the idea that a large proportion of the incidents attributed to operator and maintenance error in a nuclear or industrial plant are actually founded in our human emotions. Basic psychological theory of emotions is briefly presented and then the authors present situations and instances that can cause emotions to swell and lead to operator and maintenance error. Since emotional information is not recorded in industrial incident reports, the challenge is extended to industry, to review incident source documents for cases of emotional involvement and to develop means to collect emotion related information in future root cause analysis investigations. Training must then be provided to operators and maintainers to enable them to know one's emotions, manage emotions, motivate one's self, recognize emotions in others and handle relationships. Effective training will reduce the instances of human error based in emotions and enable a cooperative, productive environment in which to work. (author)

  8. Operator error and emotions. Operator error and emotions - a major cause of human failure

    Energy Technology Data Exchange (ETDEWEB)

    Patterson, B.K. [Human Factors Practical Incorporated (Canada); Bradley, M. [Univ. of New Brunswick, Saint John, New Brunswick (Canada); Artiss, W.G. [Human Factors Practical (Canada)

    2000-07-01

    This paper proposes the idea that a large proportion of the incidents attributed to operator and maintenance error in a nuclear or industrial plant are actually founded in our human emotions. Basic psychological theory of emotions is briefly presented and then the authors present situations and instances that can cause emotions to swell and lead to operator and maintenance error. Since emotional information is not recorded in industrial incident reports, the challenge is extended to industry, to review incident source documents for cases of emotional involvement and to develop means to collect emotion related information in future root cause analysis investigations. Training must then be provided to operators and maintainers to enable them to know one's emotions, manage emotions, motivate one's self, recognize emotions in others and handle relationships. Effective training will reduce the instances of human error based in emotions and enable a cooperative, productive environment in which to work. (author)

  9. The common mode failures analysis of the redundent system with dependent human error

    International Nuclear Information System (INIS)

    Kim, M.K.; Chang, S.H.

    1983-01-01

    Common mode failures (CMFs) have been a serious concern in the nuclear power plant. Thereis a broad category of the failure mechanisms that can cause common mode failures. This paper is a theoretical investigation of the CMFs on the unavailability of the redundent system. It is assumed that the total CMFs consist of the potential CMFs and the dependent human error CMFs. As the human error dependency is higher, the total CMFs are more effected by the dependent human error. If the human error dependence is lower, the system unavailability strongly depends on the potential CMFs, rather than the mechanical failure or the dependent human error. And it is shown that the total CMFs are dominant factor to the unavailability of the redundent system. (Author)

  10. A strategy for minimizing common mode human error in executing critical functions and tasks

    International Nuclear Information System (INIS)

    Beltracchi, L.; Lindsay, R.W.

    1992-01-01

    Human error in execution of critical functions and tasks can be costly. The Three Mile Island and the Chernobyl Accidents are examples of results from human error in the nuclear industry. There are similar errors that could no doubt be cited from other industries. This paper discusses a strategy to minimize common mode human error in the execution of critical functions and tasks. The strategy consists of the use of human redundancy, and also diversity in human cognitive behavior: skill-, rule-, and knowledge-based behavior. The authors contend that the use of diversity in human cognitive behavior is possible, and it minimizes common mode error

  11. Human error in maintenance: An investigative study for the factories of the future

    International Nuclear Information System (INIS)

    Dhillon, B S

    2014-01-01

    This paper presents a study of human error in maintenance. Many different aspects of human error in maintenance considered useful for the factories of the future are studied, including facts, figures, and examples; occurrence of maintenance error in equipment life cycle, elements of a maintenance person's time, maintenance environment and the causes for the occurrence of maintenance error, types and typical maintenance errors, common maintainability design errors and useful design guidelines to reduce equipment maintenance errors, maintenance work instructions, and maintenance error analysis methods

  12. Development of an Experimental Measurement System for Human Error Characteristics and a Pilot Test

    International Nuclear Information System (INIS)

    Jang, Tong-Il; Lee, Hyun-Chul; Moon, Kwangsu

    2017-01-01

    Some items out of individual and team characteristics were partially selected, and a pilot test was performed to measure and evaluate them using the experimental measurement system of human error characteristics. It is one of the processes to produce input data to the Eco-DBMS. And also, through the pilot test, it was tried to take methods to measure and acquire the physiological data, and to develop data format and quantification methods for the database. In this study, a pilot test to measure the stress and the tension level, and team cognitive characteristics out of human error characteristics was performed using the human error characteristics measurement and experimental evaluation system. In an experiment measuring the stress level, physiological characteristics using EEG was measured in a simulated unexpected situation. As shown in results, although this experiment was pilot, it was validated that relevant results for evaluating human error coping effects of workers’ FFD management guidelines and unexpected situation against guidelines can be obtained. In following researches, additional experiments including other human error characteristics will be conducted. Furthermore, the human error characteristics measurement and experimental evaluation system will be utilized to validate various human error coping solutions such as human factors criteria, design, and guidelines as well as supplement the human error characteristics database.

  13. A Conceptual Framework of Human Reliability Analysis for Execution Human Error in NPP Advanced MCRs

    Energy Technology Data Exchange (ETDEWEB)

    Jang, In Seok; Kim, Ar Ryum; Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of); Jung, Won Dea [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2014-08-15

    The operation environment of Main Control Rooms (MCRs) in Nuclear Power Plants (NPPs) has changed with the adoption of new human-system interfaces that are based on computer-based technologies. The MCRs that include these digital and computer technologies, such as large display panels, computerized procedures, and soft controls, are called Advanced MCRs. Among the many features of Advanced MCRs, soft controls are a particularly important feature because the operation action in NPP Advanced MCRs is performed by soft control. Using soft controls such as mouse control, and touch screens, operators can select a specific screen, then choose the controller, and finally manipulate the given devices. Due to the different interfaces between soft control and hardwired conventional type control, different human error probabilities and a new Human Reliability Analysis (HRA) framework should be considered in the HRA for advanced MCRs. In other words, new human error modes should be considered for interface management tasks such as navigation tasks, and icon (device) selection tasks in monitors and a new framework of HRA method taking these newly generated human error modes into account should be considered. In this paper, a conceptual framework for a HRA method for the evaluation of soft control execution human error in advanced MCRs is suggested by analyzing soft control tasks.

  14. A Conceptual Framework of Human Reliability Analysis for Execution Human Error in NPP Advanced MCRs

    International Nuclear Information System (INIS)

    Jang, In Seok; Kim, Ar Ryum; Seong, Poong Hyun; Jung, Won Dea

    2014-01-01

    The operation environment of Main Control Rooms (MCRs) in Nuclear Power Plants (NPPs) has changed with the adoption of new human-system interfaces that are based on computer-based technologies. The MCRs that include these digital and computer technologies, such as large display panels, computerized procedures, and soft controls, are called Advanced MCRs. Among the many features of Advanced MCRs, soft controls are a particularly important feature because the operation action in NPP Advanced MCRs is performed by soft control. Using soft controls such as mouse control, and touch screens, operators can select a specific screen, then choose the controller, and finally manipulate the given devices. Due to the different interfaces between soft control and hardwired conventional type control, different human error probabilities and a new Human Reliability Analysis (HRA) framework should be considered in the HRA for advanced MCRs. In other words, new human error modes should be considered for interface management tasks such as navigation tasks, and icon (device) selection tasks in monitors and a new framework of HRA method taking these newly generated human error modes into account should be considered. In this paper, a conceptual framework for a HRA method for the evaluation of soft control execution human error in advanced MCRs is suggested by analyzing soft control tasks

  15. A critique of recent models for human error rate assessment

    International Nuclear Information System (INIS)

    Apostolakis, G.E.

    1988-01-01

    This paper critically reviews two groups of models for assessing human error rates under accident conditions. The first group, which includes the US Nuclear Regulatory Commission (NRC) handbook model and the human cognitive reliability (HCR) model, considers as fundamental the time that is available to the operators to act. The second group, which is represented by the success likelihood index methodology multiattribute utility decomposition (SLIM-MAUD) model, relies on ratings of the human actions with respect to certain qualitative factors and the subsequent derivation of error rates. These models are evaluated with respect to two criteria: the treatment of uncertainties and the internal coherence of the models. In other words, this evaluation focuses primarily on normative aspects of these models. The principal findings are as follows: (1) Both of the time-related models provide human error rates as a function of the available time for action and the prevailing conditions. However, the HCR model ignores the important issue of state-of-knowledge uncertainties, dealing exclusively with stochastic uncertainty, whereas the model presented in the NRC handbook handles both types of uncertainty. (2) SLIM-MAUD provides a highly structured approach for the derivation of human error rates under given conditions. However, the treatment of the weights and ratings in this model is internally inconsistent. (author)

  16. The integrative future of taxonomy

    Directory of Open Access Journals (Sweden)

    Vences Miguel

    2010-05-01

    Full Text Available Abstract Background Taxonomy is the biological discipline that identifies, describes, classifies and names extant and extinct species and other taxa. Nowadays, species taxonomy is confronted with the challenge to fully incorporate new theory, methods and data from disciplines that study the origin, limits and evolution of species. Results Integrative taxonomy has been proposed as a framework to bring together these conceptual and methodological developments. Here we review perspectives for an integrative taxonomy that directly bear on what species are, how they can be discovered, and how much diversity is on Earth. Conclusions We conclude that taxonomy needs to be pluralistic to improve species discovery and description, and to develop novel protocols to produce the much-needed inventory of life in a reasonable time. To cope with the large number of candidate species revealed by molecular studies of eukaryotes, we propose a classification scheme for those units that will facilitate the subsequent assembly of data sets for the formal description of new species under the Linnaean system, and will ultimately integrate the activities of taxonomists and molecular biologists.

  17. Quality of IT service delivery — Analysis and framework for human error prevention

    KAUST Repository

    Shwartz, L.

    2010-12-01

    In this paper, we address the problem of reducing the occurrence of Human Errors that cause service interruptions in IT Service Support and Delivery operations. Analysis of a large volume of service interruption records revealed that more than 21% of interruptions were caused by human error. We focus on Change Management, the process with the largest risk of human error, and identify the main instances of human errors as the 4 Wrongs: request, time, configuration item, and command. Analysis of change records revealed that the humanerror prevention by partial automation is highly relevant. We propose the HEP Framework, a framework for execution of IT Service Delivery operations that reduces human error by addressing the 4 Wrongs using content integration, contextualization of operation patterns, partial automation of command execution, and controlled access to resources.

  18. HUMAN RELIABILITY ANALYSIS DENGAN PENDEKATAN COGNITIVE RELIABILITY AND ERROR ANALYSIS METHOD (CREAM

    Directory of Open Access Journals (Sweden)

    Zahirah Alifia Maulida

    2015-01-01

    Full Text Available Kecelakaan kerja pada bidang grinding dan welding menempati urutan tertinggi selama lima tahun terakhir di PT. X. Kecelakaan ini disebabkan oleh human error. Human error terjadi karena pengaruh lingkungan kerja fisik dan non fisik.Penelitian kali menggunakan skenario untuk memprediksi serta mengurangi kemungkinan terjadinya error pada manusia dengan pendekatan CREAM (Cognitive Reliability and Error Analysis Method. CREAM adalah salah satu metode human reliability analysis yang berfungsi untuk mendapatkan nilai Cognitive Failure Probability (CFP yang dapat dilakukan dengan dua cara yaitu basic method dan extended method. Pada basic method hanya akan didapatkan nilai failure probabailty secara umum, sedangkan untuk extended method akan didapatkan CFP untuk setiap task. Hasil penelitian menunjukkan faktor- faktor yang mempengaruhi timbulnya error pada pekerjaan grinding dan welding adalah kecukupan organisasi, kecukupan dari Man Machine Interface (MMI & dukungan operasional, ketersediaan prosedur/ perencanaan, serta kecukupan pelatihan dan pengalaman. Aspek kognitif pada pekerjaan grinding yang memiliki nilai error paling tinggi adalah planning dengan nilai CFP 0.3 dan pada pekerjaan welding yaitu aspek kognitif execution dengan nilai CFP 0.18. Sebagai upaya untuk mengurangi nilai error kognitif pada pekerjaan grinding dan welding rekomendasi yang diberikan adalah memberikan training secara rutin, work instrucstion yang lebih rinci dan memberikan sosialisasi alat. Kata kunci: CREAM (cognitive reliability and error analysis method, HRA (human reliability analysis, cognitive error Abstract The accidents in grinding and welding sectors were the highest cases over the last five years in PT. X and it caused by human error. Human error occurs due to the influence of working environment both physically and non-physically. This study will implement an approaching scenario called CREAM (Cognitive Reliability and Error Analysis Method. CREAM is one of human

  19. Some aspects of statistical modeling of human-error probability

    International Nuclear Information System (INIS)

    Prairie, R.R.

    1982-01-01

    Human reliability analyses (HRA) are often performed as part of risk assessment and reliability projects. Recent events in nuclear power have shown the potential importance of the human element. There are several on-going efforts in the US and elsewhere with the purpose of modeling human error such that the human contribution can be incorporated into an overall risk assessment associated with one or more aspects of nuclear power. An effort that is described here uses the HRA (event tree) to quantify and model the human contribution to risk. As an example, risk analyses are being prepared on several nuclear power plants as part of the Interim Reliability Assessment Program (IREP). In this process the risk analyst selects the elements of his fault tree that could be contributed to by human error. He then solicits the HF analyst to do a HRA on this element

  20. Constructing a Business Model Taxonomy

    DEFF Research Database (Denmark)

    Groth, Pernille; Nielsen, Christian

    2015-01-01

    the quality of business model taxonomy studies in the future are identified. Originality/Value: The paper highlights the benefits and potential implications of designing business model taxonomy studies and makes the case for ensuring the quality of future studies relating to e.g. performance. Reviewing......Abstract Purpose: The paper proposes a research design recipe capable of leading to future business model taxonomies and discusses the potential benefits and implications of achieving this goal. Design/Methodology/Approach: The paper provides a review of relevant scholarly literature about business...... models to clarify the subject as well as highlighting the importance of past studies of business model classifications. In addition it reviews the scholarly literature on relevant methodological approaches, such as cluster analysis and latent class analysis, for constructing a business model taxonomy...

  1. An Analysis and Quantification Method of Human Errors of Soft Controls in Advanced MCRs

    International Nuclear Information System (INIS)

    Lee, Seung Jun; Kim, Jae Whan; Jang, Seung Cheol

    2011-01-01

    In this work, a method was proposed for quantifying human errors that may occur during operation executions using soft control. Soft controls of advanced main control rooms (MCRs) have totally different features from conventional controls, and thus they may have different human error modes and occurrence probabilities. It is important to define the human error modes and to quantify the error probability for evaluating the reliability of the system and preventing errors. This work suggests a modified K-HRA method for quantifying error probability

  2. Using a Delphi Method to Identify Human Factors Contributing to Nursing Errors.

    Science.gov (United States)

    Roth, Cheryl; Brewer, Melanie; Wieck, K Lynn

    2017-07-01

    The purpose of this study was to identify human factors associated with nursing errors. Using a Delphi technique, this study used feedback from a panel of nurse experts (n = 25) on an initial qualitative survey questionnaire followed by summarizing the results with feedback and confirmation. Synthesized factors regarding causes of errors were incorporated into a quantitative Likert-type scale, and the original expert panel participants were queried a second time to validate responses. The list identified 24 items as most common causes of nursing errors, including swamping and errors made by others that nurses are expected to recognize and fix. The responses provided a consensus top 10 errors list based on means with heavy workload and fatigue at the top of the list. The use of the Delphi survey established consensus and developed a platform upon which future study of nursing errors can evolve as a link to future solutions. This list of human factors in nursing errors should serve to stimulate dialogue among nurses about how to prevent errors and improve outcomes. Human and system failures have been the subject of an abundance of research, yet nursing errors continue to occur. © 2016 Wiley Periodicals, Inc.

  3. The taxobook principles and practices of building taxonomies

    CERN Document Server

    Hlava, Marjorie

    2014-01-01

    This book outlines the basic principles of creation and maintenance of taxonomies and thesauri. It also provides step by step instructions for building a taxonomy or thesaurus and discusses the various ways to get started on a taxonomy construction project.Often, the first step is to get management and budgetary approval, so I start this book with a discussion of reasons to embark on the taxonomy journey. From there I move on to a discussion of metadata and how taxonomies and metadata are related, and then consider how, where, and why taxonomies are used.Information architecture has its corner

  4. Human error prediction and countermeasures based on CREAM in spent nuclear fuel (SNF) transportation

    International Nuclear Information System (INIS)

    Kim, Jae San

    2007-02-01

    Since the 1980s, in order to secure the storage capacity of spent nuclear fuel (SNF) at NPPs, SNF assemblies have been transported on-site from one unit to another unit nearby. However in the future the amount of the spent fuel will approach capacity in the areas used, and some of these SNFs will have to be transported to an off-site spent fuel repository. Most SNF materials used at NPPs will be transported by general cargo ships from abroad, and these SNFs will be stored in an interim storage facility. In the process of transporting SNF, human interactions will involve inspecting and preparing the cask and spent fuel, loading the cask onto the vehicle or ship, transferring the cask as well as storage or monitoring the cask. The transportation of SNF involves a number of activities that depend on reliable human performance. In the case of the transport of a cask, human errors may include spent fuel bundle misidentification or cask transport accidents among others. Reviews of accident events when transporting the Radioactive Material (RAM) throughout the world indicate that human error is the major causes for more than 65% of significant events. For the safety of SNF transportation, it is very important to predict human error and to deduce a method that minimizes the human error. This study examines the human factor effects on the safety of transporting spent nuclear fuel (SNF). It predicts and identifies the possible human errors in the SNF transport process (loading, transfer and storage of the SNF). After evaluating the human error mode in each transport process, countermeasures to minimize the human error are deduced. The human errors in SNF transportation were analyzed using Hollnagel's Cognitive Reliability and Error Analysis Method (CREAM). After determining the important factors for each process, countermeasures to minimize human error are provided in three parts: System design, Operational environment, and Human ability

  5. Human Error and the International Space Station: Challenges and Triumphs in Science Operations

    Science.gov (United States)

    Harris, Samantha S.; Simpson, Beau C.

    2016-01-01

    Any system with a human component is inherently risky. Studies in human factors and psychology have repeatedly shown that human operators will inevitably make errors, regardless of how well they are trained. Onboard the International Space Station (ISS) where crew time is arguably the most valuable resource, errors by the crew or ground operators can be costly to critical science objectives. Operations experts at the ISS Payload Operations Integration Center (POIC), located at NASA's Marshall Space Flight Center in Huntsville, Alabama, have learned that from payload concept development through execution, there are countless opportunities to introduce errors that can potentially result in costly losses of crew time and science. To effectively address this challenge, we must approach the design, testing, and operation processes with two specific goals in mind. First, a systematic approach to error and human centered design methodology should be implemented to minimize opportunities for user error. Second, we must assume that human errors will be made and enable rapid identification and recoverability when they occur. While a systematic approach and human centered development process can go a long way toward eliminating error, the complete exclusion of operator error is not a reasonable expectation. The ISS environment in particular poses challenging conditions, especially for flight controllers and astronauts. Operating a scientific laboratory 250 miles above the Earth is a complicated and dangerous task with high stakes and a steep learning curve. While human error is a reality that may never be fully eliminated, smart implementation of carefully chosen tools and techniques can go a long way toward minimizing risk and increasing the efficiency of NASA's space science operations.

  6. Cause analysis and preventives for human error events in Daya Bay NPP

    International Nuclear Information System (INIS)

    Huang Weigang; Zhang Li

    1998-01-01

    Daya Bay Nuclear Power Plant is put into commercial operation in 1994 Until 1996, there are 368 human error events in operating and maintenance area, occupying 39% of total events. These events occurred mainly in the processes of maintenance, test equipment isolation and system on-line, in particular in refuelling and maintenance. The author analyses root causes for human errorievents, which are mainly operator omission or error procedure deficiency; procedure not followed; lack of training; communication failures; work management inadequacy. The protective measures and treatment principle for human error events are also discussed, and several examples applying them are given. Finally, it is put forward that key to prevent human error event lies in the coordination and management, person in charge of work, and good work habits of staffs

  7. Diagnostic errors in pediatric radiology

    International Nuclear Information System (INIS)

    Taylor, George A.; Voss, Stephan D.; Melvin, Patrice R.; Graham, Dionne A.

    2011-01-01

    Little information is known about the frequency, types and causes of diagnostic errors in imaging children. Our goals were to describe the patterns and potential etiologies of diagnostic error in our subspecialty. We reviewed 265 cases with clinically significant diagnostic errors identified during a 10-year period. Errors were defined as a diagnosis that was delayed, wrong or missed; they were classified as perceptual, cognitive, system-related or unavoidable; and they were evaluated by imaging modality and level of training of the physician involved. We identified 484 specific errors in the 265 cases reviewed (mean:1.8 errors/case). Most discrepancies involved staff (45.5%). Two hundred fifty-eight individual cognitive errors were identified in 151 cases (mean = 1.7 errors/case). Of these, 83 cases (55%) had additional perceptual or system-related errors. One hundred sixty-five perceptual errors were identified in 165 cases. Of these, 68 cases (41%) also had cognitive or system-related errors. Fifty-four system-related errors were identified in 46 cases (mean = 1.2 errors/case) of which all were multi-factorial. Seven cases were unavoidable. Our study defines a taxonomy of diagnostic errors in a large academic pediatric radiology practice and suggests that most are multi-factorial in etiology. Further study is needed to define effective strategies for improvement. (orig.)

  8. Detailed semantic analyses of human error incidents occurring at nuclear power plants. Extraction of periodical transition of error occurrence patterns by applying multivariate analysis

    International Nuclear Information System (INIS)

    Hirotsu, Yuko; Suzuki, Kunihiko; Takano, Kenichi; Kojima, Mitsuhiro

    2000-01-01

    It is essential for preventing the recurrence of human error incidents to analyze and evaluate them with the emphasis on human factor. Detailed and structured analyses of all incidents at domestic nuclear power plants (NPPs) reported during last 31 years have been conducted based on J-HPES, in which total 193 human error cases are identified. Results obtained by the analyses have been stored into the J-HPES database. In the previous study, by applying multivariate analysis to above case studies, it was suggested that there were several occurrence patterns identified of how errors occur at NPPs. It was also clarified that the causes related to each human error are different depending on age of their occurrence. This paper described the obtained results in respects of periodical transition of human error occurrence patterns. By applying multivariate analysis to the above data, it was suggested there were two types of error occurrence patterns as to each human error type. First type is common occurrence patterns, not depending on the age, and second type is the one influenced by periodical characteristics. (author)

  9. New method of classifying human errors at nuclear power plants and the analysis results of applying this method to maintenance errors at domestic plants

    International Nuclear Information System (INIS)

    Takagawa, Kenichi; Miyazaki, Takamasa; Gofuku, Akio; Iida, Hiroyasu

    2007-01-01

    Since many of the adverse events that have occurred in nuclear power plants in Japan and abroad have been related to maintenance or operation, it is necessary to plan preventive measures based on detailed analyses of human errors made by maintenance workers or operators. Therefore, before planning preventive measures, we developed a new method of analyzing human errors. Since each human error is an unsafe action caused by some misjudgement made by a person, we decided to classify them into six categories according to the stage in the judgment process in which the error was made. By further classifying each error into either an omission-type or commission-type, we produced 12 categories of errors. Then, we divided them into the two categories of basic error tendencies and individual error tendencies, and categorized background factors into four categories: imperfect planning; imperfect facilities or tools; imperfect environment; and imperfect instructions or communication. We thus defined the factors in each category to make it easy to identify factors that caused the error. Then using this method, we studied the characteristics of human errors that involved maintenance workers and planners since many maintenance errors have occurred. Among the human errors made by workers (worker errors) during the implementation stage, the following three types were prevalent with approximately 80%: commission-type 'projection errors', omission-type comprehension errors' and commission type 'action errors'. The most common among the individual factors of worker errors was 'repetition or habit' (schema), based on the assumption of a typical situation, and the half number of the 'repetition or habit' cases (schema) were not influenced by any background factors. The most common background factor that contributed to the individual factor was 'imperfect work environment', followed by 'insufficient knowledge'. Approximately 80% of the individual factors were 'repetition or habit' or

  10. Error Made in Conversation by Indonesian Learners Learning English Based on Syntax and Exchanging Information

    Directory of Open Access Journals (Sweden)

    Melania Wiannastiti

    2014-10-01

    Full Text Available In learning a second language or foreign language (L2, learners should master the competences. Normally, L2 learners first should master the linguistic competence which includes the mastery of vocabularies, pronunciation, and grammar. The study is to find out the syntax error made by L2 learners in conversation as well as to find out the exchanging information. The data were the recording conversation of Visual Communication Design students first semester of Binus University joining English Entrant. Error analysis was used to analyze the data. There are two points of view to analyze the data: syntax from taxonomy and exchanging information. Taxonomy employs the error in omission, addition, misinformation, and mis-ordering. Exchanging information point of view employs the error in finite element and mood. The result shows that L2 learners made some errors in grammar and exchanging information because they are influenced by the L1. They tend to transfer from L1 to L2 rather than thinking to create the utterances in L2. 

  11. Analysis of measured data of human body based on error correcting frequency

    Science.gov (United States)

    Jin, Aiyan; Peipei, Gao; Shang, Xiaomei

    2014-04-01

    Anthropometry is to measure all parts of human body surface, and the measured data is the basis of analysis and study of the human body, establishment and modification of garment size and formulation and implementation of online clothing store. In this paper, several groups of the measured data are gained, and analysis of data error is gotten by analyzing the error frequency and using analysis of variance method in mathematical statistics method. Determination of the measured data accuracy and the difficulty of measured parts of human body, further studies of the causes of data errors, and summarization of the key points to minimize errors possibly are also mentioned in the paper. This paper analyses the measured data based on error frequency, and in a way , it provides certain reference elements to promote the garment industry development.

  12. Sensitivity of risk parameters to human errors in reactor safety study for a PWR

    International Nuclear Information System (INIS)

    Samanta, P.K.; Hall, R.E.; Swoboda, A.L.

    1981-01-01

    Sensitivities of the risk parameters, emergency safety system unavailabilities, accident sequence probabilities, release category probabilities and core melt probability were investigated for changes in the human error rates within the general methodological framework of the Reactor Safety Study (RSS) for a Pressurized Water Reactor (PWR). Impact of individual human errors were assessed both in terms of their structural importance to core melt and reliability importance on core melt probability. The Human Error Sensitivity Assessment of a PWR (HESAP) computer code was written for the purpose of this study. The code employed point estimate approach and ignored the smoothing technique applied in RSS. It computed the point estimates for the system unavailabilities from the median values of the component failure rates and proceeded in terms of point values to obtain the point estimates for the accident sequence probabilities, core melt probability, and release category probabilities. The sensitivity measure used was the ratio of the top event probability before and after the perturbation of the constituent events. Core melt probability per reactor year showed significant increase with the increase in the human error rates, but did not show similar decrease with the decrease in the human error rates due to the dominance of the hardware failures. When the Minimum Human Error Rate (M.H.E.R.) used is increased to 10 -3 , the base case human error rates start sensitivity to human errors. This effort now allows the evaluation of new error rate data along with proposed changes in the man machine interface

  13. Human error as a source of disturbances in Swedish nuclear power plants

    International Nuclear Information System (INIS)

    Sokolowski, E.

    1985-01-01

    Events involving human errors at the Swedish nuclear power plants are registered and periodically analyzed. The philosophy behind the scheme for data collection and analysis is discussed. Human errors cause about 10% of the disturbances registered. Only a small part of these errors are committed by operators in the control room. These and other findings differ from those in other countries. Possible reasons are put forward

  14. HUMAN ERROR QUANTIFICATION USING PERFORMANCE SHAPING FACTORS IN THE SPAR-H METHOD

    Energy Technology Data Exchange (ETDEWEB)

    Harold S. Blackman; David I. Gertman; Ronald L. Boring

    2008-09-01

    This paper describes a cognitively based human reliability analysis (HRA) quantification technique for estimating the human error probabilities (HEPs) associated with operator and crew actions at nuclear power plants. The method described here, Standardized Plant Analysis Risk-Human Reliability Analysis (SPAR-H) method, was developed to aid in characterizing and quantifying human performance at nuclear power plants. The intent was to develop a defensible method that would consider all factors that may influence performance. In the SPAR-H approach, calculation of HEP rates is especially straightforward, starting with pre-defined nominal error rates for cognitive vs. action-oriented tasks, and incorporating performance shaping factor multipliers upon those nominal error rates.

  15. Quantification of human error and common-mode failures in man-machine systems

    International Nuclear Information System (INIS)

    Lisboa, J.J.

    1988-01-01

    Quantification of human performance, particularly the determination of human error, is essential for realistic assessment of overall system performance of man-machine systems. This paper presents an analysis of human errors in nuclear power plant systems when measured against common-mode failures (CMF). Human errors evaluated are improper testing, inadequate maintenance strategy, and miscalibration. The methodology presented in the paper represents a positive contribution to power plant systems availability by identifying sources of common-mode failure when operational functions are involved. It is also applicable to other complex systems such as chemical plants, aircraft and motor industries; in fact, any large man-created, man-machine system could be included

  16. Error detection and prevention in Embedded Systems Software

    DEFF Research Database (Denmark)

    Kamel, Hani Fouad

    1996-01-01

    Despite many efforts to structure the development and design processes of embedded systems, errors are discovered at the final stages of production and sometimes after the delivery of the products. The cost of such errors can be prohibitive.Different design techniques to detect such errors...... systems, a formal model for such systems is introduced. The main characteristics of embedded systems design and the interaction of these properties are described. A taxonomy for the structure of the software developed for such systems based on the amount of processes and processors involved is presented.......The second part includes methods and techniques to detect software design errors.The third part deals with error prevention. It starts with a presentation of different models of the development processes used in industry and taught at universities. This leads us to deduce the major causes of errors...

  17. A method for analysing incidents due to human errors on nuclear installations

    International Nuclear Information System (INIS)

    Griffon, M.

    1980-01-01

    This paper deals with the development of a methodology adapted to a detailed analysis of incidents considered to be due to human errors. An identification of human errors and a search for their eventual multiple causes is then needed. They are categorized in eight classes: education and training of personnel, installation design, work organization, time and work duration, physical environment, social environment, history of the plant and performance of the operator. The method is illustrated by the analysis of a handling incident generated by multiple human errors. (author)

  18. The Human Bathtub: Safety and Risk Predictions Including the Dynamic Probability of Operator Errors

    International Nuclear Information System (INIS)

    Duffey, Romney B.; Saull, John W.

    2006-01-01

    Reactor safety and risk are dominated by the potential and major contribution for human error in the design, operation, control, management, regulation and maintenance of the plant, and hence to all accidents. Given the possibility of accidents and errors, now we need to determine the outcome (error) probability, or the chance of failure. Conventionally, reliability engineering is associated with the failure rate of components, or systems, or mechanisms, not of human beings in and interacting with a technological system. The probability of failure requires a prior knowledge of the total number of outcomes, which for any predictive purposes we do not know or have. Analysis of failure rates due to human error and the rate of learning allow a new determination of the dynamic human error rate in technological systems, consistent with and derived from the available world data. The basis for the analysis is the 'learning hypothesis' that humans learn from experience, and consequently the accumulated experience defines the failure rate. A new 'best' equation has been derived for the human error, outcome or failure rate, which allows for calculation and prediction of the probability of human error. We also provide comparisons to the empirical Weibull parameter fitting used in and by conventional reliability engineering and probabilistic safety analysis methods. These new analyses show that arbitrary Weibull fitting parameters and typical empirical hazard function techniques cannot be used to predict the dynamics of human errors and outcomes in the presence of learning. Comparisons of these new insights show agreement with human error data from the world's commercial airlines, the two shuttle failures, and from nuclear plant operator actions and transient control behavior observed in transients in both plants and simulators. The results demonstrate that the human error probability (HEP) is dynamic, and that it may be predicted using the learning hypothesis and the minimum

  19. Human error probability estimation using licensee event reports

    International Nuclear Information System (INIS)

    Voska, K.J.; O'Brien, J.N.

    1984-07-01

    Objective of this report is to present a method for using field data from nuclear power plants to estimate human error probabilities (HEPs). These HEPs are then used in probabilistic risk activities. This method of estimating HEPs is one of four being pursued in NRC-sponsored research. The other three are structured expert judgment, analysis of training simulator data, and performance modeling. The type of field data analyzed in this report is from Licensee Event reports (LERs) which are analyzed using a method specifically developed for that purpose. However, any type of field data or human errors could be analyzed using this method with minor adjustments. This report assesses the practicality, acceptability, and usefulness of estimating HEPs from LERs and comprehensively presents the method for use

  20. Development of an integrated system for estimating human error probabilities

    Energy Technology Data Exchange (ETDEWEB)

    Auflick, J.L.; Hahn, H.A.; Morzinski, J.A.

    1998-12-01

    This is the final report of a three-year, Laboratory Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). This project had as its main objective the development of a Human Reliability Analysis (HRA), knowledge-based expert system that would provide probabilistic estimates for potential human errors within various risk assessments, safety analysis reports, and hazard assessments. HRA identifies where human errors are most likely, estimates the error rate for individual tasks, and highlights the most beneficial areas for system improvements. This project accomplished three major tasks. First, several prominent HRA techniques and associated databases were collected and translated into an electronic format. Next, the project started a knowledge engineering phase where the expertise, i.e., the procedural rules and data, were extracted from those techniques and compiled into various modules. Finally, these modules, rules, and data were combined into a nearly complete HRA expert system.

  1. Research on Human-Error Factors of Civil Aircraft Pilots Based On Grey Relational Analysis

    Directory of Open Access Journals (Sweden)

    Guo Yundong

    2018-01-01

    Full Text Available In consideration of the situation that civil aviation accidents involve many human-error factors and show the features of typical grey systems, an index system of civil aviation accident human-error factors is built using human factor analysis and classification system model. With the data of accidents happened worldwide between 2008 and 2011, the correlation between human-error factors can be analyzed quantitatively using the method of grey relational analysis. Research results show that the order of main factors affecting pilot human-error factors is preconditions for unsafe acts, unsafe supervision, organization and unsafe acts. The factor related most closely with second-level indexes and pilot human-error factors is the physical/mental limitations of pilots, followed by supervisory violations. The relevancy between the first-level indexes and the corresponding second-level indexes and the relevancy between second-level indexes can also be analyzed quantitatively.

  2. Latent human error analysis and efficient improvement strategies by fuzzy TOPSIS in aviation maintenance tasks.

    Science.gov (United States)

    Chiu, Ming-Chuan; Hsieh, Min-Chih

    2016-05-01

    The purposes of this study were to develop a latent human error analysis process, to explore the factors of latent human error in aviation maintenance tasks, and to provide an efficient improvement strategy for addressing those errors. First, we used HFACS and RCA to define the error factors related to aviation maintenance tasks. Fuzzy TOPSIS with four criteria was applied to evaluate the error factors. Results show that 1) adverse physiological states, 2) physical/mental limitations, and 3) coordination, communication, and planning are the factors related to airline maintenance tasks that could be addressed easily and efficiently. This research establishes a new analytic process for investigating latent human error and provides a strategy for analyzing human error using fuzzy TOPSIS. Our analysis process complements shortages in existing methodologies by incorporating improvement efficiency, and it enhances the depth and broadness of human error analysis methodology. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  3. Analysis of human error and organizational deficiency in events considering risk significance

    International Nuclear Information System (INIS)

    Lee, Yong Suk; Kim, Yoonik; Kim, Say Hyung; Kim, Chansoo; Chung, Chang Hyun; Jung, Won Dea

    2004-01-01

    In this study, we analyzed human and organizational deficiencies in the trip events of Korean nuclear power plants. K-HPES items were used in human error analysis, and the organizational factors by Jacobs and Haber were used for organizational deficiency analysis. We proposed the use of CCDP as a risk measure to consider risk information in prioritizing K-HPES items and organizational factors. Until now, the risk significance of events has not been considered in human error and organizational deficiency analysis. Considering the risk significance of events in the process of analysis is necessary for effective enhancement of nuclear power plant safety by focusing on causes of human error and organizational deficiencies that are associated with significant risk

  4. Towards an Artificial Space Object Taxonomy

    Science.gov (United States)

    Wilkins, M.; Schumacher, P.; Jah, M.; Pfeffer, A.

    2013-09-01

    Object recognition is the first step in positively identifying a resident space object (RSO), i.e. assigning an RSO to a category such as GPS satellite or space debris. Object identification is the process of deciding that two RSOs are in fact one and the same. Provided we have appropriately defined a satellite taxonomy that allows us to place a given RSO into a particular class of object without any ambiguity, one can assess the probability of assignment to a particular class by determining how well the object satisfies the unique criteria of belonging to that class. Ultimately, tree-based taxonomies delineate unique signatures by defining the minimum amount of information required to positively identify a RSO. Therefore, taxonomic trees can be used to depict hypotheses in a Bayesian object recognition and identification process. This work describes a new RSO taxonomy along with specific reasoning behind the choice of groupings. An alternative taxonomy was recently presented at the Sixth Conference on Space Debris in Darmstadt, Germany. [1] The best example of a taxonomy that enjoys almost universal scientific acceptance is the classical Linnaean biological taxonomy. A strength of Linnaean taxonomy is that it can be used to organize the different kinds of living organisms, simply and practically. Every species can be given a unique name. This uniqueness and stability are a result of the acceptance by biologists specializing in taxonomy, not merely of the binomial names themselves. Fundamentally, the taxonomy is governed by rules for the use of these names, and these are laid down in formal Nomenclature Codes. We seek to provide a similar formal nomenclature system for RSOs through a defined tree-based taxonomy structure. Each categorization, beginning with the most general or inclusive, at any level is called a taxon. Taxon names are defined by a type, which can be a specimen or a taxon of lower rank, and a diagnosis, a statement intended to supply characters that

  5. Basic human error probabilities in advanced MCRs when using soft control

    International Nuclear Information System (INIS)

    Jang, In Seok; Seong, Poong Hyun; Kang, Hyun Gook; Lee, Seung Jun

    2012-01-01

    In a report on one of the renowned HRA methods, Technique for Human Error Rate Prediction (THERP), it is pointed out that 'The paucity of actual data on human performance continues to be a major problem for estimating HEPs and performance times in nuclear power plant (NPP) task'. However, another critical difficulty is that most current HRA databases deal with operation in conventional type of MCRs. With the adoption of new human system interfaces that are based on computer based technologies, the operation environment of MCRs in NPPs has changed. The MCRs including these digital and computer technologies, such as large display panels, computerized procedures, soft controls, and so on, are called advanced MCRs. Because of the different interfaces, different Basic Human Error Probabilities (BHEPs) should be considered in human reliability analyses (HRAs) for advanced MCRs. This study carries out an empirical analysis of human error considering soft controls. The aim of this work is not only to compile a database using the simulator for advanced MCRs but also to compare BHEPs with those of a conventional MCR database

  6. The Countermeasures against the Human Errors in Nuclear Power Plants

    International Nuclear Information System (INIS)

    Lee, Yong Hee; Kwon, Ki Chun; Lee, Jung Woon; Lee, Hyun; Jang, Tong Il

    2009-10-01

    Due to human error, the failure of nuclear power facilities essential for the prevention of accidents and related research in ergonomics and human factors, including the long term, comprehensive measures are considered technology is urgently required. Past nuclear facilities for the hardware in terms of continuing interest over subsequent definite improvement even have brought, now a nuclear facility to engage in people-related human factors for attention by nuclear facilities, ensuring the safety of its economic and industrial aspects. The point of the improvement is urgently required. The purpose of this research, including nuclear power plants in various nuclear facilities to minimize the possibility of human error by ensuring the safety for human engineering aspects will be implemented in the medium and long term preventive measures is to establish comprehensive

  7. The Countermeasures against the Human Errors in Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee; Kwon, Ki Chun; Lee, Jung Woon; Lee, Hyun; Jang, Tong Il

    2009-10-15

    Due to human error, the failure of nuclear power facilities essential for the prevention of accidents and related research in ergonomics and human factors, including the long term, comprehensive measures are considered technology is urgently required. Past nuclear facilities for the hardware in terms of continuing interest over subsequent definite improvement even have brought, now a nuclear facility to engage in people-related human factors for attention by nuclear facilities, ensuring the safety of its economic and industrial aspects. The point of the improvement is urgently required. The purpose of this research, including nuclear power plants in various nuclear facilities to minimize the possibility of human error by ensuring the safety for human engineering aspects will be implemented in the medium and long term preventive measures is to establish comprehensive.

  8. Investigations on human error hazards in recent unintended trip events of Korean nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sa Kil; Jang, Tong Il; Lee, Yong Hee; Shin, Kwang Hyeon [KAERI, Daejeon (Korea, Republic of)

    2012-10-15

    According to the Operational Performance Information System (OPIS) which has been operated to improve the public understanding by the KINS (Korea Institute of Nuclear Safety), unintended trip events by mainly human errors counted up to 38 cases (18.7%) from 2000 to 2011. Although the Nuclear Power Plant (NPP) industry in Korea has been making efforts to reduce the human errors which have largely contributed to trip events, the human error rate might keep increasing. Interestingly, digital based I and C systems is the one of the reduction factors of unintended reactor trips. Human errors, however, have occurred due to the digital based I and C systems because those systems require new or changed behaviors to the NPP operators. Therefore, it is necessary that the investigations of human errors consider a new methodology to find not only tangible behavior but also intangible behavior such as organizational behaviors. In this study we investigated human errors to find latent factors such as decisions and conditions in the all of the unintended reactor trip events during last dozen years. To find them, we applied the HFACS (Human Factors Analysis and Classification System) which is a commonly utilized tool for investigating human contributions to aviation accidents under a widespread evaluation scheme. The objective of this study is to find latent factors behind of human errors in nuclear reactor trip events. Therefore, a method to investigate unintended trip events by human errors and the results will be discussed in more detail.

  9. Investigations on human error hazards in recent unintended trip events of Korean nuclear power plants

    International Nuclear Information System (INIS)

    Kim, Sa Kil; Jang, Tong Il; Lee, Yong Hee; Shin, Kwang Hyeon

    2012-01-01

    According to the Operational Performance Information System (OPIS) which has been operated to improve the public understanding by the KINS (Korea Institute of Nuclear Safety), unintended trip events by mainly human errors counted up to 38 cases (18.7%) from 2000 to 2011. Although the Nuclear Power Plant (NPP) industry in Korea has been making efforts to reduce the human errors which have largely contributed to trip events, the human error rate might keep increasing. Interestingly, digital based I and C systems is the one of the reduction factors of unintended reactor trips. Human errors, however, have occurred due to the digital based I and C systems because those systems require new or changed behaviors to the NPP operators. Therefore, it is necessary that the investigations of human errors consider a new methodology to find not only tangible behavior but also intangible behavior such as organizational behaviors. In this study we investigated human errors to find latent factors such as decisions and conditions in the all of the unintended reactor trip events during last dozen years. To find them, we applied the HFACS (Human Factors Analysis and Classification System) which is a commonly utilized tool for investigating human contributions to aviation accidents under a widespread evaluation scheme. The objective of this study is to find latent factors behind of human errors in nuclear reactor trip events. Therefore, a method to investigate unintended trip events by human errors and the results will be discussed in more detail

  10. Fault tree model of human error based on error-forcing contexts

    International Nuclear Information System (INIS)

    Kang, Hyun Gook; Jang, Seung Cheol; Ha, Jae Joo

    2004-01-01

    In the safety-critical systems such as nuclear power plants, the safety-feature actuation is fully automated. In emergency case, the human operator could also play the role of a backup for automated systems. That is, the failure of safety-feature-actuation signal generation implies the concurrent failure of automated systems and that of manual actuation. The human operator's manual actuation failure is largely affected by error-forcing contexts (EFC). The failures of sensors and automated systems are most important ones. The sensors, the automated actuation system and the human operators are correlated in a complex manner and hard to develop a proper model. In this paper, we will explain the condition-based human reliability assessment (CBHRA) method in order to treat these complicated conditions in a practical way. In this study, we apply the CBHRA method to the manual actuation of safety features such as reactor trip and safety injection in Korean Standard Nuclear Power Plants

  11. The psychological background about human error and safety in NPP

    International Nuclear Information System (INIS)

    Zhang Li

    1992-01-01

    A human error is one of the factors which cause an accident in NPP. The in-situ psychological background plays an important role in inducing it. The author analyzes the structure of one's psychological background when one is at work, and gives a few examples of typical psychological background resulting in human errors. Finally it points out that the fundamental way to eliminate the unfavourable psychological background of safety production is to establish the safety culture in NPP along with its characteristics

  12. Review of human error analysis methodologies and case study for accident management

    International Nuclear Information System (INIS)

    Jung, Won Dae; Kim, Jae Whan; Lee, Yong Hee; Ha, Jae Joo

    1998-03-01

    In this research, we tried to establish the requirements for the development of a new human error analysis method. To achieve this goal, we performed a case study as following steps; 1. review of the existing HEA methods 2. selection of those methods which are considered to be appropriate for the analysis of operator's tasks in NPPs 3. choice of tasks for the application, selected for the case study: HRMS (Human reliability management system), PHECA (Potential Human Error Cause Analysis), CREAM (Cognitive Reliability and Error Analysis Method). And, as the tasks for the application, 'bleed and feed operation' and 'decision-making for the reactor cavity flooding' tasks are chosen. We measured the applicability of the selected methods to the NPP tasks, and evaluated the advantages and disadvantages between each method. The three methods are turned out to be applicable for the prediction of human error. We concluded that both of CREAM and HRMS are equipped with enough applicability for the NPP tasks, however, compared two methods. CREAM is thought to be more appropriate than HRMS from the viewpoint of overall requirements. The requirements for the new HEA method obtained from the study can be summarized as follows; firstly, it should deal with cognitive error analysis, secondly, it should have adequate classification system for the NPP tasks, thirdly, the description on the error causes and error mechanisms should be explicit, fourthly, it should maintain the consistency of the result by minimizing the ambiguity in each step of analysis procedure, fifty, it should be done with acceptable human resources. (author). 25 refs., 30 tabs., 4 figs

  13. Development and evaluation of a computer-aided system for analyzing human error in railway operations

    International Nuclear Information System (INIS)

    Kim, Dong San; Baek, Dong Hyun; Yoon, Wan Chul

    2010-01-01

    As human error has been recognized as one of the major contributors to accidents in safety-critical systems, there has been a strong need for techniques that can analyze human error effectively. Although many techniques have been developed so far, much room for improvement remains. As human error analysis is a cognitively demanding and time-consuming task, it is particularly necessary to develop a computerized system supporting this task. This paper presents a computer-aided system for analyzing human error in railway operations, called Computer-Aided System for Human Error Analysis and Reduction (CAS-HEAR). It supports analysts to find multiple levels of error causes and their causal relations by using predefined links between contextual factors and causal factors as well as links between causal factors. In addition, it is based on a complete accident model; hence, it helps analysts to conduct a thorough analysis without missing any important part of human error analysis. A prototype of CAS-HEAR was evaluated by nine field investigators from six railway organizations in Korea. Its overall usefulness in human error analysis was confirmed, although development of its simplified version and some modification of the contextual factors and causal factors are required in order to ensure its practical use.

  14. An improved Greengenes taxonomy with explicit ranks for ecological and evolutionary analyses of bacteria and archaea.

    Science.gov (United States)

    McDonald, Daniel; Price, Morgan N; Goodrich, Julia; Nawrocki, Eric P; DeSantis, Todd Z; Probst, Alexander; Andersen, Gary L; Knight, Rob; Hugenholtz, Philip

    2012-03-01

    Reference phylogenies are crucial for providing a taxonomic framework for interpretation of marker gene and metagenomic surveys, which continue to reveal novel species at a remarkable rate. Greengenes is a dedicated full-length 16S rRNA gene database that provides users with a curated taxonomy based on de novo tree inference. We developed a 'taxonomy to tree' approach for transferring group names from an existing taxonomy to a tree topology, and used it to apply the Greengenes, National Center for Biotechnology Information (NCBI) and cyanoDB (Cyanobacteria only) taxonomies to a de novo tree comprising 408,315 sequences. We also incorporated explicit rank information provided by the NCBI taxonomy to group names (by prefixing rank designations) for better user orientation and classification consistency. The resulting merged taxonomy improved the classification of 75% of the sequences by one or more ranks relative to the original NCBI taxonomy with the most pronounced improvements occurring in under-classified environmental sequences. We also assessed candidate phyla (divisions) currently defined by NCBI and present recommendations for consolidation of 34 redundantly named groups. All intermediate results from the pipeline, which includes tree inference, jackknifing and transfer of a donor taxonomy to a recipient tree (tax2tree) are available for download. The improved Greengenes taxonomy should provide important infrastructure for a wide range of megasequencing projects studying ecosystems on scales ranging from our own bodies (the Human Microbiome Project) to the entire planet (the Earth Microbiome Project). The implementation of the software can be obtained from http://sourceforge.net/projects/tax2tree/.

  15. Calculating method on human error probabilities considering influence of management and organization

    International Nuclear Information System (INIS)

    Gao Jia; Huang Xiangrui; Shen Zupei

    1996-01-01

    This paper is concerned with how management and organizational influences can be factored into quantifying human error probabilities on risk assessments, using a three-level Influence Diagram (ID) which is originally only as a tool for construction and representation of models of decision-making trees or event trees. An analytical model of human errors causation has been set up with three influence levels, introducing a method for quantification assessments (of the ID), which can be applied into quantifying probabilities) of human errors on risk assessments, especially into the quantification of complex event trees (system) as engineering decision-making analysis. A numerical case study is provided to illustrate the approach

  16. Redesign of a Life Span Development Course Using Fink's Taxonomy

    Science.gov (United States)

    Fallahi, Carolyn R.

    2008-01-01

    This study compared a traditional lecture-based life span development course to the same course redesigned using Fink's (2003) taxonomy of significant learning. The goals, activities, and feedback within the course corresponded to Fink's 6 taxa (knowledge, application, integration, human dimension, caring, learning how to learn). Undergraduates in…

  17. Human medial frontal cortex activity predicts learning from errors.

    Science.gov (United States)

    Hester, Robert; Barre, Natalie; Murphy, Kevin; Silk, Tim J; Mattingley, Jason B

    2008-08-01

    Learning from errors is a critical feature of human cognition. It underlies our ability to adapt to changing environmental demands and to tune behavior for optimal performance. The posterior medial frontal cortex (pMFC) has been implicated in the evaluation of errors to control behavior, although it has not previously been shown that activity in this region predicts learning from errors. Using functional magnetic resonance imaging, we examined activity in the pMFC during an associative learning task in which participants had to recall the spatial locations of 2-digit targets and were provided with immediate feedback regarding accuracy. Activity within the pMFC was significantly greater for errors that were subsequently corrected than for errors that were repeated. Moreover, pMFC activity during recall errors predicted future responses (correct vs. incorrect), despite a sizeable interval (on average 70 s) between an error and the next presentation of the same recall probe. Activity within the hippocampus also predicted future performance and correlated with error-feedback-related pMFC activity. A relationship between performance expectations and pMFC activity, in the absence of differing reinforcement value for errors, is consistent with the idea that error-related pMFC activity reflects the extent to which an outcome is "worse than expected."

  18. Trial application of a technique for human error analysis (ATHEANA)

    International Nuclear Information System (INIS)

    Bley, D.C.; Cooper, S.E.; Parry, G.W.

    1996-01-01

    The new method for HRA, ATHEANA, has been developed based on a study of the operating history of serious accidents and an understanding of the reasons why people make errors. Previous publications associated with the project have dealt with the theoretical framework under which errors occur and the retrospective analysis of operational events. This is the first attempt to use ATHEANA in a prospective way, to select and evaluate human errors within the PSA context

  19. Human error and the problem of causality in analysis of accidents

    DEFF Research Database (Denmark)

    Rasmussen, Jens

    1990-01-01

    , designers or managers have played a major role. There are, however, several basic problems in analysis of accidents and identification of human error. This paper addresses the nature of causal explanations and the ambiguity of the rules applied for identification of the events to include in analysis......Present technology is characterized by complexity, rapid change and growing size of technical systems. This has caused increasing concern with the human involvement in system safety. Analyses of the major accidents during recent decades have concluded that human errors on part of operators...

  20. An experimental approach to validating a theory of human error in complex systems

    Science.gov (United States)

    Morris, N. M.; Rouse, W. B.

    1985-01-01

    The problem of 'human error' is pervasive in engineering systems in which the human is involved. In contrast to the common engineering approach of dealing with error probabilistically, the present research seeks to alleviate problems associated with error by gaining a greater understanding of causes and contributing factors from a human information processing perspective. The general approach involves identifying conditions which are hypothesized to contribute to errors, and experimentally creating the conditions in order to verify the hypotheses. The conceptual framework which serves as the basis for this research is discussed briefly, followed by a description of upcoming research. Finally, the potential relevance of this research to design, training, and aiding issues is discussed.

  1. Human error mode identification for NPP main control room operations using soft controls

    International Nuclear Information System (INIS)

    Lee, Seung Jun; Kim, Jaewhan; Jang, Seung-Cheol

    2011-01-01

    The operation environment of main control rooms (MCRs) in modern nuclear power plants (NPPs) has considerably changed over the years. Advanced MCRs, which have been designed by adapting digital and computer technologies, have simpler interfaces using large display panels, computerized displays, soft controls, computerized procedure systems, and so on. The actions for the NPP operations are performed using soft controls in advanced MCRs. Soft controls have different features from conventional controls. Operators need to navigate the screens to find indicators and controls and manipulate controls using a mouse, touch screens, and so on. Due to these different interfaces, different human errors should be considered in the human reliability analysis (HRA) for advanced MCRs. In this work, human errors that could occur during operation executions using soft controls were analyzed. This work classified the human errors in soft controls into six types, and the reasons that affect the occurrence of the human errors were also analyzed. (author)

  2. An Empirical Study on Human Performance according to the Physical Environment (Potential Human Error Hazard) in Nuclear Power Plants

    International Nuclear Information System (INIS)

    Kim, Ar Ryum; Jang, In Seok; Seong, Proong Hyun

    2014-01-01

    The management of the physical environment for safety is more effective than a nuclear industry. Despite the physical environment such as lighting, noise satisfy with management standards, it can be background factors may cause human error and affect human performance. Because the consequence of extremely human error and human performance is high according to the physical environment, requirement standard could be covered with specific criteria. Particularly, in order to avoid human errors caused by an extremely low or rapidly-changing intensity illumination and masking effect such as power disconnection, plans for better visual environment and better function performances should be made as a careful study on efficient ways to manage and continue the better conditions is conducted

  3. The genus Gloriosa (Colchicaceae) : ethnobotany, phylogeny and taxonomy

    NARCIS (Netherlands)

    Maroyi, A.

    2012-01-01

    This thesis focuses on the ethnobotany, phylogeny and taxonomy of the genus Gloriosa L. over its distributional range. Some Gloriosa species are known to have economic and commercial value, but the genus is also well known for its complex alpha taxonomy. An appropriate taxonomy for this group is of

  4. Development of a taxonomy of performance influencing factors for human reliability assessment of accident management tasks and its application

    International Nuclear Information System (INIS)

    Kim, Jae Whan; Jung, Won Dae; Kang, Dae Il; Ha, Jae Joo

    1999-06-01

    In this study, a new PIF taxonomy for HRA of the tasks during emergency operation and accident management situations. We collected the existing PIF taxonomies as many as possible. Then, we analyzed the trend in the selection of PIFs, the frequency of use between PIFs in HRA methods, and the level of definition of PIFs, in order to reflect these characteristics into the development of a new PIF taxonomy. Next, we analyzed the principal task context during accident management to draw the context specific PIFs. Afterwards, we established several criteria for the selection of the appropriate PIFs for HRA under emergency operation and accident management situations. Finally, the final PIF taxonomy containing the subitems for assessing each PIF was constructed based on the results of the previous steps and the selection criteria. The final result of this study is the new PIF taxonomy for HRA of the tasks during emergency operation and accident management situations. The selected 11 PIFs in the study are as follows: training and experience, availability and quality of information, status and trend of critical parameters, status of safety system/component, time pressure, working environment features, team cooperation and communication, plant policy and safety culture. (author). 35 refs., 23 tabs

  5. Development of a taxonomy of performance influencing factors for human reliability assessment of accident management tasks and its application

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Whan; Jung, Won Dae; Kang, Dae Il; Ha, Jae Joo

    1999-06-01

    In this study, a new PIF taxonomy for HRA of the tasks during emergency operation and accident management situations. We collected the existing PIF taxonomies as many as possible. Then, we analyzed the trend in the selection of PIFs, the frequency of use between PIFs in HRA methods, and the level of definition of PIFs, in order to reflect these characteristics into the development of a new PIF taxonomy. Next, we analyzed the principal task context during accident management to draw the context specific PIFs. Afterwards, we established several criteria for the selection of the appropriate PIFs for HRA under emergency operation and accident management situations. Finally, the final PIF taxonomy containing the subitems for assessing each PIF was constructed based on the results of the previous steps and the selection criteria. The final result ofthis study is the new PIF taxonomy for HRA of the tasks during emergency operation and accident management situations. The selected 11 PIFs in the study are as follows: training and experience, availability and quality of information, status and trend of critical parameters, status of safety system/component, time pressure, working environment features, team cooperation and communication, plant policy and safety culture. (author). 35 refs., 23 tabs.

  6. Trend analysis of human error events and assessment of their proactive prevention measure at Rokkasho reprocessing plant

    International Nuclear Information System (INIS)

    Yamazaki, Satoru; Tanaka, Izumi; Wakabayashi, Toshio

    2012-01-01

    A trend analysis of human error events is important for preventing the recurrence of human error events. We propose a new method for identifying the common characteristics from results of trend analysis, such as the latent weakness of organization, and a management process for strategic error prevention. In this paper, we describe a trend analysis method for human error events that have been accumulated in the organization and the utilization of the results of trend analysis to prevent accidents proactively. Although the systematic analysis of human error events, the monitoring of their overall trend, and the utilization of the analyzed results have been examined for the plant operation, such information has never been utilized completely. Sharing information on human error events and analyzing their causes lead to the clarification of problems in the management and human factors. This new method was applied to the human error events that occurred in the Rokkasho reprocessing plant from 2010 October. Results revealed that the output of this method is effective in judging the error prevention plan and that the number of human error events is reduced to about 50% those observed in 2009 and 2010. (author)

  7. Comparison of risk sensitivity to human errors in the Oconee and LaSalle PRAs

    International Nuclear Information System (INIS)

    Wong, S.; Higgins, J.

    1991-01-01

    This paper describes the comparative analyses of plant risk sensitivity to human errors in the Oconee and La Salle Probabilistic Risk Assessment (PRAs). These analyses were performed to determine the reasons for the observed differences in the sensitivity of core melt frequency (CMF) to changes in human error probabilities (HEPs). Plant-specific design features, PRA methods, and the level of detail and assumptions in the human error modeling were evaluated to assess their influence risk estimates and sensitivities

  8. Nuclear Computerized Library for Assessing Reactor Reliability (NUCLARR): Guide to data processing and revision: Part 2, Human error probability data entry and revision procedures

    International Nuclear Information System (INIS)

    Gilmore, W.E.; Gertman, D.I.; Gilbert, B.G.; Reece, W.J.

    1988-11-01

    The Nuclear Computerized Library for Assessing Reactor Reliability (NUCLARR) is an automated data base management system for processing and storing human error probability (HEP) and hardware component failure data (HCFD). The NUCLARR system software resides on an IBM (or compatible) personal micro-computer. Users can perform data base searches to furnish HEP estimates and HCFD rates. In this manner, the NUCLARR system can be used to support a variety of risk assessment activities. This volume, Volume 3 of a 5-volume series, presents the procedures used to process HEP and HCFD for entry in NUCLARR and describes how to modify the existing NUCLARR taxonomy in order to add either equipment types or action verbs. Volume 3 also specifies the various roles of the administrative staff on assignment to the NUCLARR Clearinghouse who are tasked with maintaining the data base, dealing with user requests, and processing NUCLARR data. 5 refs., 34 figs., 3 tabs

  9. A Taxonomy of Privacy Constructs for Privacy-Sensitive Robotics

    OpenAIRE

    Rueben, Matthew; Grimm, Cindy M.; Bernieri, Frank J.; Smart, William D.

    2017-01-01

    The introduction of robots into our society will also introduce new concerns about personal privacy. In order to study these concerns, we must do human-subject experiments that involve measuring privacy-relevant constructs. This paper presents a taxonomy of privacy constructs based on a review of the privacy literature. Future work in operationalizing privacy constructs for HRI studies is also discussed.

  10. Interactive analysis of human error factors in NPP operation events

    International Nuclear Information System (INIS)

    Zhang Li; Zou Yanhua; Huang Weigang

    2010-01-01

    Interactive of human error factors in NPP operation events were introduced, and 645 WANO operation event reports from 1999 to 2008 were analyzed, among which 432 were found relative to human errors. After classifying these errors with the Root Causes or Causal Factors, and then applying SPSS for correlation analysis,we concluded: (1) Personnel work practices are restricted by many factors. Forming a good personnel work practices is a systematic work which need supports in many aspects. (2)Verbal communications,personnel work practices, man-machine interface and written procedures and documents play great roles. They are four interaction factors which often come in bundle. If some improvements need to be made on one of them,synchronous measures are also necessary for the others.(3) Management direction and decision process, which are related to management,have a significant interaction with personnel factors. (authors)

  11. Coping with human errors through system design: Implications for ecological interface design

    DEFF Research Database (Denmark)

    Rasmussen, Jens; Vicente, Kim J.

    1989-01-01

    Research during recent years has revealed that human errors are not stochastic events which can be removed through improved training programs or optimal interface design. Rather, errors tend to reflect either systematic interference between various models, rules, and schemata, or the effects...... of the adaptive mechanisms involved in learning. In terms of design implications, these findings suggest that reliable human-system interaction will be achieved by designing interfaces which tend to minimize the potential for control interference and support recovery from errors. In other words, the focus should...... be on control of the effects of errors rather than on the elimination of errors per se. In this paper, we propose a theoretical framework for interface design that attempts to satisfy these objectives. The goal of our framework, called ecological interface design, is to develop a meaningful representation...

  12. Support of protective work of human error in a nuclear power plant

    International Nuclear Information System (INIS)

    Yoshizawa, Yuriko

    1999-01-01

    The nuclear power plant human factor group of the Tokyo Electric Power Co., Ltd. supports various protective work of human error conducted at the nuclear power plant. Its main researching theme are studies on human factor on operation of a nuclear power plant, and on recovery and common basic study on human factor. In addition, on a base of the obtained informations, assistance to protective work of human error conducted at the nuclear power plant as well as development for its actual use was also promoted. Especially, for actions sharing some dangerous informations, various assistances such as a proposal on actual example analytical method to effectively understand a dangerous information not facially but faithfully, construction of a data base to conveniently share such dangerous information, and practice on non-accident business survey for a hint of effective promotion of the protection work, were promoted. Here were introduced on assistance and investigation for effective sharing of the dangerous informations for various actions on protection of human error mainly conducted in nuclear power plant. (G.K.)

  13. Building a taxonomy of GI knowledge

    DEFF Research Database (Denmark)

    Arleth, Mette

    2004-01-01

    This paper reports on and ongoing study concerning non-professional users` understanding of GI. Online access to GI are offered by many public authorities, in order to make the public able to serve them selves online and gain insight in the physical planning and area administration. The aim...... of this project is to investigate how and how well non-professional users actually understand GI. For that purpose a taxonomy of GI knowledge is built, drawing on Bloom`s taxonomy. The elements of this taxonomy are described after a presentation of the main research question of the study, the applications chosen...

  14. Tumor taxonomy for the developmental lineage classification of neoplasms

    International Nuclear Information System (INIS)

    Berman, Jules J

    2004-01-01

    The new 'Developmental lineage classification of neoplasms' was described in a prior publication. The classification is simple (the entire hierarchy is described with just 39 classifiers), comprehensive (providing a place for every tumor of man), and consistent with recent attempts to characterize tumors by cytogenetic and molecular features. A taxonomy is a list of the instances that populate a classification. The taxonomy of neoplasia attempts to list every known term for every known tumor of man. The taxonomy provides each concept with a unique code and groups synonymous terms under the same concept. A Perl script validated successive drafts of the taxonomy ensuring that: 1) each term occurs only once in the taxonomy; 2) each term occurs in only one tumor class; 3) each concept code occurs in one and only one hierarchical position in the classification; and 4) the file containing the classification and taxonomy is a well-formed XML (eXtensible Markup Language) document. The taxonomy currently contains 122,632 different terms encompassing 5,376 neoplasm concepts. Each concept has, on average, 23 synonyms. The taxonomy populates 'The developmental lineage classification of neoplasms,' and is available as an XML file, currently 9+ Megabytes in length. A representation of the classification/taxonomy listing each term followed by its code, followed by its full ancestry, is available as a flat-file, 19+ Megabytes in length. The taxonomy is the largest nomenclature of neoplasms, with more than twice the number of neoplasm names found in other medical nomenclatures, including the 2004 version of the Unified Medical Language System, the Systematized Nomenclature of Medicine Clinical Terminology, the National Cancer Institute's Thesaurus, and the International Classification of Diseases Oncolology version. This manuscript describes a comprehensive taxonomy of neoplasia that collects synonymous terms under a unique code number and assigns each

  15. Taxonomy and antifungal susceptibility of clinically important Rasamsonia species

    DEFF Research Database (Denmark)

    Houbraken, J.; Giraud, S.; Meijer, M.

    2013-01-01

    In recent years, Geosmithia argillacea has been increasingly reported in humans and animals and can be considered an emerging pathogen. The taxonomy of Geosmithia was recently studied, and Geosmithia argillacea and related species were transferred to the new genus Rasamsonia. The diversity among...... reported clinical isolates from animal or human patients. Susceptibility tests showed that the antifungal susceptibility profiles of the four members of the R. argillacea complex are similar, and caspofungin showed significant activity in vitro, followed by amphotericin B and posaconazole. Voriconazole...

  16. Quality assurance and human error effects on the structural safety

    International Nuclear Information System (INIS)

    Bertero, R.; Lopez, R.; Sarrate, M.

    1991-01-01

    Statistical surveys show that the frequency of failure of structures is much larger than that expected by the codes. Evidence exists that human errors (especially during the design process) is the main cause for the difference between the failure probability admitted by codes and the reality. In this paper, the attenuation of human error effects using tools of quality assurance is analyzed. In particular, the importance of the independent design review is highlighted, and different approaches are discussed. The experience from the Atucha II project, as well as the USA and German practice on independent design review, are summarized. (Author)

  17. Operator errors

    International Nuclear Information System (INIS)

    Knuefer; Lindauer

    1980-01-01

    Besides that at spectacular events a combination of component failure and human error is often found. Especially the Rasmussen-Report and the German Risk Assessment Study show for pressurised water reactors that human error must not be underestimated. Although operator errors as a form of human error can never be eliminated entirely, they can be minimized and their effects kept within acceptable limits if a thorough training of personnel is combined with an adequate design of the plant against accidents. Contrary to the investigation of engineering errors, the investigation of human errors has so far been carried out with relatively small budgets. Intensified investigations in this field appear to be a worthwhile effort. (orig.)

  18. Human factors interventions to reduce human errors and improve productivity in maintenance tasks

    International Nuclear Information System (INIS)

    Isoda, Hachiro; Yasutake, J.Y.

    1992-01-01

    This paper describes work in progress to develop interventions to reduce human errors and increase maintenance productivity in nuclear power plants. The effort is part of a two-phased Human Factors research program being conducted jointly by the Central Research Institute of Electric Power Industry (CRIEPI) in Japan and the Electric Power Research Institute (EPRI) in the United States. The overall objective of this joint research program is to identify critical maintenance tasks and to develop, implement and evaluate interventions which have high potential for reducing human errors or increasing maintenance productivity. As a result of the Phase 1 effort, ten critical maintenance tasks were identified. For these tasks, over 25 candidate interventions were identified for potential development. After careful analysis, seven interventions were selected for development during Phase 2. This paper describes the methodology used to analyze and identify the most critical tasks, the process of identifying and developing selected interventions and some of the initial results. (author)

  19. Self-assessment of human performance errors in nuclear operations

    International Nuclear Information System (INIS)

    Chambliss, K.V.

    1996-01-01

    One of the most important approaches to improving nuclear safety is to have an effective self-assessment process in place, whose cornerstone is the identification and improvement of human performance errors. Experience has shown that significant events usually have had precursors of human performance errors. If these precursors are left uncorrected or not understood, the symptoms recur and result in unanticipated events of greater safety significance. The Institute of Nuclear Power Operations (INPO) has been championing the cause of promoting excellence in human performance in the nuclear industry. INPO's report, open-quotes Excellence in Human Performance,close quotes emphasizes the importance of several factors that play a role in human performance. They include individual, supervisory, and organizational behaviors; real-time feedback that results in specific behavior to produce safe and reliable performance; and proactive measures that remove obstacles from excellent human performance. Zack Pate, chief executive officer and president of INPO, in his report, open-quotes The Control Room,close quotes provides an excellent discussion of serious events in the nuclear industry since 1994 and compares them with the results from a recent study by the National Transportation Safety Board of airline accidents in the 12-yr period from 1978 to 1990 to draw some common themes that relate to human performance issues in the control room

  20. A Conceptual Framework for Predicting Error in Complex Human-Machine Environments

    Science.gov (United States)

    Freed, Michael; Remington, Roger; Null, Cynthia H. (Technical Monitor)

    1998-01-01

    We present a Goals, Operators, Methods, and Selection Rules-Model Human Processor (GOMS-MHP) style model-based approach to the problem of predicting human habit capture errors. Habit captures occur when the model fails to allocate limited cognitive resources to retrieve task-relevant information from memory. Lacking the unretrieved information, decision mechanisms act in accordance with implicit default assumptions, resulting in error when relied upon assumptions prove incorrect. The model helps interface designers identify situations in which such failures are especially likely.

  1. A Rain Taxonomy for Degraded Visual Environment Mitigation

    Science.gov (United States)

    Gatlin, P. N.; Petersen, W. A.

    2018-01-01

    This Technical Memorandum (TM) provides a description of a rainfall taxonomy that defines the detailed characteristics of naturally occurring rainfall. The taxonomy is based on raindrop size measurements collected around the globe and encompasses several different climate types. Included in this TM is a description of these rainfall observations, an explanation of methods used to process those data, and resultant metrics comprising the rain taxonomy database. Each of the categories in the rain taxonomy are characterized by a unique set of raindrop sizes that can be used in simulations of electromagnetic wave propagation through a rain medium.

  2. Overview of the taxonomy of zooxanthellate Scleractinia.

    Science.gov (United States)

    Veron, John

    2013-11-01

    Coral taxonomy has entered a historical phase where nomenclatorial uncertainty is rapidly increasing. The fundamental cause is mandatory adherence to historical monographs that lack essential information of all sorts, and also to type specimens, if they exist at all, that are commonly unrecognizable fragments or are uncharacteristic of the species they are believed to represent. Historical problems, including incorrect subsequent type species designations, also create uncertainty for many well-established genera. The advent of in situ studies in the 1970s revealed these issues; now molecular technology is again changing the taxonomic landscape. The competing methodologies involved must be seen in context if they are to avoid becoming an additional basis for continuing nomenclatorial instability. To prevent this happening, the International Commission on Zoological Nomenclature (ICZN) will need to focus on rules that consolidate well-established nomenclature and allow for the designation of new type specimens that are unambiguous, and which include both skeletal material and soft tissue for molecular study. Taxonomic and biogeographic findings have now become linked, with molecular methodologies providing the capacity to re-visit past taxonomic decisions, and to extend both taxonomy and biogeography into the realm of evolutionary theory. It is proposed that most species will ultimately be seen as operational taxonomic units that are human rather than natural constructs, which in consequence will always have fuzzy morphological, genetic, and distribution boundaries. The pathway ahead calls for the integration of morphological and molecular taxonomies, and for website delivery of information that crosses current discipline boundaries.

  3. A Taxonomy of Manufacturing Strategies

    OpenAIRE

    Jeffrey G. Miller; Aleda V. Roth

    1994-01-01

    This paper describes the development and analysis of a numerical taxonomy of manufacturing strategies. The taxonomy was developed with standard methods of cluster analysis, and is based on the relative importance attached to eleven competitive capabilities defining the manufacturing task of 164 large American manufacturing business units. Three distinct clusters of manufacturing strategy groups were observed. Though there is an industry effect, all three manufacturing strategy types are obser...

  4. Human Reliability and the Current Dilemma in Human-Machine Interface Design Strategies

    International Nuclear Information System (INIS)

    Passalacqua, Roberto; Yamada, Fumiaki

    2002-01-01

    Since human error dominates the probability of failures of still-existing human-requiring systems (as the Monju reactor), the human-machine interface needs to be improved. Several rationales may lead to the conclusion that 'humans' should limit themselves to monitor the 'machine'. For example, this is the trend in the aviation industry: newest aircrafts are designed to be able to return to a safe state by the use of control systems, which do not need human intervention. Thus, the dilemma whether we really need operators (for example in the nuclear industry) might arise. However, social-technical approaches in recent human error analyses are pointing out the so-called 'organizational errors' and the importance of a human-machine interface harmonization. Typically plant's operators are a 'redundant' safety system with a much lower reliability (than the machine): organizational factors and harmonization requirements suggest designing the human-machine interface in a way that allows improvement of operator's reliability. In addition, taxonomy studies of accident databases have also proved that operators' training should promote processes of decision-making. This is accomplished in the latest trends of PSA technology by introducing the concept of a 'Safety Monitor' that is a computer-based tool that uses a level 1 PSA model of the plant. Operators and maintenance schedulers of the Monju FBR will be able to perform real-time estimations of the plant risk level. The main benefits are risk awareness and improvements in decision-making by operators. Also scheduled maintenance can be approached in a more rational (safe and economic) way. (authors)

  5. Review of U.S. Army Unmanned Aerial Systems Accident Reports: Analysis of Human Error Contributions

    Science.gov (United States)

    2018-03-20

    within report documents. The information presented was obtained through a request to use the U.S. Army Combat Readiness Center’s Risk Management ...controlled flight into terrain (13 accidents), fueling errors by improper techniques (7 accidents), and a variety of maintenance errors (10 accidents). The...and 9 of the 10 maintenance accidents. Table 4. Frequencies Based on Source of Human Error Human error source Presence Poor Planning

  6. Identifying Human Factors Issues in Aircraft Maintenance Operations

    Science.gov (United States)

    Veinott, Elizabeth S.; Kanki, Barbara G.; Shafto, Michael G. (Technical Monitor)

    1995-01-01

    Maintenance operations incidents submitted to the Aviation Safety Reporting System (ASRS) between 1986-1992 were systematically analyzed in order to identify issues relevant to human factors and crew coordination. This exploratory analysis involved 95 ASRS reports which represented a wide range of maintenance incidents. The reports were coded and analyzed according to the type of error (e.g, wrong part, procedural error, non-procedural error), contributing factors (e.g., individual, within-team, cross-team, procedure, tools), result of the error (e.g., aircraft damage or not) as well as the operational impact (e.g., aircraft flown to destination, air return, delay at gate). The main findings indicate that procedural errors were most common (48.4%) and that individual and team actions contributed to the errors in more than 50% of the cases. As for operational results, most errors were either corrected after landing at the destination (51.6%) or required the flight crew to stop enroute (29.5%). Interactions among these variables are also discussed. This analysis is a first step toward developing a taxonomy of crew coordination problems in maintenance. By understanding what variables are important and how they are interrelated, we may develop intervention strategies that are better tailored to the human factor issues involved.

  7. Human error: An essential problem of nuclear power plants

    International Nuclear Information System (INIS)

    Smidt, D.

    1981-01-01

    The author first defines the part played by man in the nuclear power plant and then deals in more detail with the structure of his valse behavior in tactical and strategic repect. The dicussion of tactical errors and their avoidance is follwed by a report on the actual state of plant technology and possible improvements. Subsequently a study of the strategic errors including the conclusion to be drawn until now (joint between plant and man, personal selection and education) is made. If the joints between man and machine are designed according and physiological strenghts and weaknesses of man are fully realized and taken into account human errors not be essential problem in nuclear power plant. (GL) [de

  8. An empirical study on the human error recovery failure probability when using soft controls in NPP advanced MCRs

    International Nuclear Information System (INIS)

    Jang, Inseok; Kim, Ar Ryum; Jung, Wondea; Seong, Poong Hyun

    2014-01-01

    Highlights: • Many researchers have tried to understand human recovery process or step. • Modeling human recovery process is not sufficient to be applied to HRA. • The operation environment of MCRs in NPPs has changed by adopting new HSIs. • Recovery failure probability in a soft control operation environment is investigated. • Recovery failure probability here would be important evidence for expert judgment. - Abstract: It is well known that probabilistic safety assessments (PSAs) today consider not just hardware failures and environmental events that can impact upon risk, but also human error contributions. Consequently, the focus on reliability and performance management has been on the prevention of human errors and failures rather than the recovery of human errors. However, the recovery of human errors is as important as the prevention of human errors and failures for the safe operation of nuclear power plants (NPPs). For this reason, many researchers have tried to find a human recovery process or step. However, modeling the human recovery process is not sufficient enough to be applied to human reliability analysis (HRA), which requires human error and recovery probabilities. In this study, therefore, human error recovery failure probabilities based on predefined human error modes were investigated by conducting experiments in the operation mockup of advanced/digital main control rooms (MCRs) in NPPs. To this end, 48 subjects majoring in nuclear engineering participated in the experiments. In the experiments, using the developed accident scenario based on tasks from the standard post trip action (SPTA), the steam generator tube rupture (SGTR), and predominant soft control tasks, which are derived from the loss of coolant accident (LOCA) and the excess steam demand event (ESDE), all error detection and recovery data based on human error modes were checked with the performance sheet and the statistical analysis of error recovery/detection was then

  9. A trend analysis of human error events for proactive prevention of accidents. Methodology development and effective utilization

    International Nuclear Information System (INIS)

    Hirotsu, Yuko; Ebisu, Mitsuhiro; Aikawa, Takeshi; Matsubara, Katsuyuki

    2006-01-01

    This paper described methods for analyzing human error events that has been accumulated in the individual plant and for utilizing the result to prevent accidents proactively. Firstly, a categorization framework of trigger action and causal factors of human error events were reexamined, and the procedure to analyze human error events was reviewed based on the framework. Secondly, a method for identifying the common characteristics of trigger action data and of causal factor data accumulated by analyzing human error events was clarified. In addition, to utilize the results of trend analysis effectively, methods to develop teaching material for safety education, to develop the checkpoints for the error prevention and to introduce an error management process for strategic error prevention were proposed. (author)

  10. Application of grey incidence analysis to connection between human errors and root cause

    International Nuclear Information System (INIS)

    Ren Yinxiang; Yu Ren; Zhou Gang; Chen Dengke

    2008-01-01

    By introducing grey incidence analysis, the relatively important impact of root cause upon human errors was researched in the paper. On the basis of WANO statistic data and grey incidence analysis, lack of alternate examine, bad basic operation, short of theoretical knowledge, relaxation of organization and management and deficiency of regulations are the important influence of root cause on human err ors. Finally, the question to reduce human errors was discussed. (authors)

  11. EPA Web Taxonomy

    Data.gov (United States)

    U.S. Environmental Protection Agency — EPA's Web Taxonomy is a faceted hierarchical vocabulary used to tag web pages with terms from a controlled vocabulary. Tagging enables search and discovery of EPA's...

  12. THERP and HEART integrated methodology for human error assessment

    Science.gov (United States)

    Castiglia, Francesco; Giardina, Mariarosa; Tomarchio, Elio

    2015-11-01

    THERP and HEART integrated methodology is proposed to investigate accident scenarios that involve operator errors during high-dose-rate (HDR) treatments. The new approach has been modified on the basis of fuzzy set concept with the aim of prioritizing an exhaustive list of erroneous tasks that can lead to patient radiological overexposures. The results allow for the identification of human errors that are necessary to achieve a better understanding of health hazards in the radiotherapy treatment process, so that it can be properly monitored and appropriately managed.

  13. The evolution of trypanosomatid taxonomy.

    Science.gov (United States)

    Kaufer, Alexa; Ellis, John; Stark, Damien; Barratt, Joel

    2017-06-08

    Trypanosomatids are protozoan parasites of the class Kinetoplastida predominately restricted to invertebrate hosts (i.e. possess a monoxenous life-cycle). However, several genera are pathogenic to humans, animals and plants, and have an invertebrate vector that facilitates their transmission (i.e. possess a dixenous life-cycle). Phytomonas is one dixenous genus that includes several plant pathogens transmitted by phytophagous insects. Trypanosoma and Leishmania are dixenous genera that infect vertebrates, including humans, and are transmitted by hematophagous invertebrates. Traditionally, monoxenous trypanosomatids such as Leptomonas were distinguished from morphologically similar dixenous species based on their restriction to an invertebrate host. Nonetheless, this criterion is somewhat flawed as exemplified by Leptomonas seymouri which reportedly infects vertebrates opportunistically. Similarly, Novymonas and Zelonia are presumably monoxenous genera yet sit comfortably in the dixenous clade occupied by Leishmania. The isolation of Leishmania macropodum from a biting midge (Forcipomyia spp.) rather than a phlebotomine sand fly calls into question the exclusivity of the Leishmania-sand fly relationship, and its suitability for defining the Leishmania genus. It is now accepted that classic genus-defining characteristics based on parasite morphology and host range are insufficient to form the sole basis of trypanosomatid taxonomy as this has led to several instances of paraphyly. While improvements have been made, resolution of evolutionary relationships within the Trypanosomatidae is confounded by our incomplete knowledge of its true diversity. The known trypanosomatids probably represent a fraction of those that exist and isolation of new species will help resolve relationships in this group with greater accuracy. This review incites a dialogue on how our understanding of the relationships between certain trypanosomatids has shifted, and discusses new knowledge

  14. A new taxonomy of sublinear keyword pattern matching algorithms

    NARCIS (Netherlands)

    Cleophas, L.G.W.A.; Watson, B.W.; Zwaan, G.

    2004-01-01

    Abstract This paper presents a new taxonomy of sublinear (multiple) keyword pattern matching algorithms. Based on an earlier taxonomy by Watson and Zwaan [WZ96, WZ95], this new taxonomy includes not only suffix-based algorithms related to the Boyer-Moore, Commentz-Walter and Fan-Su algorithms, but

  15. NASA Taxonomies for Searching Problem Reports and FMEAs

    Science.gov (United States)

    Malin, Jane T.; Throop, David R.

    2006-01-01

    Many types of hazard and risk analyses are used during the life cycle of complex systems, including Failure Modes and Effects Analysis (FMEA), Hazard Analysis, Fault Tree and Event Tree Analysis, Probabilistic Risk Assessment, Reliability Analysis and analysis of Problem Reporting and Corrective Action (PRACA) databases. The success of these methods depends on the availability of input data and the analysts knowledge. Standard nomenclature can increase the reusability of hazard, risk and problem data. When nomenclature in the source texts is not standard, taxonomies with mapping words (sets of rough synonyms) can be combined with semantic search to identify items and tag them with metadata based on a rich standard nomenclature. Semantic search uses word meanings in the context of parsed phrases to find matches. The NASA taxonomies provide the word meanings. Spacecraft taxonomies and ontologies (generalization hierarchies with attributes and relationships, based on terms meanings) are being developed for types of subsystems, functions, entities, hazards and failures. The ontologies are broad and general, covering hardware, software and human systems. Semantic search of Space Station texts was used to validate and extend the taxonomies. The taxonomies have also been used to extract system connectivity (interaction) models and functions from requirements text. Now the Reconciler semantic search tool and the taxonomies are being applied to improve search in the Space Shuttle PRACA database, to discover recurring patterns of failure. Usual methods of string search and keyword search fall short because the entries are terse and have numerous shortcuts (irregular abbreviations, nonstandard acronyms, cryptic codes) and modifier words cannot be used in sentence context to refine the search. The limited and fixed FMEA categories associated with the entries do not make the fine distinctions needed in the search. The approach assigns PRACA report titles to problem classes in

  16. A human error analysis methodology, AGAPE-ET, for emergency tasks in nuclear power plants and its application

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Whan; Jung, Won Dea [Korea Atomic Energy Research Institute, Taejeon (Korea)

    2002-03-01

    This report presents a procedurised human reliability analysis (HRA) methodology, AGAPE-ET (A Guidance And Procedure for Human Error Analysis for Emergency Tasks), for both qualitative error analysis and quantification of human error probability (HEP) of emergency tasks in nuclear power plants. The AGAPE-ET is based on the simplified cognitive model. By each cognitive function, error causes or error-likely situations have been identified considering the characteristics of the performance of each cognitive function and influencing mechanism of PIFs on the cognitive function. Then, error analysis items have been determined from the identified error causes or error-likely situations to help the analysts cue or guide overall human error analysis. A human error analysis procedure based on the error analysis items is organised. The basic scheme for the quantification of HEP consists in the multiplication of the BHEP assigned by the error analysis item and the weight from the influencing factors decision tree (IFDT) constituted by cognitive function. The method can be characterised by the structured identification of the weak points of the task required to perform and the efficient analysis process that the analysts have only to carry out with the necessary cognitive functions. The report also presents the the application of AFAPE-ET to 31 nuclear emergency tasks and its results. 42 refs., 7 figs., 36 tabs. (Author)

  17. An investigation on unintended reactor trip events in terms of human error hazards of Korean nuclear power plants

    International Nuclear Information System (INIS)

    Kim, Sa Kil; Lee, Yong Hee; Jang, Tong Il; Oh, Yeon Ju; Shin, Kwang Hyeon

    2014-01-01

    Highlights: • A methodology to identify human error hazards has been established. • The proposed methodology is a preventive approach to identify not only human error causes but also its hazards. • Using the HFACS framework we tried to find out not causations but all of the hazards and relationships among them. • We determined countermeasures against human errors through dealing with latent factors such as organizational influences. - Abstract: A new approach for finding the hazards of human errors, and not just their causes, in the nuclear industry is currently required. This is because finding causes of human errors is really impossible owing to the multiplicity of causes in each case. Thus, this study aims at identifying the relationships among human error hazards and determining the strategies for preventing human error events by means of a reanalysis of the reactor trip events in Korea NPPs. We investigated human errors to find latent factors such as decisions and conditions in all of the unintended reactor trip events during the last dozen years. In this study, we applied the HFACS (Human Factors Analysis and Classification System), which is a commonly utilized tool for investigating human contributions to aviation accidents under a widespread evaluation scheme. Using the HFACS framework, we tried to find out not the causations but all of the hazards and their relationships in terms of organizational factors. Through the trial, we proposed not only meaningful frequencies of each hazards also correlations of them. Also, considering the correlations of each hazards, we suggested useful strategies to prevent human error event. A method to investigate unintended nuclear reactor trips by human errors and the results will be discussed in more detail

  18. The using of the control room automation against human errors

    International Nuclear Information System (INIS)

    Kautto, A.

    1993-01-01

    The control room automation has developed very strongly during the 80's in IVO (Imatran Voima Oy). The former work expanded strongly with building of the full scope training simulator to the Loviisa plant. The important milestones has been, for example the testing of the Critical Function Monitoring System, a concept developed by Combustion Eng. Inc., in Loviisa training simulator 1982, the replacing of the process and simulator computers in Loviisa 1989, and 1990 and the presenting the use of the computer based procedures in training of operators 1993. With developing of automation and procedures it is possible to minimize the probability of human error. However, it is not possible totally eliminate the risks caused by human errors. (orig.)

  19. Characters in Arctostaphylos taxonomy

    Science.gov (United States)

    Keeley, Jon E.; Parker, V. Thomas; Vasey, Michael C.

    2017-01-01

    There is value in understanding the past and how it has affected the present. Science focuses on empirical findings, and we know that our prior experiences and those of our predecessors play important roles in determining how we interpret the present. We learn from accomplishments and foibles of predecessors and appreciate the real life experiences we have gone through. In our studies of the genus Arctostaphylos Adans. we have been struck by the fascinating stories surrounding taxonomists who have played roles in the development of our current understanding of the group. In addition to providing insights, they sometimes provide humor and lessons on the value of competition versus collaboration. We offer this history of the humans that forged the taxonomy behind Arctostaphylos classification in this light.

  20. Prediction of human errors by maladaptive changes in event-related brain networks

    NARCIS (Netherlands)

    Eichele, T.; Debener, S.; Calhoun, V.D.; Specht, K.; Engel, A.K.; Hugdahl, K.; Cramon, D.Y. von; Ullsperger, M.

    2008-01-01

    Humans engaged in monotonous tasks are susceptible to occasional errors that may lead to serious consequences, but little is known about brain activity patterns preceding errors. Using functional Mill and applying independent component analysis followed by deconvolution of hemodynamic responses, we

  1. Een revisie van de taxonomie van gifkikkers

    NARCIS (Netherlands)

    Poelman, E.H.

    2007-01-01

    Recent kwam het lang verwachte ruim tweehonderdvijftig pagina`s tellende manuscript uit met daarin een revisie van de taxonomie van gifkikkers. De auteurs onder leiding van Taran Grant stellen een nieuwe taxonomie voor, die de familie Dendrobatidae met haar tien algemener geaccepteerde genera

  2. An Estimation of Human Error Probability of Filtered Containment Venting System Using Dynamic HRA Method

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Seunghyun; Jae, Moosung [Hanyang University, Seoul (Korea, Republic of)

    2016-10-15

    The human failure events (HFEs) are considered in the development of system fault trees as well as accident sequence event trees in part of Probabilistic Safety Assessment (PSA). As a method for analyzing the human error, several methods, such as Technique for Human Error Rate Prediction (THERP), Human Cognitive Reliability (HCR), and Standardized Plant Analysis Risk-Human Reliability Analysis (SPAR-H) are used and new methods for human reliability analysis (HRA) are under developing at this time. This paper presents a dynamic HRA method for assessing the human failure events and estimation of human error probability for filtered containment venting system (FCVS) is performed. The action associated with implementation of the containment venting during a station blackout sequence is used as an example. In this report, dynamic HRA method was used to analyze FCVS-related operator action. The distributions of the required time and the available time were developed by MAAP code and LHS sampling. Though the numerical calculations given here are only for illustrative purpose, the dynamic HRA method can be useful tools to estimate the human error estimation and it can be applied to any kind of the operator actions, including the severe accident management strategy.

  3. Taxonomy of Payments

    DEFF Research Database (Denmark)

    Hedman, Jonas; Tan, Felix B.; Holst, Jacques

    2017-01-01

    that impact payers’ choice of payment instruments. Design/methodology/approach: Through in-depth interviews using the repertory grid technique, the authors explored 15 payers’ perceptions of six payment instruments, including coins, banknotes, debit cards, credit cards, mobile payments, and online banking....... The approach draws heavily on organizational systematics to better understand payers’ choice of payment instruments. Findings: A four-category taxonomy of payments was developed. The authors refer to the taxonomy as the 4Ps: the purchase, the payer, the payment instrument, and the physical technology...... or checks. Research limitations/implications: The findings suggest that payers view payment instruments in a much broader sense, including context, control, or cultural beliefs. Consequently, the authors suggest that researchers try to understand the essence of an innovation before assuming any economic...

  4. Molecular taxonomy of scopulariopsis-like fungi with description of new clinical and environmental species

    NARCIS (Netherlands)

    Jagielski, Tomasz; Sandoval-Denis, Marcelo; Yu, Jin; Yao, Limin; Bakuła, Zofia; Kalita, Joanna; Skóra, Magdalena; Krzyściak, Paweł; de Hoog, G Sybren; Guarro, Josep; Gené, Josepa

    The taxonomy of scopulariopsis-like fungi, comprising numerous human opportunistic species, has recently been reassessed with delineation of the genera Microascus, Pithoascus, Pseudoscopulariopsis, and Scopulariopsis, using morphological data and multilocus sequence analysis based on four loci (ITS,

  5. Human error recovery failure probability when using soft controls in computerized control rooms

    International Nuclear Information System (INIS)

    Jang, Inseok; Kim, Ar Ryum; Seong, Poong Hyun; Jung, Wondea

    2014-01-01

    Many literatures categorized recovery process into three phases; detection of problem situation, explanation of problem causes or countermeasures against problem, and end of recovery. Although the focus of recovery promotion has been on categorizing recovery phases and modeling recovery process, research related to human recovery failure probabilities has not been perform actively. On the other hand, a few study regarding recovery failure probabilities were implemented empirically. Summarizing, researches that have performed so far have several problems in terms of use in human reliability analysis (HRA). By adopting new human-system interfaces that are based on computer-based technologies, the operation environment of MCRs in NPPs has changed from conventional MCRs to advanced MCRs. Because of the different interfaces between conventional and advanced MCRs, different recovery failure probabilities should be considered in the HRA for advanced MCRs. Therefore, this study carries out an empirical analysis of human error recovery probabilities under an advanced MCR mockup called compact nuclear simulator (CNS). The aim of this work is not only to compile a recovery failure probability database using the simulator for advanced MCRs but also to collect recovery failure probability according to defined human error modes to compare that which human error mode has highest recovery failure probability. The results show that recovery failure probability regarding wrong screen selection was lowest among human error modes, which means that most of human error related to wrong screen selection can be recovered. On the other hand, recovery failure probabilities of operation selection omission and delayed operation were 1.0. These results imply that once subject omitted one task in the procedure, they have difficulties finding and recovering their errors without supervisor's assistance. Also, wrong screen selection had an effect on delayed operation. That is, wrong screen

  6. Taxonomies of Educational Technology Uses: Dewey, Chip and Me

    Science.gov (United States)

    Levin, James A.

    2014-01-01

    In the early 1990s, Chip Bruce created a taxonomy of education technology uses, which the author of the article helped to expand and evaluate. This taxonomy is based on John Dewey's "four impulses of the child": inquiry, construction, communication, and expression. This taxonomy has helped people interested in the uses of…

  7. Derivation of main drivers affecting the possibility of human errors during low power and shutdown operation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ar Ryum; Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of); Park, Jin Kyun; Kim, Jae Whan [KAERI, Daejeon (Korea, Republic of)

    2016-05-15

    In order to estimate the possibility of human error and identify its nature, human reliability analysis (HRA) methods have been implemented. For this, various HRA methods have been developed so far: techniques for human error rate prediction (THERP), cause based decision tree (CBDT), the cognitive reliability and error analysis method (CREAM) and so on. Most HRA methods have been developed with a focus on full power operation of NPPs even though human performance may more largely affect the safety of the system during low power and shutdown (LPSD) operation than it would when the system is in full power operation. In this regard, it is necessary to conduct a research for developing HRA method to be used in LPSD operation. For the first step of the study, main drivers which affect the possibility of human error have been developed. Drivers which are commonly called as performance shaping factors (PSFs) are aspects of the human's individual characteristics, environment, organization, or task that specifically decrements or improves human performance, thus respectively increasing or decreasing the likelihood of human errors. In order to estimate the possibility of human error and identify its nature, human reliability analysis (HRA) methods have been implemented. For this, various HRA methods have been developed so far: techniques for human error rate prediction (THERP), cause based decision tree (CBDT), the cognitive reliability and error analysis method (CREAM) and so on. Most HRA methods have been developed with a focus on full power operation of NPPs even though human performance may more largely affect the safety of the system during low power and shutdown (LPSD) operation than it would when the system is in full power operation. In this regard, it is necessary to conduct a research for developing HRA method to be used in LPSD operation. For the first step of the study, main drivers which affect the possibility of human error have been developed. Drivers

  8. Derivation of main drivers affecting the possibility of human errors during low power and shutdown operation

    International Nuclear Information System (INIS)

    Kim, Ar Ryum; Seong, Poong Hyun; Park, Jin Kyun; Kim, Jae Whan

    2016-01-01

    In order to estimate the possibility of human error and identify its nature, human reliability analysis (HRA) methods have been implemented. For this, various HRA methods have been developed so far: techniques for human error rate prediction (THERP), cause based decision tree (CBDT), the cognitive reliability and error analysis method (CREAM) and so on. Most HRA methods have been developed with a focus on full power operation of NPPs even though human performance may more largely affect the safety of the system during low power and shutdown (LPSD) operation than it would when the system is in full power operation. In this regard, it is necessary to conduct a research for developing HRA method to be used in LPSD operation. For the first step of the study, main drivers which affect the possibility of human error have been developed. Drivers which are commonly called as performance shaping factors (PSFs) are aspects of the human's individual characteristics, environment, organization, or task that specifically decrements or improves human performance, thus respectively increasing or decreasing the likelihood of human errors. In order to estimate the possibility of human error and identify its nature, human reliability analysis (HRA) methods have been implemented. For this, various HRA methods have been developed so far: techniques for human error rate prediction (THERP), cause based decision tree (CBDT), the cognitive reliability and error analysis method (CREAM) and so on. Most HRA methods have been developed with a focus on full power operation of NPPs even though human performance may more largely affect the safety of the system during low power and shutdown (LPSD) operation than it would when the system is in full power operation. In this regard, it is necessary to conduct a research for developing HRA method to be used in LPSD operation. For the first step of the study, main drivers which affect the possibility of human error have been developed. Drivers which

  9. Organising knowledge taxonomies, knowledge and organisational effectiveness

    CERN Document Server

    Lambe, Patrick

    2007-01-01

    Taxonomies are often thought to play a niche role within content-oriented knowledge management projects. They are thought to be 'nice to have' but not essential. In this ground-breaking book, Patrick Lambe shows how they play an integral role in helping organizations coordinate and communicate effectively. Through a series of case studies, he demonstrates the range of ways in which taxonomies can help organizations to leverage and articulate their knowledge. A step-by-step guide in the book to running a taxonomy project is full of practical advice for knowledge managers and business owners ali

  10. Identification of factors associated with diagnostic error in primary care.

    Science.gov (United States)

    Minué, Sergio; Bermúdez-Tamayo, Clara; Fernández, Alberto; Martín-Martín, José Jesús; Benítez, Vivian; Melguizo, Miguel; Caro, Araceli; Orgaz, María José; Prados, Miguel Angel; Díaz, José Enrique; Montoro, Rafael

    2014-05-12

    Missed, delayed or incorrect diagnoses are considered to be diagnostic errors. The aim of this paper is to describe the methodology of a study to analyse cognitive aspects of the process by which primary care (PC) physicians diagnose dyspnoea. It examines the possible links between the use of heuristics, suboptimal cognitive acts and diagnostic errors, using Reason's taxonomy of human error (slips, lapses, mistakes and violations). The influence of situational factors (professional experience, perceived overwork and fatigue) is also analysed. Cohort study of new episodes of dyspnoea in patients receiving care from family physicians and residents at PC centres in Granada (Spain). With an initial expected diagnostic error rate of 20%, and a sampling error of 3%, 384 episodes of dyspnoea are calculated to be required. In addition to filling out the electronic medical record of the patients attended, each physician fills out 2 specially designed questionnaires about the diagnostic process performed in each case of dyspnoea. The first questionnaire includes questions on the physician's initial diagnostic impression, the 3 most likely diagnoses (in order of likelihood), and the diagnosis reached after the initial medical history and physical examination. It also includes items on the physicians' perceived overwork and fatigue during patient care. The second questionnaire records the confirmed diagnosis once it is reached. The complete diagnostic process is peer-reviewed to identify and classify the diagnostic errors. The possible use of heuristics of representativeness, availability, and anchoring and adjustment in each diagnostic process is also analysed. Each audit is reviewed with the physician responsible for the diagnostic process. Finally, logistic regression models are used to determine if there are differences in the diagnostic error variables based on the heuristics identified. This work sets out a new approach to studying the diagnostic decision-making process

  11. Human reliability and risk management in the transportation of spent nuclear fuel

    International Nuclear Information System (INIS)

    Tuler, S.; Kasperson, R.E.; Ratick, S.

    1989-01-01

    This paper summarizes work on human factor contributions to risks from spent nuclear fuel transportation. Human participation may have significant effects on the levels and types of risks by enabling or initiating incidents and exacerbating adverse consequences. Human errors are defined to be the result of mismatches between perceived system state and actual system state. In complex transportation systems such mismatches may be distributed in time (e.g., during different stages of design, implementation, operation, maintenance) and location (e.g., human error, its identification, and its recovery may be geographically and institutionally separate). Risk management programs may decrease the probability of undesirable events or attenuate the consequences of mismatches. This paper presents a methodology to identify the scope and types of human-task mismatches and to identify potential management options for their prevention, mitigation, or recovery. A review of transportation accident databases, in conjunction with human error models, is used to develop a taxonomy of human errors during design for the pre-identification of potential mismatches or after incidents have occurred to evaluate their causes. Risk management options to improve human reliability are identified by a matrix that relates the multiple stages of a spent nuclear fuel transportation system to management options (e.g., training, data analysis, regulation). The paper concludes with examples to illustrate how the methodology may be applied. (author)

  12. An Android Communication App Forensic Taxonomy.

    Science.gov (United States)

    Azfar, Abdullah; Choo, Kim-Kwang Raymond; Liu, Lin

    2016-09-01

    Due to the popularity of Android devices and applications (apps), Android forensics is one of the most studied topics within mobile forensics. Communication apps, such as instant messaging and Voice over IP (VoIP), are one popular app category used by mobile device users, including criminals. Therefore, a taxonomy outlining artifacts of forensic interest involving the use of Android communication apps will facilitate the timely collection and analysis of evidentiary materials from such apps. In this paper, 30 popular Android communication apps were examined, where a logical extraction of the Android phone images was collected using XRY, a widely used mobile forensic tool. Various information of forensic interest, such as contact lists and chronology of messages, was recovered. Based on the findings, a two-dimensional taxonomy of the forensic artifacts of the communication apps is proposed, with the app categories in one dimension and the classes of artifacts in the other dimension. Finally, the artifacts identified in the study of the 30 communication apps are summarized using the taxonomy. It is expected that the proposed taxonomy and the forensic findings in this paper will assist forensic investigations involving Android communication apps. © 2016 American Academy of Forensic Sciences.

  13. Human errors in test and maintenance of nuclear power plants. Nordic project work

    International Nuclear Information System (INIS)

    Andersson, H.; Liwaang, B.

    1985-08-01

    The present report is a summary of the NKA/LIT-1 project performed for the period 1981-1985. The report summarizes work on human error influence in test and calibration activities in nuclear power plants, reviews problems regarding optimization of the test intervals, organization of test and maintenance activities, and the analysis of human error contribution to the overall risk in test and mainenace tasks. (author)

  14. Assessing human error during collecting a hydrocarbon sample of ...

    African Journals Online (AJOL)

    This paper reports the assessment method of the hydrocarbon sample collection standard operation procedure (SOP) using THERP. The Performance Shaping Factors (PSF) from THERP analyzed and assessed the human errors during collecting a hydrocarbon sample of a petrochemical refinery plant. Twenty-two ...

  15. Unravelling the tangled taxonomies of health informatics

    Directory of Open Access Journals (Sweden)

    David Barrett

    2014-08-01

    Full Text Available Even though informatics is a term used commonly in healthcare, it can be a confusing and disengaging one. Many definitions exist in the literature, and attempts have been made to develop a clear taxonomy. Despite this, informatics is still a term that lacks clarity in both its scope and the classification of sub-terms that it encompasses.This paper reviews the importance of an agreed taxonomy and explores the challenges of establishing exactly what is meant by health informatics (HI. It reviews what a taxonomy should do, summarises previous attempts at categorising and organising HI and suggests the elements to consider when seeking to develop a system of classification.The paper does not provide all the answers, but it does clarify the questions. By plotting a path towards a taxonomy of HI, it will be possible to enhance understanding and optimise the benefits of embracing technology in clinical practice.

  16. Bringing organizational factors to the fore of human error management

    International Nuclear Information System (INIS)

    Embrey, D.

    1991-01-01

    Human performance problems account for more than half of all significant events at nuclear power plants, even when these did not necessarily lead to severe accidents. In dealing with the management of human error, both technical and organizational factors need to be taken into account. Most important, a long-term commitment from senior management is needed. (author)

  17. Analysis of Human Errors in Japanese Nuclear Power Plants using JHPES/JAESS

    International Nuclear Information System (INIS)

    Kojima, Mitsuhiro; Mimura, Masahiro; Yamaguchi, Osamu

    1998-01-01

    CRIEPI (Central Research Institute for Electric Power Industries) / HFC (Human Factors research Center) developed J-HPES (Japanese version of Human Performance Enhancement System) based on the HPES which was originally developed by INPO to analyze events resulted from human errors. J-HPES was systematized into a computer program named JAESS (J-HPES Analysis and Evaluation Support System) and both systems were distributed to all Japanese electric power companies to analyze events by themselves. CRIEPI / HFC also analyzed the incidents in Japanese nuclear power plants (NPPs) which were officially reported and identified as human error related with J-HPES / JAESS. These incidents have numbered up to 188 cases over the last 30 years. An outline of this analysis is given, and some preliminary findings are shown. (authors)

  18. Preventing marine accidents caused by technology-induced human error

    OpenAIRE

    Bielić, Toni; Hasanspahić, Nermin; Čulin, Jelena

    2017-01-01

    The objective of embedding technology on board ships, to improve safety, is not fully accomplished. The paper studies marine accidents caused by human error resulting from improper human-technology interaction. The aim of the paper is to propose measures to prevent reoccurrence of such accidents. This study analyses the marine accident reports issued by Marine Accidents Investigation Branch covering the period from 2012 to 2014. The factors that caused these accidents are examined and categor...

  19. Analysis of Human Error Types and Performance Shaping Factors in the Next Generation Main Control Room

    International Nuclear Information System (INIS)

    Sin, Y. C.; Jung, Y. S.; Kim, K. H.; Kim, J. H.

    2008-04-01

    Main control room of nuclear power plants has been computerized and digitalized in new and modernized plants, as information and digital technologies make great progresses and become mature. Survey on human factors engineering issues in advanced MCRs: Model-based approach, Literature survey-based approach. Analysis of human error types and performance shaping factors is analysis of three human errors. The results of project can be used for task analysis, evaluation of human error probabilities, and analysis of performance shaping factors in the HRA analysis

  20. A taxonomy of behaviour change methods: an Intervention Mapping approach.

    Science.gov (United States)

    Kok, Gerjo; Gottlieb, Nell H; Peters, Gjalt-Jorn Y; Mullen, Patricia Dolan; Parcel, Guy S; Ruiter, Robert A C; Fernández, María E; Markham, Christine; Bartholomew, L Kay

    2016-09-01

    In this paper, we introduce the Intervention Mapping (IM) taxonomy of behaviour change methods and its potential to be developed into a coding taxonomy. That is, although IM and its taxonomy of behaviour change methods are not in fact new, because IM was originally developed as a tool for intervention development, this potential was not immediately apparent. Second, in explaining the IM taxonomy and defining the relevant constructs, we call attention to the existence of parameters for effectiveness of methods, and explicate the related distinction between theory-based methods and practical applications and the probability that poor translation of methods may lead to erroneous conclusions as to method-effectiveness. Third, we recommend a minimal set of intervention characteristics that may be reported when intervention descriptions and evaluations are published. Specifying these characteristics can greatly enhance the quality of our meta-analyses and other literature syntheses. In conclusion, the dynamics of behaviour change are such that any taxonomy of methods of behaviour change needs to acknowledge the importance of, and provide instruments for dealing with, three conditions for effectiveness for behaviour change methods. For a behaviour change method to be effective: (1) it must target a determinant that predicts behaviour; (2) it must be able to change that determinant; (3) it must be translated into a practical application in a way that preserves the parameters for effectiveness and fits with the target population, culture, and context. Thus, taxonomies of methods of behaviour change must distinguish the specific determinants that are targeted, practical, specific applications, and the theory-based methods they embody. In addition, taxonomies should acknowledge that the lists of behaviour change methods will be used by, and should be used by, intervention developers. Ideally, the taxonomy should be readily usable for this goal; but alternatively, it should be

  1. A taxonomy of behaviour change methods: an Intervention Mapping approach

    OpenAIRE

    Kok, Gerjo; Gottlieb, Nell H.; Peters, Gjalt-Jorn Y.; Mullen, Patricia Dolan; Parcel, Guy S.; Ruiter, Robert A.C.; Fern?ndez, Mar?a E.; Markham, Christine; Bartholomew, L. Kay

    2015-01-01

    ABSTRACT In this paper, we introduce the Intervention Mapping (IM) taxonomy of behaviour change methods and its potential to be developed into a coding taxonomy. That is, although IM and its taxonomy of behaviour change methods are not in fact new, because IM was originally developed as a tool for intervention development, this potential was not immediately apparent. Second, in explaining the IM taxonomy and defining the relevant constructs, we call attention to the existence of parameters fo...

  2. An advanced human reliability analysis methodology: analysis of cognitive errors focused on

    International Nuclear Information System (INIS)

    Kim, J. H.; Jeong, W. D.

    2001-01-01

    The conventional Human Reliability Analysis (HRA) methods such as THERP/ASEP, HCR and SLIM has been criticised for their deficiency in analysing cognitive errors which occurs during operator's decision making process. In order to supplement the limitation of the conventional methods, an advanced HRA method, what is called the 2 nd generation HRA method, including both qualitative analysis and quantitative assessment of cognitive errors has been being developed based on the state-of-the-art theory of cognitive systems engineering and error psychology. The method was developed on the basis of human decision-making model and the relation between the cognitive function and the performance influencing factors. The application of the proposed method to two emergency operation tasks is presented

  3. Toward genetics-based virus taxonomy: comparative analysis of a genetics-based classification and the taxonomy of picornaviruses.

    Science.gov (United States)

    Lauber, Chris; Gorbalenya, Alexander E

    2012-04-01

    Virus taxonomy has received little attention from the research community despite its broad relevance. In an accompanying paper (C. Lauber and A. E. Gorbalenya, J. Virol. 86:3890-3904, 2012), we have introduced a quantitative approach to hierarchically classify viruses of a family using pairwise evolutionary distances (PEDs) as a measure of genetic divergence. When applied to the six most conserved proteins of the Picornaviridae, it clustered 1,234 genome sequences in groups at three hierarchical levels (to which we refer as the "GENETIC classification"). In this study, we compare the GENETIC classification with the expert-based picornavirus taxonomy and outline differences in the underlying frameworks regarding the relation of virus groups and genetic diversity that represent, respectively, the structure and content of a classification. To facilitate the analysis, we introduce two novel diagrams. The first connects the genetic diversity of taxa to both the PED distribution and the phylogeny of picornaviruses. The second depicts a classification and the accommodated genetic diversity in a standardized manner. Generally, we found striking agreement between the two classifications on species and genus taxa. A few disagreements concern the species Human rhinovirus A and Human rhinovirus C and the genus Aphthovirus, which were split in the GENETIC classification. Furthermore, we propose a new supergenus level and universal, level-specific PED thresholds, not reached yet by many taxa. Since the species threshold is approached mostly by taxa with large sampling sizes and those infecting multiple hosts, it may represent an upper limit on divergence, beyond which homologous recombination in the six most conserved genes between two picornaviruses might not give viable progeny.

  4. Application of human error theory in case analysis of wrong procedures.

    Science.gov (United States)

    Duthie, Elizabeth A

    2010-06-01

    The goal of this study was to contribute to the emerging body of literature about the role of human behaviors and cognitive processes in the commission of wrong procedures. Case analysis of 5 wrong procedures in operative and nonoperative settings using James Reason's human error theory was performed. The case analysis showed that cognitive underspecification, cognitive flips, automode processing, and skill-based errors were contributory to wrong procedures. Wrong-site procedures accounted for the preponderance of the cases. Front-line supervisory staff used corrective actions that focused on the performance of the individual without taking into account cognitive factors. System fixes using human cognition concepts have a greater chance of achieving sustainable safety outcomes than those that are based on the traditional approach of counseling, education, and disciplinary action for staff.

  5. Deadline pressure and human error: a study of human failures on a particle accelerator at Brookhaven National Laboratory

    International Nuclear Information System (INIS)

    Tiagha, E.A.

    1982-01-01

    The decline in industrial efficiency may be linked to decreased reliability of complex automatic systems. This decline threatens the viability of complex organizations in industrialized economies. Industrial engineering techniques that minimize system failure by increasing the reliability of systems hardware are well developed in comparison with those available to reduce human operator errors. The problem of system reliability and the associated costs of breakdown can be reduced if we understand how highly skilled technical personnel function in complex operations and systems. The purpose of this research is to investigate how human errors are affected by deadline pressures, technical communication and other socio-dynamic factors. Through the analysis of a technologically complex particle accelerator prototype at Brookhaven National Laboratory, two failure mechanisms: (1) physical defects in the production process and (2) human operator errors were identified. Two instruments were used to collect information on human failures: objective laboratory data and a human failure questionnaire. The results of human failures from the objective data were used to test for the deadline hypothesis and also to validate the human failure questionnaire. To explain why the human failures occurred, data were collected from a four-part, closed choice questionnaire administered to two groups of scientists, engineers, and technicians, working together against a deadline to produce an engineering prototype of a particle accelerator

  6. Human reliability data, human error and accident models--illustration through the Three Mile Island accident analysis

    International Nuclear Information System (INIS)

    Le Bot, Pierre

    2004-01-01

    Our first objective is to provide a panorama of Human Reliability data used in EDF's Safety Probabilistic Studies, and then, since these concepts are at the heart of Human Reliability and its methods, to go over the notion of human error and the understanding of accidents. We are not sure today that it is actually possible to provide in this field a foolproof and productive theoretical framework. Consequently, the aim of this article is to suggest potential paths of action and to provide information on EDF's progress along those paths which enables us to produce the most potentially useful Human Reliability analyses while taking into account current knowledge in Human Sciences. The second part of this article illustrates our point of view as EDF researchers through the analysis of the most famous civil nuclear accident, the Three Mile Island unit accident in 1979. Analysis of this accident allowed us to validate our positions regarding the need to move, in the case of an accident, from the concept of human error to that of systemic failure in the operation of systems such as a nuclear power plant. These concepts rely heavily on the notion of distributed cognition and we will explain how we applied it. These concepts were implemented in the MERMOS Human Reliability Probabilistic Assessment methods used in the latest EDF Probabilistic Human Reliability Assessment. Besides the fact that it is not very productive to focus exclusively on individual psychological error, the design of the MERMOS method and its implementation have confirmed two things: the significance of qualitative data collection for Human Reliability, and the central role held by Human Reliability experts in building knowledge about emergency operation, which in effect consists of Human Reliability data collection. The latest conclusion derived from the implementation of MERMOS is that, considering the difficulty in building 'generic' Human Reliability data in the field we are involved in, the best

  7. Human error data collection as a precursor to the development of a human reliability assessment capability in air traffic management

    International Nuclear Information System (INIS)

    Kirwan, Barry; Gibson, W. Huw; Hickling, Brian

    2008-01-01

    Quantified risk and safety assessments are now required for safety cases for European air traffic management (ATM) services. Since ATM is highly human-dependent for its safety, this suggests a need for formal human reliability assessment (HRA), as carried out in other industries such as nuclear power. Since the fundamental aspect of HRA is human error data, in the form of human error probabilities (HEPs), it was decided to take a first step towards development of an ATM HRA approach by deriving some HEPs in an ATM context. This paper reports a study, which collected HEPs via analysing the results of a real-time simulation involving air traffic controllers (ATCOs) and pilots, with a focus on communication errors. This study did indeed derive HEPs that were found to be concordant with other known communication human error data. This is a first step, and shows promise for HRA in ATM, since HEPs have been derived which could be used in safety assessments, although these HEPs are for only one (albeit critical) aspect of ATCOs' tasks (communications). The paper discusses options and potential ways forward for the development of a full HRA capability in ATM

  8. Bloom's Taxonomy: Improving Assessment and Teaching-Learning Process

    Science.gov (United States)

    Chandio, Muhammad Tufail; Pandhiani, Saima Murtaza; Iqbal, Rabia

    2016-01-01

    This research study critically analyzes the scope and contribution of Bloom's Taxonomy in both assessment and teaching-learning process. Bloom's Taxonomy consists of six stages, namely; remembering, understanding, applying, analyzing, evaluating and creating and moves from lower degree to the higher degree. The study applies Bloom's Taxonomy to…

  9. Identification of failure sequences sensitive to human error

    International Nuclear Information System (INIS)

    1987-06-01

    This report prepared by the participants of the technical committee meeting on ''Identification of Failure Sequences Sensitive to Human Error'' addresses the subjects discussed during the meeting and the conclusions reached by the committee. Chapter 1 reviews the INSAG recommendations and the main elements of the IAEA Programme in the area of human element. In Chapter 2 the role of human actions in nuclear power plants safety from insights of operational experience is reviewed. Chapter 3 is concerned with the relationship between probabilistic safety assessment and human performance associated with severe accident sequences. Chapter 4 addresses the role of simulators in view of training for accident conditions. Chapter 5 presents the conclusions and future trends. The seven papers presented by members of this technical committee are also included in this technical document. A separate abstract was prepared for each of these papers

  10. Classification and taxonomy of vegetable macergens

    Directory of Open Access Journals (Sweden)

    Bukola Rhoda Aremu

    2015-11-01

    Full Text Available Macergens are bacteria capable of releasing pectic enzymes (pectolytic bacteria. These enzymatic actions result in the separation of plant tissues leading to total plant destruction. This can be attributed to soft rot diseases in vegetables. These macergens primarily belong to the genus Erwinia and to a range of opportunistic pathogens namely: the Xanthomonas spp, Pseudomonas spp., Clostridium spp., Cytophaga spp. and Bacillus spp. They consist of taxa that displayed considerable heterogeneity and intermingled with members of other genera belonging to the Enterobacteriaceae. They have been classified based on phenotypic, chemotaxonomic and genotypic which obviously not necessary in the taxonomy of all bacterial genera for defining bacterial species and describing new ones These taxonomic markers have been used traditionally as a simple technique for identification of bacterial isolates. The most important fields of taxonomy are supposed to be based on clear, reliable and worldwide applicable criteria. Hence, this review clarifies the taxonomy of the macergens to the species level and revealed that their taxonomy is beyond complete. For discovery of additional species, further research with the use modern molecular methods like phylogenomics need to be done. This can precisely define classification of macergens resulting in occasional, but significant changes in previous taxonomic schemes of these macergens.

  11. A technique for human error analysis (ATHEANA)

    International Nuclear Information System (INIS)

    Cooper, S.E.; Ramey-Smith, A.M.; Wreathall, J.; Parry, G.W.

    1996-05-01

    Probabilistic risk assessment (PRA) has become an important tool in the nuclear power industry, both for the Nuclear Regulatory Commission (NRC) and the operating utilities. Human reliability analysis (HRA) is a critical element of PRA; however, limitations in the analysis of human actions in PRAs have long been recognized as a constraint when using PRA. A multidisciplinary HRA framework has been developed with the objective of providing a structured approach for analyzing operating experience and understanding nuclear plant safety, human error, and the underlying factors that affect them. The concepts of the framework have matured into a rudimentary working HRA method. A trial application of the method has demonstrated that it is possible to identify potentially significant human failure events from actual operating experience which are not generally included in current PRAs, as well as to identify associated performance shaping factors and plant conditions that have an observable impact on the frequency of core damage. A general process was developed, albeit in preliminary form, that addresses the iterative steps of defining human failure events and estimating their probabilities using search schemes. Additionally, a knowledge- base was developed which describes the links between performance shaping factors and resulting unsafe actions

  12. A technique for human error analysis (ATHEANA)

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, S.E.; Ramey-Smith, A.M.; Wreathall, J.; Parry, G.W. [and others

    1996-05-01

    Probabilistic risk assessment (PRA) has become an important tool in the nuclear power industry, both for the Nuclear Regulatory Commission (NRC) and the operating utilities. Human reliability analysis (HRA) is a critical element of PRA; however, limitations in the analysis of human actions in PRAs have long been recognized as a constraint when using PRA. A multidisciplinary HRA framework has been developed with the objective of providing a structured approach for analyzing operating experience and understanding nuclear plant safety, human error, and the underlying factors that affect them. The concepts of the framework have matured into a rudimentary working HRA method. A trial application of the method has demonstrated that it is possible to identify potentially significant human failure events from actual operating experience which are not generally included in current PRAs, as well as to identify associated performance shaping factors and plant conditions that have an observable impact on the frequency of core damage. A general process was developed, albeit in preliminary form, that addresses the iterative steps of defining human failure events and estimating their probabilities using search schemes. Additionally, a knowledge- base was developed which describes the links between performance shaping factors and resulting unsafe actions.

  13. Grammar Errors in the Writing of Iraqi English Language Learners

    Directory of Open Access Journals (Sweden)

    Yasir Bdaiwi Jasim Al-Shujairi

    2017-10-01

    Full Text Available Several studies have been conducted to investigate the grammatical errors of Iraqi postgraduates and undergraduates in their academic writing. However, few studies have focused on the writing challenges that Iraqi pre-university students face. This research aims at examining the written discourse of Iraqi high school students and the common grammatical errors they make in their writing. The study had a mixed methods design. Through convenience sampling method, 112 compositions were collected from Iraqi pre-university students. For purpose of triangulation, an interview was conducted. The data was analyzed using Corder’s (1967 error analysis model and James’ (1998 framework of grammatical errors. Furthermore, Brown’s (2000 taxonomy was adopted to classify the types of errors. The result showed that Iraqi high school students have serious problems with the usage of verb tenses, articles, and prepositions. Moreover, the most frequent types of errors were Omission and Addition. Furthermore, it was found that intralanguage was the dominant source of errors. These findings may enlighten Iraqi students on the importance of correct grammar use for writing efficacy.

  14. Forensic Taxonomy of Android Social Apps.

    Science.gov (United States)

    Azfar, Abdullah; Choo, Kim-Kwang Raymond; Liu, Lin

    2017-03-01

    An Android social app taxonomy incorporating artifacts that are of forensic interest will enable users and forensic investigators to identify the personally identifiable information (PII) stored by the apps. In this study, 30 popular Android social apps were examined. Artifacts of forensic interest (e.g., contacts lists, chronology of messages, and timestamp of an added contact) were recovered. In addition, images were located, and Facebook token strings used to tie account identities and gain access to information entered into Facebook by a user were identified. Based on the findings, a two-dimensional taxonomy of the forensic artifacts of the social apps is proposed. A comparative summary of existing forensic taxonomies of different categories of Android apps, designed to facilitate timely collection and analysis of evidentiary materials from Android devices, is presented. © 2016 American Academy of Forensic Sciences.

  15. PRA (probabilistic risk analysis) in the nuclear sector. Quantifying human error and human malice

    International Nuclear Information System (INIS)

    Heyes, A.G.

    1995-01-01

    Regardless of the regulatory style chosen ('command and control' or 'functional') a vital prerequisite for coherent safety regulations in the nuclear power industry is the ability to assess accident risk. In this paper we present a critical analysis of current techniques of probabilistic risk analysis applied in the industry, with particular regard to the problems of quantifying risks arising from, or exacerbated by, human risk and/or human error. (Author)

  16. A Method and Support Tool for the Analysis of Human Error Hazards in Digital Devices

    International Nuclear Information System (INIS)

    Lee, Yong Hee; Kim, Seon Soo; Lee, Yong Hee

    2012-01-01

    In recent years, many nuclear power plants have adopted modern digital I and C technologies since they are expected to significantly improve their performance and safety. Modern digital technologies were expected to significantly improve both the economical efficiency and safety of nuclear power plants. However, the introduction of an advanced main control room (MCR) is accompanied with lots of changes in forms and features and differences through virtue of new digital devices. Many user-friendly displays and new features in digital devices are not enough to prevent human errors in nuclear power plants (NPPs). It may be an urgent to matter find the human errors potentials due to digital devices, and their detailed mechanisms. We can then consider them during the design of digital devices and their interfaces. The characteristics of digital technologies and devices may give many opportunities to the interface management, and can be integrated into a compact single workstation in an advanced MCR, such that workers can operate the plant with minimum burden under any operating condition. However, these devices may introduce new types of human errors, and thus we need a means to evaluate and prevent such errors, especially within digital devices for NPPs. This research suggests a new method named HEA-BIS (Human Error Analysis based on Interaction Segment) to confirm and detect human errors associated with digital devices. This method can be facilitated by support tools when used to ensure the safety when applying digital devices in NPPs

  17. Analysis of human factor in operation of nuclear power plants

    International Nuclear Information System (INIS)

    Husseiny, A.A.; Sabri, Z.A.

    1980-01-01

    A taxonomy of operator errors is developed here to provide a scheme for compiling data from field experience according to their significance to the operation and their influence on the plant performance. The reversibility of operator actions is taken as the basis of detection of the relevances of errors to the overall operation. In addition, distinction is made between system errors, such as inadequate instrumentation or logistics, and 'operator errors', which indicate that the operator is involved in inducing an operational error rather than being uniquely responsible for an incident. The developed taxonomy can be used for evaluation of the performance of operators during scheduled training programs. Identification of each class of errors would assist in upgrading performance of operators in a given plant and in filing occurrence reports that help in revising safety provisions or operation procedures. The scheme is suitable for sorting and storing failure information in a data library for ease of retrieval by reliability analysis codes. (orig.) [de

  18. Taxonomy of Streptomyces strains isolated from rhizospheres of ...

    African Journals Online (AJOL)

    Taxonomy of Streptomyces strains isolated from rhizospheres of various plant species grown in Taif region, KSA, having antagonistic activities against some microbial tissue ... African Journal of Biotechnology ... Keywords: Taxonomy, Streptomyces, microbial tissue culture contaminants, antagonistic activities, 16S rRNA

  19. Safety coaches in radiology: decreasing human error and minimizing patient harm

    Energy Technology Data Exchange (ETDEWEB)

    Dickerson, Julie M.; Adams, Janet M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); Koch, Bernadette L.; Donnelly, Lane F. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Pediatrics, Cincinnati, OH (United States); Goodfriend, Martha A. [Cincinnati Children' s Hospital Medical Center, Department of Quality Improvement, Cincinnati, OH (United States)

    2010-09-15

    Successful programs to improve patient safety require a component aimed at improving safety culture and environment, resulting in a reduced number of human errors that could lead to patient harm. Safety coaching provides peer accountability. It involves observing for safety behaviors and use of error prevention techniques and provides immediate feedback. For more than a decade, behavior-based safety coaching has been a successful strategy for reducing error within the context of occupational safety in industry. We describe the use of safety coaches in radiology. Safety coaches are an important component of our comprehensive patient safety program. (orig.)

  20. Safety coaches in radiology: decreasing human error and minimizing patient harm

    International Nuclear Information System (INIS)

    Dickerson, Julie M.; Adams, Janet M.; Koch, Bernadette L.; Donnelly, Lane F.; Goodfriend, Martha A.

    2010-01-01

    Successful programs to improve patient safety require a component aimed at improving safety culture and environment, resulting in a reduced number of human errors that could lead to patient harm. Safety coaching provides peer accountability. It involves observing for safety behaviors and use of error prevention techniques and provides immediate feedback. For more than a decade, behavior-based safety coaching has been a successful strategy for reducing error within the context of occupational safety in industry. We describe the use of safety coaches in radiology. Safety coaches are an important component of our comprehensive patient safety program. (orig.)

  1. Safety coaches in radiology: decreasing human error and minimizing patient harm.

    Science.gov (United States)

    Dickerson, Julie M; Koch, Bernadette L; Adams, Janet M; Goodfriend, Martha A; Donnelly, Lane F

    2010-09-01

    Successful programs to improve patient safety require a component aimed at improving safety culture and environment, resulting in a reduced number of human errors that could lead to patient harm. Safety coaching provides peer accountability. It involves observing for safety behaviors and use of error prevention techniques and provides immediate feedback. For more than a decade, behavior-based safety coaching has been a successful strategy for reducing error within the context of occupational safety in industry. We describe the use of safety coaches in radiology. Safety coaches are an important component of our comprehensive patient safety program.

  2. Human errors identification using the human factors analysis and classification system technique (HFACS

    Directory of Open Access Journals (Sweden)

    G. A. Shirali

    2013-12-01

    .Result: In this study, 158 reports of accident in Ahvaz steel industry were analyzed by HFACS technique. This analysis showed that most of the human errors were: in the first level was related to the skill-based errors, in the second to the physical environment, in the third level to the inadequate supervision and in the fourth level to the management of resources. .Conclusion: Studying and analyzing of past events using the HFACS technique can identify the major and root causes of accidents and can be effective on prevent repetitions of such mishaps. Also, it can be used as a basis for developing strategies to prevent future events in steel industries.

  3. A Taxonomy of Medical Uncertainties in Clinical Genome Sequencing

    Science.gov (United States)

    Han, Paul K. J.; Umstead, Kendall L.; Bernhardt, Barbara A.; Green, Robert C.; Joffe, Steven; Koenig, Barbara; Krantz, Ian; Waterston, Leo B.; Biesecker, Leslie G.; Biesecker, Barbara B.

    2017-01-01

    Purpose Clinical next generation sequencing (CNGS) is introducing new opportunities and challenges into the practice of medicine. Simultaneously, these technologies are generating uncertainties of unprecedented scale that laboratories, clinicians, and patients are required to address and manage. We describe in this report the conceptual design of a new taxonomy of uncertainties around the use of CNGS in health care. Methods Interviews to delineate the dimensions of uncertainty in CNGS were conducted with genomics experts, and themes were extracted in order to expand upon a previously published three-dimensional taxonomy of medical uncertainty. In parallel we developed an interactive website to disseminate the CNGS taxonomy to researchers and engage them in its continued refinement. Results The proposed taxonomy divides uncertainty along three axes: source, issue, and locus, and further discriminates the uncertainties into five layers with multiple domains. Using a hypothetical clinical example, we illustrate how the taxonomy can be applied to findings from CNGS and used to guide stakeholders through interpretation and implementation of variant results. Conclusion The utility of the proposed taxonomy lies in promoting consistency in describing dimensions of uncertainty in publications and presentations, to facilitate research design and management of the uncertainties inherent in the implementation of CNGS. PMID:28102863

  4. Thresholds for human detection of patient setup errors in digitally reconstructed portal images of prostate fields

    International Nuclear Information System (INIS)

    Phillips, Brooke L.; Jiroutek, Michael R.; Tracton, Gregg; Elfervig, Michelle; Muller, Keith E.; Chaney, Edward L.

    2002-01-01

    Purpose: Computer-assisted methods to analyze electronic portal images for the presence of treatment setup errors should be studied in controlled experiments before use in the clinical setting. Validation experiments using images that contain known errors usually report the smallest errors that can be detected by the image analysis algorithm. This paper offers human error-detection thresholds as one benchmark for evaluating the smallest errors detected by algorithms. Unfortunately, reliable data are lacking describing human performance. The most rigorous benchmarks for human performance are obtained under conditions that favor error detection. To establish such benchmarks, controlled observer studies were carried out to determine the thresholds of detectability for in-plane and out-of-plane translation and rotation setup errors introduced into digitally reconstructed portal radiographs (DRPRs) of prostate fields. Methods and Materials: Seventeen observers comprising radiation oncologists, radiation oncology residents, physicists, and therapy students participated in a two-alternative forced choice experiment involving 378 DRPRs computed using the National Library of Medicine Visible Human data sets. An observer viewed three images at a time displayed on adjacent computer monitors. Each image triplet included a reference digitally reconstructed radiograph displayed on the central monitor and two DRPRs displayed on the flanking monitors. One DRPR was error free. The other DRPR contained a known in-plane or out-of-plane error in the placement of the treatment field over a target region in the pelvis. The range for each type of error was determined from pilot observer studies based on a Probit model for error detection. The smallest errors approached the limit of human visual capability. The observer was told what kind of error was introduced, and was asked to choose the DRPR that contained the error. Observer decisions were recorded and analyzed using repeated

  5. Human error as the root cause of severe accidents at nuclear reactors

    International Nuclear Information System (INIS)

    Kovács Zoltán; Rýdzi, Stanislav

    2017-01-01

    A root cause is a factor inducing an undesirable event. It is feasible for root causes to be eliminated through technological process improvements. Human error was the root cause of all severe accidents at nuclear power plants. The TMI accident was caused by a series of human errors. The Chernobyl disaster occurred after a badly performed test of the turbogenerator at a reactor with design deficiencies, and in addition, the operators ignored the safety principles and disabled the safety systems. At Fukushima the tsunami risk was underestimated and the project failed to consider the specific issues of the site. The paper describes the severe accidents and points out the human errors that caused them. Also, provisions that might have eliminated those severe accidents are suggested. The fact that each severe accident occurred on a different type of reactor is relevant – no severe accident ever occurred twice at the same reactor type. The lessons learnt from the severe accidents and the safety measures implemented on reactor units all over the world seem to be effective. (orig.)

  6. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy.

    Science.gov (United States)

    Michie, Susan; Ashford, Stefanie; Sniehotta, Falko F; Dombrowski, Stephan U; Bishop, Alex; French, David P

    2011-11-01

    Current reporting of intervention content in published research articles and protocols is generally poor, with great diversity of terminology, resulting in low replicability. This study aimed to extend the scope and improve the reliability of a 26-item taxonomy of behaviour change techniques developed by Abraham and Michie [Abraham, C. and Michie, S. (2008). A taxonomy of behaviour change techniques used in interventions. Health Psychology, 27(3), 379-387.] in order to optimise the reporting and scientific study of behaviour change interventions. Three UK study centres collaborated in applying this existing taxonomy to two systematic reviews of interventions to increase physical activity and healthy eating. The taxonomy was refined in iterative steps of (1) coding intervention descriptions, and assessing inter-rater reliability, (2) identifying gaps and problems across study centres and (3) refining the labels and definitions based on consensus discussions. Labels and definitions were improved for all techniques, conceptual overlap between categories was resolved, some categories were split and 14 techniques were added, resulting in a 40-item taxonomy. Inter-rater reliability, assessed on 50 published intervention descriptions, was good (kappa = 0.79). This taxonomy can be used to improve the specification of interventions in published reports, thus improving replication, implementation and evidence syntheses. This will strengthen the scientific study of behaviour change and intervention development.

  7. Complications: acknowledging, managing, and coping with human error.

    Science.gov (United States)

    Helo, Sevann; Moulton, Carol-Anne E

    2017-08-01

    Errors are inherent in medicine due to the imperfectness of human nature. Health care providers may have a difficult time accepting their fallibility, acknowledging mistakes, and disclosing errors. Fear of litigation, shame, blame, and concern about reputation are just some of the barriers preventing physicians from being more candid with their patients, despite the supporting body of evidence that patients cite poor communication and lack of transparency as primary drivers to file a lawsuit in the wake of a medical complication. Proper error disclosure includes a timely explanation of what happened, who was involved, why the error occurred, and how it will be prevented in the future. Medical mistakes afford the opportunity for individuals and institutions to be candid about their weaknesses while improving patient care processes. When a physician takes the Hippocratic Oath they take on a tremendous sense of responsibility for the care of their patients, and often bear the burden of their mistakes in isolation. Physicians may struggle with guilt, shame, and a crisis of confidence, which may thwart efforts to identify areas for improvement that can lead to meaningful change. Coping strategies for providers include discussing the event with others, seeking professional counseling, and implementing quality improvement projects. Physicians and health care organizations need to find adaptive ways to deal with complications that will benefit patients, providers, and their institutions.

  8. Leaf morphology, taxonomy and geometric morphometrics: a simplified protocol for beginners.

    Directory of Open Access Journals (Sweden)

    Vincenzo Viscosi

    Full Text Available Taxonomy relies greatly on morphology to discriminate groups. Computerized geometric morphometric methods for quantitative shape analysis measure, test and visualize differences in form in a highly effective, reproducible, accurate and statistically powerful way. Plant leaves are commonly used in taxonomic analyses and are particularly suitable to landmark based geometric morphometrics. However, botanists do not yet seem to have taken advantage of this set of methods in their studies as much as zoologists have done. Using free software and an example dataset from two geographical populations of sessile oak leaves, we describe in detailed but simple terms how to: a compute size and shape variables using Procrustes methods; b test measurement error and the main levels of variation (population and trees using a hierachical design; c estimate the accuracy of group discrimination; d repeat this estimate after controlling for the effect of size differences on shape (i.e., allometry. Measurement error was completely negligible; individual variation in leaf morphology was large and differences between trees were generally bigger than within trees; differences between the two geographic populations were small in both size and shape; despite a weak allometric trend, controlling for the effect of size on shape slighly increased discrimination accuracy. Procrustes based methods for the analysis of landmarks were highly efficient in measuring the hierarchical structure of differences in leaves and in revealing very small-scale variation. In taxonomy and many other fields of botany and biology, the application of geometric morphometrics contributes to increase scientific rigour in the description of important aspects of the phenotypic dimension of biodiversity. Easy to follow but detailed step by step example studies can promote a more extensive use of these numerical methods, as they provide an introduction to the discipline which, for many biologists, is

  9. When soft controls get slippery: User interfaces and human error

    International Nuclear Information System (INIS)

    Stubler, W.F.; O'Hara, J.M.

    1998-01-01

    Many types of products and systems that have traditionally featured physical control devices are now being designed with soft controls--input formats appearing on computer-based display devices and operated by a variety of input devices. A review of complex human-machine systems found that soft controls are particularly prone to some types of errors and may affect overall system performance and safety. This paper discusses the application of design approaches for reducing the likelihood of these errors and for enhancing usability, user satisfaction, and system performance and safety

  10. XbD Video 2, Taxonomy of Experience (ToE) [Online

    DEFF Research Database (Denmark)

    2013-01-01

    This is the second video in the Experience-based Designing series: It describes the Taxonomy of Experience, a structural way of looking at human experiences of almost any kind.This hierarchical model is useful to researchers and decision makers as a general method or tool for guiding the collection......, processing and categorisation of field data about an everyday experience. Researchers using this model often referred to the process as 'doing a ToE'...

  11. Development of an FAA-EUROCONTROL technique for the analysis of human error in ATM : final report.

    Science.gov (United States)

    2002-07-01

    Human error has been identified as a dominant risk factor in safety-oriented industries such as air traffic control (ATC). However, little is known about the factors leading to human errors in current air traffic management (ATM) systems. The first s...

  12. ClassyFire: automated chemical classification with a comprehensive, computable taxonomy.

    Science.gov (United States)

    Djoumbou Feunang, Yannick; Eisner, Roman; Knox, Craig; Chepelev, Leonid; Hastings, Janna; Owen, Gareth; Fahy, Eoin; Steinbeck, Christoph; Subramanian, Shankar; Bolton, Evan; Greiner, Russell; Wishart, David S

    2016-01-01

    Scientists have long been driven by the desire to describe, organize, classify, and compare objects using taxonomies and/or ontologies. In contrast to biology, geology, and many other scientific disciplines, the world of chemistry still lacks a standardized chemical ontology or taxonomy. Several attempts at chemical classification have been made; but they have mostly been limited to either manual, or semi-automated proof-of-principle applications. This is regrettable as comprehensive chemical classification and description tools could not only improve our understanding of chemistry but also improve the linkage between chemistry and many other fields. For instance, the chemical classification of a compound could help predict its metabolic fate in humans, its druggability or potential hazards associated with it, among others. However, the sheer number (tens of millions of compounds) and complexity of chemical structures is such that any manual classification effort would prove to be near impossible. We have developed a comprehensive, flexible, and computable, purely structure-based chemical taxonomy (ChemOnt), along with a computer program (ClassyFire) that uses only chemical structures and structural features to automatically assign all known chemical compounds to a taxonomy consisting of >4800 different categories. This new chemical taxonomy consists of up to 11 different levels (Kingdom, SuperClass, Class, SubClass, etc.) with each of the categories defined by unambiguous, computable structural rules. Furthermore each category is named using a consensus-based nomenclature and described (in English) based on the characteristic common structural properties of the compounds it contains. The ClassyFire webserver is freely accessible at http://classyfire.wishartlab.com/. Moreover, a Ruby API version is available at https://bitbucket.org/wishartlab/classyfire_api, which provides programmatic access to the ClassyFire server and database. ClassyFire has been used to

  13. A value-based taxonomy of improvement approaches in healthcare.

    Science.gov (United States)

    Colldén, Christian; Gremyr, Ida; Hellström, Andreas; Sporraeus, Daniella

    2017-06-19

    Purpose The concept of value is becoming increasingly fashionable in healthcare and various improvement approaches (IAs) have been introduced with the aim of increasing value. The purpose of this paper is to construct a taxonomy that supports the management of parallel IAs in healthcare. Design/methodology/approach Based on previous research, this paper proposes a taxonomy that includes the dimensions of view on value and organizational focus; three contemporary IAs - lean, value-based healthcare, and patient-centered care - are related to the taxonomy. An illustrative qualitative case study in the context of psychiatric (psychosis) care is then presented that contains data from 23 interviews and focuses on the value concept, IAs, and the proposed taxonomy. Findings Respondents recognized the dimensions of the proposed taxonomy and indicated its usefulness as support for choosing and combining different IAs into a coherent management model, and for facilitating dialog about IAs. The findings also suggested that the view of value as "health outcomes" is widespread, but healthcare professionals are less likely than managers to also view value as a process. Originality/value The conceptual contribution of this paper is to delineate some important characteristics of IAs in relation to the emerging "value era". It also highlights the coexistence of different IAs in healthcare management practice. A taxonomy is proposed that can help managers choose, adapt, and combine IAs in local management models.

  14. Company Taxonomy development

    DEFF Research Database (Denmark)

    Lund, Haakon; Ørnager, Susanne

    2016-01-01

    analyses of search log-files from WFP intranet portal (WFPgo) from September to November 2013, the results were applied and a suggested taxonomy tested at workshops conducted for the staff in headquarters. Findings – The results reveal an organization with a high demand for easier access to information...

  15. Seismic-load-induced human errors and countermeasures using computer graphics in plant-operator communication

    International Nuclear Information System (INIS)

    Hara, Fumio

    1988-01-01

    This paper remarks the importance of seismic load-induced human errors in plant operation by delineating the characteristics of the task performance of human beings under seismic loads. It focuses on man-machine communication via multidimensional data like that conventionally displayed on large panels in a plant control room. It demonstrates a countermeasure to human errors using a computer graphics technique that conveys the global state of the plant operation to operators through cartoon-like, colored graphs in the form of faces that, with different facial expressions, show the plant safety status. (orig.)

  16. Development of the Human Error Management Criteria and the Job Aptitude Evaluation Criteria for Rail Safety Personnel

    Energy Technology Data Exchange (ETDEWEB)

    Koo, In Soo; Seo, Sang Mun; Park, Geun Ok (and others)

    2008-08-15

    It has been estimated that up to 90% of all workplace accidents have human error as a cause. Human error has been widely recognized as a key factor in almost all the highly publicized accidents, including Daegu subway fire of February 18, 2003 killed 198 people and injured 147. Because most human behavior is 'unintentional', carried out automatically, root causes of human error should be carefully investigated and regulated by a legal authority. The final goal of this study is to set up some regulatory guidance that are supposed to be used by the korean rail organizations related to safety managements and the contents are : - to develop the regulatory guidance for managing human error, - to develop the regulatory guidance for managing qualifications of rail drivers - to develop the regulatory guidance for evaluating the aptitude of the safety-related personnel.

  17. Development of the Human Error Management Criteria and the Job Aptitude Evaluation Criteria for Rail Safety Personnel

    International Nuclear Information System (INIS)

    Koo, In Soo; Seo, Sang Mun; Park, Geun Ok

    2008-08-01

    It has been estimated that up to 90% of all workplace accidents have human error as a cause. Human error has been widely recognized as a key factor in almost all the highly publicized accidents, including Daegu subway fire of February 18, 2003 killed 198 people and injured 147. Because most human behavior is 'unintentional', carried out automatically, root causes of human error should be carefully investigated and regulated by a legal authority. The final goal of this study is to set up some regulatory guidance that are supposed to be used by the korean rail organizations related to safety managements and the contents are : - to develop the regulatory guidance for managing human error, - to develop the regulatory guidance for managing qualifications of rail drivers - to develop the regulatory guidance for evaluating the aptitude of the safety-related personnel

  18. DNA barcoding and traditional taxonomy: an integrated approach for biodiversity conservation.

    Science.gov (United States)

    Sheth, Bhavisha P; Thaker, Vrinda S

    2017-07-01

    Biological diversity is depleting at an alarming rate. Additionally, a vast amount of biodiversity still remains undiscovered. Taxonomy has been serving the purpose of describing, naming, and classifying species for more than 250 years. DNA taxonomy and barcoding have accelerated the rate of this process, thereby providing a tool for conservation practice. DNA barcoding and traditional taxonomy have their own inherent merits and demerits. The synergistic use of both methods, in the form of integrative taxonomy, has the potential to contribute to biodiversity conservation in a pragmatic timeframe and overcome their individual drawbacks. In this review, we discuss the basics of both these methods of biological identification (traditional taxonomy and DNA barcoding), the technical advances in integrative taxonomy, and future trends. We also present a comprehensive compilation of published examples of integrative taxonomy that refer to nine topics within biodiversity conservation. Morphological and molecular species limits were observed to be congruent in ∼41% of the 58 source studies. The majority of the studies highlighted the description of cryptic diversity through the use of molecular data, whereas research areas like endemism, biological invasion, and threatened species were less discussed in the literature.

  19. Taxonomy of the extrasolar planet.

    Science.gov (United States)

    Plávalová, Eva

    2012-04-01

    When a star is described as a spectral class G2V, we know that the star is similar to our Sun. We know its approximate mass, temperature, age, and size. When working with an extrasolar planet database, it is very useful to have a taxonomy scale (classification) such as, for example, the Harvard classification for stars. The taxonomy has to be easily interpreted and present the most relevant information about extrasolar planets. I propose an extrasolar planet taxonomy scale with four parameters. The first parameter concerns the mass of an extrasolar planet in the form of units of the mass of other known planets, where M represents the mass of Mercury, E that of Earth, N Neptune, and J Jupiter. The second parameter is the planet's distance from its parent star (semimajor axis) described in a logarithm with base 10. The third parameter is the mean Dyson temperature of the extrasolar planet, for which I established four main temperature classes: F represents the Freezing class, W the Water class, G the Gaseous class, and R the Roasters class. I devised one additional class, however: P, the Pulsar class, which concerns extrasolar planets orbiting pulsar stars. The fourth parameter is eccentricity. If the attributes of the surface of the extrasolar planet are known, we are able to establish this additional parameter where t represents a terrestrial planet, g a gaseous planet, and i an ice planet. According to this taxonomy scale, for example, Earth is 1E0W0t, Neptune is 1N1.5F0i, and extrasolar planet 55 Cnc e is 9E-1.8R1.

  20. Perancangan Fasilitas Kerja untuk Mereduksi Human Error

    Directory of Open Access Journals (Sweden)

    Harmein Nasution

    2012-01-01

    Full Text Available Work equipments and environment which are not design ergonomically can cause physical exhaustion to the workers. As a result of that physical exhaustion, many defects in the production lines can happen due to human error and also cause musculoskeletal complaints. To overcome, those effects, we occupied methods for analyzing the workers posture based on the SNQ (Standard Nordic Questionnaire, plibel, QEC (Quick Exposure Check and biomechanism. Moreover, we applied those methods for designing rolling machines and grip egrek ergono-mically, so that the defects on those production lines can be minimized.

  1. Modelling the basic error tendencies of human operators

    Energy Technology Data Exchange (ETDEWEB)

    Reason, J.

    1988-01-01

    The paper outlines the primary structural features of human cognition: a limited, serial workspace interacting with a parallel distributed knowledge base. It is argued that the essential computational features of human cognition - to be captured by an adequate operator model - reside in the mechanisms by which stored knowledge structures are selected and brought into play. Two such computational 'primitives' are identified: similarity-matching and frequency-gambling. These two retrieval heuristics, it is argued, shape both the overall character of human performance (i.e. its heavy reliance on pattern-matching) and its basic error tendencies ('strong-but-wrong' responses, confirmation, similarity and frequency biases, and cognitive 'lock-up'). The various features of human cognition are integrated with a dynamic operator model capable of being represented in software form. This computer model, when run repeatedly with a variety of problem configurations, should produce a distribution of behaviours which, in toto, simulate the general character of operator performance.

  2. Modelling the basic error tendencies of human operators

    International Nuclear Information System (INIS)

    Reason, J.

    1988-01-01

    The paper outlines the primary structural features of human cognition: a limited, serial workspace interacting with a parallel distributed knowledge base. It is argued that the essential computational features of human cognition - to be captured by an adequate operator model - reside in the mechanisms by which stored knowledge structures are selected and brought into play. Two such computational 'primitives' are identified: similarity-matching and frequency-gambling. These two retrieval heuristics, it is argued, shape both the overall character of human performance (i.e. its heavy reliance on pattern-matching) and its basic error tendencies ('strong-but-wrong' responses, confirmation, similarity and frequency biases, and cognitive 'lock-up'). The various features of human cognition are integrated with a dynamic operator model capable of being represented in software form. This computer model, when run repeatedly with a variety of problem configurations, should produce a distribution of behaviours which, in total, simulate the general character of operator performance. (author)

  3. Modelling the basic error tendencies of human operators

    International Nuclear Information System (INIS)

    Reason, James

    1988-01-01

    The paper outlines the primary structural features of human cognition: a limited, serial workspace interacting with a parallel distributed knowledge base. It is argued that the essential computational features of human cognition - to be captured by an adequate operator model - reside in the mechanisms by which stored knowledge structures are selected and brought into play. Two such computational 'primitives' are identified: similarity-matching and frequency-gambling. These two retrieval heuristics, it is argued, shape both the overall character of human performance (i.e. its heavy reliance on pattern-matching) and its basic error tendencies ('strong-but-wrong' responses, confirmation, similarity and frequency biases, and cognitive 'lock-up'). The various features of human cognition are integrated with a dynamic operator model capable of being represented in software form. This computer model, when run repeatedly with a variety of problem configurations, should produce a distribution of behaviours which, in toto, simulate the general character of operator performance. (author)

  4. Rethinking Bloom's Taxonomy: Implications for Testing and Assessment.

    Science.gov (United States)

    Anderson, Lorin W.

    This paper describes a work in progress on a second edition of "Taxonomy of Educational Objectives, The Classification of Educational Goals, Handbook I: Cognitive Domain," also known as "Bloom's Taxonomy" (B. Bloom and others, Eds., 1956). The new edition will be grounded in the collective wisdom of the original…

  5. A PROPOSED TAXONOMY OF THE PERCEPTUAL DOMAIN AND SOME SUGGESTED APPLICATIONS.

    Science.gov (United States)

    MOORE, MAXINE R.

    THIS PROPOSAL FOR A PRELIMINARY TAXONOMY OF THE PERCEPTUAL DOMAIN, ORGANIZED ON THE PRINCIPLE OF INTEGRATION, DREW ON GUILFORD'S THEORETICAL AND FACTOR-ANALYTICAL WORK, ON WITKIN'S FIGURE-GROUND STUDIES, AND ON THE "TAXONOMY OF EDUCATIONAL OBJECTIVES" MODELS. THE TAXONOMY CATEGORIES ARE SENSATION, FIGURE PERCEPTION, SYMBOL PERCEPTION, PERCEPTION…

  6. Human error in strabismus surgery: Quantification with a sensitivity analysis

    NARCIS (Netherlands)

    S. Schutte (Sander); J.R. Polling (Jan Roelof); F.C.T. van der Helm (Frans); H.J. Simonsz (Huib)

    2009-01-01

    textabstractBackground: Reoperations are frequently necessary in strabismus surgery. The goal of this study was to analyze human-error related factors that introduce variability in the results of strabismus surgery in a systematic fashion. Methods: We identified the primary factors that influence

  7. A Benefit/Cost/Deficit (BCD) model for learning from human errors

    International Nuclear Information System (INIS)

    Vanderhaegen, Frederic; Zieba, Stephane; Enjalbert, Simon; Polet, Philippe

    2011-01-01

    This paper proposes an original model for interpreting human errors, mainly violations, in terms of benefits, costs and potential deficits. This BCD model is then used as an input framework to learn from human errors, and two systems based on this model are developed: a case-based reasoning system and an artificial neural network system. These systems are used to predict a specific human car driving violation: not respecting the priority-to-the-right rule, which is a decision to remove a barrier. Both prediction systems learn from previous violation occurrences, using the BCD model and four criteria: safety, for identifying the deficit or the danger; and opportunity for action, driver comfort, and time spent; for identifying the benefits or the costs. The application of learning systems to predict car driving violations gives a rate over 80% of correct prediction after 10 iterations. These results are validated for the non-respect of priority-to-the-right rule.

  8. Human Factors in Financial Trading

    Science.gov (United States)

    Leaver, Meghan; Reader, Tom W.

    2016-01-01

    Objective This study tests the reliability of a system (FINANS) to collect and analyze incident reports in the financial trading domain and is guided by a human factors taxonomy used to describe error in the trading domain. Background Research indicates the utility of applying human factors theory to understand error in finance, yet empirical research is lacking. We report on the development of the first system for capturing and analyzing human factors–related issues in operational trading incidents. Method In the first study, 20 incidents are analyzed by an expert user group against a referent standard to establish the reliability of FINANS. In the second study, 750 incidents are analyzed using distribution, mean, pathway, and associative analysis to describe the data. Results Kappa scores indicate that categories within FINANS can be reliably used to identify and extract data on human factors–related problems underlying trading incidents. Approximately 1% of trades (n = 750) lead to an incident. Slip/lapse (61%), situation awareness (51%), and teamwork (40%) were found to be the most common problems underlying incidents. For the most serious incidents, problems in situation awareness and teamwork were most common. Conclusion We show that (a) experts in the trading domain can reliably and accurately code human factors in incidents, (b) 1% of trades incur error, and (c) poor teamwork skills and situation awareness underpin the most critical incidents. Application This research provides data crucial for ameliorating risk within financial trading organizations, with implications for regulation and policy. PMID:27142394

  9. Identification of Hypertension Management-related Errors in a Personal Digital Assistant-based Clinical Log for Nurses in Advanced Practice Nurse Training

    Directory of Open Access Journals (Sweden)

    Nam-Ju Lee, DNSc, RN

    2010-03-01

    Conclusion: The Hypertension Diagnosis and Management Error Taxonomy was useful for identifying errors based on documentation in a clinical log. The results provide an initial understanding of the nature of errors associated with hypertension diagnosis and management of nurses in APN training. The information gained from this study can contribute to educational interventions that promote APN competencies in identification and management of hypertension as well as overall patient safety and informatics competencies.

  10. Application of Modern Experimental Technique to Solve Morphological Complexity in Plants Taxonomy

    Directory of Open Access Journals (Sweden)

    SURANTO

    2000-07-01

    Full Text Available Modern taxonomy has two approaches, i.e. classical and experimental taxonomy. Classical taxonomy uses morphological characters, while experimental taxonomy uses broader methods including chemistry, physics and mathematics, in the form of laboratory data that are revealed together with the progress of optical technique (microscope, chemistry methods (chromatography, electrophoresis, etc. Modern taxonomy tends to use series of interrelated data. More data used would result in more validity and give better clarification of taxonomic status. A lot of modern taxonomic data such as palynology, cytotaxonomy (cytology, chemical constituent (chemotaxonomy, isozyme and DNA sequencing were used recently.

  11. How to Cope with the Rare Human Error Events Involved with organizational Factors in Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sa Kil; Luo, Meiling; Lee, Yong Hee [Korea Atomic Research Institute, Daejeon (Korea, Republic of)

    2014-10-15

    The current human error guidelines (e.g. US DOD handbooks, US NRC Guidelines) are representative tools to prevent human errors. These tools, however, have limits that they do not adapt all operating situations and circumstances such as design base events. In other words, these tools are only adapted foreseeable standardized operating situations and circumstances. In this study, our research team proposed an evidence-based approach such as UK's safety case to coping with the rare human error events such as TMI, Chernobyl, Fukushima accidents. These accidents are representative events involved with rare human errors. Our research team defined the 'rare human errors' as the follow three characterized events; Extremely low frequency Extremely high complicated structure Extremely serious damage of human life and property A safety case is a structured argument, supported by evidence, intended to justify that a system is acceptably safe. The definition by UK defense standard 00-56 issue 4 states that such an evidence-based approach can be contrast with a prescriptive approach to safety certification, which require safety to be justified using a prescribed process. Safety managements and safety regulatory activities based on safety case are effective to control organizational factors in terms of integrated safety management. Especially safety issues relevant with public acceptance are useful to provide practical evidences to the public reasonably. European Union including UK has developed the concept of engineered safety management system to deal with public acceptance using the safety case. In Korea nuclear industry, the Korean Atomic Research Institute has firstly performed a basic research to adapt the safety case in the field of radioactive waste according to the IAEA SSG-23(KAERI/TR-4497, 4531). Excepting the radioactive waste, there is no try to adapt the safety case yet. Most incidents and accidents involved human during operating NPPs have a tendency

  12. How to Cope with the Rare Human Error Events Involved with organizational Factors in Nuclear Power Plants

    International Nuclear Information System (INIS)

    Kim, Sa Kil; Luo, Meiling; Lee, Yong Hee

    2014-01-01

    The current human error guidelines (e.g. US DOD handbooks, US NRC Guidelines) are representative tools to prevent human errors. These tools, however, have limits that they do not adapt all operating situations and circumstances such as design base events. In other words, these tools are only adapted foreseeable standardized operating situations and circumstances. In this study, our research team proposed an evidence-based approach such as UK's safety case to coping with the rare human error events such as TMI, Chernobyl, Fukushima accidents. These accidents are representative events involved with rare human errors. Our research team defined the 'rare human errors' as the follow three characterized events; Extremely low frequency Extremely high complicated structure Extremely serious damage of human life and property A safety case is a structured argument, supported by evidence, intended to justify that a system is acceptably safe. The definition by UK defense standard 00-56 issue 4 states that such an evidence-based approach can be contrast with a prescriptive approach to safety certification, which require safety to be justified using a prescribed process. Safety managements and safety regulatory activities based on safety case are effective to control organizational factors in terms of integrated safety management. Especially safety issues relevant with public acceptance are useful to provide practical evidences to the public reasonably. European Union including UK has developed the concept of engineered safety management system to deal with public acceptance using the safety case. In Korea nuclear industry, the Korean Atomic Research Institute has firstly performed a basic research to adapt the safety case in the field of radioactive waste according to the IAEA SSG-23(KAERI/TR-4497, 4531). Excepting the radioactive waste, there is no try to adapt the safety case yet. Most incidents and accidents involved human during operating NPPs have a tendency

  13. Human error in strabismus surgery : Quantification with a sensitivity analysis

    NARCIS (Netherlands)

    Schutte, S.; Polling, J.R.; Van der Helm, F.C.T.; Simonsz, H.J.

    2008-01-01

    Background- Reoperations are frequently necessary in strabismus surgery. The goal of this study was to analyze human-error related factors that introduce variability in the results of strabismus surgery in a systematic fashion. Methods- We identified the primary factors that influence the outcome of

  14. New classification of operators' human errors at overseas nuclear power plants and preparation of easy-to-use case sheets

    International Nuclear Information System (INIS)

    Takagawa, Kenichi

    2004-01-01

    At nuclear power plants, plant operators examine other human error cases, including those that occurred at other plants, so that they can learn from such experiences and avoid making similar errors again. Although there is little data available on errors made at domestic plants, nuclear operators in foreign countries are reporting even minor irregularities and signs of faults, and a large amount of data on human errors at overseas plants could be collected and examined. However, these overseas data have not been used effectively because most of them are poorly organized or not properly classified and are often hard to understand. Accordingly, we carried out a study on the cases of human errors at overseas power plants in order to help plant personnel clearly understand overseas experiences and avoid repeating similar errors, The study produced the following results, which were put to use at nuclear power plants and other facilities. (1) ''One-Point-Advice'' refers to a practice where a leader gives pieces of advice to his team of operators in order to prevent human errors before starting work. Based on this practice and those used in the aviation industry, we have developed a new method of classifying human errors that consists of four basic actions and three applied actions. (2) We used this new classification method to classify human errors made by operators at overseas nuclear power plants. The results show that the most frequent errors caused not by operators themselves but due to insufficient team monitoring, for which superiors and/or their colleagues were responsible. We therefore analyzed and classified possible factors contributing to insufficient team monitoring, and demonstrated that the frequent errors have also occurred at domestic power plants. (3) Using the new classification formula, we prepared a human error case sheets that is easy for plant personnel to understand. The sheets are designed to make data more understandable and easier to remember

  15. Understanding the Advising Learning Process Using Learning Taxonomies

    Science.gov (United States)

    Muehleck, Jeanette K.; Smith, Cathleen L.; Allen, Janine M.

    2014-01-01

    To better understand the learning that transpires in advising, we used Anderson et al.'s (2001) revision of Bloom's (1956) taxonomy and Krathwohl, Bloom, and Masia's (1964) affective taxonomy to analyze eight student-reported advising outcomes from Smith and Allen (2014). Using the cognitive processes and knowledge domains of Anderson et al.'s…

  16. Auditing as Part of the Terminology Design Life Cycle

    Science.gov (United States)

    Min, Hua; Perl, Yehoshua; Chen, Yan; Halper, Michael; Geller, James; Wang, Yue

    2006-01-01

    Objective To develop and test an auditing methodology for detecting errors in medical terminologies satisfying systematic inheritance. This methodology is based on various abstraction taxonomies that provide high-level views of a terminology and highlight potentially erroneous concepts. Design Our auditing methodology is based on dividing concepts of a terminology into smaller, more manageable units. First, we divide the terminology’s concepts into areas according to their relationships/roles. Then each multi-rooted area is further divided into partial-areas (p-areas) that are singly-rooted. Each p-area contains a set of structurally and semantically uniform concepts. Two kinds of abstraction networks, called the area taxonomy and p-area taxonomy, are derived. These taxonomies form the basis for the auditing approach. Taxonomies tend to highlight potentially erroneous concepts in areas and p-areas. Human reviewers can focus their auditing efforts on the limited number of problematic concepts following two hypotheses on the probable concentration of errors. Results A sample of the area taxonomy and p-area taxonomy for the Biological Process (BP) hierarchy of the National Cancer Institute Thesaurus (NCIT) was derived from the application of our methodology to its concepts. These views led to the detection of a number of different kinds of errors that are reported, and to confirmation of the hypotheses on error concentration in this hierarchy. Conclusion Our auditing methodology based on area and p-area taxonomies is an efficient tool for detecting errors in terminologies satisfying systematic inheritance of roles, and thus facilitates their maintenance. This methodology concentrates a domain expert’s manual review on portions of the concepts with a high likelihood of errors. PMID:16929044

  17. Systematic Analysis of Video Data from Different Human-Robot Interaction Studies: A Categorisation of Social Signals During Error Situations

    OpenAIRE

    Manuel eGiuliani; Nicole eMirnig; Gerald eStollnberger; Susanne eStadler; Roland eBuchner; Manfred eTscheligi

    2015-01-01

    Human?robot interactions are often affected by error situations that are caused by either the robot or the human. Therefore, robots would profit from the ability to recognize when error situations occur. We investigated the verbal and non-verbal social signals that humans show when error situations occur in human?robot interaction experiments. For that, we analyzed 201 videos of five human?robot interaction user studies with varying tasks from four independent projects. The analysis shows tha...

  18. Ontologies, taxonomies and thesauri in systems science and systematics

    CERN Document Server

    Currás, Emilia

    2010-01-01

    The originality of this book, which deals with such a new subject matter, lies in the application of methods and concepts never used before - such as ontologies and taxonomies, as well as thesauri - to the ordering of knowledge based on primary information. Chapters in the book also examine the study of ontologies, taxonomies and thesauri from the perspective of systematics and general systems theory. Ontologies, Taxonomies and Thesauri in Systems Science and Systematics will be extremely useful to those operating within the network of related fields, which includes documentation and informati

  19. DNA barcoding and traditional taxonomy unified through Integrative Taxonomy: a view that challenges the debate questioning both methodologies

    OpenAIRE

    Pires, Amanda Ciprandi; Marinoni, Luciane

    2010-01-01

    The taxonomic crisis, emphasized in recent years, is marked by the lack of popularity (lack of interest in taxonomy) and financial incentives to study biodiversity. This situation, coupled with the issues involved with the necessity of knowing many yet undiscovered species, has meant that new technologies, including the use of DNA, have emerged to revitalize taxonomy. Part of the scientific community, however, has rejected the use of these innovative ideas. DNA barcoding has especially been t...

  20. Adaptability in the workplace: development of a taxonomy of adaptive performance.

    Science.gov (United States)

    Pulakos, E D; Arad, S; Donovan, M A; Plamondon, K E

    2000-08-01

    The purpose of this research was to develop a taxonomy of adaptive job performance and examine the implications of this taxonomy for understanding, predicting, and training adaptive behavior in work settings. Two studies were conducted to address this issue. In Study 1, over 1,000 critical incidents from 21 different jobs were content analyzed to identify an 8-dimension taxonomy of adaptive performance. Study 2 reports the development and administration of an instrument, the Job Adaptability Inventory, that was used to empirically examine the proposed taxonomy in 24 different jobs. Exploratory factor analyses using data from 1,619 respondents supported the proposed 8-dimension taxonomy from Study 1. Subsequent confirmatory factor analyses on the remainder of the sample (n = 1,715) indicated a good fit for the 8-factor model. Results and implications are discussed.

  1. Trend analysis and comparison of operators' human error events occurred at overseas and domestic nuclear power plants

    International Nuclear Information System (INIS)

    Takagawa, Kenichi

    2006-01-01

    Human errors by operators at overseas and domestic nuclear power plants during the period from 2002 to 2005 were compared and their trends analyzed. The most frequently cited cause of such errors was 'insufficient team monitoring' (inadequate superiors' and other crews' instructions and supervision) both at overseas and domestic plants, followed by 'insufficient self-checking' (lack of cautions by the operator himself). A comparison of the effects of the errors on the operations of plants in Japan and the United Sates showed that the drop in plant output and plant shutdowns at plants in Japan were approximately one-tenth of those in the United States. The ratio of automatic reactor trips to the total number of human errors reported is about 6% for both Japanese and American plants. Looking at changes in the incidence of human errors by years of occurrence, although a distinctive trend cannot be identified for domestic nuclear power plants due to insufficient reported cases, 'inadequate self-checking' as a factor contributing to human errors at overseas nuclear power plants has decreased significantly over the past four years. Regarding changes in the effects of human errors on the operations of plants during the four-year period, events leading to an automatic reactor trip have tended to increase at American plants. Conceivable factors behind this increasing tendency included lack of operating experience by a team (e.g., plant transients and reactor shutdowns and startups) and excessive dependence on training simulators. (author)

  2. Identification of factors associated with diagnostic error in primary care

    Science.gov (United States)

    2014-01-01

    Background Missed, delayed or incorrect diagnoses are considered to be diagnostic errors. The aim of this paper is to describe the methodology of a study to analyse cognitive aspects of the process by which primary care (PC) physicians diagnose dyspnoea. It examines the possible links between the use of heuristics, suboptimal cognitive acts and diagnostic errors, using Reason’s taxonomy of human error (slips, lapses, mistakes and violations). The influence of situational factors (professional experience, perceived overwork and fatigue) is also analysed. Methods Cohort study of new episodes of dyspnoea in patients receiving care from family physicians and residents at PC centres in Granada (Spain). With an initial expected diagnostic error rate of 20%, and a sampling error of 3%, 384 episodes of dyspnoea are calculated to be required. In addition to filling out the electronic medical record of the patients attended, each physician fills out 2 specially designed questionnaires about the diagnostic process performed in each case of dyspnoea. The first questionnaire includes questions on the physician’s initial diagnostic impression, the 3 most likely diagnoses (in order of likelihood), and the diagnosis reached after the initial medical history and physical examination. It also includes items on the physicians’ perceived overwork and fatigue during patient care. The second questionnaire records the confirmed diagnosis once it is reached. The complete diagnostic process is peer-reviewed to identify and classify the diagnostic errors. The possible use of heuristics of representativeness, availability, and anchoring and adjustment in each diagnostic process is also analysed. Each audit is reviewed with the physician responsible for the diagnostic process. Finally, logistic regression models are used to determine if there are differences in the diagnostic error variables based on the heuristics identified. Discussion This work sets out a new approach to studying the

  3. Sleep quality, posttraumatic stress, depression, and human errors in train drivers: a population-based nationwide study in South Korea.

    Science.gov (United States)

    Jeon, Hong Jin; Kim, Ji-Hae; Kim, Bin-Na; Park, Seung Jin; Fava, Maurizio; Mischoulon, David; Kang, Eun-Ho; Roh, Sungwon; Lee, Dongsoo

    2014-12-01

    Human error is defined as an unintended error that is attributable to humans rather than machines, and that is important to avoid to prevent accidents. We aimed to investigate the association between sleep quality and human errors among train drivers. Cross-sectional. Population-based. A sample of 5,480 subjects who were actively working as train drivers were recruited in South Korea. The participants were 4,634 drivers who completed all questionnaires (response rate 84.6%). None. The Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), the Impact of Event Scale-Revised (IES-R), the State-Trait Anxiety Inventory (STAI), and the Korean Occupational Stress Scale (KOSS). Of 4,634 train drivers, 349 (7.5%) showed more than one human error per 5 y. Human errors were associated with poor sleep quality, higher PSQI total scores, short sleep duration at night, and longer sleep latency. Among train drivers with poor sleep quality, those who experienced severe posttraumatic stress showed a significantly higher number of human errors than those without. Multiple logistic regression analysis showed that human errors were significantly associated with poor sleep quality and posttraumatic stress, whereas there were no significant associations with depression, trait and state anxiety, and work stress after adjusting for age, sex, education years, marital status, and career duration. Poor sleep quality was found to be associated with more human errors in train drivers, especially in those who experienced severe posttraumatic stress. © 2014 Associated Professional Sleep Societies, LLC.

  4. Using Authentic Medication Errors to Promote Pharmacy Student Critical Thinking and Active Learning

    Directory of Open Access Journals (Sweden)

    Reza Karimi

    2018-01-01

    Full Text Available Objective: To promote first year (P1 pharmacy students’ awareness of medication error prevention and to support student learning in biomedical and pharmaceutical sciences. Innovation: A novel curricular activity was created and referred to as “Medication Errors and Sciences Applications (MESA”. The MESA activity encouraged discussions of patient safety among students and faculty to link medication errors to biomedical and pharmaceutical sciences, which ultimately reinforced student learning in P1 curricular topics.   Critical Analysis: Three P1 cohorts implemented the MESA activity and approximately 75% of students from each cohort completed a reliable assessment instrument. Each P1 cohort had at least 14 student teams who generated professional reports analyzing authentic medication errors. The quantitative assessment results indicated that 70-85% of students believed that the MESA activity improved student learning in biomedical and pharmaceutical sciences. More than 95% of students agreed that the MESA activity introduced them to medication errors. Approximately 90% of students agreed that the MESA activity integrated the knowledge and skills they developed through the P1 curriculum, promoted active learning and critical thinking, and encouraged students to be self-directed learners. Furthermore, our data indicated that approximately 90% of students stated that the achievement of Bloom’s taxonomy's six learning objectives was promoted by completing the MESA activity. Next Steps: Pharmacy students’ awareness of medication errors is a critical component of pharmacy education, which pharmacy educators can integrate with biomedical and pharmaceutical sciences to enhance student learning in the P1 year. Treatment of Human Subjects: IRB exemption granted   Type: Note License: CC BY

  5. Good people who try their best can have problems: recognition of human factors and how to minimise error.

    Science.gov (United States)

    Brennan, Peter A; Mitchell, David A; Holmes, Simon; Plint, Simon; Parry, David

    2016-01-01

    Human error is as old as humanity itself and is an appreciable cause of mistakes by both organisations and people. Much of the work related to human factors in causing error has originated from aviation where mistakes can be catastrophic not only for those who contribute to the error, but for passengers as well. The role of human error in medical and surgical incidents, which are often multifactorial, is becoming better understood, and includes both organisational issues (by the employer) and potential human factors (at a personal level). Mistakes as a result of individual human factors and surgical teams should be better recognised and emphasised. Attitudes and acceptance of preoperative briefing has improved since the introduction of the World Health Organization (WHO) surgical checklist. However, this does not address limitations or other safety concerns that are related to performance, such as stress and fatigue, emotional state, hunger, awareness of what is going on situational awareness, and other factors that could potentially lead to error. Here we attempt to raise awareness of these human factors, and highlight how they can lead to error, and how they can be minimised in our day-to-day practice. Can hospitals move from being "high risk industries" to "high reliability organisations"? Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Identification and Assessment of Human Errors in Postgraduate Endodontic Students of Kerman University of Medical Sciences by Using the SHERPA Method

    Directory of Open Access Journals (Sweden)

    Saman Dastaran

    2016-03-01

    Full Text Available Introduction: Human errors are the cause of many accidents, including industrial and medical, therefore finding out an approach for identifying and reducing them is very important. Since no study has been done about human errors in the dental field, this study aimed to identify and assess human errors in postgraduate endodontic students of Kerman University of Medical Sciences by using the SHERPA Method. Methods: This cross-sectional study was performed during year 2014. Data was collected using task observation and interviewing postgraduate endodontic students. Overall, 10 critical tasks, which were most likely to cause harm to patients were determined. Next, Hierarchical Task Analysis (HTA was conducted and human errors in each task were identified by the Systematic Human Error Reduction Prediction Approach (SHERPA technique worksheets. Results: After analyzing the SHERPA worksheets, 90 human errors were identified including (67.7% action errors, (13.3% checking errors, (8.8% selection errors, (5.5% retrieval errors and (4.4% communication errors. As a result, most of them were action errors and less of them were communication errors. Conclusions: The results of the study showed that the highest percentage of errors and the highest level of risk were associated with action errors, therefore, to reduce the occurrence of such errors and limit their consequences, control measures including periodical training of work procedures, providing work check-lists, development of guidelines and establishment of a systematic and standardized reporting system, should be put in place. Regarding the results of this study, the control of recovery errors with the highest percentage of undesirable risk and action errors with the highest frequency of errors should be in the priority of control

  7. Human factors evaluation of remote afterloading brachytherapy: Human error and critical tasks in remote afterloading brachytherapy and approaches for improved system performance. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Callan, J.R.; Kelly, R.T.; Quinn, M.L. [Pacific Science and Engineering Group, San Diego, CA (United States)] [and others

    1995-05-01

    Remote Afterloading Brachytherapy (RAB) is a medical process used in the treatment of cancer. RAB uses a computer-controlled device to remotely insert and remove radioactive sources close to a target (or tumor) in the body. Some RAB problems affecting the radiation dose to the patient have been reported and attributed to human error. To determine the root cause of human error in the RAB system, a human factors team visited 23 RAB treatment sites in the US The team observed RAB treatment planning and delivery, interviewed RAB personnel, and performed walk-throughs, during which staff demonstrated the procedures and practices used in performing RAB tasks. Factors leading to human error in the RAB system were identified. The impact of those factors on the performance of RAB was then evaluated and prioritized in terms of safety significance. Finally, the project identified and evaluated alternative approaches for resolving the safety significant problems related to human error.

  8. Human factors evaluation of remote afterloading brachytherapy: Human error and critical tasks in remote afterloading brachytherapy and approaches for improved system performance. Volume 1

    International Nuclear Information System (INIS)

    Callan, J.R.; Kelly, R.T.; Quinn, M.L.

    1995-05-01

    Remote Afterloading Brachytherapy (RAB) is a medical process used in the treatment of cancer. RAB uses a computer-controlled device to remotely insert and remove radioactive sources close to a target (or tumor) in the body. Some RAB problems affecting the radiation dose to the patient have been reported and attributed to human error. To determine the root cause of human error in the RAB system, a human factors team visited 23 RAB treatment sites in the US The team observed RAB treatment planning and delivery, interviewed RAB personnel, and performed walk-throughs, during which staff demonstrated the procedures and practices used in performing RAB tasks. Factors leading to human error in the RAB system were identified. The impact of those factors on the performance of RAB was then evaluated and prioritized in terms of safety significance. Finally, the project identified and evaluated alternative approaches for resolving the safety significant problems related to human error

  9. Process error rates in general research applications to the Human ...

    African Journals Online (AJOL)

    Objective. To examine process error rates in applications for ethics clearance of health research. Methods. Minutes of 586 general research applications made to a human health research ethics committee (HREC) from April 2008 to March 2009 were examined. Rates of approval were calculated and reasons for requiring ...

  10. Development and evaluation of a specialized task taxonomy for spatial planning - A map literacy experiment with topographic maps

    Science.gov (United States)

    Rautenbach, Victoria; Coetzee, Serena; Çöltekin, Arzu

    2017-05-01

    Topographic maps are among the most commonly used map types, however, their complex and information-rich designs depicting natural, human-made and cultural features make them difficult to read. Regardless of their complexity, spatial planners make extensive use of topographic maps in their work. On the other hand, various studies suggest that map literacy among the development planning professionals in South Africa is not very high. The widespread use of topographic maps combined with the low levels of map literacy presents challenges for effective development planning. In this paper we address some of these challenges by developing a specialized task taxonomy based on systematically assessed map literacy levels; and conducting an empirical experiment with topographic maps to evaluate our task taxonomy. In such empirical studies if non-realistic tasks are used, the results of map literacy tests may be skewed. Furthermore, experience and familiarity with the studied map type play a role in map literacy. There is thus a need to develop map literacy tests aimed at planners specifically. We developed a taxonomy of realistic map reading tasks typically executed during the planning process. The taxonomy defines six levels tasks of increasing difficulty and complexity, ranging from recognising symbols to extracting knowledge. We hypothesized that competence in the first four levels indicates functional map literacy. In this paper, we present results from an empirical experiment with 49 map literate participants solving a subset of tasks from the first four levels of the taxonomy with a topographic map. Our findings suggest that the proposed taxonomy is a good reference for evaluating topographic map literacy. Participants solved the tasks on all four levels as expected and we therefore conclude that the experiment based on the first four levels of the taxonomy successfully determined the functional map literacy of the participants. We plan to continue the study for the

  11. Quantifying errors and omissions in alien species lists: The introduction status of Melaleuca species in South Africa as a case study

    Directory of Open Access Journals (Sweden)

    Llewellyn Jacobs

    2017-01-01

    Full Text Available Introduced species lists provide essential background information for biological invasions research and management. The compilation of these lists is, however, prone to a variety of errors. We highlight the frequency and consequences of such errors using introduced Melaleuca (sensu lato, including Callistemon species in South Africa as a case study. We examined 111 herbarium specimens from South Africa and noted the categories and sub-categories of errors that occurred in identification. We also used information from herbarium specimens and distribution data collected in the field to determine whether a species was introduced, naturalized and invasive. We found that 72% of the specimens were not named correctly. These were due to human error (70% (misidentification, and improved identifications and species identification problems (30% (synonyms arising from inclusion of Callistemon, and unresolved taxonomy. At least 36 Melaleuca species have been introduced to South Africa, and field observations indicate that ten of these have naturalized, including five that are invasive. While most of the errors likely have negligible impact on management, we highlight one case where incorrect identification lead to an inappropriate management approach and some instances of errors in published lists. Invasive species lists need to be carefully reviewed to minimise errors, and herbarium specimens supported by DNA identification are required where identification using morphological features is particularly challenging.

  12. A taxonomy of epithelial human cancer and their metastases

    Directory of Open Access Journals (Sweden)

    De Moor Bart

    2009-12-01

    . Moreover, a signature was developed based on our unsupervised clustering of breast tumors and this was predictive for disease-specific survival in three independent studies. Next, the metastases from ovarian, breast, lung and vulva cluster with their tissue of origin while metastases from colon showed a bimodal distribution. A significant part clusters with tissue of origin while the remaining tumors cluster with the tissue of destination. Conclusion Our molecular taxonomy of epithelial human cancer indicates surprising correlations over tissues. This may have a significant impact on the classification of many cancer sites and may guide pathologists, both in research and daily practice. Moreover, these results based on unsupervised analysis yielded a signature predictive of clinical outcome in breast cancer. Additionally, we hypothesize that metastases from gastrointestinal origin either remember their tissue of origin or adapt to the tissue of destination. More specifically, colon metastases in the liver show strong evidence for such a bimodal tissue specific profile.

  13. An Evidence-based Forensic Taxonomy of Windows Phone Dating Apps.

    Science.gov (United States)

    Cahyani, Niken Dwi Wahyu; Choo, Kim-Kwang Raymond; Ab Rahman, Nurul Hidayah; Ashman, Helen

    2018-05-21

    Advances in technologies including development of smartphone features have contributed to the growth of mobile applications, including dating apps. However, online dating services can be misused. To support law enforcement investigations, a forensic taxonomy that provides a systematic classification of forensic artifacts from Windows Phone 8 (WP8) dating apps is presented in this study. The taxonomy has three categories, namely: Apps Categories, Artifacts Categories, and Data Partition Categories. This taxonomy is built based on the findings from a case study of 28 mobile dating apps, using mobile forensic tools. The dating app taxonomy can be used to inform future studies of dating and related apps, such as those from Android and iOS platforms. © 2018 American Academy of Forensic Sciences.

  14. The role of human error in risk analysis: Application to pre- and post-maintenance procedures of process facilities

    International Nuclear Information System (INIS)

    Noroozi, Alireza; Khakzad, Nima; Khan, Faisal; MacKinnon, Scott; Abbassi, Rouzbeh

    2013-01-01

    Human factors play an important role in the safe operation of a facility. Human factors include the systematic application of information about human characteristics and behavior to increase the safety of a process system. A significant proportion of human errors occur during the maintenance phase. However, the quantification of human error probabilities in the maintenance phase has not been given the amount of attention it deserves. This paper focuses on a human factors analysis in pre-and post- pump maintenance operations. The procedures for removing process equipment from service (pre-maintenance) and returning the equipment to service (post-maintenance) are considered for possible failure scenarios. For each scenario, human error probability is calculated for each activity using the Success Likelihood Index Method (SLIM). Consequences are also assessed in this methodology. The risk assessment is conducted for each component and the overall risk is estimated by adding individual risks. The present study is aimed at highlighting the importance of considering human error in quantitative risk analyses. The developed methodology has been applied to a case study of an offshore process facility

  15. Accounting for measurement error in human life history trade-offs using structural equation modeling.

    Science.gov (United States)

    Helle, Samuli

    2018-03-01

    Revealing causal effects from correlative data is very challenging and a contemporary problem in human life history research owing to the lack of experimental approach. Problems with causal inference arising from measurement error in independent variables, whether related either to inaccurate measurement technique or validity of measurements, seem not well-known in this field. The aim of this study is to show how structural equation modeling (SEM) with latent variables can be applied to account for measurement error in independent variables when the researcher has recorded several indicators of a hypothesized latent construct. As a simple example of this approach, measurement error in lifetime allocation of resources to reproduction in Finnish preindustrial women is modelled in the context of the survival cost of reproduction. In humans, lifetime energetic resources allocated in reproduction are almost impossible to quantify with precision and, thus, typically used measures of lifetime reproductive effort (e.g., lifetime reproductive success and parity) are likely to be plagued by measurement error. These results are contrasted with those obtained from a traditional regression approach where the single best proxy of lifetime reproductive effort available in the data is used for inference. As expected, the inability to account for measurement error in women's lifetime reproductive effort resulted in the underestimation of its underlying effect size on post-reproductive survival. This article emphasizes the advantages that the SEM framework can provide in handling measurement error via multiple-indicator latent variables in human life history studies. © 2017 Wiley Periodicals, Inc.

  16. A Reasoning Technique for Taxonomy Expert System of Living Organisms

    OpenAIRE

    desiani, anita; Firdaus, Firdaus; Maiyanti, Sri Indra

    2016-01-01

    Taxonomy of living organisms can help scientists to sort organisms in order and help them to identify new organisms by finding out which their groups. It also is easier to study organisms when they are sorted in groups. Taxonomy of living organisms system is a important basic part of ecology system. Researcher should know about any organisms that they noted in an ecology. Integration between classification taxonomy of Living Organisms and technology information will have many advantages for ...

  17. An Analytical Overview of Spirituality in NANDA-I Taxonomies.

    Science.gov (United States)

    Mesquita, Ana Cláudia; Caldeira, Sílvia; Chaves, Erika; Carvalho, Emilia Campos de

    2017-03-01

    To discuss the approach of spirituality in NANDA-I taxonomies, based on the elements that characterize this phenomenon. This study was based on concepts that are usually adopted in the literature for defining spirituality and on the analysis of the NANDA-I taxonomies from I to III. Spirituality is included in all taxonomies but all three are missing some attributes to guarantee the completeness of this dimension for nursing diagnosis. Taxonomy III makes different approaches to spirituality and some inconsistencies. Contribute to the development and review of the new proposal for taxonomy. Discutir a abordagem à espiritualidade nas taxonomias da NANDA-I, baseada nos elementos que caracterizam este fenômeno. MÉTODOS: Este estudo foi baseado em conceitos usualmente adotados na literatura de enfermagem para definir espiritualidade e na análise das taxonomias da NANDA-I, desde a I à III. A espiritualidade está incluída nas taxonomias, porém estas carecem de atributos do seu conceito. CONCLUSÕES: A taxonomia III faz diferentes abordagens à espiritualidade, porém com algumas inconsistências identificadas. IMPLICAÇÕES PARA A ENFERMAGEM: Esta análise pode contribuir para o desenvolvimento e revisão da taxonomia III. © 2017 NANDA International, Inc.

  18. A model-based and computer-aided approach to analysis of human errors in nuclear power plants

    International Nuclear Information System (INIS)

    Yoon, Wan C.; Lee, Yong H.; Kim, Young S.

    1996-01-01

    Since the operator's mission in NPPs is increasingly defined by cognitive tasks such as monitoring, diagnosis and planning, the focus of human error analysis should also move from external actions to internal decision-making processes. While more elaborate analysis of cognitive aspects of human errors will help understand their causes and derive effective countermeasures, a lack of framework and an arbitrary resolution of description may hamper the effectiveness of such analysis. This paper presents new model-based schemes of event description and error classification as well as an interactive computerized support system. The schemes and the support system were produced in an effort to develop an improved version of HPES. The use of a decision-making model enables the analyst to document cognitive aspects of human performance explicitly and in a proper resolution. The stage-specific terms used in the proposed schemes make the task of characterizing human errors easier and confident for field analysts. The support system was designed to help the analyst achieve a contextually well-integrated analysis throughout the different parts of HPES

  19. Cybercrimes: A Proposed Taxonomy and Challenges

    Directory of Open Access Journals (Sweden)

    Harmandeep Singh Brar

    2018-01-01

    Full Text Available Cybersecurity is one of the most important concepts of cyberworld which provides protection to the cyberspace from various types of cybercrimes. This paper provides an updated survey of cybersecurity. We conduct the survey of security of recent prominent researches and categorize the recent incidents in context to various fundamental principles of cybersecurity. We have proposed a new taxonomy of cybercrime which can cover all types of cyberattacks. We have analyzed various cyberattacks as per the updated cybercrime taxonomy to identify the challenges in the field of cybersecurity and highlight various research directions as future work in this field.

  20. Pragmatic Strategies and Linguistic Structures in Making ‘Suggestions’: Towards Comprehensive Taxonomies

    Directory of Open Access Journals (Sweden)

    Hossein Abolfathiasl

    2013-11-01

    Full Text Available This paper analyses and upgrades taxonomies of strategies and structures for the speech act of suggesting based on existing taxonomies and classifications in the pragmatics research literature. Previous studies have focused mainly on linguistic structures used to perform the speech act of suggesting. Thus, there seems to be a need to provide a more comprehensive set of taxonomies for structures as well as strategies that can be used in EFL/ESL classrooms and for research on the speech act of suggesting. To this end, the speech act of suggesting is defined first and the features of this speech act are discussed. Second, the most recent classifications proposed for structures and linguistic realization strategies for suggestions were analysed and contrasted and a more comprehensive taxonomy of structures and linguistic realization strategies is provided, based on previous taxonomies. Finally, taxonomy of politeness strategies in making suggestions are provided, based on recent studies in cross-cultural pragmatics research.

  1. Hospital medication errors in a pharmacovigilance system in Colombia

    Directory of Open Access Journals (Sweden)

    Jorge Enrique Machado-Alba

    2015-11-01

    Full Text Available Objective: this study analyzes the medication errors reported to a pharmacovigilance system by 26 hospitals for patients in the healthcare system of Colombia. Methods: this retrospective study analyzed the medication errors reported to a systematized database between 1 January 2008 and 12 September 2013. The medication is dispensed by the company Audifarma S.A. to hospitals and clinics around Colombia. Data were classified according to the taxonomy of the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP. The data analysis was performed using SPSS 22.0 for Windows, considering p-values < 0.05 significant. Results: there were 9 062 medication errors in 45 hospital pharmacies. Real errors accounted for 51.9% (n = 4 707, of which 12.0% (n = 567 reached the patient (Categories C to I and caused harm (Categories E to I to 17 subjects (0.36%. The main process involved in errors that occurred (categories B to I was prescription (n = 1 758, 37.3%, followed by dispensation (n = 1 737, 36.9%, transcription (n = 970, 20.6% and administration (n = 242, 5.1%. The errors in the administration process were 45.2 times more likely to reach the patient (CI 95%: 20.2–100.9. Conclusions: medication error reporting systems and prevention strategies should be widespread in hospital settings, prioritizing efforts to address the administration process.

  2. The current approach to human error and blame in the NHS.

    Science.gov (United States)

    Ottewill, Melanie

    There is a large body of research to suggest that serious errors are widespread throughout medicine. The traditional response to these adverse events has been to adopt a 'person approach' - blaming the individual seen as 'responsible'. The culture of medicine is highly complicit in this response. Such an approach results in enormous personal costs to the individuals concerned and does little to address the root causes of errors and thus prevent their recurrence. Other industries, such as aviation, where safety is a paramount concern and which have similar structures to the medical profession, have, over the past decade or so, adopted a 'systems' approach to error, recognizing that human error is ubiquitous and inevitable and that systems need to be developed with this in mind. This approach has been highly successful, but has necessitated, first and foremost, a cultural shift. It is in the best interests of patients, and medical professionals alike, that such a shift is embraced in the NHS.

  3. Basic design of multimedia system for the representation of human error cases in nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Woon; Park, Geun Ok [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1994-04-01

    We have developed a multimedia system for the representation of human error cases with the education and training on human errors can be done effectively. The followings are major topics during the basic design; 1 Establishment of a basic concept for representing human error cases using multimedia, 2 Establishment of a design procedure for the multimedia system, 3 Establishment of a hardware and software environment for operating the multimedia system, 4 Design of multimedia input and output interfaces. In order to verify the results of this basic design, we implemented the basic design with an incident triggered by operator`s misaction which occurred at Uljin NPP Unit 1. (Author) 12 refs., 30 figs.,.

  4. Microbial taxonomy in the post-genomic era: Rebuilding from scratch?

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, Cristiane C. [Univ. of Rio de Janeiro (UFRJ) (Brazil); Amaral, Gilda R. [Univ. of Rio de Janeiro (UFRJ) (Brazil); Campeão, Mariana [Univ. of Rio de Janeiro (UFRJ) (Brazil); Edwards, Robert A. [Univ. of Rio de Janeiro (UFRJ) (Brazil); San Diego State Univ., CA (United States); Argonne National Lab. (ANL), Argonne, IL (United States); Polz, Martin F. [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States); Dutilh, Bas E. [Univ. of Rio de Janeiro (UFRJ) (Brazil); Radbould Univ., Nijmegen (Netherlands); Ussery, David W. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Sawabe, Tomoo [Hokkaido Univ., Hakodate (Japan); Swings, Jean [Univ. of Rio de Janeiro (UFRJ) (Brazil); Ghent Univ. (Belgium); Thompson, Fabiano L. [Univ. of Rio de Janeiro (UFRJ) (Brazil); Advanced Systems Laboratory Production Management COPPE / UFRJ, Rio de Janeiro (Brazil)

    2014-12-23

    Microbial taxonomy should provide adequate descriptions of bacterial, archaeal, and eukaryotic microbial diversity in ecological, clinical, and industrial environments. We re-evaluated the prokaryote species twice. It is time to revisit polyphasic taxonomy, its principles, and its practice, including its underlying pragmatic species concept. We will be able to realize an old dream of our predecessor taxonomists and build a genomic-based microbial taxonomy, using standardized and automated curation of high-quality complete genome sequences as the new gold standard.

  5. Development of Human Factor Management Requirements and Human Error Classification for the Prevention of Railway Accident

    International Nuclear Information System (INIS)

    Kwak, Sang Log; Park, Chan Woo; Shin, Seung Ryoung

    2008-08-01

    Railway accident analysis results show that accidents cased by human factors are not decreasing, whereas H/W related accidents are steadily decreasing. For the efficient management of human factors, many expertise on design, conditions, safety culture and staffing are required. But current safety management activities on safety critical works are focused on training, due to the limited resource and information. In order to improve railway safety, human factors management requirements for safety critical worker and human error classification is proposed in this report. For this accident analysis, status of safety measure on human factor, safety management system on safety critical worker, current safety planning is analysis

  6. How we learn to make decisions: rapid propagation of reinforcement learning prediction errors in humans.

    Science.gov (United States)

    Krigolson, Olav E; Hassall, Cameron D; Handy, Todd C

    2014-03-01

    Our ability to make decisions is predicated upon our knowledge of the outcomes of the actions available to us. Reinforcement learning theory posits that actions followed by a reward or punishment acquire value through the computation of prediction errors-discrepancies between the predicted and the actual reward. A multitude of neuroimaging studies have demonstrated that rewards and punishments evoke neural responses that appear to reflect reinforcement learning prediction errors [e.g., Krigolson, O. E., Pierce, L. J., Holroyd, C. B., & Tanaka, J. W. Learning to become an expert: Reinforcement learning and the acquisition of perceptual expertise. Journal of Cognitive Neuroscience, 21, 1833-1840, 2009; Bayer, H. M., & Glimcher, P. W. Midbrain dopamine neurons encode a quantitative reward prediction error signal. Neuron, 47, 129-141, 2005; O'Doherty, J. P. Reward representations and reward-related learning in the human brain: Insights from neuroimaging. Current Opinion in Neurobiology, 14, 769-776, 2004; Holroyd, C. B., & Coles, M. G. H. The neural basis of human error processing: Reinforcement learning, dopamine, and the error-related negativity. Psychological Review, 109, 679-709, 2002]. Here, we used the brain ERP technique to demonstrate that not only do rewards elicit a neural response akin to a prediction error but also that this signal rapidly diminished and propagated to the time of choice presentation with learning. Specifically, in a simple, learnable gambling task, we show that novel rewards elicited a feedback error-related negativity that rapidly decreased in amplitude with learning. Furthermore, we demonstrate the existence of a reward positivity at choice presentation, a previously unreported ERP component that has a similar timing and topography as the feedback error-related negativity that increased in amplitude with learning. The pattern of results we observed mirrored the output of a computational model that we implemented to compute reward

  7. A taxonomy of multinational ethical and methodological standards for clinical trials of therapeutic interventions

    Science.gov (United States)

    Ashton, Carol M; Wray, Nelda P; Jarman, Anna F; Kolman, Jacob M; Wenner, Danielle M; Brody, Baruch A

    2013-01-01

    Background If trials of therapeutic interventions are to serve society’s interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical-trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world’s nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample (N=55) of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial’s stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. PMID:21429960

  8. Impact of human error on lumber yield in rough mills

    Science.gov (United States)

    Urs Buehlmann; R. Edward Thomas; R. Edward Thomas

    2002-01-01

    Rough sawn, kiln-dried lumber contains characteristics such as knots and bark pockets that are considered by most people to be defects. When using boards to produce furniture components, these defects are removed to produce clear, defect-free parts. Currently, human operators identify and locate the unusable board areas containing defects. Errors in determining a...

  9. Human-simulation-based learning to prevent medication error: A systematic review.

    Science.gov (United States)

    Sarfati, Laura; Ranchon, Florence; Vantard, Nicolas; Schwiertz, Vérane; Larbre, Virginie; Parat, Stéphanie; Faudel, Amélie; Rioufol, Catherine

    2018-01-31

    In the past 2 decades, there has been an increasing interest in simulation-based learning programs to prevent medication error (ME). To improve knowledge, skills, and attitudes in prescribers, nurses, and pharmaceutical staff, these methods enable training without directly involving patients. However, best practices for simulation for healthcare providers are as yet undefined. By analysing the current state of experience in the field, the present review aims to assess whether human simulation in healthcare helps to reduce ME. A systematic review was conducted on Medline from 2000 to June 2015, associating the terms "Patient Simulation," "Medication Errors," and "Simulation Healthcare." Reports of technology-based simulation were excluded, to focus exclusively on human simulation in nontechnical skills learning. Twenty-one studies assessing simulation-based learning programs were selected, focusing on pharmacy, medicine or nursing students, or concerning programs aimed at reducing administration or preparation errors, managing crises, or learning communication skills for healthcare professionals. The studies varied in design, methodology, and assessment criteria. Few demonstrated that simulation was more effective than didactic learning in reducing ME. This review highlights a lack of long-term assessment and real-life extrapolation, with limited scenarios and participant samples. These various experiences, however, help in identifying the key elements required for an effective human simulation-based learning program for ME prevention: ie, scenario design, debriefing, and perception assessment. The performance of these programs depends on their ability to reflect reality and on professional guidance. Properly regulated simulation is a good way to train staff in events that happen only exceptionally, as well as in standard daily activities. By integrating human factors, simulation seems to be effective in preventing iatrogenic risk related to ME, if the program is

  10. Faces in places: humans and machines make similar face detection errors.

    Directory of Open Access Journals (Sweden)

    Bernard Marius 't Hart

    Full Text Available The human visual system seems to be particularly efficient at detecting faces. This efficiency sometimes comes at the cost of wrongfully seeing faces in arbitrary patterns, including famous examples such as a rock configuration on Mars or a toast's roast patterns. In machine vision, face detection has made considerable progress and has become a standard feature of many digital cameras. The arguably most wide-spread algorithm for such applications ("Viola-Jones" algorithm achieves high detection rates at high computational efficiency. To what extent do the patterns that the algorithm mistakenly classifies as faces also fool humans? We selected three kinds of stimuli from real-life, first-person perspective movies based on the algorithm's output: correct detections ("real faces", false positives ("illusory faces" and correctly rejected locations ("non faces". Observers were shown pairs of these for 20 ms and had to direct their gaze to the location of the face. We found that illusory faces were mistaken for faces more frequently than non faces. In addition, rotation of the real face yielded more errors, while rotation of the illusory face yielded fewer errors. Using colored stimuli increases overall performance, but does not change the pattern of results. When replacing the eye movement by a manual response, however, the preference for illusory faces over non faces disappeared. Taken together, our data show that humans make similar face-detection errors as the Viola-Jones algorithm, when directing their gaze to briefly presented stimuli. In particular, the relative spatial arrangement of oriented filters seems of relevance. This suggests that efficient face detection in humans is likely to be pre-attentive and based on rather simple features as those encoded in the early visual system.

  11. Operationalizing value-based pricing of medicines : a taxonomy of approaches.

    Science.gov (United States)

    Sussex, Jon; Towse, Adrian; Devlin, Nancy

    2013-01-01

    The UK Government is proposing a novel form of price regulation for branded medicines, which it has dubbed 'value-based pricing' (VBP). The specifics of how VBP will work are unclear. We provide an account of the possible means by which VBP of medicines might be operationalized, and a taxonomy to describe and categorize the various approaches. We begin with a brief discussion of the UK Government's proposal for VBP and proceed to define a taxonomy of approaches to VBP. The taxonomy has five main dimensions: (1) what is identified as being of value, (2) how each element is measured, (3) how it is valued, (4) how the different elements of value are aggregated, and (5) how the result is then used to determine the price of a medicine. We take as our starting point that VBP will include a measure of health gain and that, as proposed by the UK Government, this will be built on the QALY. Our principal interest is in the way criteria other than QALYs are taken into account, including severity of illness, the extent of unmet need, and wider societal considerations such as impacts on carers. We set out to: (1) identify and describe the full range of alternative means by which 'value' might be measured and valued, (2) identify and describe the options available for aggregating the different components of value to establish a maximum price, and (3) note the challenges and relative advantages associated with these approaches. We review the means by which aspects of VBP are currently operationalized in a selection of countries and place these, and proposals for the UK, in the context of our taxonomy. Finally, we give an initial assessment of the challenges, pros and cons of each approach. We conclude that identifying where VBP should lie on each of the five dimensions entails value judgements: there are no simple 'right or wrong' solutions. If a wider definition of value than incremental QALYs gained is adopted, as is desirable, then a pragmatic way to aggregate the different

  12. Comparison of the THERP quantitative tables with the human reliability analysis techniques of second generation

    International Nuclear Information System (INIS)

    Alvarenga, Marco Antonio Bayout; Fonseca, Renato Alves

    2009-01-01

    The methodology THERP is classified as a Human Reliability Analysis (HRA) technique of first generation and its emergence was an important initial step for the development of HRA techniques in the industry. Due to the fact of being a first generation technique, THERP quantification tables of human errors are based on a taxonomy that does not take into account the human errors mechanisms. Concerning the three cognitive levels in the Rasmussen framework for the cognitive information processing in human beings, THERP deals in most cases with errors that happen in the perceptual-motor level (stimulus-response). In the rules level, this technique can work better using the time dependent probabilities curves of diagnosis errors, obtained in nuclear power plants simulators. Nevertheless, this is done without processing any error mechanisms. Another deficiency is the fact that the performance shaping factors are in limited number. Furthermore, the influences (predictable or not) of operational context, arising from operational deviations of the most probable (in terms of occurrence probabilities) standard scenarios beside the consequent operational tendencies (operator actions) are not estimated. This work makes a critical analysis of these deficiencies and it points out possible solutions in order to modify the THERP tables, seeking a realistic quantification, that does not underestimate or overestimate the human errors probabilities when applying the HRA techniques to nuclear power plants. The critical analysis is accomplished through a qualitative comparison between THERP, a HRA technique of first generation, with CREAM, as well as ATHEANA, which are HRA techniques of second generation. (author)

  13. Comparison of the THERP quantitative tables with the human reliability analysis techniques of second generation

    Energy Technology Data Exchange (ETDEWEB)

    Alvarenga, Marco Antonio Bayout; Fonseca, Renato Alves [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil)], e-mail: bayout@cnen.gov.br, e-mail: rfonseca@cnen.gov.br

    2009-07-01

    The methodology THERP is classified as a Human Reliability Analysis (HRA) technique of first generation and its emergence was an important initial step for the development of HRA techniques in the industry. Due to the fact of being a first generation technique, THERP quantification tables of human errors are based on a taxonomy that does not take into account the human errors mechanisms. Concerning the three cognitive levels in the Rasmussen framework for the cognitive information processing in human beings, THERP deals in most cases with errors that happen in the perceptual-motor level (stimulus-response). In the rules level, this technique can work better using the time dependent probabilities curves of diagnosis errors, obtained in nuclear power plants simulators. Nevertheless, this is done without processing any error mechanisms. Another deficiency is the fact that the performance shaping factors are in limited number. Furthermore, the influences (predictable or not) of operational context, arising from operational deviations of the most probable (in terms of occurrence probabilities) standard scenarios beside the consequent operational tendencies (operator actions) are not estimated. This work makes a critical analysis of these deficiencies and it points out possible solutions in order to modify the THERP tables, seeking a realistic quantification, that does not underestimate or overestimate the human errors probabilities when applying the HRA techniques to nuclear power plants. The critical analysis is accomplished through a qualitative comparison between THERP, a HRA technique of first generation, with CREAM, as well as ATHEANA, which are HRA techniques of second generation. (author)

  14. Comment: 61 [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available .png Taxonomy icon (c) Database Center for Life Science licensed under CC Attribution2.1 Japan イメージを差し替えました(添付は旧イメージ) ttamura 2009/04/21 12:50:03 ...

  15. Comment: 215 [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available 215.png Taxonomy icon (c) Database Center for Life Science licensed under CC Attribution2.1 Japan アイコン:電子顕微鏡バージョン bando 2010/02/15 15:30:03 2010/02/15 15:30:03 ...

  16. Action errors, error management, and learning in organizations.

    Science.gov (United States)

    Frese, Michael; Keith, Nina

    2015-01-03

    Every organization is confronted with errors. Most errors are corrected easily, but some may lead to negative consequences. Organizations often focus on error prevention as a single strategy for dealing with errors. Our review suggests that error prevention needs to be supplemented by error management--an approach directed at effectively dealing with errors after they have occurred, with the goal of minimizing negative and maximizing positive error consequences (examples of the latter are learning and innovations). After defining errors and related concepts, we review research on error-related processes affected by error management (error detection, damage control). Empirical evidence on positive effects of error management in individuals and organizations is then discussed, along with emotional, motivational, cognitive, and behavioral pathways of these effects. Learning from errors is central, but like other positive consequences, learning occurs under certain circumstances--one being the development of a mind-set of acceptance of human error.

  17. An empirical study on the basic human error probabilities for NPP advanced main control room operation using soft control

    International Nuclear Information System (INIS)

    Jang, Inseok; Kim, Ar Ryum; Harbi, Mohamed Ali Salem Al; Lee, Seung Jun; Kang, Hyun Gook; Seong, Poong Hyun

    2013-01-01

    Highlights: ► The operation environment of MCRs in NPPs has changed by adopting new HSIs. ► The operation action in NPP Advanced MCRs is performed by soft control. ► Different basic human error probabilities (BHEPs) should be considered. ► BHEPs in a soft control operation environment are investigated empirically. ► This work will be helpful to verify if soft control has positive or negative effects. -- Abstract: By adopting new human–system interfaces that are based on computer-based technologies, the operation environment of main control rooms (MCRs) in nuclear power plants (NPPs) has changed. The MCRs that include these digital and computer technologies, such as large display panels, computerized procedures, soft controls, and so on, are called Advanced MCRs. Among the many features in Advanced MCRs, soft controls are an important feature because the operation action in NPP Advanced MCRs is performed by soft control. Using soft controls such as mouse control, touch screens, and so on, operators can select a specific screen, then choose the controller, and finally manipulate the devices. However, because of the different interfaces between soft control and hardwired conventional type control, different basic human error probabilities (BHEPs) should be considered in the Human Reliability Analysis (HRA) for advanced MCRs. Although there are many HRA methods to assess human reliabilities, such as Technique for Human Error Rate Prediction (THERP), Accident Sequence Evaluation Program (ASEP), Human Error Assessment and Reduction Technique (HEART), Human Event Repository and Analysis (HERA), Nuclear Computerized Library for Assessing Reactor Reliability (NUCLARR), Cognitive Reliability and Error Analysis Method (CREAM), and so on, these methods have been applied to conventional MCRs, and they do not consider the new features of advance MCRs such as soft controls. As a result, there is an insufficient database for assessing human reliabilities in advanced

  18. Error management process for power stations

    International Nuclear Information System (INIS)

    Hirotsu, Yuko; Takeda, Daisuke; Fujimoto, Junzo; Nagasaka, Akihiko

    2016-01-01

    The purpose of this study is to establish 'error management process for power stations' for systematizing activities for human error prevention and for festering continuous improvement of these activities. The following are proposed by deriving concepts concerning error management process from existing knowledge and realizing them through application and evaluation of their effectiveness at a power station: an entire picture of error management process that facilitate four functions requisite for maraging human error prevention effectively (1. systematizing human error prevention tools, 2. identifying problems based on incident reports and taking corrective actions, 3. identifying good practices and potential problems for taking proactive measures, 4. prioritizeng human error prevention tools based on identified problems); detail steps for each activity (i.e. developing an annual plan for human error prevention, reporting and analyzing incidents and near misses) based on a model of human error causation; procedures and example of items for identifying gaps between current and desired levels of executions and outputs of each activity; stages for introducing and establishing the above proposed error management process into a power station. By giving shape to above proposals at a power station, systematization and continuous improvement of activities for human error prevention in line with the actual situation of the power station can be expected. (author)

  19. Are Faculty Predictions or Item Taxonomies Useful for Estimating the Outcome of Multiple-Choice Examinations?

    Science.gov (United States)

    Kibble, Jonathan D.; Johnson, Teresa

    2011-01-01

    The purpose of this study was to evaluate whether multiple-choice item difficulty could be predicted either by a subjective judgment by the question author or by applying a learning taxonomy to the items. Eight physiology faculty members teaching an upper-level undergraduate human physiology course consented to participate in the study. The…

  20. Human Error Prediction and Countermeasures based on CREAM in Loading and Storage Phase of Spent Nuclear Fuel (SNF)

    International Nuclear Information System (INIS)

    Kim, Jae San; Kim, Min Su; Jo, Seong Youn

    2007-01-01

    With the steady demands for nuclear power energy in Korea, the amount of accumulated SNF has inevitably increased year by year. Thus far, SNF has been on-site transported from one unit to a nearby unit or an on-site dry storage facility. In the near future, as the amount of SNF generated approaches the capacity of these facilities, a percentage of it will be transported to another SNF storage facility. In the process of transporting SNF, human interactions involve inspecting and preparing the cask and spent fuel, loading the cask, transferring the cask and storage or monitoring the cask, etc. So, human actions play a significant role in SNF transportation. In analyzing incidents that have occurred during transport operations, several recent studies have indicated that 'human error' is a primary cause. Therefore, the objectives of this study are to predict and identify possible human errors during the loading and storage of SNF. Furthermore, after evaluating human error for each process, countermeasures to minimize human error are deduced

  1. Advances in molecular identification, taxonomy, genetic variation and diagnosis of Toxocara spp.

    Science.gov (United States)

    Chen, Jia; Zhou, Dong-Hui; Nisbet, Alasdair J; Xu, Min-Jun; Huang, Si-Yang; Li, Ming-Wei; Wang, Chun-Ren; Zhu, Xing-Quan

    2012-10-01

    The genus Toxocara contains parasitic nematodes of human and animal health significance, such as Toxocara canis, Toxocara cati and Toxocara vitulorum. T. canis and T. cati are among the most prevalent parasites of dogs and cats with a worldwide distribution. Human infection with T. canis and T. cati, which can cause a number of clinical manifestations such as visceral larva migrans (VLMs), ocular larva migrans (OLMs), eosinophilic meningoencephalitis (EME), covert toxocariasis (CT) and neurotoxocariasis, is considered the most prevalent neglected helminthiasis in industrialized countries. The accurate identification Toxocara spp. and their unequivocal differentiation from each other and from other ascaridoid nematodes causing VLMs and OLMs has important implications for studying their taxonomy, epidemiology, population genetics, diagnosis and control. Due to the limitations of traditional (morphological) approaches for identification and diagnosis of Toxocara spp., PCR-based techniques utilizing a range of genetic markers in the nuclear and mitochondrial genomes have been developed as useful alternative approaches because of their high sensitivity, specificity, rapidity and utility. In this article, we summarize the current state of knowledge and advances in molecular identification, taxonomy, genetic variation and diagnosis of Toxocara spp. with prospects for further studies. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. Genomic taxonomy of vibrios

    DEFF Research Database (Denmark)

    Thompson, Cristiane C.; Vicente, Ana Carolina P.; Souza, Rangel C.

    2009-01-01

    BACKGROUND: Vibrio taxonomy has been based on a polyphasic approach. In this study, we retrieve useful taxonomic information (i.e. data that can be used to distinguish different taxonomic levels, such as species and genera) from 32 genome sequences of different vibrio species. We use a variety of...

  3. Taxonomy for Education and Training in Clinical Neuropsychology: past, present, and future.

    Science.gov (United States)

    Sperling, Scott A; Cimino, Cynthia R; Stricker, Nikki H; Heffelfinger, Amy K; Gess, Jennifer L; Osborn, Katie E; Roper, Brad L

    2017-07-01

    Historically, the clinical neuropsychology training community has not clearly or consistently defined education or training opportunities. The lack of consistency has limited students' and trainees' ability to accurately assess and compare the intensity of neuropsychology-specific training provided by programs. To address these issues and produce greater 'truth in advertising' across programs, CNS, with SCN's Education Advisory Committee (EAC), ADECN, AITCN, and APPCN constructed a specialty-specific taxonomy, namely, the Taxonomy for Education and Training in Clinical Neuropsychology. The taxonomy provides consensus in the description of training offered by doctoral, internship, and postdoctoral programs, as well as at the post-licensure stage. Although the CNS approved the taxonomy in February 2015, many programs have not adopted its language. Increased awareness of the taxonomy and the reasons behind its development and structure, as well as its potential benefits, are warranted. In 2016, a working group of clinical neuropsychologists from the EAC and APPCN, all authors of this manuscript, was created and tasked with disseminating information about the taxonomy. Group members held regular conference calls, leading to the generation of this manuscript. This manuscript is the primary byproduct of the working group. Its purpose is to (1) outline the history behind the development of the taxonomy, (2) detail its structure and utility, (3) address the expected impact of its adoption, and (4) call for its adoption across training programs. This manuscript outlines the development and structure of the clinical neuropsychology taxonomy and addresses the need for its adoption across training programs.

  4. Hierarchical learning induces two simultaneous, but separable, prediction errors in human basal ganglia.

    Science.gov (United States)

    Diuk, Carlos; Tsai, Karin; Wallis, Jonathan; Botvinick, Matthew; Niv, Yael

    2013-03-27

    Studies suggest that dopaminergic neurons report a unitary, global reward prediction error signal. However, learning in complex real-life tasks, in particular tasks that show hierarchical structure, requires multiple prediction errors that may coincide in time. We used functional neuroimaging to measure prediction error signals in humans performing such a hierarchical task involving simultaneous, uncorrelated prediction errors. Analysis of signals in a priori anatomical regions of interest in the ventral striatum and the ventral tegmental area indeed evidenced two simultaneous, but separable, prediction error signals corresponding to the two levels of hierarchy in the task. This result suggests that suitably designed tasks may reveal a more intricate pattern of firing in dopaminergic neurons. Moreover, the need for downstream separation of these signals implies possible limitations on the number of different task levels that we can learn about simultaneously.

  5. Features of an advanced human reliability analysis method, AGAPE-ET

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Whan; Jung, Won Dea; Park, Jin Kyun [Korea Atomic Energy Research Institute, Taejeon (Korea, Republic of)

    2005-11-15

    This paper presents the main features of an advanced human reliability analysis (HRA) method, AGAPE-ET. It has the capabilities to deal with the diagnosis failures and the errors of commission (EOC), which have not been normally treated in the conventional HRAs. For the analysis of the potential for diagnosis failures, an analysis framework, which is called the misdiagnosis tree analysis (MDTA), and a taxonomy of the misdiagnosis causes with appropriate quantification schemes are provided. For the identification of the EOC events from the misdiagnosis, some procedural guidance is given. An example of the application of the method is also provided.

  6. Features of an advanced human reliability analysis method, AGAPE-ET

    International Nuclear Information System (INIS)

    Kim, Jae Whan; Jung, Won Dea; Park, Jin Kyun

    2005-01-01

    This paper presents the main features of an advanced human reliability analysis (HRA) method, AGAPE-ET. It has the capabilities to deal with the diagnosis failures and the errors of commission (EOC), which have not been normally treated in the conventional HRAs. For the analysis of the potential for diagnosis failures, an analysis framework, which is called the misdiagnosis tree analysis (MDTA), and a taxonomy of the misdiagnosis causes with appropriate quantification schemes are provided. For the identification of the EOC events from the misdiagnosis, some procedural guidance is given. An example of the application of the method is also provided

  7. Why Do People Regulate Their Emotions? A Taxonomy of Motives in Emotion Regulation.

    Science.gov (United States)

    Tamir, Maya

    2016-08-01

    Emotion regulation involves the pursuit of desired emotional states (i.e., emotion goals) in the service of superordinate motives. The nature and consequences of emotion regulation, therefore, are likely to depend on the motives it is intended to serve. Nonetheless, limited attention has been devoted to studying what motivates emotion regulation. By mapping the potential benefits of emotion to key human motives, this review identifies key classes of motives in emotion regulation. The proposed taxonomy distinguishes between hedonic motives that target the immediate phenomenology of emotions, and instrumental motives that target other potential benefits of emotions. Instrumental motives include behavioral, epistemic, social, and eudaimonic motives. The proposed taxonomy offers important implications for understanding the mechanism of emotion regulation, variation across individuals and contexts, and psychological function and dysfunction, and points to novel research directions. © 2015 by the Society for Personality and Social Psychology, Inc.

  8. A basic framework for the analysis of the human error potential due to the computerization in nuclear power plants

    International Nuclear Information System (INIS)

    Lee, Y. H.

    1999-01-01

    Computerization and its vivid benefits expected in the nuclear power plant design cannot be realized without verifying the inherent safety problems. Human error aspect is also included in the verification issues. The verification spans from the perception of the changes in operation functions such as automation to the unfamiliar experience of operators due to the interface change. Therefore, a new framework for human error analysis might capture both the positive and the negative effect of the computerization. This paper suggest a basic framework for error identification through the review of the existing human error studies and the experience of computerizations in nuclear power plants

  9. A human error probability estimate methodology based on fuzzy inference and expert judgment on nuclear plants

    International Nuclear Information System (INIS)

    Nascimento, C.S. do; Mesquita, R.N. de

    2009-01-01

    Recent studies point human error as an important factor for many industrial and nuclear accidents: Three Mile Island (1979), Bhopal (1984), Chernobyl and Challenger (1986) are classical examples. Human contribution to these accidents may be better understood and analyzed by using Human Reliability Analysis (HRA), which has being taken as an essential part on Probabilistic Safety Analysis (PSA) of nuclear plants. Both HRA and PSA depend on Human Error Probability (HEP) for a quantitative analysis. These probabilities are extremely affected by the Performance Shaping Factors (PSF), which has a direct effect on human behavior and thus shape HEP according with specific environment conditions and personal individual characteristics which are responsible for these actions. This PSF dependence raises a great problem on data availability as turn these scarcely existent database too much generic or too much specific. Besides this, most of nuclear plants do not keep historical records of human error occurrences. Therefore, in order to overcome this occasional data shortage, a methodology based on Fuzzy Inference and expert judgment was employed in this paper in order to determine human error occurrence probabilities and to evaluate PSF's on performed actions by operators in a nuclear power plant (IEA-R1 nuclear reactor). Obtained HEP values were compared with reference tabled data used on current literature in order to show method coherence and valid approach. This comparison leads to a conclusion that this work results are able to be employed both on HRA and PSA enabling efficient prospection of plant safety conditions, operational procedures and local working conditions potential improvements (author)

  10. Human Error Analysis in a Permit to Work System: A Case Study in a Chemical Plant

    Directory of Open Access Journals (Sweden)

    Mehdi Jahangiri

    2016-03-01

    Conclusion: The SPAR-H method applied in this study could analyze and quantify the potential human errors and extract the required measures for reducing the error probabilities in PTW system. Some suggestions to reduce the likelihood of errors, especially in the field of modifying the performance shaping factors and dependencies among tasks are provided.

  11. Relating Complexity and Error Rates of Ontology Concepts. More Complex NCIt Concepts Have More Errors.

    Science.gov (United States)

    Min, Hua; Zheng, Ling; Perl, Yehoshua; Halper, Michael; De Coronado, Sherri; Ochs, Christopher

    2017-05-18

    Ontologies are knowledge structures that lend support to many health-information systems. A study is carried out to assess the quality of ontological concepts based on a measure of their complexity. The results show a relation between complexity of concepts and error rates of concepts. A measure of lateral complexity defined as the number of exhibited role types is used to distinguish between more complex and simpler concepts. Using a framework called an area taxonomy, a kind of abstraction network that summarizes the structural organization of an ontology, concepts are divided into two groups along these lines. Various concepts from each group are then subjected to a two-phase QA analysis to uncover and verify errors and inconsistencies in their modeling. A hierarchy of the National Cancer Institute thesaurus (NCIt) is used as our test-bed. A hypothesis pertaining to the expected error rates of the complex and simple concepts is tested. Our study was done on the NCIt's Biological Process hierarchy. Various errors, including missing roles, incorrect role targets, and incorrectly assigned roles, were discovered and verified in the two phases of our QA analysis. The overall findings confirmed our hypothesis by showing a statistically significant difference between the amounts of errors exhibited by more laterally complex concepts vis-à-vis simpler concepts. QA is an essential part of any ontology's maintenance regimen. In this paper, we reported on the results of a QA study targeting two groups of ontology concepts distinguished by their level of complexity, defined in terms of the number of exhibited role types. The study was carried out on a major component of an important ontology, the NCIt. The findings suggest that more complex concepts tend to have a higher error rate than simpler concepts. These findings can be utilized to guide ongoing efforts in ontology QA.

  12. ICTV Virus Taxonomy Profile: Pleolipoviridae

    Czech Academy of Sciences Publication Activity Database

    Bamford, D.H.; Pietila, M.K.; Roine, E.; Atanasova, N.S.; Dienstbier, Ana; Oksanen, H.M.

    2017-01-01

    Roč. 98, č. 12 (2017), s. 2916-2917 ISSN 0022-1317 Institutional support: RVO:61388971 Keywords : Pleolipoviridae * taxonomy * Halorubrum pleomorphic virus 1 Subject RIV: EE - Microbiology, Virology OBOR OECD: Microbiology Impact factor: 2.838, year: 2016

  13. Asteroid taxonomy

    International Nuclear Information System (INIS)

    Tholen, D.J.

    1989-01-01

    The spectral reflectivity of asteroid surfaces over the wavelength range of 0.3 to 1.1 μm can be used to classify these objects onto several broad groups with similar spectral characteristics. The three most recently developed taxonomies group the asteroids into 9, 11 or 14 different classes, depending on the technique used to perform the analysis. The distribution of the taxonomic classes shows that darker and redder objects become more dominant at larger heliocentric distances, while the rare asteroid types are found more frequently among the small objects of the planet-crossing population

  14. Psychological scaling of expert estimates of human error probabilities: application to nuclear power plant operation

    International Nuclear Information System (INIS)

    Comer, K.; Gaddy, C.D.; Seaver, D.A.; Stillwell, W.G.

    1985-01-01

    The US Nuclear Regulatory Commission and Sandia National Laboratories sponsored a project to evaluate psychological scaling techniques for use in generating estimates of human error probabilities. The project evaluated two techniques: direct numerical estimation and paired comparisons. Expert estimates were found to be consistent across and within judges. Convergent validity was good, in comparison to estimates in a handbook of human reliability. Predictive validity could not be established because of the lack of actual relative frequencies of error (which will be a difficulty inherent in validation of any procedure used to estimate HEPs). Application of expert estimates in probabilistic risk assessment and in human factors is discussed

  15. Human errors during the simulations of an SGTR scenario: Application of the HERA system

    International Nuclear Information System (INIS)

    Jung, Won Dea; Whaley, April M.; Hallbert, Bruce P.

    2009-01-01

    Due to the need of data for a Human Reliability Analysis (HRA), a number of data collection efforts have been undertaken in several different organizations. As a part of this effort, a human error analysis that focused on a set of simulator records on a Steam Generator Tube Rupture (SGTR) scenario was performed by using the Human Event Repository and Analysis (HERA) system. This paper summarizes the process and results of the HERA analysis, including discussions about the usability of the HERA system for a human error analysis of simulator data. Five simulated records of an SGTR scenario were analyzed with the HERA analysis process in order to scrutinize the causes and mechanisms of the human related events. From this study, the authors confirmed that the HERA was a serviceable system that can analyze human performance qualitatively from simulator data. It was possible to identify the human related events in the simulator data that affected the system safety not only negatively but also positively. It was also possible to scrutinize the Performance Shaping Factors (PSFs) and the relevant contributory factors with regard to each identified human event

  16. Human reliability analysis during PSA at Trillo NPP: main characteristics and analysis of diagnostic errors

    International Nuclear Information System (INIS)

    Barquin, M.A.; Gomez, F.

    1998-01-01

    The design difference between Trillo NPP and other Spanish nuclear power plants (basic Westinghouse and General Electric designs) were made clear in the Human Reliability Analysis of the Probabilistic Safety Analysis (PSA) for Trillo NPP. The object of this paper is to describe the most significant characteristics of the Human Reliability Analysis carried out in the PSA, with special emphasis on the possible diagnostic errors and their consequences, based on the characteristics in the Emergency Operations Manual for Trillo NPP. - In the case of human errors before the initiating event (type 1), the existence of four redundancies in most of the plant safety systems, means that the impact of this type or error on the final results of the PSA is insignificant. However, in the case common cause errors, especially in certain calibration errors, some actions are significant in the final equation for core damage - The number of human actions that the operator has to carry out during the accidents (type 3) modelled, is relatively small in comparison with this value in other PSAs. This is basically due to the high level of automation at Rillo NPP - The Plant Operations Manual cannot be strictly considered to be a symptoms-based procedure. The operation Group must select the chapter from the Operations Manual to be followed, after having diagnosed the perturbing event, using for this purpose and Emergency and Anomaly Decision Tree (M.O.3.0.1) based on the different indications, alarms and symptoms present in the plant after the perturbing event. For this reason, it was decided to analyse the possible diagnosis errors. In the bibliography on diagnosis and commission errors available at the present time, there is no precise methodology for the analysis of this type of error and its incorporation into PSAs. The method used in the PSA for Trillo y NPP to evaluate this type of interaction, is to develop a Diagnosis Error Table, the object of which is to identify the situations in

  17. An assessment of the risk significance of human errors in selected PSAs and operating events

    International Nuclear Information System (INIS)

    Palla, R.L. Jr.; El-Bassioni, A.

    1991-01-01

    Sensitivity studies based on Probabilistic Safety Assessments (PSAs) for a pressurized water reactor and a boiling water reactor are described. In each case human errors modeled in the PSAs were categorized according to such factors as error type, location, timing, and plant personnel involved. Sensitivity studies were then conducted by varying the error rates in each category and evaluating the corresponding change in total core damage frequency and accident sequence frequency. Insights obtained are discussed and reasons for differences in risk sensitivity between plants are explored. A separate investigation into the role of human error in risk-important operating events is also described. This investigation involved the analysis of data from the USNRC Accident Sequence Precursor program to determine the effect of operator-initiated events on accident precursor trends, and to determine whether improved training can be correlated to current trends. The findings of this study are also presented. 5 refs., 15 figs., 1 tab

  18. Scaling prediction errors to reward variability benefits error-driven learning in humans.

    Science.gov (United States)

    Diederen, Kelly M J; Schultz, Wolfram

    2015-09-01

    Effective error-driven learning requires individuals to adapt learning to environmental reward variability. The adaptive mechanism may involve decays in learning rate across subsequent trials, as shown previously, and rescaling of reward prediction errors. The present study investigated the influence of prediction error scaling and, in particular, the consequences for learning performance. Participants explicitly predicted reward magnitudes that were drawn from different probability distributions with specific standard deviations. By fitting the data with reinforcement learning models, we found scaling of prediction errors, in addition to the learning rate decay shown previously. Importantly, the prediction error scaling was closely related to learning performance, defined as accuracy in predicting the mean of reward distributions, across individual participants. In addition, participants who scaled prediction errors relative to standard deviation also presented with more similar performance for different standard deviations, indicating that increases in standard deviation did not substantially decrease "adapters'" accuracy in predicting the means of reward distributions. However, exaggerated scaling beyond the standard deviation resulted in impaired performance. Thus efficient adaptation makes learning more robust to changing variability. Copyright © 2015 the American Physiological Society.

  19. Systematic analysis of dependent human errors from the maintenance history at finnish NPPs - A status report

    Energy Technology Data Exchange (ETDEWEB)

    Laakso, K. [VTT Industrial Systems (Finland)

    2002-12-01

    Operating experience has shown missed detection events, where faults have passed inspections and functional tests to operating periods after the maintenance activities during the outage. The causes of these failures have often been complex event sequences, involving human and organisational factors. Especially common cause and other dependent failures of safety systems may significantly contribute to the reactor core damage risk. The topic has been addressed in the Finnish studies of human common cause failures, where experiences on latent human errors have been searched and analysed in detail from the maintenance history. The review of the bulk of the analysis results of the Olkiluoto and Loviisa plant sites shows that the instrumentation and control and electrical equipment is more prone to human error caused failure events than the other maintenance and that plant modifications and also predetermined preventive maintenance are significant sources of common cause failures. Most errors stem from the refuelling and maintenance outage period at the both sites, and less than half of the dependent errors were identified during the same outage. The dependent human errors originating from modifications could be reduced by a more tailored specification and coverage of their start-up testing programs. Improvements could also be achieved by a more case specific planning of the installation inspection and functional testing of complicated maintenance works or work objects of higher plant safety and availability importance. A better use and analysis of condition monitoring information for maintenance steering could also help. The feedback from discussions of the analysis results with plant experts and professionals is still crucial in developing the final conclusions and recommendations that meet the specific development needs at the plants. (au)

  20. A philosophical taxonomy of ethically significant moral distress.

    Science.gov (United States)

    Thomas, Tessy A; McCullough, Laurence B

    2015-02-01

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

  1. Developing a taxonomy of coordination behaviours in nuclear power plant control rooms during emergencies.

    Science.gov (United States)

    Wang, Dunxing; Gao, Qin; Li, Zhizhong; Song, Fei; Ma, Liang

    2017-12-01

    This study aims to develop a taxonomy of coordination behaviours during emergencies in nuclear power plants (NPPs). We summarised basic coordination behaviours from literature in aviation, health care and nuclear field and identified coordination behaviours specific to the nuclear domain by interviewing and surveying control crew operators. The established taxonomy includes 7 workflow stages and 24 basic coordination behaviours. To evaluate the reliability and feasibility of the taxonomy, we analysed 12 videos of operators' training sessions by coding coordination behaviours with the taxonomy and the inter-rater reliability was acceptable. Further analysis of the frequency, the duration and the direction of the coordination behaviours revealed four coordination problems. This taxonomy provides a foundation of systematic observation of coordination behaviours among NPP crews, advances researchers' understanding of the coordination mechanism during emergencies in NPPs and facilitate the possibility to deepen the understanding of the relationships between coordination behaviours and team performance. Practitioner Summary: A taxonomy of coordination behaviours during emergencies in nuclear power plants was developed. Reliability and feasibility of the taxonomy was verified through the analysis of 12 training sessions. The taxonomy can serve as an observation system for analysis of coordination behaviours and help to identify coordination problems of control crews.

  2. The application of two recently developed human reliability techniques to cognitive error analysis

    International Nuclear Information System (INIS)

    Gall, W.

    1990-01-01

    Cognitive error can lead to catastrophic consequences for manned systems, including those whose design renders them immune to the effects of physical slips made by operators. Four such events, pressurized water and boiling water reactor accidents which occurred recently, were analysed. The analysis identifies the factors which contributed to the errors and suggests practical strategies for error recovery or prevention. Two types of analysis were conducted: an unstructured analysis based on the analyst's knowledge of psychological theory, and a structured analysis using two recently-developed human reliability analysis techniques. In general, the structured techniques required less effort to produce results and these were comparable to those of the unstructured analysis. (author)

  3. An Optimized Player Taxonomy Model for Mobile MMORPGs with Millions of Users

    OpenAIRE

    You, Fang; Liu, Jianping; Guan, Xinjian; Wang, Jianmin; Zheng, Zibin; Tam, Peter

    2011-01-01

    Massively multiplayer online role-playing games (MMORPGs) have great potential as sites for research within the social and human-computer interaction. In the MMORPGs, a stability player taxonomy model is very important for game design. It helps to balance different types of players and improve business strategy of the game. The players in mobile MMORPGs are also connected with social networks; many studies only use the player's own attributes statistics or questionnaire survey method to predi...

  4. Plant specification of a generic human-error data through a two-stage Bayesian approach

    International Nuclear Information System (INIS)

    Heising, C.D.; Patterson, E.I.

    1984-01-01

    Expert judgement concerning human performance in nuclear power plants is quantitatively coupled with actuarial data on such performance in order to derive plant-specific human-error rate probability distributions. The coupling procedure consists of a two-stage application of Bayes' theorem to information which is grouped by type. The first information type contains expert judgement concerning human performance at nuclear power plants in general. Data collected on human performance at a group of similar plants forms the second information type. The third information type consists of data on human performance in a specific plant which has the same characteristics as the group members. The first and second information types are coupled in the first application of Bayes' theorem to derive a probability distribution for population performance. This distribution is then combined with the third information type in a second application of Bayes' theorem to determine a plant-specific human-error rate probability distribution. The two stage Bayesian procedure thus provides a means to quantitatively couple sparse data with expert judgement in order to obtain a human performance probability distribution based upon available information. Example calculations for a group of like reactors are also given. (author)

  5. Taking human error into account in the design of nuclear reactor centres

    International Nuclear Information System (INIS)

    Prouillac; Lerat; Janoir.

    1982-05-01

    The role of the operator in the centralized management of pressurized water reactors is studied. Different types of human error likely to arise, the means of their prevention and methods of mitigating their consequences are presented. Some possible improvements are outlined

  6. The application of human error prevention tool in Tianwan nuclear power station

    International Nuclear Information System (INIS)

    Qiao Zhiguo

    2013-01-01

    This paper mainly discusses the application and popularization of human error prevention tool in Tianwan nuclear power station, including the study on project implementation background, main contents and innovation, performance management, innovation practice and development, and performance of innovation application. (authors)

  7. Norms for environmentally responsible behaviour: An extended taxonomy

    DEFF Research Database (Denmark)

    Thøgersen, John

    2006-01-01

    and shopping. Also the frequency of the four behaviours was measured. The revised taxonomy has content, discriminant, predictive, and nomological validity and satisfactory test-retest reliability. The most internalized of the new norm constructs, integrated norms, is most strongly correlated with conventional...... measures of personal and moral norms. However, other constructs in the proposed taxonomy still contribute significantly to predicting conventional norm measures after controlling for integrated norms. This documents the motivational ambiguity of the conventional personal norm construct. The patterns...

  8. Comment: 219 [Taxonomy Icon

    Lifescience Database Archive (English)

    Full Text Available Japanese medaka Oryzias latipes Oryzias_latipes_L.png 219.png Taxonomy icon (c) Database Center for Life Sci...ence licensed under CC Attribution2.1 Japan アイコン:メダカ HNI-Ⅱ系統バージョン bando 2010/02/15 15:31:07 2010/02/16 09:53:27 ...

  9. The error in total error reduction.

    Science.gov (United States)

    Witnauer, James E; Urcelay, Gonzalo P; Miller, Ralph R

    2014-02-01

    Most models of human and animal learning assume that learning is proportional to the discrepancy between a delivered outcome and the outcome predicted by all cues present during that trial (i.e., total error across a stimulus compound). This total error reduction (TER) view has been implemented in connectionist and artificial neural network models to describe the conditions under which weights between units change. Electrophysiological work has revealed that the activity of dopamine neurons is correlated with the total error signal in models of reward learning. Similar neural mechanisms presumably support fear conditioning, human contingency learning, and other types of learning. Using a computational modeling approach, we compared several TER models of associative learning to an alternative model that rejects the TER assumption in favor of local error reduction (LER), which assumes that learning about each cue is proportional to the discrepancy between the delivered outcome and the outcome predicted by that specific cue on that trial. The LER model provided a better fit to the reviewed data than the TER models. Given the superiority of the LER model with the present data sets, acceptance of TER should be tempered. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Control of Human Error and comparison Level risk after correction action With the SHERPA Method in a control Room of petrochemical industry

    Directory of Open Access Journals (Sweden)

    A. Zakerian

    2011-12-01

    Full Text Available Background and aims Today in many jobs like nuclear, military and chemical industries, human errors may result in a disaster. Accident in different places of the world emphasizes this subject and we indicate for example, Chernobyl disaster in (1986, tree Mile accident in (1974 and Flixborough explosion in (1974.So human errors identification especially in important and intricate systems is necessary and unavoidable for predicting control methods.   Methods Recent research is a case study and performed in Zagross Methanol Company in Asalouye (South pars.   Walking –Talking through method with process expert and control room operators, inspecting technical documents are used for collecting required information and completing Systematic Human Error Reductive and Predictive Approach (SHERPA worksheets.   Results analyzing SHERPA worksheet indicated that, were accepting capable invertebrate errors % 71.25, % 26.75 undesirable errors, % 2 accepting capable(with change errors, % 0 accepting capable errors, and after correction action forecast Level risk to this arrangement, accepting capable invertebrate errors % 0, % 4.35 undesirable errors , % 58.55 accepting capable(with change errors, % 37.1 accepting capable errors .   ConclusionFinally this result is comprehension that this method in different industries especially in chemical industries is enforceable and useful for human errors identification that may lead to accident and adventures.

  11. Detailed semantic analyses of human error incidents occurring at domestic nuclear power plants to fiscal year 2000

    International Nuclear Information System (INIS)

    Tsuge, Tadashi; Hirotsu, Yuko; Takano, Kenichi; Ebisu, Mitsuhiro; Tsumura, Joji

    2003-01-01

    Analysing and evaluating observed cases of human error incidents with the emphasis on human factors and behavior involved was essential for preventing recurrence of those. CRIEPI has been conducting detailed and structures analyses of all incidents reported during last 35 year based on J-HPES, from the beginning of the first Tokai nuclear power operation till fiscal year of 2000, in which total 212 human error cases are identified. Results obtained by the analyses have been stored into the J-HPES data-base. This summarized the semantic analyses on all case-studies stored in the above data-base to grasp the practical and concrete contents and trend of more frequently observed human errors (as are called trigger actions here), causal factors and preventive measures. These semantic analyses have been executed by classifying all those items into some categories that could be considered as having almost the same meaning using the KJ method. Followings are obtained typical results by above analyses: (1) Trigger action-Those could be classified into categories of operation or categories of maintenance. Operational timing errors' and 'operational quantitative errors' were major actions in trigger actions of operation, those occupied about 20% among all actions. At trigger actions of maintenance, 'maintenance quantitative error' were major actions, those occupied quarter among all actions; (2) Causal factor- 'Human internal status' were major factors, as in concrete factors, those occupied 'improper persistence' and 'lack of knowledge'; (3) Preventive measure-Most frequent measures got were job management changes in procedural software improvements, which was from 70% to 80%. As for preventive measures of operation, software improvements have been implemented on 'organization and work practices' and 'individual consciousness'. Concerning preventive measures of maintenance, improvements have been implemented on 'organization and work practices'. (author)

  12. A Taxonomy of Latent Structure Assumptions for Probability Matrix Decomposition Models.

    Science.gov (United States)

    Meulders, Michel; De Boeck, Paul; Van Mechelen, Iven

    2003-01-01

    Proposed a taxonomy of latent structure assumptions for probability matrix decomposition (PMD) that includes the original PMD model and a three-way extension of the multiple classification latent class model. Simulation study results show the usefulness of the taxonomy. (SLD)

  13. Taxonomy in biomedical resources of the Exclusive Economic Zone of India

    Digital Repository Service at National Institute of Oceanography (India)

    Parulekar, A.H.

    stream_size 9 stream_content_type text/plain stream_name Taxonomy_Environ_Biol_1990_49.pdf.txt stream_source_info Taxonomy_Environ_Biol_1990_49.pdf.txt Content-Encoding ISO-8859-1 Content-Type text/plain; charset=ISO-8859-1 ...

  14. Human Error and General Aviation Accidents: A Comprehensive, Fine-Grained Analysis Using HFACS

    National Research Council Canada - National Science Library

    Wiegmann, Douglas; Faaborg, Troy; Boquet, Albert; Detwiler, Cristy; Holcomb, Kali; Shappell, Scott

    2005-01-01

    ... of both commercial and general aviation (GA) accidents. These analyses have helped to identify general trends in the types of human factors issues and aircrew errors that have contributed to civil aviation accidents...

  15. Determining The Factors Causing Human Error Deficiencies At A Public Utility Company

    Directory of Open Access Journals (Sweden)

    F. W. Badenhorst

    2004-11-01

    Full Text Available According to Neff (1977, as cited by Bergh (1995, the westernised culture considers work important for industrial mental health. Most individuals experience work positively, which creates a positive attitude. Should this positive attitude be inhibited, workers could lose concentration and become bored, potentially resulting in some form of human error. The aim of this research was to determine the factors responsible for human error events, which lead to power supply failures at Eskom power stations. Proposals were made for the reduction of these contributing factors towards improving plant performance. The target population was 700 panel operators in Eskom’s Power Generation Group. The results showed that factors leading to human error can be reduced or even eliminated. Opsomming Neff (1977 soos aangehaal deur Bergh (1995, skryf dat in die westerse kultuur werk belangrik vir bedryfsgeestesgesondheid is. Die meeste persone ervaar werk as positief, wat ’n positiewe gesindheid kweek. Indien hierdie positiewe gesindheid geïnhibeer word, kan dit lei tot ’n gebrek aan konsentrasie by die werkers. Werkers kan verveeld raak en dit kan weer lei tot menslike foute. Die doel van hierdie navorsing is om die faktore vas te stel wat tot menslike foute lei, en wat bydra tot onderbrekings in kragvoorsiening by Eskom kragstasies. Voorstelle is gemaak vir die vermindering van hierdie bydraende faktore ten einde die kragaanleg se prestasie te verbeter. Die teiken-populasie was 700 paneel-operateurs in die Kragopwekkingsgroep by Eskom. Die resultate dui daarop dat die faktore wat aanleiding gee tot menslike foute wel verminder, of geëlimineer kan word.

  16. Unpacking the Revised Bloom's Taxonomy: Developing Case-Based Learning Activities

    Science.gov (United States)

    Nkhoma, Mathews Zanda; Lam, Tri Khai; Sriratanaviriyakul, Narumon; Richardson, Joan; Kam, Booi; Lau, Kwok Hung

    2017-01-01

    Purpose: The purpose of this paper is to propose the use of case studies in teaching an undergraduate course of Internet for Business in class, based on the revised Bloom's taxonomy. The study provides the empirical evidence about the effect of case-based teaching method integrated the revised Bloom's taxonomy on students' incremental learning,…

  17. A Preliminary Study on the Measures to Assess the Organizational Safety: The Cultural Impact on Human Error Potential

    International Nuclear Information System (INIS)

    Lee, Yong Hee; Lee, Yong Hee

    2011-01-01

    The Fukushima I nuclear accident following the Tohoku earthquake and tsunami on 11 March 2011 occurred after twelve years had passed since the JCO accident which was caused as a result of an error made by JCO employees. These accidents, along with the Chernobyl accident, associated with characteristic problems of various organizations caused severe social and economic disruptions and have had significant environmental and health impact. The cultural problems with human errors occur for various reasons, and different actions are needed to prevent different errors. Unfortunately, much of the research on organization and human error has shown widely various or different results which call for different approaches. In other words, we have to find more practical solutions from various researches for nuclear safety and lead a systematic approach to organizational deficiency causing human error. This paper reviews Hofstede's criteria, IAEA safety culture, safety areas of periodic safety review (PSR), teamwork and performance, and an evaluation of HANARO safety culture to verify the measures used to assess the organizational safety

  18. A Preliminary Study on the Measures to Assess the Organizational Safety: The Cultural Impact on Human Error Potential

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-15

    The Fukushima I nuclear accident following the Tohoku earthquake and tsunami on 11 March 2011 occurred after twelve years had passed since the JCO accident which was caused as a result of an error made by JCO employees. These accidents, along with the Chernobyl accident, associated with characteristic problems of various organizations caused severe social and economic disruptions and have had significant environmental and health impact. The cultural problems with human errors occur for various reasons, and different actions are needed to prevent different errors. Unfortunately, much of the research on organization and human error has shown widely various or different results which call for different approaches. In other words, we have to find more practical solutions from various researches for nuclear safety and lead a systematic approach to organizational deficiency causing human error. This paper reviews Hofstede's criteria, IAEA safety culture, safety areas of periodic safety review (PSR), teamwork and performance, and an evaluation of HANARO safety culture to verify the measures used to assess the organizational safety

  19. Transporter taxonomy - a comparison of different transport protein classification schemes.

    Science.gov (United States)

    Viereck, Michael; Gaulton, Anna; Digles, Daniela; Ecker, Gerhard F

    2014-06-01

    Currently, there are more than 800 well characterized human membrane transport proteins (including channels and transporters) and there are estimates that about 10% (approx. 2000) of all human genes are related to transport. Membrane transport proteins are of interest as potential drug targets, for drug delivery, and as a cause of side effects and drug–drug interactions. In light of the development of Open PHACTS, which provides an open pharmacological space, we analyzed selected membrane transport protein classification schemes (Transporter Classification Database, ChEMBL, IUPHAR/BPS Guide to Pharmacology, and Gene Ontology) for their ability to serve as a basis for pharmacology driven protein classification. A comparison of these membrane transport protein classification schemes by using a set of clinically relevant transporters as use-case reveals the strengths and weaknesses of the different taxonomy approaches.

  20. Errors and violations

    International Nuclear Information System (INIS)

    Reason, J.

    1988-01-01

    This paper is in three parts. The first part summarizes the human failures responsible for the Chernobyl disaster and argues that, in considering the human contribution to power plant emergencies, it is necessary to distinguish between: errors and violations; and active and latent failures. The second part presents empirical evidence, drawn from driver behavior, which suggest that errors and violations have different psychological origins. The concluding part outlines a resident pathogen view of accident causation, and seeks to identify the various system pathways along which errors and violations may be propagated

  1. Instruments and Taxonomy of Workplace Bullying in Health Care Organizations

    Directory of Open Access Journals (Sweden)

    Eun-Jun Park, PhD, RN

    2017-12-01

    Full Text Available Summary: Purpose: This study was aimed to evaluate the methodological issues and comprehensiveness of workplace bullying instruments and to suggest a taxonomy of psychological abuse. Methods: Nineteen instruments applied in health care organizations and 469 questionnaire items mainly regarding psychological abuse were collected through a literature review. Three researchers classified the questionnaire items according to a “taxonomy of psychological abuse in the workplace.” Results: Many instruments of workplace bullying were developed in the 2000s using a reflective measurement model, but their psychometric property was not sufficient and the measurement model is questioned. Based on the questionnaire items, the “taxonomy of psychological abuse in the workplace” was modified by adding two new subcategories (unachievable work and unfair treatment and clarifying some operational definitions. According to the modified taxonomy of 11 (subcategories, the reviewed instruments assessed 6.5 (subcategories on average. No instrument measured all (subcategories. Category 4.2 (disrespect, humiliation, and rejection of the person was measured in all instruments, followed by Categories 5 (professional discredit and denigration and 1.2 (social isolation behaviors. Conclusion: The current instruments are not comprehensive enough. It is suggested that the modified taxonomy is verified and guide more reliable and inclusive instruments in the future. Furthermore, a formative measurement model, which defines a bullying as an inventory of different types of behaviors, should be used. Keywords: aggression, bullying, hostility, mobbing, surveys and questionnaires

  2. Climbing Bloom's taxonomy pyramid: Lessons from a graduate histology course.

    Science.gov (United States)

    Zaidi, Nikki B; Hwang, Charles; Scott, Sara; Stallard, Stefanie; Purkiss, Joel; Hortsch, Michael

    2017-09-01

    Bloom's taxonomy was adopted to create a subject-specific scoring tool for histology multiple-choice questions (MCQs). This Bloom's Taxonomy Histology Tool (BTHT) was used to analyze teacher- and student-generated quiz and examination questions from a graduate level histology course. Multiple-choice questions using histological images were generally assigned a higher BTHT level than simple text questions. The type of microscopy technique (light or electron microscopy) used for these image-based questions did not result in any significant differences in their Bloom's taxonomy scores. The BTHT levels for teacher-generated MCQs correlated positively with higher discrimination indices and inversely with the percent of students answering these questions correctly (difficulty index), suggesting that higher-level Bloom's taxonomy questions differentiate well between higher- and lower-performing students. When examining BTHT scores for MCQs that were written by students in a Multiple-Choice Item Development Assignment (MCIDA) there was no significant correlation between these scores and the students' ability to answer teacher-generated MCQs. This suggests that the ability to answer histology MCQs relies on a different skill set than the aptitude to construct higher-level Bloom's taxonomy questions. However, students significantly improved their average BTHT scores from the midterm to the final MCIDA task, which indicates that practice, experience and feedback increased their MCQ writing proficiency. Anat Sci Educ 10: 456-464. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

  3. A literature review on the levels of automation during the years. What are the different taxonomies that have been proposed?

    Science.gov (United States)

    Vagia, Marialena; Transeth, Aksel A; Fjerdingen, Sigurd A

    2016-03-01

    In this paper we present a literature review of the evolution of the levels of autonomy from the end of the 1950s up until now. The motivation of this study was primarily to gather and to compare the literature that exists, on taxonomies on levels of automation. Technical developments within both computer hardware and software have made it possible to introduce autonomy into virtually all aspects of human-machine systems. The current study, is focusing on how different authors treat the problem of different levels of automation. The outcome of this study is to present the differences between the proposed levels of automation and the various taxonomies, giving the potential users a number of choices in order to decide which taxonomy satisfies their needs better. In addition, this paper surveys deals with the term adaptive automation, which seems to be a new trend in the literature on autonomy. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  4. Multiple sequential failure model: A probabilistic approach to quantifying human error dependency

    International Nuclear Information System (INIS)

    Samanta

    1985-01-01

    This paper rpesents a probabilistic approach to quantifying human error dependency when multiple tasks are performed. Dependent human failures are dominant contributors to risks from nuclear power plants. An overview of the Multiple Sequential Failure (MSF) model developed and its use in probabilistic risk assessments (PRAs) depending on the available data are discussed. A small-scale psychological experiment was conducted on the nature of human dependency and the interpretation of the experimental data by the MSF model show remarkable accommodation of the dependent failure data. The model, which provides an unique method for quantification of dependent failures in human reliability analysis, can be used in conjunction with any of the general methods currently used for performing the human reliability aspect in PRAs

  5. Systematic analysis of video data from different human-robot interaction studies: a categorization of social signals during error situations.

    Science.gov (United States)

    Giuliani, Manuel; Mirnig, Nicole; Stollnberger, Gerald; Stadler, Susanne; Buchner, Roland; Tscheligi, Manfred

    2015-01-01

    Human-robot interactions are often affected by error situations that are caused by either the robot or the human. Therefore, robots would profit from the ability to recognize when error situations occur. We investigated the verbal and non-verbal social signals that humans show when error situations occur in human-robot interaction experiments. For that, we analyzed 201 videos of five human-robot interaction user studies with varying tasks from four independent projects. The analysis shows that there are two types of error situations: social norm violations and technical failures. Social norm violations are situations in which the robot does not adhere to the underlying social script of the interaction. Technical failures are caused by technical shortcomings of the robot. The results of the video analysis show that the study participants use many head movements and very few gestures, but they often smile, when in an error situation with the robot. Another result is that the participants sometimes stop moving at the beginning of error situations. We also found that the participants talked more in the case of social norm violations and less during technical failures. Finally, the participants use fewer non-verbal social signals (for example smiling, nodding, and head shaking), when they are interacting with the robot alone and no experimenter or other human is present. The results suggest that participants do not see the robot as a social interaction partner with comparable communication skills. Our findings have implications for builders and evaluators of human-robot interaction systems. The builders need to consider including modules for recognition and classification of head movements to the robot input channels. The evaluators need to make sure that the presence of an experimenter does not skew the results of their user studies.

  6. Statistical evaluation of major human errors during the development of new technological systems

    International Nuclear Information System (INIS)

    Campbell, G; Ott, K.O.

    1979-01-01

    Statistical procedures are presented to evaluate major human errors during the development of a new system, errors that have led or can lead to accidents or major failures. The first procedure aims at estimating the average residual occurrence rate for s or major failures after several have occurred. The procedure is solely based on the historical record. Certain idealizations are introduced that allow the application of a sound statistical evaluation procedure. These idealizations are practically realized to a sufficient degree such that the proposed estimation procedure yields meaningful results, even for situations with a sparse data base, represented by very few accidents. Under the assumption that the possible human-error-related failure times have exponential distributions, the statistical technique of isotonic regression is proposed to estimate the failure rates due to human design error at the failure times of the system. The last value in the sequence of estimates gives the residual accident chance. In addition, theactual situation is tested against the hypothesis that the failure rate of the system remains constant over time. This test determines the chance for a decreasing failure rate being incidental, rather than an indication of an actual learning process. Both techniques can be applied not merely to a single system but to an entire series of similar systems that a technology would generate, enabling the assessment of technological improvement. For the purpose of illustration, the nuclear decay of isotopes was chosen as an example, since the assumptions of the model are rigorously satisfied in this case. This application shows satisfactory agreement of the estimated and actual failure rates (which are exactly known in this example), although the estimation was deliberately based on a sparse historical record

  7. Human trichuriasis

    DEFF Research Database (Denmark)

    Betson, Martha; Søe, Martin Jensen; Nejsum, Peter

    2015-01-01

    Human trichuriasis is a neglected tropical disease which affects hundreds of millions of people worldwide and is particularly prevalent among children living in areas where sanitation is poor. This review examines the current knowledge on the taxonomy, genetics and phylogeography of human Trichuris...

  8. EPA's Information Architecture and Web Taxonomy

    Science.gov (United States)

    EPA's Information Architecture creates a topical organization of our website, instead of an ownership-based organization. The EPA Web Taxonomy allows audiences easy access to relevant information from EPA programs, by using a common vocabulary.

  9. The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions

    DEFF Research Database (Denmark)

    Kent, Michael L; Tighe, Patrick J; Belfer, Inna

    2017-01-01

    the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION), American Pain Society (APS), and American Academy of Pain Medicine (AAPM). METHODS: As a complement to a taxonomy recently developed for chronic pain, the ACTTION public-private partnership...... with the US Food and Drug Administration, the APS, and the AAPM convened a consensus meeting of experts to develop an acute pain taxonomy using prevailing evidence. Key issues pertaining to the distinct nature of acute pain are presented followed by the agreed-upon taxonomy. The ACTTION-APS-AAPM Acute Pain...... Taxonomy will include the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Future efforts will consist of working groups utilizing this taxonomy to develop diagnostic criteria...

  10. A Sensitivity Study of Human Errors in Optimizing Surveillance Test Interval (STI) and Allowed Outage Time (AOT) of Standby Safety System

    International Nuclear Information System (INIS)

    Chung, Dae Wook; Shin, Won Ky; You, Young Woo; Yang, Hui Chang

    1998-01-01

    In most cases, the surveillance test intervals (STIs), allowed outage times (AOTS) and testing strategies of safety components in nuclear power plant are prescribed in plant technical specifications. And, in general, it is required that standby safety system shall be redundant (i.e., composed of multiple components) and these components are tested by either staggered test strategy or sequential test strategy. In this study, a linear model is presented to incorporate the effects of human errors associated with test into the evaluation of unavailability. The average unavailabilities of 1/4, 2/4 redundant systems are computed considering human error and testing strategy. The adverse effects of test on system unavailability, such as component wear and test-induced transient have been modelled. The final outcome of this study would be the optimized human error domain from 3-D human error sensitivity analysis by selecting finely classified segment. The results of sensitivity analysis show that the STI and AOT can be optimized provided human error probability is maintained within allowable range. (authors)

  11. Investigating the causes of human error-induced incidents in the maintenance operations of petrochemical industry by using HFACS

    Directory of Open Access Journals (Sweden)

    Mohammadreza Azhdari

    2017-03-01

    Full Text Available Background & Objectives: Maintenance is an important tool for the petrochemical industries to prevent of accidents and increase operational and process safety success. The purpose of this study was to identify the possible causes of incidents caused by human error in the petrochemical maintenance activities by using Human Factors Analysis and Classification System (HFACS. Methods: This study is a cross-sectional analysis that was conducted in Zagros Petrochemical Company, Asaluyeh-Iran. A checklist of human error-induced incidents was developed based on four HFACS main levels and nineteen sub-groups. Hierarchical task analysis (HTA technique was used to identify maintenance activities and tasks. The main causes of possible incidents were identified by checklist and recorded. Corrective and preventive actions were defined depending on priority.   Results: The content analysis of worksheets of 444 activities showed 37.6% of the causes at the level of unsafe actions, 27.5% at the level of unsafe supervision, 20.9% at the level of preconditions for unsafe acts and 14% of the causes at the level of organizational effects. The HFACS sub-groups showed errors (24.36% inadequate supervision (14.89% and violations (13.26% with the most frequency. Conclusion: In order to prevent and reduce the occurrence of the identified errors, reducing the rate of the detected errors is crucial. Findings of this study showed that appropriate controlling measures such as periodical training of work procedures and supervision improvement decrease the human error-induced incidents in petrochemical industry maintenance.

  12. Quality of IT service delivery — Analysis and framework for human error prevention

    KAUST Repository

    Shwartz, L.; Rosu, D.; Loewenstern, D.; Buco, M. J.; Guo, S.; Lavrado, Rafael Coelho; Gupta, M.; De, P.; Madduri, V.; Singh, J. K.

    2010-01-01

    In this paper, we address the problem of reducing the occurrence of Human Errors that cause service interruptions in IT Service Support and Delivery operations. Analysis of a large volume of service interruption records revealed that more than 21

  13. Interpersonal lexicon : Structural evidence from two independently constructed verb-based taxonomies

    NARCIS (Netherlands)

    De Raad, B.

    1999-01-01

    In this study the structure of interpersonal behavior is investigated according to the principles of the so-called psycholexical approach. As bases for this study, we used the data from a taxonomy of interpersonal behavior verbs and a subset of data from a taxonomy of interpersonal tl-nir verbs. The

  14. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders.

    Science.gov (United States)

    Peck, C C; Goulet, J-P; Lobbezoo, F; Schiffman, E L; Alstergren, P; Anderson, G C; de Leeuw, R; Jensen, R; Michelotti, A; Ohrbach, R; Petersson, A; List, T

    2014-01-01

    There is a need to expand the current temporomandibular disorders' (TMDs) classification to include less common but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing and further criteria refinement. A working group [members of the International RDC/TMD Consortium Network of the International Association for Dental Research (IADR), members of the Orofacial Pain Special Interest Group (SIG) of the International Association for the Study of Pain (IASP), and members from other professional societies] reviewed disorders for inclusion based on clinical significance, the availability of plausible diagnostic criteria and the ability to operationalise and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMDs taxonomy was presented for feedback at international meetings. Of 56 disorders considered, 37 were included in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalised diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. The expanded TMDs taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalise and test the proposed taxonomy and diagnostic criteria. © 2014 John Wiley & Sons Ltd.

  15. A study on the critical factors of human error in civil aviation: An early warning management perspective in Bangladesh

    Directory of Open Access Journals (Sweden)

    Md. Salah Uddin Rajib

    2015-01-01

    Full Text Available The safety of civil aviation will be more secured if the errors in all the facets can be reduced. Like the other industrial sectors, human resource is one of the most complex and sensitive resources for the civil aviation. The error of human resources can cause fatal disasters. In these days, a good volume of researches have been conducted on the disaster of civil aviation. The researchers have identified the causes of the civil aviation disasters from various perspectives. They identified the areas where more concern is needed to reduce the disastrous impacts. This paper aims to find out the critical factors of human error in civil aviation in a developing country (Bangladesh as it is accepted that human error is one of main causes of civil aviation disasters. The paper reviews the previous research to find out the critical factors conceptually. Fuzzy analytical hierarchy process (FAHP has been used to find out the critical factors systematically. Analyses indicate that the concentration on precondition for unsafe acts (including sub-factors is required to ensure the aviation safety.

  16. Tephritid taxonomy into the 21st century - Research opportunities and applications

    International Nuclear Information System (INIS)

    Drew, R.A.I.; Romig, M.C.

    2000-01-01

    We write with the firm conviction that taxonomic research forms the essential foundation for all other areas of investigation within the field of biology. This has been well demonstrated in the Tephritidae and is a position at which we have arrived through many years' experience in fruit fly systematic research covering taxonomy, behaviour, biology, ecology and pest control. The importance of sound taxonomic research is highlighted at this time by the known presence of many sibling species complexes across the family. Within the Dacinae, for example, major pest species often occur within groups of closely related species, most of which are not pests. The dorsalis complex of Southeast Asia and the musae complex of Papua New Guinea are examples. Tephritid taxonomy has a long history (over two centuries) and rich heritage with some 4,500 species having been described since the mid-1700s. This research has been carried out in major research centres around the world and particularly in Australia, Europe, Hawaii, mainland USA and South Africa. In Mexico in February 1998, a significant meeting was held on the biology/behaviour and taxonomy of Tephritidae. Specialist researchers in this area presented valuable and interesting data on 'Phylogeny and Evolution of Behaviour' in fruit flies. In summarising current knowledge on the taxonomy and biology of the Tephritidae, the meeting highlighted the outstanding achievements of taxonomy in its contributions to both basic research and pest management programmes over many decades of tephritid studies world-wide. This presentation provides a link between the meetings in Mexico and Penang and enables us to present a summary of our current knowledge and genuine valuable applications of tephritid taxonomy to the overall fruit fly research and pest management effort. In doing this, this presentation also fits into the theme of this conference in Penang, 'Fruit Flies- current global scenario'

  17. Detecting Role Errors in the Gene Hierarchy of the NCI Thesaurus

    Directory of Open Access Journals (Sweden)

    Yehoshua Perl

    2008-01-01

    Full Text Available Gene terminologies are playing an increasingly important role in the ever-growing field of genomic research. While errors in large, complex terminologies are inevitable, gene terminologies are even more susceptible to them due to the rapid growth of genomic knowledge and the nature of its discovery. It is therefore very important to establish quality- assurance protocols for such genomic-knowledge repositories. Different kinds of terminologies oftentimes require auditing methodologies adapted to their particular structures. In light of this, an auditing methodology tailored to the characteristics of the NCI Thesaurus’s (NCIT’s Gene hierarchy is presented. The Gene hierarchy is of particular interest to the NCIT’s designers due to the primary role of genomics in current cancer research. This multiphase methodology focuses on detecting role-errors, such as missing roles or roles with incorrect or incomplete target structures, occurring within that hierarchy. The methodology is based on two kinds of abstraction networks, called taxonomies, that highlight the role distribution among concepts within the IS-A (subsumption hierarchy. These abstract views tend to highlight portions of the hierarchy having a higher concentration of errors. The errors found during an application of the methodology

  18. Identification and Evaluation of Human Errors in the Medication Process Using the Extended CREAM Technique

    Directory of Open Access Journals (Sweden)

    Iraj Mohammadfam

    2017-10-01

    Full Text Available Background Medication process is a powerful instrument for curing patients. Obeying the commands of this process has an important role in the treatment and provision of care to patients. Medication error, as a complicated process, can occur in any stage of this process, and to avoid it, appropriate decision-making, cognition, and performance of the hospital staff are needed. Objectives The present study aimed at identifying and evaluating the nature and reasons of human errors in the medication process in a hospital using the extended CREAM method. Methods This was a qualitative and cross-sectional study conducted in a hospital in Hamadan. In this study, first, the medication process was selected as a critical issue based on the opinions of experts, specialists, and experienced individuals in the nursing and medical departments. Then, the process was analyzed into relative steps and substeps using the method of HTA and was evaluated using extended CREAM technique considering the probability of human errors. Results Based on the findings achieved through the basic CREAM method, the highest CFPt was in the step of medicine administration to patients (0.056. Moreover, the results revealed that the highest CFPt was in the substeps of calculating the dose of medicine and determining the method of prescription and identifying the patient (0.0796 and 0.0785, respectively. Also, the least CFPt was related to transcribing the prescribed medicine from file to worksheet of medicine (0.0106. Conclusions Considering the critical consequences of human errors in the medication process, holding pharmacological retraining classes, using the principles of executing pharmaceutical orders, increasing medical personnel, reducing working overtime, organizing work shifts, and using error reporting systems are of paramount importance.

  19. Abstraction of complex concepts with a refined partial-area taxonomy of SNOMED

    Science.gov (United States)

    Wang, Yue; Halper, Michael; Wei, Duo; Perl, Yehoshua; Geller, James

    2012-01-01

    An algorithmically-derived abstraction network, called the partial-area taxonomy, for a SNOMED hierarchy has led to the identification of concepts considered complex. The designation “complex” is arrived at automatically on the basis of structural analyses of overlap among the constituent concept groups of the partial-area taxonomy. Such complex concepts, called overlapping concepts, constitute a tangled portion of a hierarchy and can be obstacles to users trying to gain an understanding of the hierarchy’s content. A new methodology for partitioning the entire collection of overlapping concepts into singly-rooted groups, that are more manageable to work with and comprehend, is presented. Different kinds of overlapping concepts with varying degrees of complexity are identified. This leads to an abstract model of the overlapping concepts called the disjoint partial-area taxonomy, which serves as a vehicle for enhanced, high-level display. The methodology is demonstrated with an application to SNOMED’s Specimen hierarchy. Overall, the resulting disjoint partial-area taxonomy offers a refined view of the hierarchy’s structural organization and conceptual content that can aid users, such as maintenance personnel, working with SNOMED. The utility of the disjoint partial-area taxonomy as the basis for a SNOMED auditing regimen is presented in a companion paper. PMID:21878396

  20. Monte Carlo simulation of expert judgments on human errors in chemical analysis--a case study of ICP-MS.

    Science.gov (United States)

    Kuselman, Ilya; Pennecchi, Francesca; Epstein, Malka; Fajgelj, Ales; Ellison, Stephen L R

    2014-12-01

    Monte Carlo simulation of expert judgments on human errors in a chemical analysis was used for determination of distributions of the error quantification scores (scores of likelihood and severity, and scores of effectiveness of a laboratory quality system in prevention of the errors). The simulation was based on modeling of an expert behavior: confident, reasonably doubting and irresolute expert judgments were taken into account by means of different probability mass functions (pmfs). As a case study, 36 scenarios of human errors which may occur in elemental analysis of geological samples by ICP-MS were examined. Characteristics of the score distributions for three pmfs of an expert behavior were compared. Variability of the scores, as standard deviation of the simulated score values from the distribution mean, was used for assessment of the score robustness. A range of the score values, calculated directly from elicited data and simulated by a Monte Carlo method for different pmfs, was also discussed from the robustness point of view. It was shown that robustness of the scores, obtained in the case study, can be assessed as satisfactory for the quality risk management and improvement of a laboratory quality system against human errors. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. The human fallibility of scientists : Dealing with error and bias in academic research

    NARCIS (Netherlands)

    Veldkamp, Coosje

    2017-01-01

    THE HUMAN FALLIBILITY OF SCIENTISTS Dealing with error and bias in academic research Recent studies have highlighted that not all published findings in the scientific lit¬erature are trustworthy, suggesting that currently implemented control mechanisms such as high standards for the reporting of

  2. Systematic comparative content analysis of 17 psychosocial work environment questionnaires using a new taxonomy.

    Science.gov (United States)

    Kop, Jean-Luc; Althaus, Virginie; Formet-Robert, Nadja; Grosjean, Vincent

    2016-04-01

    Many questionnaires have been developed to measure how psychosocial characteristics are perceived in a work environment. But the content validity of these questionnaires has rarely been questioned due to the absence of a reference taxonomy for characteristics of work environments. To propose an exhaustive taxonomy of work environment characteristics involved in psychosocial risks and to apply this taxonomy to questionnaires on workplace psychosocial factors. The taxonomy was developed by categorizing factors present in the main theoretical models of the field. Questionnaire items most frequently cited in scientific literature were retained for classification. The taxonomy was structured into four hierarchical levels and comprises 53 categories. The 17 questionnaires analyzed included 927 items: 59 from the "physical environment" category, 116 from the "social environment" category, 236 from the "work activity" category, 255 from the "activity management" category, and 174 from the "organizational context" category. There are major content differences among analyzed questionnaires. This study offers a means for selecting a scale on the basis of content.

  3. The Hierarchical Taxonomy of Psychopathology (HiTOP) : A Dimensional Alternative to Traditional Nosologies

    NARCIS (Netherlands)

    Kotov, Roman; Krueger, Robert F.; Watson, David; Achenbach, Thomas M.; Althoff, Robert R.; Bagby, R. Michael; Brown, Timothy A.; Carpenter, William T.; Caspi, Avshalom; Clark, Lee Anna; Eaton, Nicholas R.; Forbes, Miriam K.; Forbush, Kelsie T.; Goldberg, David; Hasin, Deborah; Hyman, Steven E.; Ivanova, Masha Y.; Lynam, Donald R.; Markon, Kristian; Miller, Joshua D.; Moffitt, Terrie E.; Morey, Leslie C.; Mullins-Sweatt, Stephanie N.; Ormel, Johan; Patrick, Christopher J.; Regier, Darrel A.; Rescorla, Leslie; Ruggero, Camilo J.; Samuel, Douglas B.; Sellbom, Martin; Simms, Leonard J.; Skodol, Andrew E.; Slade, Tim; South, Susan C.; Tackett, Jennifer L.; Waldman, Irwin D.; Waszczuk, Monika A.; Widiger, Thomas A.; Wright, Aidan G. C.; Zimmerman, Mark

    The reliability and validity of traditional taxonomies are limited by arbitrary boundaries between psychopathology and normality, often unclear boundaries between disorders, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. These taxonomies went beyond

  4. The chemotaxonomic classification of Rhodiola plants and its correlation with morphological characteristics and genetic taxonomy.

    Science.gov (United States)

    Liu, Zhenli; Liu, Yuanyan; Liu, Chunsheng; Song, Zhiqian; Li, Qing; Zha, Qinglin; Lu, Cheng; Wang, Chun; Ning, Zhangchi; Zhang, Yuxin; Tian, Cheng; Lu, Aiping

    2013-07-12

    Rhodiola plants are used as a natural remedy in the western world and as a traditional herbal medicine in China, and are valued for their ability to enhance human resistance to stress or fatigue and to promote longevity. Due to the morphological similarities among different species, the identification of the genus remains somewhat controversial, which may affect their safety and effectiveness in clinical use. In this paper, 47 Rhodiola samples of seven species were collected from thirteen local provinces of China. They were identified by their morphological characteristics and genetic and phytochemical taxonomies. Eight bioactive chemotaxonomic markers from four chemical classes (phenylpropanoids, phenylethanol derivatives, flavonoids and phenolic acids) were determined to evaluate and distinguish the chemotaxonomy of Rhodiola samples using an HPLC-DAD/UV method. Hierarchical cluster analysis (HCA) and principal component analysis (PCA) were applied to compare the two classification methods between genetic and phytochemical taxonomy. The established chemotaxonomic classification could be effectively used for Rhodiola species identification.

  5. Current status of the genetics and molecular taxonomy of Echinococcus species.

    Science.gov (United States)

    McManus, D P

    2013-11-01

    The taxonomy of Echinococcus has long been controversial. Based mainly on differences in morphology and host-parasite specificity characteristics, 16 species and 13 subspecies were originally described. Subsequently, most of these taxa were regarded as synonyms for Echinococcus granulosus and only 4 valid species were recognised: E. granulosus; E. multilocularis; E. oligarthrus and E. vogeli. But, over the past 50 years, laboratory and field observations have revealed considerable phenotypic variability between isolates of Echinococcus, particularly those of E. granulosus, which include differences in: morphology in both larval and adult stages, development in vitro and in vivo, host infectivity and specificity, chemical composition, metabolism, proteins and enzymes, pathogenicity and antigenicity. The application of molecular tools has revealed differences in nucleic acid sequences that reflect this phenotypic variation and the genetic and phenotypic characteristics complement the previous observations made by the descriptive parasitologists many years ago. The fact that some of these variants or strains are poorly or not infective to humans has resulted in a reappraisal of the public health significance of Echinococcus in areas where such variants occur. A revised taxonomy for species in the Echinococcus genus has been proposed that is generally accepted, and is based on the new molecular data and the biological and epidemiological characteristics of host-adapted species and strains.

  6. Development of a consensus taxonomy of sedentary behaviors (SIT: report of Delphi Round 1.

    Directory of Open Access Journals (Sweden)

    Sebastien Francois Martin Chastin

    Full Text Available BACKGROUND: Over the last decade, sedentary behaviors have emerged as a distinctive behavioral paradigm with deleterious effects on health independent of physical activity. The next phase of research is to establish dose response between sedentary behaviors and health outcomes and improve understanding of context and determinants of these behaviors. Establishing a common taxonomy of these behaviors is a necessary step in this process. AIM: The Sedentary behavior International Taxonomy project was developed to establish a classification of sedentary behaviors by use of a formal consensus process. METHODS: The study follows a Delphi process in three Rounds. A preparatory stage informed the development of terms of reference documents. In Round 1, experts were asked to make statements about the taxonomy; 1 its purpose and use ; 2 the domains, categories or facets that should be consider and include; 3 the structure/architecture to arrange and link these domains and facets. In Round 2 experts will be presented with a draft taxonomy emerging from Round 1 and invited to comment and propose alterations. The taxonomy will then be finalised at the outset of this stage. RESULTS: Results of Round 1 are reported here. There is a general consensus that a taxonomy will help advances in research by facilitating systematic and standardised: 1 investigation and analysis; 2 reporting and communication; 3 data pooling, comparison and meta-analysis; 4 development of measurement tools; 4 data descriptions, leading to higher quality in data querying and facilitate discoveries. There is also a consensus that such a taxonomy should be flexible to accommodate diverse purposes of use, and future advances in the field and yet provide a cross-disciplinary common language. A consensual taxonomy structure emerged with nine primary facets (Purpose, Environment, Posture, Social, Measurement, Associated behavior, Status, Time, Type and the draft structure presented here for

  7. Metagenomic Taxonomy-Guided Database-Searching Strategy for Improving Metaproteomic Analysis.

    Science.gov (United States)

    Xiao, Jinqiu; Tanca, Alessandro; Jia, Ben; Yang, Runqing; Wang, Bo; Zhang, Yu; Li, Jing

    2018-04-06

    Metaproteomics provides a direct measure of the functional information by investigating all proteins expressed by a microbiota. However, due to the complexity and heterogeneity of microbial communities, it is very hard to construct a sequence database suitable for a metaproteomic study. Using a public database, researchers might not be able to identify proteins from poorly characterized microbial species, while a sequencing-based metagenomic database may not provide adequate coverage for all potentially expressed protein sequences. To address this challenge, we propose a metagenomic taxonomy-guided database-search strategy (MT), in which a merged database is employed, consisting of both taxonomy-guided reference protein sequences from public databases and proteins from metagenome assembly. By applying our MT strategy to a mock microbial mixture, about two times as many peptides were detected as with the metagenomic database only. According to the evaluation of the reliability of taxonomic attribution, the rate of misassignments was comparable to that obtained using an a priori matched database. We also evaluated the MT strategy with a human gut microbial sample, and we found 1.7 times as many peptides as using a standard metagenomic database. In conclusion, our MT strategy allows the construction of databases able to provide high sensitivity and precision in peptide identification in metaproteomic studies, enabling the detection of proteins from poorly characterized species within the microbiota.

  8. Uncorrected refractive errors.

    Science.gov (United States)

    Naidoo, Kovin S; Jaggernath, Jyoti

    2012-01-01

    Global estimates indicate that more than 2.3 billion people in the world suffer from poor vision due to refractive error; of which 670 million people are considered visually impaired because they do not have access to corrective treatment. Refractive errors, if uncorrected, results in an impaired quality of life for millions of people worldwide, irrespective of their age, sex and ethnicity. Over the past decade, a series of studies using a survey methodology, referred to as Refractive Error Study in Children (RESC), were performed in populations with different ethnic origins and cultural settings. These studies confirmed that the prevalence of uncorrected refractive errors is considerably high for children in low-and-middle-income countries. Furthermore, uncorrected refractive error has been noted to have extensive social and economic impacts, such as limiting educational and employment opportunities of economically active persons, healthy individuals and communities. The key public health challenges presented by uncorrected refractive errors, the leading cause of vision impairment across the world, require urgent attention. To address these issues, it is critical to focus on the development of human resources and sustainable methods of service delivery. This paper discusses three core pillars to addressing the challenges posed by uncorrected refractive errors: Human Resource (HR) Development, Service Development and Social Entrepreneurship.

  9. Uncorrected refractive errors

    Directory of Open Access Journals (Sweden)

    Kovin S Naidoo

    2012-01-01

    Full Text Available Global estimates indicate that more than 2.3 billion people in the world suffer from poor vision due to refractive error; of which 670 million people are considered visually impaired because they do not have access to corrective treatment. Refractive errors, if uncorrected, results in an impaired quality of life for millions of people worldwide, irrespective of their age, sex and ethnicity. Over the past decade, a series of studies using a survey methodology, referred to as Refractive Error Study in Children (RESC, were performed in populations with different ethnic origins and cultural settings. These studies confirmed that the prevalence of uncorrected refractive errors is considerably high for children in low-and-middle-income countries. Furthermore, uncorrected refractive error has been noted to have extensive social and economic impacts, such as limiting educational and employment opportunities of economically active persons, healthy individuals and communities. The key public health challenges presented by uncorrected refractive errors, the leading cause of vision impairment across the world, require urgent attention. To address these issues, it is critical to focus on the development of human resources and sustainable methods of service delivery. This paper discusses three core pillars to addressing the challenges posed by uncorrected refractive errors: Human Resource (HR Development, Service Development and Social Entrepreneurship.

  10. A Practitioner's Perspective on Taxonomy, Ontology and Findability

    Science.gov (United States)

    Berndt, Sarah

    2011-01-01

    This slide presentation reviews the presenters perspective on developing a taxonomy for JSC to capitalize on the accomplishments of yesterday, while maintaining the flexibility needed for the evolving information of today. A clear vision and scope for the semantic system is integral to its success. The vision for the JSC Taxonomy is to connect information stovepipes to present a unified view for information and knowledge across the Center, across organizations, and across decades. Semantic search at JSC means seamless integration of disparate information sets into a single interface. Ever increasing use, interest, and organizational participation mark successful integration and provide the framework for future application.

  11. Taxonomy, Ontology and Semantics at Johnson Space Center

    Science.gov (United States)

    Berndt, Sarah Ann

    2011-01-01

    At NASA Johnson Space Center (JSC), the Chief Knowledge Officer has been developing the JSC Taxonomy to capitalize on the accomplishments of yesterday while maintaining the flexibility needed for the evolving information environment of today. A clear vision and scope for the semantic system is integral to its success. The vision for the JSC Taxonomy is to connect information stovepipes to present a unified view for information and knowledge across the Center, across organizations, and across decades. Semantic search at JSC means seemless integration of disparate information sets into a single interface. Ever increasing use, interest, and organizational participation mark successful integration and provide the framework for future application.

  12. A method to deal with installation errors of wearable accelerometers for human activity recognition

    International Nuclear Information System (INIS)

    Jiang, Ming; Wang, Zhelong; Shang, Hong; Li, Hongyi; Wang, Yuechao

    2011-01-01

    Human activity recognition (HAR) by using wearable accelerometers has gained significant interest in recent years in a range of healthcare areas, including inferring metabolic energy expenditure, predicting falls, measuring gait parameters and monitoring daily activities. The implementation of HAR relies heavily on the correctness of sensor fixation. The installation errors of wearable accelerometers may dramatically decrease the accuracy of HAR. In this paper, a method is proposed to improve the robustness of HAR to the installation errors of accelerometers. The method first calculates a transformation matrix by using Gram–Schmidt orthonormalization in order to eliminate the sensor's orientation error and then employs a low-pass filter with a cut-off frequency of 10 Hz to eliminate the main effect of the sensor's misplacement. The experimental results showed that the proposed method obtained a satisfactory performance for HAR. The average accuracy rate from ten subjects was 95.1% when there were no installation errors, and was 91.9% when installation errors were involved in wearable accelerometers

  13. Constructive Alignment and the SOLO Taxonomy

    DEFF Research Database (Denmark)

    Brabrand, Claus; Dahl, Bettina

    2008-01-01

    the science faculties at University of Aarhus, Denmark (AU) and the University of Southern Denmark (SDU) that had been rewritten to explicitly incorporate course objectives, interpreted as intended learning outcomes (ILOs), using the principles of Constructive Alignment and the SOLO Taxonomy. In this paper we...

  14. Does the A-not-B error in adult pet dogs indicate sensitivity to human communication?

    Science.gov (United States)

    Kis, Anna; Topál, József; Gácsi, Márta; Range, Friederike; Huber, Ludwig; Miklósi, Adám; Virányi, Zsófia

    2012-07-01

    Recent dog-infant comparisons have indicated that the experimenter's communicative signals in object hide-and-search tasks increase the probability of perseverative (A-not-B) errors in both species (Topál et al. 2009). These behaviourally similar results, however, might reflect different mechanisms in dogs and in children. Similar errors may occur if the motor response of retrieving the object during the A trials cannot be inhibited in the B trials or if the experimenter's movements and signals toward the A hiding place in the B trials ('sham-baiting') distract the dogs' attention. In order to test these hypotheses, we tested dogs similarly to Topál et al. (2009) but eliminated the motor search in the A trials and 'sham-baiting' in the B trials. We found that neither an inability to inhibit previously rewarded motor response nor insufficiencies in their working memory and/or attention skills can explain dogs' erroneous choices. Further, we replicated the finding that dogs have a strong tendency to commit the A-not-B error after ostensive-communicative hiding and demonstrated the crucial effect of socio-communicative cues as the A-not-B error diminishes when location B is ostensively enhanced. These findings further support the hypothesis that the dogs' A-not-B error may reflect a special sensitivity to human communicative cues. Such object-hiding and search tasks provide a typical case for how susceptibility to human social signals could (mis)lead domestic dogs.

  15. Product Engineering Class in the Software Safety Risk Taxonomy for Building Safety-Critical Systems

    Science.gov (United States)

    Hill, Janice; Victor, Daniel

    2008-01-01

    When software safety requirements are imposed on legacy safety-critical systems, retrospective safety cases need to be formulated as part of recertifying the systems for further use and risks must be documented and managed to give confidence for reusing the systems. The SEJ Software Development Risk Taxonomy [4] focuses on general software development issues. It does not, however, cover all the safety risks. The Software Safety Risk Taxonomy [8] was developed which provides a construct for eliciting and categorizing software safety risks in a straightforward manner. In this paper, we present extended work on the taxonomy for safety that incorporates the additional issues inherent in the development and maintenance of safety-critical systems with software. An instrument called a Software Safety Risk Taxonomy Based Questionnaire (TBQ) is generated containing questions addressing each safety attribute in the Software Safety Risk Taxonomy. Software safety risks are surfaced using the new TBQ and then analyzed. In this paper we give the definitions for the specialized Product Engineering Class within the Software Safety Risk Taxonomy. At the end of the paper, we present the tool known as the 'Legacy Systems Risk Database Tool' that is used to collect and analyze the data required to show traceability to a particular safety standard

  16. Human error probability quantification using fuzzy methodology in nuclear plants

    International Nuclear Information System (INIS)

    Nascimento, Claudio Souza do

    2010-01-01

    This work obtains Human Error Probability (HEP) estimates from operator's actions in response to emergency situations a hypothesis on Research Reactor IEA-R1 from IPEN. It was also obtained a Performance Shaping Factors (PSF) evaluation in order to classify them according to their influence level onto the operator's actions and to determine these PSF actual states over the plant. Both HEP estimation and PSF evaluation were done based on Specialists Evaluation using interviews and questionnaires. Specialists group was composed from selected IEA-R1 operators. Specialist's knowledge representation into linguistic variables and group evaluation values were obtained through Fuzzy Logic and Fuzzy Set Theory. HEP obtained values show good agreement with literature published data corroborating the proposed methodology as a good alternative to be used on Human Reliability Analysis (HRA). (author)

  17. Climbing Bloom's Taxonomy Pyramid: Lessons from a Graduate Histology Course

    Science.gov (United States)

    Zaidi, Nikki B.; Hwang, Charles; Scott, Sara; Stallard, Stefanie; Purkiss, Joel; Hortsch, Michael

    2017-01-01

    Bloom's taxonomy was adopted to create a subject-specific scoring tool for histology multiple-choice questions (MCQs). This Bloom's Taxonomy Histology Tool (BTHT) was used to analyze teacher- and student-generated quiz and examination questions from a graduate level histology course. Multiple-choice questions using histological images were…

  18. A new taxonomy for stakeholder engagement in patient-centered outcomes research.

    Science.gov (United States)

    Concannon, Thomas W; Meissner, Paul; Grunbaum, Jo Anne; McElwee, Newell; Guise, Jeanne-Marie; Santa, John; Conway, Patrick H; Daudelin, Denise; Morrato, Elaine H; Leslie, Laurel K

    2012-08-01

    Despite widespread agreement that stakeholder engagement is needed in patient-centered outcomes research (PCOR), no taxonomy exists to guide researchers and policy makers on how to address this need. We followed an iterative process, including several stages of stakeholder review, to address three questions: (1) Who are the stakeholders in PCOR? (2) What roles and responsibilities can stakeholders have in PCOR? (3) How can researchers start engaging stakeholders? We introduce a flexible taxonomy called the 7Ps of Stakeholder Engagement and Six Stages of Research for identifying stakeholders and developing engagement strategies across the full spectrum of research activities. The path toward engagement will not be uniform across every research program, but this taxonomy offers a common starting point and a flexible approach.

  19. Genomic taxonomy of vibrios

    Directory of Open Access Journals (Sweden)

    Iida Tetsuya

    2009-10-01

    Full Text Available Abstract Background Vibrio taxonomy has been based on a polyphasic approach. In this study, we retrieve useful taxonomic information (i.e. data that can be used to distinguish different taxonomic levels, such as species and genera from 32 genome sequences of different vibrio species. We use a variety of tools to explore the taxonomic relationship between the sequenced genomes, including Multilocus Sequence Analysis (MLSA, supertrees, Average Amino Acid Identity (AAI, genomic signatures, and Genome BLAST atlases. Our aim is to analyse the usefulness of these tools for species identification in vibrios. Results We have generated four new genome sequences of three Vibrio species, i.e., V. alginolyticus 40B, V. harveyi-like 1DA3, and V. mimicus strains VM573 and VM603, and present a broad analyses of these genomes along with other sequenced Vibrio species. The genome atlas and pangenome plots provide a tantalizing image of the genomic differences that occur between closely related sister species, e.g. V. cholerae and V. mimicus. The vibrio pangenome contains around 26504 genes. The V. cholerae core genome and pangenome consist of 1520 and 6923 genes, respectively. Pangenomes might allow different strains of V. cholerae to occupy different niches. MLSA and supertree analyses resulted in a similar phylogenetic picture, with a clear distinction of four groups (Vibrio core group, V. cholerae-V. mimicus, Aliivibrio spp., and Photobacterium spp.. A Vibrio species is defined as a group of strains that share > 95% DNA identity in MLSA and supertree analysis, > 96% AAI, ≤ 10 genome signature dissimilarity, and > 61% proteome identity. Strains of the same species and species of the same genus will form monophyletic groups on the basis of MLSA and supertree. Conclusion The combination of different analytical and bioinformatics tools will enable the most accurate species identification through genomic computational analysis. This endeavour will culminate in

  20. Working group of experts on rare events in human error analysis and quantification

    International Nuclear Information System (INIS)

    Goodstein, L.P.

    1977-01-01

    In dealing with the reference problem of rare events in nuclear power plants, the group has concerned itself with the man-machine system and, in particular, with human error analysis and quantification. The Group was requested to review methods of human reliability prediction, to evaluate the extent to which such analyses can be formalized and to establish criteria to be met by task conditions and system design which would permit a systematic, formal analysis. Recommendations are given on the Fessenheim safety system

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