The on scene command and control system (OSC2) : an integrated incident command system (ICS) forms-database management system and oil spill trajectory and fates model

International Nuclear Information System (INIS)

Anderson, E.; Galagan, C.; Howlett, E.

1998-01-01

The On Scene Command and Control (OSC 2 ) system is an oil spill modeling tool which was developed to combine Incident Command System (ICS) forms, an underlying database, an integrated geographical information system (GIS) and an oil spill trajectory and fate model. The first use of the prototype OSC 2 system was at a PREP drill conducted at the U.S. Coast Guard Marine Safety Office, San Diego, in April 1998. The goal of the drill was to simulate a real-time response over a 36-hour period using the Unified Command System. The simulated spill was the result of a collision between two vessels inside San Diego Bay that caused the release of 2,000 barrels of fuel oil. The hardware component of the system which was tested included three notebook computers, two laser printers, and a poster printer. The field test was a success but it was not a rigorous test of the system's capabilities. The map display was useful in quickly setting up the ICS divisions and groups and in deploying resources. 6 refs., 1 tab., 5 figs

Classification of medication incidents associated with information technology.

Science.gov (United States)

Cheung, Ka-Chun; van der Veen, Willem; Bouvy, Marcel L; Wensing, Michel; van den Bemt, Patricia M L A; de Smet, Peter A G M

2014-02-01

Information technology (IT) plays a pivotal role in improving patient safety, but can also cause new problems for patient safety. This study analyzed the nature and consequences of a large sample of IT-related medication incidents, as reported by healthcare professionals in community pharmacies and hospitals. The medication incidents submitted to the Dutch central medication incidents registration (CMR) reporting system were analyzed from the perspective of the healthcare professional with the Magrabi classification. During classification new terms were added, if necessary. The principal source of the IT-related problem, nature of error. Additional measures: consequences of incidents, IT systems, phases of the medication process. From March 2010 to February 2011 the CMR received 4161 incidents: 1643 (39.5%) from community pharmacies and 2518 (60.5%) from hospitals. Eventually one of six incidents (16.1%, n=668) were related to IT; in community pharmacies more incidents (21.5%, n=351) were related to IT than in hospitals (12.6%, n=317). In community pharmacies 41.0% (n=150) of the incidents were about choosing the wrong medicine. Most of the erroneous exchanges were associated with confusion of medicine names and poor design of screens. In hospitals 55.3% (n=187) of incidents concerned human-machine interaction-related input during the use of computerized prescriber order entry. These use problems were also a major problem in pharmacy information systems outside the hospital. A large sample of incidents shows that many of the incidents are related to IT, both in community pharmacies and hospitals. The interaction between human and machine plays a pivotal role in IT incidents in both settings.

Incidence and cost of medications dispensed despite electronic medical record discontinuation.

Science.gov (United States)

Baranowski, Patrick J; Peterson, Kristin L; Statz-Paynter, Jamie L; Zorek, Joseph A

2015-01-01

To determine the incidence and cost of medications dispensed despite discontinuation (MDDD) of the medications in the electronic medical record within an integrated health care organization. Dean Health System, with medical clinics and pharmacies linked by an electronic medical record, and a shared health plan and pharmacy benefits management company. Pharmacist-led quality improvement project using retrospective chart review. Electronic medical records, pharmacy records, and prescription claims data from patients 18 years of age or older who had a prescription filled for a chronic condition from June 2012 to August 2013 and submitted a claim through the Dean Health Plan were aggregated and cross-referenced to identify MDDD. Descriptive statistics were used to characterize demographics and MDDD incidence. Fisher's exact test and independent samples t tests were used to compare MDDD and non-MDDD groups. Wholesale acquisition cost was applied to each MDDD event. 7,406 patients met inclusion criteria. For 223 (3%) patients with MDDD, 253 independent events were identified. In terms of frequency per category, antihypertensive agents topped the list, followed, in descending order, by anticonvulsants, antilipemics, antidiabetics, and anticoagulants. Nine medications accounted for 59% (150 of 253) of all MDDD events; these included (again in descending order): gabapentin, atorvastatin, simvastatin, hydrochlorothiazide, lisinopril, warfarin, furosemide, metformin, and metoprolol. Mail-service pharmacies accounted for the highest incidence (5.3%) of MDDD, followed by mass merchandisers (4.6%) and small chains (3.9%). The total cost attributable to MDDD was $9,397.74. Development of a technology-based intervention to decrease the incidence of MDDD may be warranted to improve patient safety and decrease health care costs.

[Mass maritime casualty incidents in German waters: structures and resources].

Science.gov (United States)

Castan, J; Paschen, H-R; Wirtz, S; Dörges, V; Wenderoth, S; Peters, J; Blunk, Y; Bielstein, A; Kerner, T

2012-07-01

The Central Command for Maritime Emergencies was founded in Germany in 2003 triggered by the fire on board of the cargo ship "Pallas" in 1998. Its mission is to coordinate and direct measures at or above state level in maritime emergency situations in the North Sea and the Baltic Sea. A special task in this case is to provide firefighting and medical care. To face these challenges at sea emergency doctors and firemen have been specially trained. This form of organization provides a concept to counter mass casualty incidents and peril situations at sea. Since the foundation of the Central Command for Maritime Emergencies there have been 5 operations for firefighting units and 4 for medical response teams. Assignments and structure of the Central Command for Maritime Emergencies are unique in Europe.

Statistical text classifier to detect specific type of medical incidents.

Science.gov (United States)

Wong, Zoie Shui-Yee; Akiyama, Masanori

2013-01-01

WHO Patient Safety has put focus to increase the coherence and expressiveness of patient safety classification with the foundation of International Classification for Patient Safety (ICPS). Text classification and statistical approaches has showed to be successful to identifysafety problems in the Aviation industryusing incident text information. It has been challenging to comprehend the taxonomy of medical incidents in a structured manner. Independent reporting mechanisms for patient safety incidents have been established in the UK, Canada, Australia, Japan, Hong Kong etc. This research demonstrates the potential to construct statistical text classifiers to detect specific type of medical incidents using incident text data. An illustrative example for classifying look-alike sound-alike (LASA) medication incidents using structured text from 227 advisories related to medication errors from Global Patient Safety Alerts (GPSA) is shown in this poster presentation. The classifier was built using logistic regression model. ROC curve and the AUC value indicated that this is a satisfactory good model.

Command and Control during Security Incidents/Emergencies

Energy Technology Data Exchange (ETDEWEB)

Knipper, W. [NSTec

2013-10-16

This presentation builds on our response to events that pose, or have the potential to pose, a serious security or law enforcement risk and must be responded to and controlled in a clear a decisive fashion. We will examine some common concepts in the command and control of security-centric events.

Constipation - prevalence and incidence among medical patients acutely admitted to hospital with a medical condition

DEFF Research Database (Denmark)

Noiesen, Eline; Trosborg, Ingelise; Bager, Louise

2014-01-01

To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients.......To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients....

Regional coordination in medical emergencies and major incidents; plan, execute and teach

Directory of Open Access Journals (Sweden)

Hedelin Annika

2009-07-01

Full Text Available Abstract Background Although disasters and major incidents are difficult to predict, the results can be mitigated through planning, training and coordinated management of available resources. Following a fire in a disco in Gothenburg, causing 63 deaths and over 200 casualties, a medical disaster response centre was created. The center was given the task to coordinate risk assessments, disaster planning and training of staff within the region and on an executive level, to be the point of contact (POC with authority to act as "gold control," i.e. to take immediate strategic command over all medical resources within the region if needed. The aim of this study was to find out if the centre had achieved its tasks by analyzing its activities. Methods All details concerning alerts of the regional POC was entered a web-based log by the duty officer. The data registered in this database was analyzed during a 3-year period. Results There was an increase in number of alerts between 2006 and 2008, which resulted in 6293 activities including risk assessments and 4473 contacts with major institutions or key persons to coordinate or initiate actions. Eighty five percent of the missions were completed within 24 h. Twenty eight exercises were performed of which 4 lasted more than 24 h. The centre also offered 145 courses in disaster and emergency medicine and crisis communication. Conclusion The data presented in this study indicates that the center had achieved its primary tasks. Such regional organization with executive, planning, teaching and training responsibilities offers possibilities for planning, teaching and training disaster medicine by giving immediate feed-back based on real incidents.

Technology-related medication errors in a tertiary hospital: a 5-year analysis of reported medication incidents.

Science.gov (United States)

Samaranayake, N R; Cheung, S T D; Chui, W C M; Cheung, B M Y

2012-12-01

Healthcare technology is meant to reduce medication errors. The objective of this study was to assess unintended errors related to technologies in the medication use process. Medication incidents reported from 2006 to 2010 in a main tertiary care hospital were analysed by a pharmacist and technology-related errors were identified. Technology-related errors were further classified as socio-technical errors and device errors. This analysis was conducted using data from medication incident reports which may represent only a small proportion of medication errors that actually takes place in a hospital. Hence, interpretation of results must be tentative. 1538 medication incidents were reported. 17.1% of all incidents were technology-related, of which only 1.9% were device errors, whereas most were socio-technical errors (98.1%). Of these, 61.2% were linked to computerised prescription order entry, 23.2% to bar-coded patient identification labels, 7.2% to infusion pumps, 6.8% to computer-aided dispensing label generation and 1.5% to other technologies. The immediate causes for technology-related errors included, poor interface between user and computer (68.1%), improper procedures or rule violations (22.1%), poor interface between user and infusion pump (4.9%), technical defects (1.9%) and others (3.0%). In 11.4% of the technology-related incidents, the error was detected after the drug had been administered. A considerable proportion of all incidents were technology-related. Most errors were due to socio-technical issues. Unintended and unanticipated errors may happen when using technologies. Therefore, when using technologies, system improvement, awareness, training and monitoring are needed to minimise medication errors. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Command and Control for Homeland Security

National Research Council Canada - National Science Library

Greene, Marjorie

2007-01-01

... Analysis of the Toronto SARS Outbreak, Vertical Integration, Vertical Integration in a Military Command Hierarchy, Information flows for a domestic incident, C2 for Homeland Security will benefit...

Reporting Helicopter Emergency Medical Services in Major Incidents

DEFF Research Database (Denmark)

Fattah, Sabina; Johnsen, Anne Siri; Sollid, Stephen J M

2016-01-01

OBJECTIVE: Research on helicopter emergency medical services (HEMS) in major incidents is predominately based on case descriptions reported in a heterogeneous fashion. Uniform data reported with a consensus-based template could facilitate the collection, analysis, and exchange of experiences...... variables were determined by consensus. These variables were formatted in a template with 4 main categories: HEMS background information, the major incident characteristics relevant to HEMS, the HEMS response to the major incident, and the key lessons learned. CONCLUSION: Based on opinions from European...

Using incident reports to inform the prevention of medication administration errors.

Science.gov (United States)

Härkänen, Marja; Saano, Susanna; Vehviläinen-Julkunen, Katri

2017-11-01

To describe ways of preventing medication administration errors based on reporters' views expressed in medication administration incident reports. Medication administration errors are very common, and nurses play important roles in committing and in preventing such errors. Thus far, incident reporters' perceptions of how to prevent medication administration errors have rarely been analysed. This is a qualitative, descriptive study using an inductive content analysis of the incident reports related to medication administration errors (n = 1012). These free-text descriptions include reporters' views on preventing the reoccurrence of medication administration errors. The data were collected from two hospitals in Finland and pertain to incidents that were reported between 1 January 2013 and 31 December 2014. Reporters' views on preventing medication administration errors were divided into three main categories related to individuals (health professionals), teams and organisations. The following categories related to individuals in preventing medication administration errors were identified: (1) accuracy and preciseness; (2) verification; and (3) following the guidelines, responsibility and attitude towards work. The team categories were as follows: (1) distribution of work; (2) flow of information and cooperation; and (3) documenting and marking the drug information. The categories related to organisation were as follows: (1) work environment; (2) resources; (3) training; (4) guidelines; and (5) development of the work. Health professionals should administer medication with a high moral awareness and an attempt to concentrate on the task. Nonetheless, the system should support health professionals by providing a reasonable work environment and encouraging collaboration among the providers to facilitate the safe administration of medication. Although there are numerous approaches to supporting medication safety, approaches that support the ability of individual health

Urgent medical response in CBR incidents

International Nuclear Information System (INIS)

Castulik, P.; Slabotinsky, J.; Kralik, L.; Bradka, S.

2009-01-01

During CBR incidents with releases of hazardous materials (HazMat), there is extremely urgent aim of first rescuing responders to safe the life for as much as possible victims and reducing health consequences from the exposure of the HazMat. Highest priority of the response is to be applied, if victims are exposed with chemicals through their airways and/or mucous membranes. There is general approach in the emergency medical services (EMS) stated that the victims being in critical status have to receive emergency medical care on-site even prior the transportation to a medical facility. However, in a case of CBR events the EMS prefer to provide the First Aid for victims to be already decontaminated as mass casualties, e.g. by the firemen and transferred to a safe zone. This approach is to be time consuming and thus creating delays in medical care not in the favor of a victim's successful survival. In order to overcome this approach, there are needs for eminent ceasing of the victims exposure, protection of breathing tract/ventilation support and administration of antidotes, if available. All this have to be done in shortest time since HazMat incident/accident occurs. This presentation is focusing on emergency provisions for saving victims directly in contaminated environment through the assistance by responders, concentrating on search and rescue of victims, their emergency decontamination, breathing protection, clothing removal, ventilation support, antidote administration, fixing and bandage of trauma injuries prior transportation and/or mass decontamination. This experience is shared based on a field exercise with the EMS volunteers (Red Cross), fire brigade volunteers and university's students.(author)

An Investigation of Operational Decision Making in Situ: Incident Command in the U.K. Fire and Rescue Service.

Science.gov (United States)

Cohen-Hatton, Sabrina R; Butler, Philip C; Honey, Robert C

2015-08-01

The aim of this study was to better understand the nature of decision making at operational incidents in order to inform operational guidance and training. Normative models of decision making have been adopted in the guidance and training for emergency services. In these models, it is assumed that decision makers assess the current situation, formulate plans, and then execute the plans. However, our understanding of how decision making unfolds at operational incidents remains limited. Incident commanders, attending 33 incidents across six U.K. Fire and Rescue Services, were fitted with helmet-mounted cameras, and the resulting video footage was later independently coded and used to prompt participants to provide a running commentary concerning their decisions. The analysis revealed that assessment of the operational situation was most often followed by plan execution rather than plan formulation, and there was little evidence of prospection about the potential consequences of actions. This pattern of results was consistent across different types of incident, characterized by level of risk and time pressure, but was affected by the operational experience of the participants. Decision making did not follow the sequence of phases assumed by normative models and conveyed in current operational guidance but instead was influenced by both reflective and reflexive processes. These results have clear implications for understanding operational decision making as it occurs in situ and suggest a need for future guidance and training to acknowledge the role of reflexive processes. © 2015, Human Factors and Ergonomics Society.

Application of Incident Command Structure to clinical trial management in the academic setting: principles and lessons learned.

Science.gov (United States)

Reynolds, Penny S; Michael, Mary J; Spiess, Bruce D

2017-02-09

Clinical trial success depends on appropriate management, but practical guidance to trial organisation and planning is lacking. The Incident Command System (ICS) is the 'gold standard' management system developed for managing diverse operations in major incident and public health arenas. It enables effective and flexible management through integration of personnel, procedures, resources, and communications within a common hierarchical organisational structure. Conventional ICS organisation consists of five function modules: Command, Planning, Operations, Logistics, and Finance/Administration. Large clinical trials will require a separate Regulatory Administrative arm, and an Information arm, consisting of dedicated data management and information technology staff. We applied ICS principles to organisation and management of the Prehospital Use of Plasma in Traumatic Haemorrhage (PUPTH) trial. This trial was a multidepartmental, multiagency, randomised clinical trial investigating prehospital administration of thawed plasma on mortality and coagulation response in severely injured trauma patients. We describe the ICS system as it would apply to large clinical trials in general, and the benefits, barriers, and lessons learned in utilising ICS principles to reorganise and coordinate the PUPTH trial. Without a formal trial management structure, early stages of the trial were characterised by inertia and organisational confusion. Implementing ICS improved organisation, coordination, and communication between multiple agencies and service groups, and greatly streamlined regulatory compliance administration. However, unfamiliarity of clinicians with ICS culture, conflicting resource allocation priorities, and communication bottlenecks were significant barriers. ICS is a flexible and powerful organisational tool for managing large complex clinical trials. However, for successful implementation the cultural, psychological, and social environment of trial participants must be

The Role of Emergency Medical Service in CBR Incidents

International Nuclear Information System (INIS)

Castulik, P.

2007-01-01

Majority of Emergency Medical Services (EMS) have daily extensive experience with rescue of casualties having trauma injuries, resulting from conventional incidents. In the case of non-conventional incidents involving chemical, bacteriological or radiological (CBR) hazardous materials operational scene for all responders is begin to be more complicated due contamination of casualties, equipment and environment. Especially EMS personnel and receiving staff at the hospital have to work under very demanding condition due to burden of personal protective equipment (PPE) and awareness to avoiding cross-contamination during handling casualties. Those conditions require significantly different approaches for search and rescue of victims from incident site, through transportation and effective treatment at medical facilities. In cases when chemicals will be major hazard materials, the speed of rescue and treatment of victims is a major challenge. Each minute matter, and any delay of response could seriously complicated saving of lives and successful recovery of exposed victims. Success in rescue victims is finally measured thorough the ability of the first responders to save people... ALIVE..., no matter what surrounding condition is. The presentation is providing a view and suggestions on more rapid immediate medical response during non-conventional incidents. It names basic concept based on preparedness, early identification of CBR hazards through signs and symptoms of casualties, priorities of rescue procedures and care on-site, needs of decontamination, rapid evacuation casualties from a scene and immediate hospital response.(author)

Medical treatment of radiation damages and medical emergency planning in case of nuclear power plant incidents and accidents

International Nuclear Information System (INIS)

Ohlenschlaeger, L.

1981-03-01

Medical measures in case of radiation damages are discussed on the basis of five potential categories of radiation incidents and accidents, respectively, viz. contaminations, incorporations, external local and general radiation over-exposures, contaminated wounds, and combinations of radiation damages and conventional injuries. Considerations are made for diagnostic and therapeutic initial measures especially in case of minor and moderate radiation accidents. The medical emergency planning is reviewed by means of definations used in the practical handling of incidents or accidents. The parameters are: extent of the incident or accident, number of persons involved, severity of radiation damage. Based on guiding symptoms the criteria for the classification into minor, moderate or severe radiation accidents are discussed. Reference is made to the Medical Radiation Protection Centers existing in the Federal Republic of Germany and the possibility of getting advices in case of radiation incidents and accidents. (orig.) [de

Public Health and Medical Preparedness for a Nuclear Detonation: The Nuclear Incident Medical Enterprise

Science.gov (United States)

Coleman, C. Norman; Sullivan, Julie M.; Bader, Judith L.; Murrain-Hill, Paula; Koerner, John F.; Garrett, Andrew L.; Weinstock, David M.; Case, Cullen; Hrdina, Chad; Adams, Steven A.; Whitcomb, Robert C.; Graeden, Ellie; Shankman, Robert; Lant, Timothy; Maidment, Bert W.; Hatchett, Richard C.

2014-01-01

Resilience and the ability to mitigate the consequences of a nuclear incident are enhanced by (1) effective planning, preparation and training; (2) ongoing interaction, formal exercises, and evaluation among the sectors involved; (3) effective and timely response and communication; and (4) continuous improvements based on new science, technology, experience and ideas. Public health and medical planning require a complex, multi-faceted systematic approach involving federal, state, local, tribal and territorial governments, private sector organizations, academia, industry, international partners, and individual experts and volunteers. The approach developed by the U.S. Department of Health and Human Services Nuclear Incident Medical Enterprise (NIME) is the result of efforts from government and nongovernment experts. It is a “bottom-up” systematic approach built on the available and emerging science that considers physical infrastructure damage, the spectrum of injuries, a scarce resources setting, the need for decision making in the face of a rapidly evolving situation with limited information early on, timely communication and the need for tools and just-in-time information for responders who will likely be unfamiliar with radiation medicine and uncertain and overwhelmed in the face of the large number of casualties and the presence of radioactivity. The components of NIME can be used to support planning for, response to, and recovery from the effects of a nuclear incident. Recognizing that it is a continuous work-in-progress, the current status of the public health and medical preparedness and response for a nuclear incident is provided. PMID:25551496

Medication Incidents Related to Automated Dose Dispensing in Community Pharmacies and Hospitals - A Reporting System Study

Science.gov (United States)

Cheung, Ka-Chun; van den Bemt, Patricia M. L. A.; Bouvy, Marcel L.; Wensing, Michel; De Smet, Peter A. G. M.

2014-01-01

Introduction Automated dose dispensing (ADD) is being introduced in several countries and the use of this technology is expected to increase as a growing number of elderly people need to manage their medication at home. ADD aims to improve medication safety and treatment adherence, but it may introduce new safety issues. This descriptive study provides insight into the nature and consequences of medication incidents related to ADD, as reported by healthcare professionals in community pharmacies and hospitals. Methods The medication incidents that were submitted to the Dutch Central Medication incidents Registration (CMR) reporting system were selected and characterized independently by two researchers. Main Outcome Measures Person discovering the incident, phase of the medication process in which the incident occurred, immediate cause of the incident, nature of incident from the healthcare provider's perspective, nature of incident from the patient's perspective, and consequent harm to the patient caused by the incident. Results From January 2012 to February 2013 the CMR received 15,113 incidents: 3,685 (24.4%) incidents from community pharmacies and 11,428 (75.6%) incidents from hospitals. Eventually 1 of 50 reported incidents (268/15,113 = 1.8%) were related to ADD; in community pharmacies more incidents (227/3,685 = 6.2%) were related to ADD than in hospitals (41/11,428 = 0.4%). The immediate cause of an incident was often a change in the patient's medicine regimen or relocation. Most reported incidents occurred in two phases: entering the prescription into the pharmacy information system and filling the ADD bag. Conclusion A proportion of incidents was related to ADD and is reported regularly, especially by community pharmacies. In two phases, entering the prescription into the pharmacy information system and filling the ADD bag, most incidents occurred. A change in the patient's medicine regimen or relocation was the immediate causes of an incident

A management plan for hospitals and medical centers facing radiation incidents.

Science.gov (United States)

Davari, Fereshteh; Zahed, Arash

2015-09-01

Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

Utilisation of helicopter emergency medical services in the early medical response to major incidents: a systematic literature review.

Science.gov (United States)

Johnsen, Anne Siri; Fattah, Sabina; Sollid, Stephen J M; Rehn, Marius

2016-02-09

This systematic review identifies, describes and appraises the literature describing the utilisation of helicopter emergency medical services (HEMS) in the early medical response to major incidents. Early prehospital phase of a major incident. Systematic literature review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, PsycINFO, Scopus, Cinahl, Bibsys Ask, Norart, Svemed and UpToDate were searched using phrases that combined HEMS and 'major incidents' to identify when and how HEMS was utilised. The identified studies were subjected to data extraction and appraisal. The database search identified 4948 articles. Based on the title and abstract, the full text of 96 articles was obtained; of these, 37 articles were included in the review, and an additional five were identified by searching the reference lists of the 37 articles. HEMS was used to transport medical and rescue personnel to the incident and to transport patients to the hospital, especially when the infrastructure was damaged. Insufficient air traffic control, weather conditions, inadequate landing sites and failing communication were described as challenging in some incidents. HEMS was used mainly for patient treatment and to transport patients, personnel and equipment in the early medical management of major incidents, but the optimal utilisation of this specialised resource remains unclear. This review identified operational areas with improvement potential. A lack of systematic indexing, heterogeneous data reporting and weak methodological design, complicated the identification and comparison of incidents, and more systematic reporting is needed. CRD42013004473. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Medication incidents in primary care medicine: a prospective study in the Swiss Sentinel Surveillance Network (Sentinella).

Science.gov (United States)

Gnädinger, Markus; Conen, Dieter; Herzig, Lilli; Puhan, Milo A; Staehelin, Alfred; Zoller, Marco; Ceschi, Alessandro

2017-07-26

To describe the type, frequency, seasonal and regional distribution of medication incidents in primary care in Switzerland and to elucidate possible risk factors for medication incidents. Prospective surveillance study. Swiss primary healthcare, Swiss Sentinel Surveillance Network. Patients with drug treatment who experienced any erroneous event related to the medication process and interfering with normal treatment course, as judged by their physician. The 180 physicians in the study were general practitioners or paediatricians participating in the Swiss Federal Sentinel reporting system in 2015. Primary: medication incidents; secondary: potential risk factors like age, gender, polymedication, morbidity, care-dependency, previous hospitalisation. The mean rates of detected medication incidents were 2.07 per general practitioner per year (46.5 per 1 00 000 contacts) and 0.15 per paediatrician per year (2.8 per 1 00 000 contacts), respectively. The following factors were associated with medication incidents (OR, 95% CI): higher age 1.004 per year (1.001; 1.006), care by community nurse 1.458 (1.025; 2.073) and care by an institution 1.802 (1.399; 2.323), chronic conditions 1.052 (1.029; 1.075) per condition, medications 1.052 (1.030; 1.074) per medication, as well as Thurgau Morbidity Index for stage 4: 1.292 (1.004; 1.662), stage 5: 1.420 (1.078; 1.868) and stage 6: 1.680 (1.178; 2.396), respectively. Most cases were linked to an incorrect dosage for a given patient, while prescription of an erroneous medication was the second most common error. Medication incidents are common in adult primary care, whereas they rarely occur in paediatrics. Older and multimorbid patients are at a particularly high risk for medication incidents. Reasons for medication incidents are diverse but often seem to be linked to communication problems. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

Incident Management: Process into Practice

Science.gov (United States)

Isaac, Gayle; Moore, Brian

2011-01-01

Tornados, shootings, fires--these are emergencies that require fast action by school district personnel, but they are not the only incidents that require risk management. The authors have introduced the National Incident Management System (NIMS) and the Incident Command System (ICS) and assured that these systems can help educators plan for and…

Risk factors for incident delirium in an acute general medical setting: a retrospective case-control study.

Science.gov (United States)

Tomlinson, Emily Jane; Phillips, Nicole M; Mohebbi, Mohammadreza; Hutchinson, Alison M

2017-03-01

To determine predisposing and precipitating risk factors for incident delirium in medical patients during an acute hospital admission. Incident delirium is the most common complication of hospital admission for older patients. Up to 30% of hospitalised medical patients experience incident delirium. Determining risk factors for delirium is important for identifying patients who are most susceptible to incident delirium. Retrospective case-control study with two controls per case. An audit tool was used to review medical records of patients admitted to acute medical units for data regarding potential risk factors for delirium. Data were collected between August 2013 and March 2014 at three hospital sites of a healthcare organisation in Melbourne, Australia. Cases were 161 patients admitted to an acute medical ward and diagnosed with incident delirium between 1 January 2012 and 31 December 2013. Controls were 321 patients sampled from the acute medical population admitted within the same time range, stratified for admission location and who did not develop incident delirium during hospitalisation. Identified using logistic regression modelling, predisposing risk factors for incident delirium were dementia, cognitive impairment, functional impairment, previous delirium and fracture on admission. Precipitating risk factors for incident delirium were use of an indwelling catheter, adding more than three medications during admission and having an abnormal sodium level during admission. Multiple risk factors for incident delirium exist; patients with a history of delirium, dementia and cognitive impairment are at greatest risk of developing delirium during hospitalisation. Nurses and other healthcare professionals should be aware of patients who have one or more risk factors for incident delirium. Knowledge of risk factors for delirium has the potential to increase the recognition and understanding of patients who are vulnerable to delirium. Early recognition and

Medical and policy considerations for nuclear and radiation accidents, incidents and terrorism.

Science.gov (United States)

Gale, Robert Peter

2017-11-01

The purpose of this review is to address the increasing medical and public concern regarding the health consequences of radiation exposure, a concern shaped not only by fear of another Chernobyl or Fukushima nuclear power facility accident but also by the intentional use of a nuclear weapon, a radiological dispersion device, a radiological exposure device, or an improved nuclear device by rogue states such as North Korea and terrorist organizations such as Al Qaeda and ISIS. The United States has the medical capacity to respond to a limited nuclear or radiation accident or incident but an effective medical response to a catastrophic nuclear event is impossible. Dealing effectively with nuclear and radiation accidents or incidents requires diverse strategies, including policy decisions, public education, and medical preparedness. I review medical consequences of exposures to ionizing radiations, likely concomitant injuries and potential medical intervention. These data should help haematologists and other healthcare professionals understand the principles of medical consequences of nuclear terrorism. However, the best strategy is prevention.

Identifying medication error chains from critical incident reports: a new analytic approach.

Science.gov (United States)

Huckels-Baumgart, Saskia; Manser, Tanja

2014-10-01

Research into the distribution of medication errors usually focuses on isolated stages within the medication use process. Our study aimed to provide a novel process-oriented approach to medication incident analysis focusing on medication error chains. Our study was conducted across a 900-bed teaching hospital in Switzerland. All reported 1,591 medication errors 2009-2012 were categorized using the Medication Error Index NCC MERP and the WHO Classification for Patient Safety Methodology. In order to identify medication error chains, each reported medication incident was allocated to the relevant stage of the hospital medication use process. Only 25.8% of the reported medication errors were detected before they propagated through the medication use process. The majority of medication errors (74.2%) formed an error chain encompassing two or more stages. The most frequent error chain comprised preparation up to and including medication administration (45.2%). "Non-consideration of documentation/prescribing" during the drug preparation was the most frequent contributor for "wrong dose" during the administration of medication. Medication error chains provide important insights for detecting and stopping medication errors before they reach the patient. Existing and new safety barriers need to be extended to interrupt error chains and to improve patient safety. © 2014, The American College of Clinical Pharmacology.

Medical management of three workers following a radiation exposure incident

International Nuclear Information System (INIS)

House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L.

1992-01-01

The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms

Medical management of three workers following a radiation exposure incident

Energy Technology Data Exchange (ETDEWEB)

House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L. (Department of Occupational and Environmental Health, St. Michael' s Hospital, Toronto, Ontario (Canada))

1992-01-01

The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms.

A management plan for hospitals and medical centers facing radiation incidents

Directory of Open Access Journals (Sweden)

Fereshteh Davari

2015-01-01

Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

Westgate Shootings: An Emergency Department Approach to a Mass-casualty Incident.

Science.gov (United States)

Wachira, Benjamin W; Abdalla, Ramadhani O; Wallis, Lee A

2014-10-01

At approximately 12:30 pm on Saturday September 21, 2013, armed assailants attacked the upscale Westgate shopping mall in the Westlands area of Nairobi, Kenya. Using the seven key Major Incident Medical Management and Support (MIMMS) principles, command, safety, communication, assessment, triage, treatment, and transport, the Aga Khan University Hospital, Nairobi (AKUH,N) emergency department (ED) successfully coordinated the reception and care of all the casualties brought to the hospital. This report describes the AKUH,N ED response to the first civilian mass-casualty shooting incident in Kenya, with the hope of informing the development and implementation of mass-casualty emergency preparedness plans by other EDs and hospitals in Kenya, appropriate for the local health care system.

28 CFR 552.26 - Medical attention in use of force and application of restraints incidents.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Medical attention in use of force and application of restraints incidents. 552.26 Section 552.26 Judicial Administration BUREAU OF PRISONS... § 552.26 Medical attention in use of force and application of restraints incidents. (a) In immediate use...

Constipation--prevalence and incidence among medical patients acutely admitted to hospital with a medical condition.

Science.gov (United States)

Noiesen, Eline; Trosborg, Ingelise; Bager, Louise; Herning, Margrethe; Lyngby, Christel; Konradsen, Hanne

2014-08-01

To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients. Constipation is a common medical problem with severe consequences, and most people suffer from constipation at some point in their lives. In the general population, constipation is one of the most common complaints and is a significant personal and public health burden. Alteration in patients' patterns of elimination while in hospital has long been identified as either a potential or an actual problem that requires attention. Knowledge of the prevalence and incidence of constipation during hospitalisation is only sporadic. The study was descriptive and a prospective cohort design was chosen. The Constipation Assessment Scale was translated into Danish and was used for the assessment of patient-reported bowel function. Five nurses made the assessments at admission to the acute medical ward and three days after admission. Three hundred and seventy-three patients participated in this study. Thirty-nine percent of the patients showed symptoms of constipation at admission. Of the patients who did not have the symptoms at admission, 43% developed the symptoms during the first three days of their stay in hospital. Significantly more of the older patients developed symptoms of moderate constipation. The incidence rate was 143 new cases per 1000 patient days. In this study, symptoms of constipation were common among patients acutely admitted to hospital due to different medical conditions. Symptoms of constipation were also developed during the first three days of the stay in hospital. The study highlights the need to develop both clinical guidelines towards treating constipation, and preventive measures to ensure that patients do not become constipated while staying in hospital. © 2013 John Wiley & Sons Ltd.

ARAC: A unique command and control resource

Energy Technology Data Exchange (ETDEWEB)

Bradley, M.M.; Baskett, R.L.; Ellis, J.S. [and others

1996-04-01

The Atmospheric Release Advisory Capability (ARAC) at Lawrence Livermore National Laboratory (LLNL) is a centralized federal facility designed to provide real-time, world-wide support to military and civilian command and control centers by predicting the impacts of inadvertent or intentional releases of nuclear, biological, or chemical materials into the atmosphere. ARAC is a complete response system consisting of highly trained and experienced personnel, continually updated computer models, redundant data collection systems, and centralized and remote computer systems. With over 20 years of experience responding to domestic and international incidents, strong linkages with the Department of Defense, and the ability to conduct classified operations, ARAC is a unique command and control resource.

ARAC: A unique command and control resource

International Nuclear Information System (INIS)

Bradley, M.M.; Baskett, R.L.; Ellis, J.S.

1996-04-01

The Atmospheric Release Advisory Capability (ARAC) at Lawrence Livermore National Laboratory (LLNL) is a centralized federal facility designed to provide real-time, world-wide support to military and civilian command and control centers by predicting the impacts of inadvertent or intentional releases of nuclear, biological, or chemical materials into the atmosphere. ARAC is a complete response system consisting of highly trained and experienced personnel, continually updated computer models, redundant data collection systems, and centralized and remote computer systems. With over 20 years of experience responding to domestic and international incidents, strong linkages with the Department of Defense, and the ability to conduct classified operations, ARAC is a unique command and control resource

What are incident reports telling us? A comparative study at two Australian hospitals of medication errors identified at audit, detected by staff and reported to an incident system.

Science.gov (United States)

Westbrook, Johanna I; Li, Ling; Lehnbom, Elin C; Baysari, Melissa T; Braithwaite, Jeffrey; Burke, Rosemary; Conn, Chris; Day, Richard O

2015-02-01

To (i) compare medication errors identified at audit and observation with medication incident reports; (ii) identify differences between two hospitals in incident report frequency and medication error rates; (iii) identify prescribing error detection rates by staff. Audit of 3291 patient records at two hospitals to identify prescribing errors and evidence of their detection by staff. Medication administration errors were identified from a direct observational study of 180 nurses administering 7451 medications. Severity of errors was classified. Those likely to lead to patient harm were categorized as 'clinically important'. Two major academic teaching hospitals in Sydney, Australia. Rates of medication errors identified from audit and from direct observation were compared with reported medication incident reports. A total of 12 567 prescribing errors were identified at audit. Of these 1.2/1000 errors (95% CI: 0.6-1.8) had incident reports. Clinically important prescribing errors (n = 539) were detected by staff at a rate of 218.9/1000 (95% CI: 184.0-253.8), but only 13.0/1000 (95% CI: 3.4-22.5) were reported. 78.1% (n = 421) of clinically important prescribing errors were not detected. A total of 2043 drug administrations (27.4%; 95% CI: 26.4-28.4%) contained ≥ 1 errors; none had an incident report. Hospital A had a higher frequency of incident reports than Hospital B, but a lower rate of errors at audit. Prescribing errors with the potential to cause harm frequently go undetected. Reported incidents do not reflect the profile of medication errors which occur in hospitals or the underlying rates. This demonstrates the inaccuracy of using incident frequency to compare patient risk or quality performance within or across hospitals. New approaches including data mining of electronic clinical information systems are required to support more effective medication error detection and mitigation. © The Author 2015. Published by Oxford University Press in association

Assessment of Evidence Base from Medical Debriefs Data on Space Motion Sickness Incidence and Treatment

Science.gov (United States)

Younker, D.R.; Daniels, V.R.; Boyd, J.L.; Putcha, L.

2008-01-01

An objective of this data compilation and analysis project is to examine incidence and treatment efficacy of common patho-physiological disturbances during spaceflight. Analysis of medical debriefs data indicated that astronauts used medications to alleviate symptoms of four major ailments for which astronauts received treatment for sleep disturbances, space motion sickness (SMS), pain (headache, back pain) and sinus congestion. In the present data compilation and analysis project on SMS treatment during space missions, subject demographics (gender, age, first-time or repeat flyer), incidence and severity of SMS symptoms and subjective treatment efficacy from 317 crewmember debrief records were examined from STS-1 through STS-89. Preliminary analysis of data revealed that 50% of crew members reported SMS symptoms on at least one flight and 22% never experienced it. In addition, there were 387 medication dosing episodes reported, and promethazine was the most commonly used medication. Results of analysis of symptom check lists, medication use/efficacy and gender and flight record differences in incidence and treatment efficacy will be presented. Evidence gaps for treatment efficacy along with medication use trend analysis will be identified.

Learning from incident reports in the Australian medical imaging setting: handover and communication errors.

Science.gov (United States)

Hannaford, N; Mandel, C; Crock, C; Buckley, K; Magrabi, F; Ong, M; Allen, S; Schultz, T

2013-02-01

To determine the type and nature of incidents occurring within medical imaging settings in Australia and identify strategies that could be engaged to reduce the risk of their re-occurrence. 71 search terms, related to clinical handover and communication, were applied to 3976 incidents in the Radiology Events Register. Detailed classification and thematic analysis of a subset of incidents that involved handover or communication (n=298) were undertaken to identify the most prevalent types of error and to make recommendations about patient safety initiatives in medical imaging. Incidents occurred most frequently during patient preparation (34%), when requesting imaging (27%) and when communicating a diagnosis (23%). Frequent problems within each of these stages of the imaging cycle included: inadequate handover of patients (41%) or unsafe or inappropriate transfer of the patient to or from medical imaging (35%); incorrect information on the request form (52%); and delayed communication of a diagnosis (36%) or communication of a wrong diagnosis (36%). The handover of patients and clinical information to and from medical imaging is fraught with error, often compromising patient safety and resulting in communication of delayed or wrong diagnoses, unnecessary radiation exposure and a waste of limited resources. Corrective strategies to address safety concerns related to new information technologies, patient transfer and inadequate test result notification policies are relevant to all healthcare settings. Handover and communication errors are prevalent in medical imaging. System-wide changes that facilitate effective communication are required.

Incidence Rate of Community-Acquired Sepsis Among Hospitalized Acute Medical Patients-A Population-Based Survey

DEFF Research Database (Denmark)

Henriksen, Daniel Pilsgaard; Laursen, Christian B; Jensen, Thøger Gorm

2015-01-01

to the hospital. DESIGN:: Population-based survey. SETTING:: Medical emergency department from September 1, 2010, to August 31, 2011. PATIENTS:: All patients were manually reviewed using a structured protocol in order to identify the presence of infection. Vital signs and laboratory values were collected...... to define the presence of systemic inflammatory response syndrome and organ dysfunction. MEASUREMENTS AND MAIN RESULTS:: Incidence rate of sepsis of any severity. Among 8,358 admissions to the medical emergency department, 1,713 patients presented with an incident admission of sepsis of any severity, median...... on symptoms and clinical findings at arrival, incidence rates of patients admitted to a medical emergency department with sepsis and severe sepsis are more frequent than previously reported based on discharge diagnoses....

US command improvements and command vulnerability

International Nuclear Information System (INIS)

Ball, D.; Bethe, H.A.; Blair, B.G.; Bracken, P.; Carter, A.B.; Dickinson, H.; Garwin, R.L.; Holloway, D.; Kendall, H.W.

1988-01-01

In essence, the United States still relies on the strategic command system erected during the 1960s and 1970s, but as we have seen, this system suffers from a number of serious weaknesses. Among these the authors emphasized the vulnerability of vital communications even before any warheads impact directly on U.S. targets, as well as the systems; heavy reliance on a relatively small number of limited-endurance aircraft as command posts and radio relays. This paper focuses on the committed improvement program, assess its impact on command vulnerability, and offer suggestions for further command improvements designed to enhance crisis stability and to facilitate ware termination should deterrence fail. The reader should note that this chapter is rather more technical than the remainder of this book

The Incidence of Needlestick Injuries During Perineorrhaphy and Attitudes Toward Occurrence Reports Among Medical Students

Directory of Open Access Journals (Sweden)

Nalinee Panichyawat

2016-07-01

Full Text Available Background: Medical students are at risk of needlestick injuries (NSIs while performing obstetrical procedures especially perineorrhaphy, because of their less experience. This study aims to determine the incidence and causes of NSIs during perineorrhaphy and medical students’ attitudes toward occurrence reports. Methods: A cross-sectional study was conducted. After completion of Obstetrics & Gynaecology rotation, the data from final year medical students were collected using a self-administered questionnaire. Results: Of 390 medical students, 290 (74.4% returned questionnaires with complete data. The annual NSIs incidence during perineorrhaphy was 26.9%. The most common site of injury was the index finger of the non- dominant hand (66.2%. Common causes of NSIs were time pressure (52.1% and lack of surgical skills (50.7%. Nearly half of students (41% did not report their occurrence, and 81.3% of injured students believed that NSIs were harmless. Conclusion: The incidence of NSIs during perineorrhaphy and the non-reporting occurrence were quite high among medical students. Structural clinical supervision by medical staffs, HBV vaccination for all medical students, and instruction on standard pre-exposure precaution should be applied. We advocate a strategy plan for increasing students’ awareness and having a simple occurrence reporting system for NSIs, with clear guidelines on post-exposure protocols in all medical schools and teaching hospitals.

Medical support for law enforcement-extended operations incidents.

Science.gov (United States)

Levy, Matthew J; Tang, Nelson

2014-01-01

As the complexity and frequency of law enforcement-extended operations incidents continue to increase, so do the opportunities for adverse health and well-being impacts on the responding officers. These types of clinical encounters have not been well characterized nor have the medical response strategies which have been developed to effectively manage these encounters been well described. The purpose of this article is to provide a descriptive epidemiology of the clinical encounters reported during extended law enforcement operations, as well as to describe a best practices approach for their effective management. This study retrospectively examined the clinical encounters of the Maryland State Police (MSP) Tactical Medical Unit (TMU) during law enforcement extended operations incidents lasting 8 or more hours. In addition, a qualitative analysis was performed on clinical data collected by federal law enforcement agencies during their extended operations. Forty-four percent of missions (455/1,047) supported by the MSP TMU lasted 8 or more hours. Twenty-six percent of these missions (117/455) resulted in at least one patient encounter. Nineteen percent of patient chief complaints (45/238) were related to heat illness/ dehydration. Fifteen percent of encounters (36/238) were for musculoskeletal injury/pain. Eight percent of patients (19/238) had nonspecific sick call (minor illness) complaints. The next most common occurring complaints were cold-related injuries, headache, sinus congestion, and wound/laceration, each of which accounted for 7 percent of patients (16/238), respectively. Analysis of federal law enforcement agencies' response to such events yielded similar clinical encounters. A wide range of health problems are reported by extended law enforcement operations personnel. Timely and effective treatment of these problems can help ensure that the broader operations mission is not compromised. An appropriate operational strategy for managing health complaints

Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration.

Science.gov (United States)

Westover, Arthur N; Nakonezny, Paul A; Halm, Ethan A; Adinoff, Bryon

2018-05-01

Non-medical use of prescribed stimulant medications is a growing concern. This study's aims were to ascertain the demographics of stimulant medication users compared with non-users, examine temporal trends of stimulant medication use and estimate risk factors for development of amphetamine use disorder (AUD) and mortality among new users of stimulant medications. Cox proportional hazards regression in a retrospective cohort adjusted by baseline covariates. United States, national administrative database of the Veterans Affairs (VA) health-care system. Adult incident users of stimulant medications (n = 78 829) from fiscal years (FY) 2001 to 2012. Primary outcomes were time-to-event: (1) occurrence of AUD diagnosis and (2) death. Baseline covariates included demographic information, Food and Drug Administration (FDA)-approved indications for stimulant use, substance use disorders (SUD) and depression. Stimulant users compared with non-users were younger, more likely to be non-Hispanic white and female. Incident stimulant medication users increased threefold from FY2001-FY2012 and eightfold among adults aged 18-44 years. Nearly one in 10 incident users in FY2012 had a comorbid baseline SUD. Off-label use was common-nearly three of every five incident users in FY2012. Comorbid SUDs among incident stimulant medication users were risk factors for occurrence of AUD during follow-up, with adjusted hazard ratio (AHR) estimates ranging from 1.54 to 2.83 (Ps users in the Veterans Affairs health-care system, measured from fiscal years 2001 to 2012, comorbid substance use disorders were common and were risk factors for development of an amphetamine use disorder (AUD). Increased mortality risk among incident users of stimulant medications was observed among both those who developed an AUD later and those whose use was defined as off-label. © 2017 Society for the Study of Addiction.

In-flight medical emergencies during airline operations: a survey of physicians on the incidence, nature, and available medical equipment

Directory of Open Access Journals (Sweden)

Hinkelbein J

2017-02-01

Full Text Available Jochen Hinkelbein,1,2 Christopher Neuhaus,2,3 Lennert Böhm,1 Steffen Kalina,1 Stefan Braunecker1,2 1Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, 2Working group “Emergency Medicine and Air Rescue”, German Society for Aviation and Space Medicine (DGLRM, Munich, 3Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany Background: Data on the incidence of in-flight medical emergencies on-board civil aircraft are uncommon and rarely published. Such data could provide information regarding required medical equipment on-board aircraft and requisite training for cabin crew. The aim of the present study was to gather data on the incidences, nature, and medical equipment for in-flight medical emergencies by way of a survey of physician members of a German aerospace medical society.Materials and methods: Using unipark.de (QuestBack GmbH, Cologne, Germany, an online survey was developed and used to gather specific information. Members of the German Society for Aviation and Space Medicine (Deutsche Gesellschaft für Luft- und Raumfahrtmedizin e.V.; DGLRM were invited to participate in the survey during a 4-week period (21 March 2015 to 20 April 2015. Chi-square test was used for statistical analysis (p<0.05 was considered significant.Results: Altogether, 121 members of the society responded to the survey (n=335 sent out. Of the 121 respondents, n=54 (44.6% of the participants (89.9% male and 10.1% female; mean age, 54.1 years; n=121 were involved in at least one in-flight medical emergency. Demographic parameters in this survey were in concordance with the society members’ demographics. The mean duration of flights was 5.7 hours and the respondents performed 7.1 airline flights per year (median. Cardiovascular (40.0% and neurological disorders (17.8% were the most frequent diagnoses. The medical equipment (78.7% provided was sufficient. An emergency diversion was

The incidence and severity of errors in pharmacist-written discharge medication orders

OpenAIRE

Onatade, Raliat; Sawieres, Sara; Veck, Alexandra; Smith, Lindsay; Gore, Shivani; Al-Azeib, Sumiah

2017-01-01

Background Errors in discharge prescriptions are problematic. When hospital pharmacists write discharge prescriptions improvements are seen in the quality and efficiency of discharge. There is limited information on the incidence of errors in pharmacists’ medication orders. Objective To investigate the extent and clinical significance of errors in pharmacist-written discharge medication orders. Setting 1000-bed teaching hospital in London, UK. Method Pharmacists in this London hospital routin...

Hospital incident command system (HICS performance in Iran; decision making during disasters

Directory of Open Access Journals (Sweden)

Djalali Ahmadreza

2012-02-01

Full Text Available Abstract Background Hospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises. Methods This observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job action sheets of the HICS were used as measurements of performance. Each indicator was considered as 1, 2 or 3 in accordance with the HICS. Fair performance was determined as Results None of the participating hospitals had a hospital disaster management plan. The performance according to HICS was intermediate for 83% (n = 19 of the participating hospitals. No hospital had a high level of performance. The performance level for the individual sections was intermediate or fair, except for the logistic and finance sections which demonstrated a higher level of performance. The public hospitals had overall higher performances than university hospitals (P = 0.04. Conclusions The decision making performance in the Iranian hospitals, as measured during table top exercises and using the indicators proposed by HICS was intermediate to poor. In addition, this study demonstrates that the HICS job action sheets can be used as a template for measuring the hospital response. Simulations can be used to assess preparedness, but the correlation with outcome remains to be studied.

Commanders' Survey: School for Command Preparation Feedback

National Research Council Canada - National Science Library

Frame, Adela

1997-01-01

.... All command designees attend the PreCommand Course (PCC). PCC provides common understanding of current doctrine, and up-to-date information on Army-wide policy, programs and special items of interest...

Female all cancer incidence in medical radiation workers in Latvia 1982-2002

International Nuclear Information System (INIS)

Matisane, L.; Carpenter, L.; Venables, K.

2005-01-01

Medical radiation workers belong to one of the oldest occupational groups exposed to external radiation. Since the various radiological protection recommendations have been introduced, now ths process has resulted in low-dose exposure, regular monitoring of exposure and establishment of national dose registration bodies. In order to provide additional information to studies on cancer incidence among medical radiation workers (specially female workers) and in order to assess all cancer incidence in female medical radiation workers in Latvia, a retrospective cohort study based on the National Dose Register was set up in Latvia. The study cohort consisted of all workers employed in health care, occupationally exposed to ionising radiation for more than one year in any of the public health care establishments in Latvia, except military ones, between 1 January 1972 and 1 January 2002 and who were registered in the National Dose Register of Latvia. The cohort consisted of 1416 female medical radiation workers either in hospitals or outpatient departments, or both. The cohort included diagnostic and therapeutic radiologists with predominantly medical qualification, it also included radiotechnologits, nurses, junior nurses, but it did not include academic, physicists and dentists. In all cases the calculated SIR was over than expected or close to expected. Several major differences in study design makes ir difficult to compare the results of this study with the results of the studies carried out in other countries

Exertional heat illness incidence and on-site medical team preparedness in warm weather

Science.gov (United States)

Hosokawa, Yuri; Adams, William M.; Belval, Luke N.; Davis, Robert J.; Huggins, Robert A.; Jardine, John F.; Katch, Rachel K.; Stearns, Rebecca L.; Casa, Douglas J.

2018-03-01

To investigate the influence of estimated wet bulb globe temperature (WBGT) and the International Institute of Race Medicine (IIRM) activity modification guidelines on the incidence of exertional heat stroke (EHS) and heat exhaustion (HEx) and the ability of an on-site medical team to treat those afflicted. Medical records of EHS and HEx patients over a 17-year period from the New Balance Falmouth Road Race were examined. Climatologic data from nearby weather stations were obtained to calculate WBGT with the Australian Bureau of Meteorology (WBGTA) and Liljegren (WBGTL) models. Incidence rate (IR) of EHS, HEx, and combined total of EHS and HEx (COM) were calculated, and linear regression analyses were performed to assess the relationship between IR and WBGTA or WBGTL. One-way ANOVA was performed to compare differences in EHS, HEx, and COM incidence to four alert levels in the IIRM guidelines. Incidence of EHS, HEx, and COM was 2.12, 0.98, and 3.10 cases per 1000 finishers. WBGTA explained 48, 4, and 46% of the variance in EHS, HEx, and COM IR; WBGTL explained 63, 13, and 69% of the variance in EHS, HEx, and COM IR. Main effect of WBGTA and WBGTL on the alert levels were observed in EHS and COM IR (p < 0.05). The cumulative number of EHS patients treated did not exceed the number of cold water immersion tubs available to treat them. EHS IR increased as WBGT and IIRM alert level increased, indicating the need for appropriate risk mitigation strategies and on-site medical treatment.

Modifying Post-Operative Medical Care after EBV Implant May Reduce Pneumothorax Incidence.

Directory of Open Access Journals (Sweden)

Dominik Herzog

Full Text Available Endoscopic lung volume reduction (ELVR with valves has been shown to improve COPD patients with severe emphysema. However, a major complication is pneumothoraces, occurring typically soon after valve implantation, with severe consequences if not managed promptly. Based on the knowledge that strain activity is related to a higher risk of pneumothoraces, we asked whether modifying post-operative medical care with the inclusion of strict short-term limitation of strain activity is associated with a lower incidence of pneumothorax.Seventy-two (72 emphysematous patients without collateral ventilation were treated with bronchial valves and included in the study. Thirty-two (32 patients received standard post-implantation medical management (Standard Medical Care (SMC, and 40 patients received a modified medical care that included an additional bed rest for 48 hours and cough suppression, as needed (Modified Medical Care (MMC.The baseline characteristics were similar for the two groups, except there were more males in the SMC cohort. Overall, ten pneumothoraces occurred up to four days after ELVR, eight pneumothoraces in the SMC, and only two in the MMC cohorts (p=0.02. Complicated pneumothoraces and pneumothoraces after upper lobe treatment were significantly lower in MMC (p=0.02. Major clinical outcomes showed no significant differences between the two cohorts.In conclusion, modifying post-operative medical care to include bed rest for 48 hours after ELVR and cough suppression, if needed, might reduce the incidence of pneumothoraces. Prospective randomized studies with larger numbers of well-matched patients are needed to confirm the data.

Medication incident reporting in residential aged care facilities: Limitations and risks to residents’ safety

Directory of Open Access Journals (Sweden)

Tariq Amina

2012-11-01

Full Text Available Abstract Background Medication incident reporting (MIR is a key safety critical care process in residential aged care facilities (RACFs. Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs. Methods The study was undertaken in three RACFs (part of a large non-profit organisation in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach. Results The findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a design MIR artefacts that facilitate identification of the root causes of medication incidents, b integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs. Conclusions This study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes.

Medication incident reporting in residential aged care facilities: Limitations and risks to residents’ safety

Science.gov (United States)

2012-01-01

Background Medication incident reporting (MIR) is a key safety critical care process in residential aged care facilities (RACFs). Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs. Methods The study was undertaken in three RACFs (part of a large non-profit organisation) in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach. Results The findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a) design MIR artefacts that facilitate identification of the root causes of medication incidents, b) integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c) support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs. Conclusions This study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes. PMID:23122411

Command Resiliency: An Adaptive Response Strategy for Complex Incidents

National Research Council Canada - National Science Library

Pfeifer, Joseph W

2005-01-01

.... Unless organizations develop a resilient response strategy that can adapt organizational and operational elements to respond to new terrorist incidents, they will find themselves with the same...

Factors that influence the recognition, reporting and resolution of incidents related to medical devices and other healthcare technologies: a systematic review.

Science.gov (United States)

Polisena, Julie; Gagliardi, Anna; Urbach, David; Clifford, Tammy; Fiander, Michelle

2015-03-29

Medical devices have improved the treatment of many medical conditions. Despite their benefit, the use of devices can lead to unintended incidents, potentially resulting in unnecessary harm, injury or complications to the patient, a complaint, loss or damage. Devices are used in hospitals on a routine basis. Research to date, however, has been primarily limited to describing incidents rates, so the optimal design of a hospital-based surveillance system remains unclear. Our research objectives were twofold: i) to explore factors that influence device-related incident recognition, reporting and resolution and ii) to investigate interventions or strategies to improve the recognition, reporting and resolution of medical device-related incidents. We searched the bibliographic databases: MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and PsycINFO database. Grey literature (literature that is not commercially available) was searched for studies on factors that influence incident recognition, reporting and resolution published and interventions or strategies for their improvement from 2003 to 2014. Although we focused on medical devices, other health technologies were eligible for inclusion. Thirty studies were included in our systematic review, but most studies were concentrated on other health technologies. The study findings indicate that fear of punishment, uncertainty of what should be reported and how incident reports will be used and time constraints to incident reporting are common barriers to incident recognition and reporting. Relevant studies on the resolution of medical errors were not found. Strategies to improve error reporting include the use of an electronic error reporting system, increased training and feedback to frontline clinicians about the reported error. The available evidence on factors influencing medical device-related incident recognition, reporting and resolution by healthcare professionals can inform data collection and

The Impact of Incident Disclosure Behaviors on Medical Malpractice Claims.

Science.gov (United States)

Giraldo, Priscila; Sato, Luke; Castells, Xavier

2017-06-30

To provide preliminary estimates of incident disclosure behaviors on medical malpractice claims. We conducted a descriptive analysis of data on medical malpractice claims obtained from the Controlled Risk Insurance Company and Risk Management Foundation of Harvard Medical Institutions (Cambridge, Massachusetts) between 2012 and 2013 (n = 434). The characteristics of disclosure and apology after medical errors were analyzed. Of 434 medical malpractice claims, 4.6% (n = 20) medical errors had been disclosed to the patient at the time of the error, and 5.9% (n = 26) had been followed by disclosure and apology. The highest number of disclosed injuries occurred in 2011 (23.9%; n = 11) and 2012 (34.8%; n = 16). There was no incremental increase during the financial years studied (2012-2013). The mean age of informed patients was 52.96 years, 58.7 % of the patients were female, and 52.2% were inpatients. Of the disclosed errors, 26.1% led to an adverse reaction, and 17.4% were fatal. The cause of disclosed medical error was improper surgical performance in 17.4% (95% confidence interval, 6.4-28.4). Disclosed medical errors were classified as medium severity in 67.4%. No apology statement was issued in 54.5% of medical errors classified as high severity. At the health-care centers studied, when a claim followed a medical error, providers infrequently disclosed medical errors or apologized to the patient or relatives. Most of the medical errors followed by disclosure and apology were classified as being of high and medium severity. No changes were detected in the volume of lawsuits over time.

Exertional heat illness incidence and on-site medical team preparedness in warm weather.

Science.gov (United States)

Hosokawa, Yuri; Adams, William M; Belval, Luke N; Davis, Robert J; Huggins, Robert A; Jardine, John F; Katch, Rachel K; Stearns, Rebecca L; Casa, Douglas J

2018-03-29

To investigate the influence of estimated wet bulb globe temperature (WBGT) and the International Institute of Race Medicine (IIRM) activity modification guidelines on the incidence of exertional heat stroke (EHS) and heat exhaustion (HEx) and the ability of an on-site medical team to treat those afflicted. Medical records of EHS and HEx patients over a 17-year period from the New Balance Falmouth Road Race were examined. Climatologic data from nearby weather stations were obtained to calculate WBGT with the Australian Bureau of Meteorology (WBGT A ) and Liljegren (WBGT L ) models. Incidence rate (IR) of EHS, HEx, and combined total of EHS and HEx (COM) were calculated, and linear regression analyses were performed to assess the relationship between IR and WBGT A or WBGT L . One-way ANOVA was performed to compare differences in EHS, HEx, and COM incidence to four alert levels in the IIRM guidelines. Incidence of EHS, HEx, and COM was 2.12, 0.98, and 3.10 cases per 1000 finishers. WBGT A explained 48, 4, and 46% of the variance in EHS, HEx, and COM IR; WBGT L explained 63, 13, and 69% of the variance in EHS, HEx, and COM IR. Main effect of WBGT A and WBGT L on the alert levels were observed in EHS and COM IR (p < 0.05). The cumulative number of EHS patients treated did not exceed the number of cold water immersion tubs available to treat them. EHS IR increased as WBGT and IIRM alert level increased, indicating the need for appropriate risk mitigation strategies and on-site medical treatment.

Biodosimetry: Medicine, Science, and Systems to Support the Medical Decision-Maker Following a Large Scale Nuclear or Radiation Incident

International Nuclear Information System (INIS)

Coleman, C. Norman; Koerner, John F.

2016-01-01

The public health and medical response to a radiological or nuclear incident requires the capability to sort, assess, treat, triage and to ultimately discharge, refer or transport people to their next step in medical care. The size of the incident and scarcity of resources at the location of each medical decision point will determine how patients are triaged and treated. This will be a rapidly evolving situation impacting medical responders at regional, national and international levels. As capabilities, diagnostics and medical countermeasures improve, a dynamic system-based approach is needed to plan for and manage the incident, and to adapt effectively in real time. In that the concepts and terms can be unfamiliar and possibly confusing, resources and a concept of operations must be considered well in advance. An essential underlying tenet is that medical evaluation and care will be managed by health-care professionals with biodosimetry assays providing critical supporting data. (authors)

Adapting Cognitive Task Analysis to Investigate Clinical Decision Making and Medication Safety Incidents.

Science.gov (United States)

Russ, Alissa L; Militello, Laura G; Glassman, Peter A; Arthur, Karen J; Zillich, Alan J; Weiner, Michael

2017-05-03

Cognitive task analysis (CTA) can yield valuable insights into healthcare professionals' cognition and inform system design to promote safe, quality care. Our objective was to adapt CTA-the critical decision method, specifically-to investigate patient safety incidents, overcome barriers to implementing this method, and facilitate more widespread use of cognitive task analysis in healthcare. We adapted CTA to facilitate recruitment of healthcare professionals and developed a data collection tool to capture incidents as they occurred. We also leveraged the electronic health record (EHR) to expand data capture and used EHR-stimulated recall to aid reconstruction of safety incidents. We investigated 3 categories of medication-related incidents: adverse drug reactions, drug-drug interactions, and drug-disease interactions. Healthcare professionals submitted incidents, and a subset of incidents was selected for CTA. We analyzed several outcomes to characterize incident capture and completed CTA interviews. We captured 101 incidents. Eighty incidents (79%) met eligibility criteria. We completed 60 CTA interviews, 20 for each incident category. Capturing incidents before interviews allowed us to shorten the interview duration and reduced reliance on healthcare professionals' recall. Incorporating the EHR into CTA enriched data collection. The adapted CTA technique was successful in capturing specific categories of safety incidents. Our approach may be especially useful for investigating safety incidents that healthcare professionals "fix and forget." Our innovations to CTA are expected to expand the application of this method in healthcare and inform a wide range of studies on clinical decision making and patient safety.

Using total quality management approach to improve patient safety by preventing medication error incidences*.

Science.gov (United States)

Yousef, Nadin; Yousef, Farah

2017-09-04

Whereas one of the predominant causes of medication errors is a drug administration error, a previous study related to our investigations and reviews estimated that the incidences of medication errors constituted 6.7 out of 100 administrated medication doses. Therefore, we aimed by using six sigma approach to propose a way that reduces these errors to become less than 1 out of 100 administrated medication doses by improving healthcare professional education and clearer handwritten prescriptions. The study was held in a General Government Hospital. First, we systematically studied the current medication use process. Second, we used six sigma approach by utilizing the five-step DMAIC process (Define, Measure, Analyze, Implement, Control) to find out the real reasons behind such errors. This was to figure out a useful solution to avoid medication error incidences in daily healthcare professional practice. Data sheet was used in Data tool and Pareto diagrams were used in Analyzing tool. In our investigation, we reached out the real cause behind administrated medication errors. As Pareto diagrams used in our study showed that the fault percentage in administrated phase was 24.8%, while the percentage of errors related to prescribing phase was 42.8%, 1.7 folds. This means that the mistakes in prescribing phase, especially because of the poor handwritten prescriptions whose percentage in this phase was 17.6%, are responsible for the consequent) mistakes in this treatment process later on. Therefore, we proposed in this study an effective low cost strategy based on the behavior of healthcare workers as Guideline Recommendations to be followed by the physicians. This method can be a prior caution to decrease errors in prescribing phase which may lead to decrease the administrated medication error incidences to less than 1%. This improvement way of behavior can be efficient to improve hand written prescriptions and decrease the consequent errors related to administrated

Data acquisition and command system for use with a microprocessor-based control chassis

International Nuclear Information System (INIS)

Halbig, J.K.; Klosterbuer, S.F.; Martinez, V.A. Jr.

1980-01-01

The Pion Generation for Medical Irradiations (PIGMI) program at the Los Alamos Scientific Laboratory is developing the technology to build smaller, less expensive, and more reliable proton linear accelerators for medical applications, and has designed a powerful, simple, inexpensive, and reliable control and data acquisition system that is central to the program development. The system is a NOVA-3D minicomputer interfaced to several outlying microprocessor-based controllers, which accomplish control and data acquisition through data I/O chasis. The equipment interface chassis, which can issue binary commands, read binary data, issue analog commands, and read timed and untimed analog data is described

Patterns in blood pressure medication use in US incident dialysis patients over the first 6 months

NARCIS (Netherlands)

St Peter, Wendy L.; Sozio, Stephen M.; Shafi, Tariq; Ephraim, Patti L.; Luly, Jason; McDermott, Aidan; Bandeen-Roche, Karen; Meyer, Klemens B.; Crews, Deidra C.; Scialla, Julia J.; Miskulin, Dana C.; Tangri, Navdeep; Jaar, Bernard G.; Michels, Wieneke M.; Wu, Albert W.; Boulware, L. Ebony

2013-01-01

Several observational studies have evaluated the effect of a single exposure window with blood pressure (BP) medications on outcomes in incident dialysis patients, but whether BP medication prescription patterns remain stable or a single exposure window design is adequate to evaluate effect on

Exploring reflective 'critical incident' documentation of professionalism lapses in a medical undergraduate setting

Directory of Open Access Journals (Sweden)

McLachlan John C

2009-07-01

Full Text Available Abstract Background Measuring professionalism in undergraduate medical students is a difficult process, and no one method has currently emerged as the definitive means of assessment in this field. Student skills in reflection have been shown to be highly important in the development of professional behaviours. By studying student reflections on lapses in professional judgement, recorded as 'critical incidents', it is possible to explore themes which are significant for the development of professional behaviour in an undergraduate setting. Methods We examined critical incident reporting combined with optional written student reflection as a method for exploring professionalism in undergraduate medical students. 228 students split between Year 1 and 2 of one academic year of undergraduate medicine were studied retrospectively and a grounded theory approach to analysis was employed. Results This year generated 16 critical incident reports and corresponding student reflections, all of which were considered. In addition to identifying the nature of the critical incidents, 3 principal themes emerged. These were the impact and consequences of the report having been made, student reactions to the events (both positive and negative, and student responses regarding future actions. Conclusion This study indicates that unprofessional behaviour can be identified and challenged by both the faculty and the students involved, and suggests that positive behavioural changes might be made with the aim of preventing future occurrences. We provide a low cost approach of measuring and recording professional behaviour.

The role of poison control centers in CBRN incidents

International Nuclear Information System (INIS)

Borron, S. W.; Haynes, J.; Young, P.

2009-01-01

Poison Control Centers (PCCs) have historically played a limited, parallel role in management of CBRN incidents; they are frequently called for advice by the public or health care providers when such incidents occur, but in many cases are not considered an integral part of the CBRN disaster emergency response team, lacking a 'place' in the Incident Command Structure (ICS). This is unfortunate, as PCCs represent an important public health resource. The roughly 60 centers in the U.S. are available 24/7, 365 days/year. Telephones are manned by professionals, including pharmacists and nurses with additional specialized training in poisoning response. PCC medical directors are generally trained in Emergency Medicine, Pediatrics or Preventive Medicine, with subspecialty training in Medical Toxicology. Many toxicologists attend specialized training in the radiation emergency management at REAC/TS. PCCs have extensive databases for poisoning management coupled with GIS surveillance. This combination of expertise and information renders PCCs well prepared to advice on decontamination and treatment of CBRN-contaminated victims. Their toxicology expertise allows their participation in risk assessment. PCCs are highly trusted by the community, enhancing their role in risk communication. We recently initiated a program that provides guidance on activation of PCCs by the Region 6 Regional Response Team (RRT6), Co-Chaired by the US Environmental Protection Agency (EPA) and the US Coast Guard, serving as the federal component of the National Response System for the states of Arkansas, Louisiana, New Mexico, Oklahoma, and Texas. The program will be described, with emphasis on how PCCs may work within ICS.(author)

The incidence and types of medication errors in patients receiving antiretroviral therapy in resource-constrained settings.

Directory of Open Access Journals (Sweden)

Kenneth Anene Agu

Full Text Available This study assessed the incidence and types of medication errors, interventions and outcomes in patients on antiretroviral therapy (ART in selected HIV treatment centres in Nigeria.Of 69 health facilities that had program for active screening of medication errors, 14 were randomly selected for prospective cohort assessment. All patients who filled/refilled their antiretroviral medications between February 2009 and March 2011 were screened for medication errors using study-specific pharmaceutical care daily worksheet (PCDW. All potential or actual medication errors identified, interventions provided and the outcomes were documented in the PCDW. Interventions included pharmaceutical care in HIV training for pharmacists amongst others. Chi-square was used for inferential statistics and P0.05. The major medications errors identified were 26.4% incorrect ART regimens prescribed; 19.8% potential drug-drug interaction or contraindication present; and 16.6% duration and/or frequency of medication inappropriate. Interventions provided included 67.1% cases of prescriber contacted to clarify/resolve errors and 14.7% cases of patient counselling and education; 97.4% of potential/actual medication error(s were resolved.The incidence rate of medication errors was somewhat high; and majority of identified errors were related to prescription of incorrect ART regimens and potential drug-drug interactions; the prescriber was contacted and the errors were resolved in majority of cases. Active screening for medication errors is feasible in resource-limited settings following a capacity building intervention.

Shaken but prepared: Analysis of disaster response at an academic medical centre following the Boston Marathon bombings.

Science.gov (United States)

Osgood, Robert; Scanlon, Courtney; Jotwani, Rohan; Rodkey, Daniel; Arshanskiy, Maria; Salem, Deeb

Over the last decade, there has been a rise in the number of mass casualty incidences (MCIs) and their subsequent effect on hospital systems. While there has been much discussion over improving procedures to treat victims of MCIs, there has not been a thorough, systems-based analysis concerning the costs incurred by hospitals during such events. Here the authors examine the history of the Hospital Incident Command Center and how its evolution at Tufts Medical Center helped mitigate the damage following the Boston Marathon Bombings. Tufts' unique variations to the Hospital Incident Command Center include strategic communication hierarchies and a 'zero cost centre' financial system which both provided for a quick and adaptive response. Operating in collaboration with the Conference of Boston Teaching Hospitals encouraged coordination and preparation during emergency situations such as mass casualty events. The direct and indirect effects on Tufts Medical Center stemming from the Boston Marathon Bombings were analysed. Tufts MC treated 36 victims immediately following the MCI. The estimated total cost during the week of April 15 to April 19, 2013 was $776,051. The cost was primarily comprised of lost revenue from cancelled outpatient and inpatient hospital services, as well as expenses incurred due to overtime pay, salary expenses, PPE kits and hospitality services. Finally, the authors examine ways to reduce the future costs during emergency situations through increasing communication with employees, understanding the source of all direct expenses, and mitigating excess risk by developing partnerships with other hospital systems.

The incidence of burnout or compassion fatigue in medical dosimetrists as a function of various stress and psychologic factors

Energy Technology Data Exchange (ETDEWEB)

Howard, Michelle, E-mail: Mhoward24601@yahoo.com [University of Wisconsin—La Crosse, WI 54601 (United States)

2013-04-01

ABSTRACT: Burnout and compassion fatigue (CF) adversely affect medical professionals, including those employed in radiation oncology. Previously conducted research acknowledged the presence of burnout in populations of radiation therapists, radiation oncologists, and oncology nursing staff. The aim of the following research was to measure the incidence of burnout or CF in the specific population of medical dosimetrists surveyed. As professional members of the radiation oncology team, this group had not been included in published research data to date. The hypothesis of the subsequent study stated that a comparable incidence of burnout would be observed among medical dosimetrists as had been reported by earlier researchers for a population of radiation therapists. A survey tool based on the Maslach Burnout Inventory (MBI) and distributed to full members of the American Association of Medical Dosimetrists (AAMD) was utilized as the research measurement method. Results obtained indicated an incidence rates of burnout or CF for medical dosimetrists were less than the rates previously measured for radiation therapists (53% vs 11% for emotional exhaustion [EE] and 45% vs 27% for depersonalization [DP]). The incidence of burnout was based on the Burnout Inventory (BI) developed for the research project. Each of the subscales, EE, DP, and decreased personal accomplishment (PA), was considered and analyzed independently. Although not as prevalent among medical dosimetrists as a variety of additional radiation oncology professionals, a significant portion of the population demonstrated signs of burnout or CF. Future concerns abound for the population of medical dosimetrists as a large number of members scored positive for intermediate risk of burnout and CF. Additionally, a large portion of the population was found to be rapidly approaching retirement.

The incidence of burnout or compassion fatigue in medical dosimetrists as a function of various stress and psychologic factors

International Nuclear Information System (INIS)

Howard, Michelle

2013-01-01

ABSTRACT: Burnout and compassion fatigue (CF) adversely affect medical professionals, including those employed in radiation oncology. Previously conducted research acknowledged the presence of burnout in populations of radiation therapists, radiation oncologists, and oncology nursing staff. The aim of the following research was to measure the incidence of burnout or CF in the specific population of medical dosimetrists surveyed. As professional members of the radiation oncology team, this group had not been included in published research data to date. The hypothesis of the subsequent study stated that a comparable incidence of burnout would be observed among medical dosimetrists as had been reported by earlier researchers for a population of radiation therapists. A survey tool based on the Maslach Burnout Inventory (MBI) and distributed to full members of the American Association of Medical Dosimetrists (AAMD) was utilized as the research measurement method. Results obtained indicated an incidence rates of burnout or CF for medical dosimetrists were less than the rates previously measured for radiation therapists (53% vs 11% for emotional exhaustion [EE] and 45% vs 27% for depersonalization [DP]). The incidence of burnout was based on the Burnout Inventory (BI) developed for the research project. Each of the subscales, EE, DP, and decreased personal accomplishment (PA), was considered and analyzed independently. Although not as prevalent among medical dosimetrists as a variety of additional radiation oncology professionals, a significant portion of the population demonstrated signs of burnout or CF. Future concerns abound for the population of medical dosimetrists as a large number of members scored positive for intermediate risk of burnout and CF. Additionally, a large portion of the population was found to be rapidly approaching retirement

Factors affecting fire suppression costs as identified by incident management teams

Science.gov (United States)

Janie Canton-Thompson; Brooke Thompson; Krista Gebert; David Calkin; Geoff Donovan; Greg Jones

2006-01-01

This study uses qualitative sociological methodology to discover information and insights about the role of Incident Management Teams in wildland fire suppression costs. We interviewed 48 command and general staff members of Incident Management Teams throughout the United States. Interviewees were asked about team structure, functioning, and decision making as a...

Association of current work and sleep situations with excessive daytime sleepiness and medical incidents among Japanese physicians.

Science.gov (United States)

Kaneita, Yoshitaka; Ohida, Takashi

2011-10-15

The aim of the present study was to clarify the current work and sleep situations of physicians in Japan and to clarify the association between these situations and excessive daytime sleepiness as well as medical incidents. A self-administered questionnaire survey was conducted among the members of the Japan Medical Association in 2008. The randomly selected subjects comprised 3,000 male physicians and 1,500 female physicians. Valid responses were obtained from 3,486 physicians (2,298 men and 1,188 women). Mean sleep duration was 6 h 36 min for men and 6 h 8 min for women. The prevalence of lack of rest due to sleep deprivation was 30.4% among men and 36.6% among women; the prevalence of insomnia was 21.0% and 18.1%, respectively; and the prevalence of EDS was 3.5%. The adjusted odds ratio for EDS was high for physicians who reported short sleep duration, lack of rest due to sleep deprivation, and a high frequency of on-call/overnight work. Physicians who had experienced a medical incident within the previous one month accounted for 19.0% of participants. The adjusted odds ratio for medical incidents was high for those subjected to long working hours, high frequency of on-call/overnight works, lack of rest due to sleep deprivation, and insomnia. In order to facilitate optimal health management for physicians as well as securing medical safety, it is important to fully consider the work and sleep situations of physicians.

Medical students' perceptions of a novel institutional incident reporting system : A thematic analysis.

Science.gov (United States)

Gordon, Morris; Parakh, Dillan

2017-10-01

Errors in healthcare are a major patient safety issue, with incident reporting a key solution. The incident reporting system has been integrated within a new medical curriculum, encouraging medical students to take part in this key safety process. The aim of this study was to describe the system and assess how students perceived the reporting system with regards to its role in enhancing safety. Employing a thematic analysis, this study used interviews with medical students at the end of the first year. Thematic indices were developed according to the information emerging from the data. Through open, axial and then selective stages of coding, an understanding of how the system was perceived was established. Analysis of the interview specified five core themes: (1) Aims of the incident reporting system; (2) internalized cognition of the system; (3) the impact of the reporting system; (4) threshold for reporting; (5) feedback on the systems operation. Selective analysis revealed three overriding findings: lack of error awareness and error wisdom as underpinned by key theoretical constructs, student support of the principle of safety, and perceptions of a blame culture. Students did not interpret reporting as a manner to support institutional learning and safety, rather many perceived it as a tool for a blame culture. The impact reporting had on students was unexpected and may give insight into how other undergraduates and early graduates interpret such a system. Future studies should aim to produce interventions that can support a reporting culture.

Incidence and factors associated with medication nonadherence in patients with mental illness: a cross-sectional study.

Science.gov (United States)

Lucca, J M; Ramesh, M; Parthasarathi, G; Ram, D

2015-01-01

In spite of the progress made in the treatment of psychiatric disorders during the last few decades, nonadherence continues to be a frequent phenomenon, often associated with potentially severe clinical consequences and increased health-care costs. There are numerous factors associated with medication nonadherence in patients with mental illness. The aim of the study was to determine the incidence and factors associated with medication nonadherence among psychiatric outpatients. A cross-sectional study was carried out in the outpatient psychiatric department of an Indian tertiary care private hospital over a period of 1 year. Patients aged 18 years and above who presented with mental illness as diagnosed by the International Classification of Diseases (ICD)-10 and who were receiving at least one psychotropic medication for at least 1 month were included in the study. Medication adherence was assessed using the Medication Adherence Rating Scale (MARS). Of the 400 patients, 172 (43%) were nonadherent to their prescribed medications. There is a statistically significant association between the education (P = 0.001), number of drugs (P = 0.002), family income (P = 0.013), and nonadherence. Among the 172 patients, 33.5 % were nonadherent to their therapy due to patient-related factors followed by drug-related factors (32%) and disease-related factors (31%). The overall incidence of medication nonadherence in patients with mental illness was 43%. Numerous factors contributed to medication nonadherence. Strategies need to be developed and implemented to enhance medication adherence, and thereby achieve a better therapeutic outcome in patients with mental illness.

Incidence and factors associated with medication nonadherence in patients with mental illness: A cross-sectional study

Directory of Open Access Journals (Sweden)

J M Lucca

2015-01-01

Full Text Available Background: In spite of the progress made in the treatment of psychiatric disorders during the last few decades, nonadherence continues to be a frequent phenomenon, often associated with potentially severe clinical consequences and increased health-care costs. There are numerous factors associated with medication nonadherence in patients with mental illness. The aim of the study was to determine the incidence and factors associated with medication nonadherence among psychiatric outpatients. Materials and Methods: A cross-sectional study was carried out in the outpatient psychiatric department of an Indian tertiary care private hospital over a period of 1 year. Patients aged 18 years and above who presented with mental illness as diagnosed by the International Classification of Diseases (ICD-10 and who were receiving at least one psychotropic medication for at least 1 month were included in the study. Medication adherence was assessed using the Medication Adherence Rating Scale (MARS. Results: Of the 400 patients, 172 (43% were nonadherent to their prescribed medications. There is a statistically significant association between the education (P = 0.001, number of drugs (P = 0.002, family income (P = 0.013, and nonadherence. Among the 172 patients, 33.5 % were nonadherent to their therapy due to patient-related factors followed by drug-related factors (32% and disease-related factors (31%. Conclusion: The overall incidence of medication nonadherence in patients with mental illness was 43%. Numerous factors contributed to medication nonadherence. Strategies need to be developed and implemented to enhance medication adherence, and thereby achieve a better therapeutic outcome in patients with mental illness.

The Unspoken Consequence of Command, Control Communications Technology: Enhanced Micromanagement by Risk-Averse Commanders

National Research Council Canada - National Science Library

Carozza, John

2004-01-01

.... However, along with its benefits, this command, control and communications (C3) network includes the dangerous consequence of eroding the autonomy of tactical command through enhanced micromanagement by risk-averse operational commanders...

Incidence of medically attended influenza infection and cases averted by vaccination, 2011/12 and 2012/13 influenza seasons

Science.gov (United States)

Jackson, Michael L.; Jackson, Lisa A.; Kieke, Burney; McClure, David; Gaglani, Manjusha; Murthy, Kempapura; Malosh, Ryan; Monto, Arnold; Zimmerman, Richard K.; Foppa, Ivo M.; Flannery, Brendan; Thompson, Mark G.

2018-01-01

Background We estimated the burden of outpatient influenza and cases prevented by vaccination during the 2011/12 and 2012/13 influenza seasons using data from the United States Influenza Vaccine Effectiveness (US Flu VE) Network. Methods We defined source populations of persons who could seek care for acute respiratory illness (ARI) at each of the five US Flu VE Network sites. We identified all members of the source population who were tested for influenza during US Flu VE influenza surveillance. Each influenza-positive subject received a sampling weight based on the proportion of source population members who were tested for influenza, stratified by site, age, and other factors. We used the sampling weights to estimate the cumulative incidence of medically attended influenza in the source populations. We estimated cases averted by vaccination using estimates of cumulative incidence, vaccine coverage, and vaccine effectiveness. Results Cumulative incidence of medically attended influenza ranged from 0.8% to 2.8% across sites during 2011/12 and from 2.6% to 6.5% during the 2012/13 season. Stratified by age, incidence ranged from 1.2% among adults 50 years of age and older in 2011/12 to 10.9% among children 6 months to 8 years of age in 2012/13. Cases averted by vaccination ranged from 4 to 41 per 1,000 vaccinees, depending on the study site and year. Conclusions The incidence of medically attended influenza varies greatly by year and even by geographic region within the same year. The number of cases averted by vaccination varies greatly based on overall incidence and on vaccine coverage. PMID:26271827

The incidence of smoking and risk factors for smoking initiation in medical faculty students: cohort study

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Turkay Mehtap

2006-05-01

Full Text Available Abstract Background Medical education requires detailed investigation because it is a period during which the attitudes and behaviors of physicians develop. The purpose of this study was to calculate the yearly smoking prevalence and incidence rates of medical faculty students and to identify the risk factors for adopting smoking behaviour. Methods This is a cohort study in which every student was asked about their smoking habits at the time of first registration to the medical faculty, and was monitored every year. Smoking prevalence, yearly incidence of initiation of smoking and average years of smoking were calculated in analysis. Results At the time of registration, 21.8% of the students smoked. At the end of six years, males had smoked for an average of 2.6 ± 3.0 years and females for 1.0 ± 1.8 years (p Conclusion The first 3 years of medical education are the most risky period for initiation of smoking. We found that factors such as being male, having a smoking friend in the same environment and having a high trait anxiety score were related to the initiation of smoking. Targeted smoking training should be mandatory for students in the Medical Faculty.

How often are patients harmed when they visit the computed tomography suite? A multi-year experience, in incident reporting, in a large academic medical center

International Nuclear Information System (INIS)

Mansouri, Mohammad; Aran, Shima; Shaqdan, Khalid W.; Abujudeh, Hani H.

2016-01-01

Our goal is to present our multi-year experience in incident reporting in CT in a large medical centre. This is an IRB-approved, HIPAA-compliant study. Informed consent was waived for this study. The electronic safety incident reporting system of our hospital was searched for the variables from April 2006 to September 2012. Incident classifications were diagnostic test orders, ID/documentation, safety/security/conduct, service coordination, surgery/procedure, line/tube, fall, medication/IV safety, employee general incident, environment/equipment, adverse drug reaction, skin/tissue and diagnosis/treatment. A total of 1918 incident reports occurred in the study period and 843,902 CT examinations were performed. The rate of safety incident was 0.22 % (1918/843,902). The highest incident rates were due to adverse drug reactions (652/843,902 = 0.077 %) followed by medication/IV safety (573/843,902 = 0.068 %) and diagnostic test orders (206/843,902 = 0.024 %). Overall 45 % of incidents (869/1918) caused no harm and did not affect the patient, 33 % (637/1918) caused no harm but affected the patient, 22 % (420/1918) caused temporary or minor harm/damage and less than 1 % (10/1918) caused permanent or major harm/damage or death. Our study shows a total safety incident report rate of 0.22 % in CT. The most common incidents are adverse drug reaction, medication/IV safety and diagnostic test orders. (orig.)

Advantages and disadvantages of the Belgian not-only-fault system for medical incidents.

Science.gov (United States)

Vandersteegen, Tom; Marneffe, Wim; Vandijck, Dominique

2017-02-01

In 2010, the Belgian compensation system for medical incidents was reformed, in order to overcome some important deficiencies of court procedures. This resulted in a not-only-fault compensation system, following the establishment of the Fund for Medical Accidents (FMA). This paper seeks to clarify the main advantages and disadvantages of this reform. After all, the legislator paid little attention to the impact on physicians, who also seem to be insufficiently informed. However, currently the FMA experiences a significant delay in processing compensation requests. The true effects of the not-only-fault system for patients and physicians as well as for health care quality therefore still remain unclear today.

An Evaluation of the Frequency and Severity of Motion Sickness Incidences in Personnel Within the Command and Control Vehicle (C2V)

Science.gov (United States)

Cowings, Patricia S.; Toscano, William B.; DeRoshia, Charles

1998-01-01

The purpose of this study was to assess the frequency and severity of motion sickness in personnel during a field exercise in the Command and Control Vehicle (C2V). This vehicle contains four workstations where military personnel are expected to perform command decisions in the field during combat conditions. Eight active duty military men (U.S. Army) at the Yuma Proving Grounds in Arizona participated in this study. All subjects were given baseline performance tests while their physiological responses were monitored on the first day. On the second day of their participation, subjects rode in the C2V while their physiological responses and performance measures were recorded. Self-reports of motion sickness were also recorded. Results showed that only one subject experienced two incidences of emesis. However, seven out of the eight subjects reported other motion sickness symptoms; most predominant was the report of drowsiness, which occurred a total of 19 times. Changes in physiological responses were observed relative to motion sickness symptoms reported and the different environmental conditions (i.e., level, hills, gravel) during the field exercise. Performance data showed an overall decrement during the C2V exercise. These findings suggest that malaise and severe drowsiness can potentially impact the operational efficiency of the C2V crew. It was concluded that conflicting sensory information from the subject's visual displays and movements of the vehicle during the field exercise significantly contributed to motion sickness symptoms. It was recommended that a second study be conducted to further evaluate the impact of seat position or orientation and C2V experience on motion sickness susceptibility. Further, it was recommended that an investigation be performed on behavioral methods for improving crew alertness, motivation, and performance and for reducing malaise.

Security technology discussion for emergency command system of nuclear power plant

International Nuclear Information System (INIS)

Liu Zhenjun

2014-01-01

Nuclear power plant emergency command system can provide valuable data for emergency personnel, such as the unit data, weather data, environmental radiation data. In the course of emergency response, the emergency command system provides decision support to quickly and effectively control and mitigate the consequences of the nuclear accident, to avoid and reduce the dose received by staff and the public, to protect the environment and the public. There are high performance requirements on the security of the system and the data transmission. Based on the previous project and new demand after the Fukushima incident, the security technology design of emergency system in nuclear power plant was discussed. The results show that the introduction of information security technology can effectively ensure the security of emergency systems, and enhance the capacity of nuclear power plant to deal with nuclear accidents. (author)

Median and ulnar neuropathies in U.S. Army Medical Command Band members.

Science.gov (United States)

Shaffer, Scott W; Koreerat, Nicholas R; Gordon, Lindsay B; Santillo, Douglas R; Moore, Josef H; Greathouse, David G

2013-12-01

Musicians have been reported as having a high prevalence of upper-extremity musculoskeletal disorders, including carpal tunnel syndrome. The purpose of this study was to determine the presence of median and ulnar neuropathies in U.S. Army Medical Command (MEDCOM) Band members at Fort Sam Houston, Texas. Thirty-five MEDCOM Band members (30 males, 5 females) volunteered to participate. There were 33 right-handed musicians, and the mean length of time in the MEDCOM Band was 12.2 yrs (range, 1-30 yrs). Subjects completed a history form, were interviewed, and underwent a physical examination of the cervical spine and bilateral upper extremities. Nerve conduction studies of the bilateral median and ulnar nerves were performed. Electrophysiological variables served as the reference standard for median and ulnar neuropathy and included distal sensory latencies, distal motor latencies, amplitudes, conduction velocities, and comparison study latencies. Ten of the 35 subjects (29%) presented with abnormal electrophysiologic values suggestive of an upper extremity mononeuropathy. Nine of the subjects had abnormal median nerve electrophysiologic values at or distal to the wrist; 2 had bilateral abnormal values. One had an abnormal ulnar nerve electrophysiologic assessment at the elbow. Nine of these 10 subjects had clinical examination findings consistent with the electrophysiological findings. The prevalence of mononeuropathies in this sample of band members is similar to that found in previous research involving civilian musicians (20-36%) and far exceeds that reported in the general population. Prospective research investigating screening, examination items, and injury prevention measures in musicians appears to be warranted.

Response to a Chemical Incident or Accident -- Who Is In Charge?

National Research Council Canada - National Science Library

Briggs, Darryl J

2007-01-01

.... The thesis of the paper is as follows: Combatant Commanders and the Services must have specific guidance and appropriate authorities to be able to effectively manage a Chemical Accident and Incident Response and Assistance (CAIRA...

The ergonomics of command and control

OpenAIRE

Stanton, NA; Baber, C

2006-01-01

Since its inception, just after the Second World War, ergonomics research has paid special attention to the issues surrounding human control of systems. Command and Control environments continue to represent a challenging domain for Ergonomics research. We take a broad view of Command and Control research, to include C2 (Command and Control), C3 (Command, Control and Communication), and C4 (Command, Control, Communication and Computers) as well as human supervisory control paradigms. This spe...

Command and Control of Joint Air Operations through Mission Command

Science.gov (United States)

2016-06-01

and outlines the C2 architecture systems, processes, and philosophy of com- mand required to enable mission command effectively. Mission Command...General Dempsey highlights the fact that “trust is the moral sinew that binds the distributed Joint Force 2020 together” and observes that “unless...con- fident about how their subordinates will make decisions and adapt to the dynamic battlespace environment. Processes, Systems, and Philosophy of

Systems analysis of clinical incidents as a basis for improvement the quality of medical care delivered to patients with arterial hypertension

OpenAIRE

Posnenkova O.M.; Kiselev A.R.; Popova Y.V.; Volkova E.N.; Gridnev V.I.

2014-01-01

Background — Systems analysis of clinical incidents – is a relatively novel approach to medical care quality improvement. Its basis is studying of healthcare system with use of modeling. The purpose of the present work was to compare the potential value of different modeling methods, which implemented in systems analysis of clinical incidents, and form the basis for improvement the quality of medical care delivered to patients with arterial hypertension (AH). Material and Methods — Thre...

AFRICOM: Combatant Command for the 21st Century

National Research Council Canada - National Science Library

Juergens, Jr., Richard A

2008-01-01

...: European Command, Southern Command, Northern Command, Central Command, and Pacific Command, as the Department of Defense's unified command structure responsible for specific geographical regions of the world...

[Ethical Debates Related to the Allocation of Medical Resources During the Response to the Mass Casualty Incident at Formosa Fun Coast Water Park].

Science.gov (United States)

Tang, Jing-Shia; Chen, Chia-Jung; Huang, Mei-Chih

2017-02-01

Disasters are unpredictable and often result in mass casualties. Limited medical resources often affect the response to mass casualty incidents, undermining the ability of responders to adequately protect all of the casualties. Thus, the injuries of casualties are classified in hopes of fully utilizing medical resources efficiently in order to save the maximum possible number of people. However, as opinions on casualty prioritization are subjective, disagreements and disputes often arise regarding allocating medical resources. The present article focused on the 2015 explosion at Formosa Fun Coast, a recreational water park in Bali, New Taipei City, Taiwan as a way to explore the dilemma over the triage and resource allocation for casualties with burns over 90% and 50-60% of their bodies. The principles of utilitarianism and deontology in Western medicine were used to discuss the reasons and rationale behind the allocation of medical resources during this incident. Confucianism, a philosophical mindset that significantly influences Taiwanese society today, was then discussed to describe the "miracles" that happened during the incident, including the acquisition of assistance from the public and medical professionals. External supplies and professional help (social resources) were provided voluntarily after this incident, which had a profound impact on both the immediate response and the longer-term recovery efforts.

Medical and Non-Medical Predictors of Disability Discharge Disposition for Navy Personnel with a Back Problem: A Focus on Entitlement

Science.gov (United States)

1988-03-28

Washington D.C. 20350-1000. Stryker, S., & Gottlieb, A. (1981). Attribution theory and symbolic interactionism : A comparison. In J.H. Howes, W...ERFORMIING ORGANIZATION 6b OFFiCE SYMBOL 7a NAME OF MONITORING ORGANIZATION (If applicable) Naval Health Research Center 40 Commander, Naval Medical Command...Washington, DC 20372 ea NAME OF FUNDING/SPONSORING Bb OFFICE SYMBOL 9. PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER ORGANIZATION Naval Medical (If applicable

The Royal Naval Medical Services: delivering medical operational capability. the 'black art' of Medical Operational Planning.

Science.gov (United States)

Faye, M

2013-01-01

This article looks to dispel the mysteries of the 'black art' of Medical Operational Planning whilst giving an overview of activity within the Medical Operational Capability area of Medical Division (Med Div) within Navy Command Headquarters (NCHQ) during a period when the Royal Naval Medical Services (RNMS) have been preparing and reconfiguring medical capability for the future contingent battle spaces. The rolling exercise program has been used to illustrate the ongoing preparations taken by the Medical Operational Capability (Med Op Cap) and the Medical Force Elements to deliver medical capability in the littoral and maritime environments.

ٍEffective factors on the Incidence of medication errors from the nursing staff perspective in various department of Fasa Hospital

Directory of Open Access Journals (Sweden)

Mostafa Bizhani

2013-06-01

Full Text Available  Background and Objective: The incidence of medical errors is deemed one of the unavoidable cases of serious threats to the health and safety of patients. This study aimed to determine the factors influencing medication errors from the perspective of the nursing staff. Materials and Methods: This descriptive -analytic study recruited 80 nurses working in various wards in Fasa Hospital. The nurses were selected via the availability sampling method, and their perspective on factors affecting medication errors was gathered using a questionnaire designed for this study. The data were analyzed with SPSS-15 software.   Results: The most important causes of medication errors were work fatigue, low nurse-to-patient ratio, long working hours, high density of work in units, and doing other tasks. Other variables such as age and gender as well as factors effective on the incidence of medication errors are mentioned in the full text. Conclusion: From the nurses’ standpoint, workload and the patient-to-nurse ratio were the most significant factors leading to medication errors.

Patient safety incident reports related to traditional Japanese Kampo medicines: medication errors and adverse drug events in a university hospital for a ten-year period.

Science.gov (United States)

Shimada, Yutaka; Fujimoto, Makoto; Nogami, Tatsuya; Watari, Hidetoshi; Kitahara, Hideyuki; Misawa, Hiroki; Kimbara, Yoshiyuki

2017-12-21

Kampo medicine is traditional Japanese medicine, which originated in ancient traditional Chinese medicine, but was introduced and developed uniquely in Japan. Today, Kampo medicines are integrated into the Japanese national health care system. Incident reporting systems are currently being widely used to collect information about patient safety incidents that occur in hospitals. However, no investigations have been conducted regarding patient safety incident reports related to Kampo medicines. The aim of this study was to survey and analyse incident reports related to Kampo medicines in a Japanese university hospital to improve future patient safety. We selected incident reports related to Kampo medicines filed in Toyama University Hospital from May 2007 to April 2017, and investigated them in terms of medication errors and adverse drug events. Out of 21,324 total incident reports filed in the 10-year survey period, we discovered 108 Kampo medicine-related incident reports. However, five cases were redundantly reported; thus, the number of actual incidents was 103. Of those, 99 incidents were classified as medication errors (77 administration errors, 15 dispensing errors, and 7 prescribing errors), and four were adverse drug events, namely Kampo medicine-induced interstitial pneumonia. The Kampo medicine (crude drug) that was thought to induce interstitial pneumonia in all four cases was Scutellariae Radix, which is consistent with past reports. According to the incident severity classification system recommended by the National University Hospital Council of Japan, of the 99 medication errors, 10 incidents were classified as level 0 (an error occurred, but the patient was not affected) and 89 incidents were level 1 (an error occurred that affected the patient, but did not cause harm). Of the four adverse drug events, two incidents were classified as level 2 (patient was transiently harmed, but required no treatment), and two incidents were level 3b (patient was

WS-006: EPR-First Responders: Operations in the control system incident

International Nuclear Information System (INIS)

2011-01-01

The purpose of this working session is about the operations in a control system incident. The participants can apply the knowledge acquired in a bus accident exercise where the passengers are in contamination risk by dangerous material. They have to identify the incident commander, the type of response required, the risks of the emergency, the requirements for transporting the victims to the hospital and the actors involved in a radiological emergency

[Teaching non-technical skills for critical incidents: Crisis resource management training for medical students].

Science.gov (United States)

Krüger, A; Gillmann, B; Hardt, C; Döring, R; Beckers, S K; Rossaint, R

2009-06-01

Physicians have to demonstrate non-technical skills, such as communication and team leading skills, while coping with critical incidents. These skills are not taught during medical education. A crisis resource management (CRM) training was established for 4th to 6th year medical students using a full-scale simulator mannikin (Emergency Care Simulator, ECS, METI). The learning objectives of the course were defined according to the key points of Gaba's CRM concept. The training consisted of theoretical and practical parts (3 simulation scenarios with debriefing). Students' self-assessment before and after the training provided the data for evaluation of the training outcome. A total of 65 students took part in the training. The course was well received in terms of overall course quality, debriefings and didactic presentation, the mean overall mark being 1.4 (1: best, 6: worst). After the course students felt significantly more confident when facing incidents in clinical practice. The main learning objectives were achieved. The effectiveness of applying the widely used ECS full-scale simulator in interdisciplinary teaching has been demonstrated. The training exposes students to crisis resource management issues and motivates them to develop non-technical skills.

Measuring medication adherence in patients with incident hypertension: a retrospective cohort study.

Science.gov (United States)

Tang, Karen L; Quan, Hude; Rabi, Doreen M

2017-02-13

Though pharmacy claims data are commonly used to study medication adherence, there remains no standard operational definition for adherence especially for patients on multiple medications. Even when studies use the same terminology, the actual methods of calculating adherence can differ drastically. It is unclear whether the use of different definitions results in different conclusions regarding adherence and associated outcomes. The objective of our study was to compare adherence rates and associations with mortality using different operational definitions of adherence, and using various methods of handling concurrent medication use. We conducted a cohort study of patients aged ≥65 years from Manitoba, Canada, with incident hypertension diagnosed in 2004 and followed to 2009. We calculated adherence rates to anti-hypertensive medications using different operational definitions of medication adherence (including interval and prescription based medication possession ratios [MPR] and proportion of days covered [PDC]). For those on concurrent medications, we calculated adherence rates using the different methods of handling concurrent medication use, for each definition. We used logistic regression to determine the association between adherence and mortality for each operational definition. Among 2199 patients, 24.1% to 90.5% and 71.2% to 92.7% were considered adherent when using fixed interval and prescription-based interval medication possession ratios [MPRi and MPRp] respectively, depending on how concurrent medications were handled. Adherence was inversely associated with death, with the strongest association for MPRp measures. This association was significant only when considering adherence to any anti-hypertensive [aOR 0.70, 95% CI 0.51, 0.97], or when the mean of the class-specific MPRp's [adjusted OR 0.71, 95% CI 0.53, 0.95] was used. No significant association existed when the highest or lowest class-specific MPRp was used as the adherence estimate. The

Force Protection and Command Relationships: Who's Responsible

National Research Council Canada - National Science Library

Moller, James

1998-01-01

.... This monograph analyzes the joint force protection program by investigating the terms: command, chain of command, command relationship, and how these terms authorize and empower a commander to implement this program across the joint force...

Successful remediation of patient safety incidents: a tale of two medication errors.

Science.gov (United States)

Helmchen, Lorens A; Richards, Michael R; McDonald, Timothy B

2011-01-01

As patient safety acquires strategic importance for all stakeholders in the health care delivery chain, one promising mechanism centers on the proactive disclosure of medical errors to patients. Yet, disclosure and apology alone will not be effective in fully addressing patients' concerns after an adverse event unless they are paired with a remediation component. The purpose of this study was to identify key features of successful remediation efforts that accompany the proactive disclosure of medical errors to patients. We describe and contrast two recent and very similar cases of preventable medical error involving inappropriate medication at a large tertiary-care academic medical center in the Midwestern United States. Despite their similarity, the two medical errors led to very different health outcomes and remediation trajectories for the injured patients. Although one error causing no permanent harm was mismanaged to the lasting dissatisfaction of the patient, the other resulted in the death of the patient but was remediated to the point of allowing the family to come to terms with the loss and even restored a modicum of trust in the providers' sincerity. To maximize the opportunities for successful remediation, as soon as possible after the incident, providers should pledge to injured patients and their relatives that they will assist and accompany them in their recovery as long as necessary and then follow through on their pledge. As the two case studies show, it takes training and vigilance to ensure adherence to these principles and reach an optimal outcome for patients and their relatives.

Structured multi-stream command language

International Nuclear Information System (INIS)

Glad, A.S.

1982-12-01

A multi-stream command language was implemented to provide the sequential and decision-making operations necessary to run the neutral-beam ion sources connected to the Doublet III tokamak fusion device. A multi-stream command language was implemented in Pascal on a Classic 7870 running under MAX IV. The purpose of this paper is threefold. First, to provide a brief description of the programs comprising the command language including the operating system interaction. Second, to give a description of the language syntax and commands necessary to develop a procedure stream. Third, to provide a description of the normal operating procedures for executing either the sequential or interactive streams

Command and Control of Private Security Contractors: Are They a Viable Force Option for the Combatant Commander?

National Research Council Canada - National Science Library

Sherard, Scott H

2008-01-01

If a Combatant Commander (CCDR) or Joint Force Commander (JFC) were to take command of the approximately 25,000 security contractors in Iraq, a force of such size and capability would prove to be a valuable operational asset...

Indoor fire in a nursing home : evaluation of the medical response to a mass casualty incident based on a standardized protocol

NARCIS (Netherlands)

Koning, S. W.; Ellerbroek, P. M.; Leenen, L. P. H.

This retrospective study reports the outcome of a mass casualty incident (MCI) caused by a fire in a nursing home. Data from the medical charts and registration system of the Major Incident Hospital (MIH) and ambulance service were analyzed. The evaluation reports from the MIH and an independent

DolphinAtack: Inaudible Voice Commands

OpenAIRE

Zhang, Guoming; Yan, Chen; Ji, Xiaoyu; Zhang, Taimin; Zhang, Tianchen; Xu, Wenyuan

2017-01-01

Speech recognition (SR) systems such as Siri or Google Now have become an increasingly popular human-computer interaction method, and have turned various systems into voice controllable systems(VCS). Prior work on attacking VCS shows that the hidden voice commands that are incomprehensible to people can control the systems. Hidden voice commands, though hidden, are nonetheless audible. In this work, we design a completely inaudible attack, DolphinAttack, that modulates voice commands on ultra...

To Take Care of Them: An Ethical Case Study of the Canal Incident

Science.gov (United States)

2013-06-14

opinions, emotional responses, and systems such as ethical relativism ,87 divine command theory,88 utilitarianism,89 deontology,90 and virtue ethics .91...TO TAKE CARE OF THEM: AN ETHICAL CASE STUDY OF THE CANAL INCIDENT A... ETHICAL CASE STUDY OF THE CANAL INCIDENT 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Emmitt Maxwell Furner II 5d. PROJECT

Capturing a Commander's decision making style

Science.gov (United States)

Santos, Eugene; Nguyen, Hien; Russell, Jacob; Kim, Keumjoo; Veenhuis, Luke; Boparai, Ramnjit; Stautland, Thomas Kristoffer

2017-05-01

A Commander's decision making style represents how he weighs his choices and evaluates possible solutions with regards to his goals. Specifically, in the naval warfare domain, it relates the way he processes a large amount of information in dynamic, uncertain environments, allocates resources, and chooses appropriate actions to pursue. In this paper, we describe an approach to capture a Commander's decision style by creating a cognitive model that captures his decisionmaking process and evaluate this model using a set of scenarios using an online naval warfare simulation game. In this model, we use the Commander's past behaviors and generalize Commander's actions across multiple problems and multiple decision making sequences in order to recommend actions to a Commander in a manner that he may have taken. Our approach builds upon the Double Transition Model to represent the Commander's focus and beliefs to estimate his cognitive state. Each cognitive state reflects a stage in a Commander's decision making process, each action reflects the tasks that he has taken to move himself closer to a final decision, and the reward reflects how close he is to achieving his goal. We then use inverse reinforcement learning to compute a reward for each of the Commander's actions. These rewards and cognitive states are used to compare between different styles of decision making. We construct a set of scenarios in the game where rational, intuitive and spontaneous decision making styles will be evaluated.

Combatant Commanders Informational Series, USEUCOM

National Research Council Canada - National Science Library

Burton, Steven

1996-01-01

...) and the diverse challenges it faces require it to maintain one of the highest operational and personnel tempos of the combatant command, are limited in the opportunity of personnel new to the command...

STS-37 Commander Nagel in commanders seat on OV-104's flight deck

Science.gov (United States)

1991-01-01

STS-37 Commander Steven R. Nagel, wearing launch and entry suit (LES), sits at commanders station on the forward flight deck of Atlantis, Orbiter Vehicle (OV) 104. Surrounding Nagel are the seat headrest, control panels, checklists, forward flight deck windows, and three drinking water containers with straws attached to forward panel F2.

National health and medical services response to incidents of chemical and biological terrorism.

Science.gov (United States)

Tucker, J B

1997-08-06

In response to the growing threat of terrorism with chemical and biological weapons, the US government has developed a national concept of operations for emergency health and medical services response. This capability was developed and tested for the first time during the Atlanta Olympic Games in the summer of 1996. In the event of a chemical or biological terrorist incident that exceeded local and state-level response capabilities, federal agencies would provide specialized teams and equipment to help manage the consequences of the attack and treat, decontaminate, and evacuate casualties. The US Congress has also established a Domestic Preparedness Program that provides for enhanced training of local first-responders and the formation of metropolitan medical strike teams in major cities around the country. While these national response capabilities are promising, their implementation to date has been problematic and their ultimate effectiveness is uncertain.

32 CFR 700.1053 - Commander of a task force.

Science.gov (United States)

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Commander of a task force. 700.1053 Section 700... Command Detail to Duty § 700.1053 Commander of a task force. (a) A geographic fleet commander, and any other naval commander, may detail in command of a task force, or other task command, any eligible...

Command World

National Research Council Canada - National Science Library

Wong, Leah Y; Lange, Douglas S; Sebastyn, Jerome T; Roof, William H

2006-01-01

.... The Command World scenario was expressly designed as a crisis action planning exercise in order to replicate the communications, collaboration, and information requirements inherent in a military...

Command Decision-Making: Experience Counts

National Research Council Canada - National Science Library

Wolgast, Kelly A

2005-01-01

Decision-making is the mainstay of military leadership and command. Due to the changed nature of the current military environment, military commanders can no longer rely solely on the traditional Military Decision-making Process (MDMP...

Paramount Interest: Command Relationships in Amphibious Warfare

National Research Council Canada - National Science Library

Peabody, Hitch

2004-01-01

In 2001, U.S. amphibious forces abandoned sixty years of established command and control doctrine, replacing the traditional senior-subordinate relationship between Navy and Marine commanders with coequal command. Why did it change...

Incidence and Nature of Medical Attendance Injuries in English Community Rugby Union

Science.gov (United States)

Roberts, Simon P.; Trewartha, Grant; England, Mike; Stokes, Keith A.

2014-01-01

Background: Previous research has identified injury patterns during community-level rugby union match play, but none have investigated the frequency and reasons for on-field injury management. Purpose: To establish the frequency, reasons, and patterns of on-field injury management in English community rugby, including differences between different levels of play. Study Design: Descriptive epidemiology study. Methods: Over 3 seasons, injury information was collected from 46 (2009-2010), 67 (2010-2011), and 76 (2011-2012) English community clubs (Rugby Football Union [RFU] levels 3-9). Club injury management staff reported information for all medical attendances during match play, including details on the injury site and type, playing position (seasons 2010-2011 and 2011-2012 only), and whether the player was removed from play. Clubs were subdivided into groups A (RFU levels 3 and 4 [mainly semiprofessional]; n = 39), B (RFU levels 5 and 6 [mainly amateur]; n = 71), and C (RFU levels 7-9 [social and recreational]; n = 79) to differentiate playing levels. Results: The overall medical attendance incidence was 229 per 1000 player-match hours (95% CI, 226-232), with 45 players removed per 1000 player-match hours (95% CI, 44-46). Attendance incidence for group A (294 per 1000 player-match hours; 95% CI, 287-301) was higher compared with group B (213; 95% CI, 208-218; P < .001) and C (204; 95% CI, 200-209; P < .001). There was a higher incidence of attendances to forwards (254; 95% CI, 249-259) compared with backs (191; 95% CI, 187-196; P < .001). The head was the most common specific site of injury (55 per 1000 player-match hours; 95% CI, 53-57) but the lower limb region overall accounted for most attendances (87; 95% CI, 85-89) and the greatest chance of removal from the pitch (22; 95% CI, 21-23). Conclusion: With the likelihood of 1 injury for each team per match severe enough for the player to leave the pitch and with at least 1 attendance for a head injury per match

Test Telemetry And Command System (TTACS)

Science.gov (United States)

Fogel, Alvin J.

1994-01-01

The Jet Propulsion Laboratory has developed a multimission Test Telemetry and Command System (TTACS) which provides a multimission telemetry and command data system in a spacecraft test environment. TTACS reuses, in the spacecraft test environment, components of the same data system used for flight operations; no new software is developed for the spacecraft test environment. Additionally, the TTACS is transportable to any spacecraft test site, including the launch site. The TTACS is currently operational in the Galileo spacecraft testbed; it is also being provided to support the Cassini and Mars Surveyor Program projects. Minimal personnel data system training is required in the transition from pre-launch spacecraft test to post-launch flight operations since test personnel are already familiar with the data system's operation. Additionally, data system components, e.g. data display, can be reused to support spacecraft software development; and the same data system components will again be reused during the spacecraft integration and system test phases. TTACS usage also results in early availability of spacecraft data to data system development and, as a result, early data system development feedback to spacecraft system developers. The TTACS consists of a multimission spacecraft support equipment interface and components of the multimission telemetry and command software adapted for a specific project. The TTACS interfaces to the spacecraft, e.g., Command Data System (CDS), support equipment. The TTACS telemetry interface to the CDS support equipment performs serial (RS-422)-to-ethernet conversion at rates between 1 bps and 1 mbps, telemetry data blocking and header generation, guaranteed data transmission to the telemetry data system, and graphical downlink routing summary and control. The TTACS command interface to the CDS support equipment is nominally a command file transferred in non-real-time via ethernet. The CDS support equipment is responsible for

Medical Surveillance for a Soldier Centered Battlespace Awareness

National Research Council Canada - National Science Library

Schmorrow, Dylan D; Solhan, George; Kruse, Amy A

2004-01-01

.... Medical technologies have progressed to the degree that portable, rugged, and wireless designs can be conceived of that could give coalition commanders and medical personnel a view of the health...

U.S. Pacific Command > About USPACOM > History

Science.gov (United States)

USPACOM U.S. Pacific Command Search USPACOM: Search Search Search USPACOM: Search Home Leadership People's Republic of China, the Democratic People's Republic of Korea, Mongolia, and the Republic of its surrounding waters under the leadership of one commander, providing a unity of command absent from

Global Command and Control Management Structure

National Research Council Canada - National Science Library

1995-01-01

This instruction establishes: responsibilities for the Joint Staff, Services, Defense agencies, combatant and functional unified commands, and other activities regarding management of Global Command and Control (GCC...

Incidence of Traumatic Brain Injury Across the Full Disease Spectrum: A Population-Based Medical Record Review Study

Science.gov (United States)

Leibson, Cynthia L.; Brown, Allen W.; Ransom, Jeanine E.; Diehl, Nancy N.; Perkins, Patricia K.; Mandrekar, Jay; Malec, James F.

2012-01-01

Background Extremely few objective estimates of traumatic brain injury incidence include all ages, both sexes, all injury mechanisms, and the full spectrum from very mild to fatal events. Methods We used unique Rochester Epidemiology Project medical records-linkage resources, including highly sensitive and specific diagnostic coding, to identify all Olmsted County, MN, residents with diagnoses suggestive of traumatic brain injury regardless of age, setting, insurance, or injury mechanism. Provider-linked medical records for a 16% random sample were reviewed for confirmation as definite, probable, possible (symptomatic), or no traumatic brain injury. We estimated incidence per 100,000 person-years for 1987–2000 and compared these record-review rates with rates obtained using Centers for Disease Control and Prevention (CDC) data-systems approach. For the latter, we identified all Olmsted County residents with any CDC-specified diagnosis codes recorded on hospital/emergency department administrative claims or death certificates 1987–2000. Results Of sampled individuals, 1257 met record-review criteria for incident traumatic brain injury; 56% were ages 16–64 years, 56% were male, 53% were symptomatic. Mechanism, sex, and diagnostic certainty differed by age. The incidence rate per 100,000 person-years was 558 (95% confidence interval = 528–590) versus 341 (331–350) using the CDC data system approach. The CDC approach captured only 40% of record-review cases. Seventy-four percent of missing cases presented to hospital/emergency department; none had CDC-specified codes assigned on hospital/emergency department administrative claims or death certificates; 66% were symptomatic. Conclusions Capture of symptomatic traumatic brain injuries requires a wider range of diagnosis codes, plus sampling strategies to avoid high rates of false-positive events. PMID:21968774

A Novel wave-form command shaper for overhead cranes

Directory of Open Access Journals (Sweden)

KHALED ALHAZZA

2013-12-01

Full Text Available In this work, a novel command shaping control strategy for oscillation reduction of simple harmonic oscillators is proposed, and validated experimentally. A wave-form acceleration command shaper is derived analytically. The performance of the proposed shaper is simulated numerically, and validated experimentally on a scaled model of an overhead crane. Amplitude modulation is used to enhance the shaper performance, which results in a modulated wave-form command shaper. It is determined that the proposed wave-form and modulated wave-form command shaper profiles are capable of eliminating travel and residual oscillations. Furthermore, unlike traditional impulse and step command shapers, the proposed command shaper has piecewise smoother acceleration, velocity, and displacement profiles. Experimental results using continuous and discrete commands are presented. Experiments with discrete commands involved embedding a saturation model-based feedback in the algorithm of the command shaper.

Increased situation awareness in major incidents-radio frequency identification (RFID) technique: a promising tool.

Science.gov (United States)

Jokela, Jorma; Rådestad, Monica; Gryth, Dan; Nilsson, Helené; Rüter, Anders; Svensson, Leif; Harkke, Ville; Luoto, Markku; Castrén, Maaret

2012-02-01

In mass-casualty situations, communications and information management to improve situational awareness is a major challenge for responders. In this study, the feasibility of a prototype system that utilizes commercially available, low-cost components, including Radio Frequency Identification (RFID) and mobile phone technology, was tested in two simulated mass-casualty incidents. The feasibility and the direct benefits of the system were evaluated in two simulated mass-casualty situations: one in Finland involving a passenger ship accident resulting in multiple drowning/hypothermia patients, and another at a major airport in Sweden using an aircraft crash scenario. Both simulations involved multiple agencies and functioned as test settings for comparing the disaster management's situational awareness with and without using the RFID-based system. Triage documentation was done using both an RFID-based system, which automatically sent the data to the Medical Command, and a traditional method using paper triage tags. The situational awareness was measured by comparing the availability of up-to date information at different points in the care chain using both systems. Information regarding the numbers and status or triage classification of the casualties was available approximately one hour earlier using the RFID system compared to the data obtained using the traditional method. The tested prototype system was quick, stable, and easy to use, and proved to work seamlessly even in harsh field conditions. It surpassed the paper-based system in all respects except simplicity of use. It also improved the general view of the mass-casualty situations, and enhanced medical emergency readiness in a multi-organizational medical setting. The tested technology is feasible in a mass-casualty incident; further development and testing should take place.

Exposure to reactive intermediate-inducing drugs during pregnancy and the incident use of psychotropic medications among children.

Science.gov (United States)

Tran, Yen-Hao; Groen, Henk; Bergman, Jorieke E H; Hak, Eelko; Wilffert, Bob

2017-03-01

Our study aimed to investigate the association between prenatal exposure to reactive intermediate (RI)-inducing drugs and the initiation of psychotropic medications among children. We designed a cohort study using a pharmacy prescription database. Pregnant women were considered exposed when they received a prescription of RI-inducing drugs. These drugs could be either used alone (RI+/FAA-) or combined with drugs exhibiting folic acid antagonism (FAA, RI+/FAA+). The reference group included pregnant women who did not receive any RI-inducing drugs or FAA drugs. We analyzed 4116 exposed and 30 422 reference pregnancies. The hazard ratio (HR) with 95% confidence interval (CI) was 1.27 (95%CI 1.15-1.41) for pregnancies exposed to RI-inducing drugs as a whole. Considering subgroups of RI-inducing drugs, prenatal exposure to both RI+/FAA+ and RI+/FAA- was associated with the children's initiation of psychotropic medications, HRs being 1.35 (95%CI 1.10-1.66) and 1.26 (1.13-1.41), respectively. The HRs were increased with prolonged exposure to RI-inducing drugs, especially in the first and second trimesters. In a detailed examination of the psychotropics, the incidences of receiving antimigraine preparations and psychostimulants were significantly increased for the exposed children, compared with the reference children. The incidences of receiving antipsychotics and hypnotics were also higher for the exposed children; however, the HRs did not reach significance after adjustment. We found a significantly increased incident use of psychotropic medications among children prenatally exposed to RI-inducing drugs, especially during the first and second trimesters. This suggests a detrimental effect during critical periods of brain development. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Command in a field hospital.

Science.gov (United States)

Bricknell, M C M

2003-03-01

This paper examines the challenges involved in commanding a field hospital. There are frequent, dynamic tensions between the military culture that is based on a task-focussed, hierarchical structure and the clinical culture that is based on flat, process-focussed, multidisciplinary teams. The paper outlines the cultural environment of the field hospital and then examines the deployment sequence whereby a functioning clinical facility may be created from a group of disparate individuals. There are a number of tools that may assist with this including the personality of the Commanding Officer, individual skills, the creation of an organizational identity and the choice of command structure.

Operation of emergency operating centers during mass casualty incidents in taiwan: a disaster management perspective.

Science.gov (United States)

Wen, Jet-Chau; Tsai, Chia-Chou; Chen, Mei-Hsuan; Chang, Wei-Ta

2014-10-01

On April 27, 2011, a train derailed and crashed in Taiwan, causing a mass casualty incident (MCI) that was similar to a previous event and with similar consequences. In both disasters, the emergency operating centers (EOCs) could not effectively integrate associated agencies to deal with the incident. The coordination and utilization of resources were inefficient, which caused difficulty in command structure operation and casualty evacuation. This study was designed to create a survey questionnaire with problem items using disaster management phases mandated by Taiwan's Emergency Medical Care Law (EMCL), use statistical methods (t test) to analyze the results and issues the EOCs encountered during the operation, and propose solutions for those problems. Findings showed that EOCs lacked authority to intervene or coordinate with associated agencies. Also, placing emphasis on the recovery phase should improve future prevention and response mechanisms. To improve the response to MCIs, the EMCL needs to be amended to give EOCs the lead during disasters; use feedback from the recovery phase to improve future disaster management and operation coordination; and establish an information-sharing platform across agencies to address all aspects of relief work.(Disaster Med Public Health Preparedness. 2014;0:1-6).

Soviet command and control in a historical context

OpenAIRE

Kern, Jeffrey A.

1981-01-01

Approved for public release; distribution is unlimited An examination is made of the historical antecedents of present day command and control doctrine in the Soviet Union. The continuity of principal characteristics is demonstrated. The ideological determinants shaping the command and control system are first developed. These include centralism, collective decision-making, unity of command, and redundancy. Practical consequences of these are explored. The functioning of Soviet command...

Development and evaluation of a new simulation model for interactive training of the medical response to major incidents and disasters.

Science.gov (United States)

Lennquist Montán, K; Hreckovski, B; Dobson, B; Örtenwall, P; Montán, C; Khorram-Manesh, A; Lennquist, S

2014-08-01

The need for and benefit of simulation models for interactive training of the response to major incidents and disasters has been increasingly recognized during recent years. One of the advantages with such models is that all components of the chain of response can be trained simultaneously. This includes the important communication/coordination between different units, which has been reported as the most common cause of failure. Very few of the presently available simulation models have been suitable for the simultaneous training of decision-making on all levels of the response. In this study, a new simulation model, originally developed for the scientific evaluation of methodology, was adapted to and developed for the postgraduate courses in Medical Response to Major Incidents (MRMI) organized under the auspices of the European Society for Trauma and Emergency Surgery (ESTES). The aim of the present study was to describe this development process, the model it resulted in, and the evaluation of this model. The simulation model was based on casualty cards giving all information normally available for the triage and primary management of traumatized patients. The condition of the patients could be changed by the instructor according to the time passed since the time of injury and treatments performed. Priority of the casualties as well as given treatments could be indicated on the cards by movable markers, which also gave the time required for every treatment. The exercises were run with real consumption of time and resources for all measures performed. The magnetized cards were moved by the trainees through the scene, through the transport lines, and through the hospitals where all functions were trained. For every patient was given the definitive diagnosis and the times within certain treatments had to be done to avoid preventable mortality and complications, which could be related to trauma-scores. The methodology was tested in nine MRMI courses with a total of

Design and validation of a questionnaire on nursing competence in the notification of medication incidents.

Science.gov (United States)

Salcedo-Diego, Isabel; de Andrés-Gimeno, Begoña; Ruiz-Antorán, Belén; Layunta, Rocío; Serrano-Gallardo, Pilar

To design and perform a face and content validation of a questionnaire to measure the competence of hospital RN to report medication incidents. Content and face questionnaire validation descriptive study. A review of the literature was performed for the creation of ítems. A panel of six experts assessed the relevance of the inclusion of each ítem in the questionnaire by calculating the position index; ítems with position index >0.70 were selected. The questionnaire was piloted by 59 RN. Finally, a meeting was convened with experts, in order to reduce the length of the piloted questionnaire through review, discussion and decision by consensus on each item. From the literature review, a battery of 151 ítems grouped into three elements of competence: attitudes, knowledge and skills was created. 52.9% (n=80) of the ítems received a position index > 0.70. The response rate in the pilot study was 40.65%. The median time to complete the questionnaire was 23:35minutes. After reduction by the experts, the final questionnaire comprised 45 ítems grouped into 32 questions. The NORMA questionnaire, designed to explore the competence of hospital RN to report medication incidents, has adequate face and content validity and is easy to administer, enabling its institutional implementation. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

[The detector, the command neuron and plastic convergence].

Science.gov (United States)

Sokolov, E N

1977-01-01

The paper deals with the structure of detectors, the function of commanding neurones and the problem of relationship between detectors and commanding neurons. An example of hierarchial organization of detectors is provided by the colour analyser in which a layer of receptors, a layer of opponent neurones and a layer of colour-selective detectors are singled out. The colour detector is selectively sensitive to a certain combination of excitations at the input. If the detector is selectively activated by a certain combination of excitations at the input, the selective activation of the commanding neurone through a pool of motoneurones brings about a reaction at the output, specific in its organization. The reflexogenic zone of the reaction is determined by the detectors which converge on the commanding neurone controlling the given reaction. The plasticity of the reaction results from a plastic convergence of the detectors on the commanding neurone which controls the reaction. This comprises selective switching off the detectors from the commanding neurone (habituation) and connecting the detectors to the commanding neurone (facilitation).

Association of iodine fortification with incident use of antithyroid medication – a Danish nationwide study

DEFF Research Database (Denmark)

Cerqueira, Charlotte; Knudsen, Nils; Ovesen, Lars

2009-01-01

Context: Iodine-induced hyperthyroidism has been reported in the early phases of almost all iodine fortification programs, depending on prior iodine intake in the population, the amount of fortification, and the rate of change. Objective: The aim of the study was to monitor the effect of the Dani...... fortification induced a temporary, modest increase in the incidence of hyperthyroidism as measured by use of antithyroid medication. A new steady state has not yet evolved. (J Clin Endocrinol Metab 94: 2400-2405, 2009)...

Potential media influence on the high incidence of medical disputes from the perspective of plastic surgeons.

Science.gov (United States)

Chen, Chiehfeng; Lin, Ching-Feng; Chen, Cha-Chun; Chiu, Shih-Feng; Shih, Fuh-Yuan; Lyu, Shu-Yu; Lee, Ming-Been

2017-08-01

The main purpose of this study is to investigate the prevalence of medical disputes among plastic surgeons in Taiwan and to elucidate their perspectives regarding the influence of medical litigation media coverage on the physician-patient relationship. A self-administered questionnaire was distributed among plastic surgeons attending a series of continuing education training lectures organized by the Taiwan Society of Plastic Surgery in 2015. Of the 109 respondents, over a third (36.4%) had previously experienced a medical dispute. The vast majority of both physicians who had medical disputes (77.1%) and those who did not (72.1%) felt that the media tends to be supportive of patients in their reporting, and 37.1% of all plastic surgeons felt that the media always portrays the patient as a victim. Respondents who experienced medical disputes in this study felt that the top five leading causes of the high incidence of medical disputes were patient disappointment with procedure results (81.1%), insufficient patient psychological preparation or emotional instability (61.7%), inadequate risk communication on the part of the physician (64.9%), patient uneasiness with the procedure or perception of carelessness (60.6%), and insufficient physician training or incorrect medical evaluation (57.4%). Over a third of the respondents had previously experienced a medical dispute. This study highlights the perception among plastic surgeons that the media reporting of medical disputes and medical litigation is biased in favor of the patients, with 37.1% of the plastic surgeons surveyed opining that patients are always cast as victims. Copyright © 2017. Published by Elsevier B.V.

The Battle Command Sustainment Support System: Initial Analysis Report

Science.gov (United States)

2016-09-01

products including jet fuels, distillate fuels, residual fuels, automotive gasoline , specified bulk lubricating oils, aircraft engine oils, fuel...contained within this report. 15. SUBJECT TERMS Mission command Software Tactical applications (TacApps) Command post ...computing environment (CPCE) Command post client Battle command sustainment support System (BCS3) Logistics

Key Planning Factors for Recovery from a Radiological Terrorism Incident

Science.gov (United States)

2012-09-01

measurements are made, these are collected electronically4 and automatically exported to local operation centers and incident command posts where the...economic, natural and built environments and a move to self-sufficiency, sustainability and resilience.” As can be seen in Figure 3-11, some long-term...Transportation and access routes Bridges Streets and thoroughfares Sidewalks and walkways Release of property from radiologically controlled areas

Two 238Pu inhalation incidents

International Nuclear Information System (INIS)

Fleming, R.R.; Hall, R.M.

1978-06-01

Two employees inhaled significant amounts of 238 Pu in separate unrelated contamination incidents in 1977. Both acute exposure incidents are described and the urine, feces, and in-vivo chest count data for each employee. Case B ( 238 PuNO 3 ) received 24 DTPA treatments beginning the day of the incident while, for medical reasons, Case A ( 238 PuO 2 ) received no therapy

[Results of provisional use of a system for voluntary anonymous reporting of incidents that threaten patient safety in the emergency medical services of Asturias].

Science.gov (United States)

Galván Núñez, Pablo; Santander Barrios, María Dolores; Villa Álvarez, María Cristina; Castro Delgado, Rafael; Alonso Lorenzo, Julio C; Arcos González, Pedro

2016-06-01

To describe the reported incidents and adverse events in the emergency medical services of Asturias, Spain, and assess their consequences, delays caused, and preventability. Prospective, observational study of incidents reported by the staff of the emergency medical services of Asturias after implementation of a system devised by the researchers. Incident reports were received for 0.48% (95% CI, 0.41%-0.54%) of the emergencies attended. Patient safety was compromised in 74.7% of the reported incidents. Problems arising in the emergency response coordination center (ERCC) accounted for 37.6% of the incidents, transport problems for 13.4%, vehicular problems for 10.8%, and communication problems for 8.8%. Seventy percent of the reported incidents caused delays in care; 55% of the reported incidents that put patients at risk (according to severity assessment code ratings) corresponded to problems related to human or material resources. A total of 88.1% of the incidents reported were considered avoidable. Some type of intervention was required to attenuate the effects of 46.2% of the adverse events reported. The measures that staff members most often proposed to prevent adverse events were to increase human and material resources (28.3%), establish protocols (14.5%), and comply with quality of care recommendations (9.7%). It is important to promote a culture of safety and incident reporting among health care staff in Asturias given the number of serious adverse events. Reporting is necessary for understanding the errors made and taking steps to prevent them. The ERCC is the point in the system where incidents are particularly likely to appear and be noticed and reported.

New onset of insomnia in hospitalized patients in general medical wards: incidence, causes, and resolution rate

OpenAIRE

Ho, An; Raja, Bronson; Waldhorn, Richard; Baez, Valentina; Mohammed, Idiris

2017-01-01

ABSTRACT Background: Insomnia is common in hospitalized patients. However, no study has examined new onset of insomnia in patients without a prior history of insomnia. Objectives: Incidence of new onset of insomnia in inpatients, associated factors and resolution rate after 2 weeks. Method: This is a prospective observational study conducted at a community hospital. We used the Insomnia Severity Index questionnaire to screen for insomnia in all patients located in the general medical floors f...

Defining the management role of the department medical director.

Science.gov (United States)

Brady, T F; Carpenter, C R

1986-01-01

Through analysis of medical and administrative director positions it is possible to identify an organizational structure for medical departments that enhances departmental operations. Possible roles and tasks that describe managerial responsibilities are considered, and a review of the literature identifies options for how these roles or tasks can be shared between medical and nonmedical managers at the departmental level. These options are refined based on interviews with department-level managers at a case study hospital. Three models are then explored: unity of command, shared accountability, and split accountability. The unity of command model is recommended. In this model, the medical director assumes total authority and accountability for departmental operations through some sort of "enfranchisement." A more formal planning process and a review of job descriptions are also recommended.

32 CFR 700.1054 - Command of a naval base.

Science.gov (United States)

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Command of a naval base. 700.1054 Section 700.1054 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY... Command Detail to Duty § 700.1054 Command of a naval base. The officer detailed to command a naval base...

32 CFR 215.7 - Command relationships.

Science.gov (United States)

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Command relationships. 215.7 Section 215.7 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS EMPLOYMENT OF MILITARY RESOURCES IN THE EVENT OF CIVIL DISTURBANCES § 215.7 Command relationships...

Hospital planning for weapons of mass destruction incidents

Directory of Open Access Journals (Sweden)

Perry Ronald

2006-01-01

Full Text Available As terrorists attacks increase in frequency, hospital disaster plans need to be scrutinized to ensure that they take into account issues unique to weapons of mass destruction. This paper reports a review of the literature addressing hospital experiences with such incidents and the planning lessons thus learned. Construction of hospital disaster plans is examined as an ongoing process guided by the disaster planning committee. Hospitals are conceived as one of the components of a larger community disaster planning efforts, with specific attention devoted to defining important linkages among response organizations. This includes the public health authorities, political authorities, prehospital care agencies, and emergency management agencies. A review is completed of six special elements of weapons of mass destruction incidents that should be addressed in hospital disaster plans: incident command, hospital security, patient surge, decontamination, mental health consequences, and communications. The paper closes with a discussion of the importance of training and exercises in maintaining and improving the disaster plan.

Schema for Spacecraft-Command Dictionary

Science.gov (United States)

Laubach, Sharon; Garcia, Celina; Maxwell, Scott; Wright, Jesse

2008-01-01

An Extensible Markup Language (XML) schema was developed as a means of defining and describing a structure for capturing spacecraft command- definition and tracking information in a single location in a form readable by both engineers and software used to generate software for flight and ground systems. A structure defined within this schema is then used as the basis for creating an XML file that contains command definitions.

32 CFR 552.65 - Command supervision.

Science.gov (United States)

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Command supervision. 552.65 Section 552.65 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS AND NATIONAL CEMETERIES REGULATIONS AFFECTING MILITARY RESERVATIONS Solicitation on Military Reservations § 552.65 Command supervision. (a) All insurance...

Peptic Ulcer Disease Risk in Chronic Kidney Disease: Ten-Year Incidence, Ulcer Location, and Ulcerogenic Effect of Medications

Science.gov (United States)

Liang, Chih-Chia; Muo, Chih-Hsin; Wang, I-Kuan; Chang, Chiz-Tzung; Chou, Che-Yi; Liu, Jiung-Hsiun; Yen, Tzung-Hai; Huang, Chiu-Ching; Chung, Chi-Jung

2014-01-01

Objectives We aimed at determining peptic ulcer disease (PUD) incidence among chronic kidney disease (CKD) patients during 1998–2008, compared to patients without CKD, and at examining associations between CKD and PUD. Methods Data for 1998–2008 were extracted from the National Health Insurance Research Database in Taiwan. The annual PUD incidence (cases per thousand persons per year) was calculated separately for patients with and without CKD. Characteristics of patients with newly diagnosed PUD (n = 16322) were compared to those of a control group without PUD (n = 32644). The 2 groups were matched for age, sex, and index year. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression. Results Over the 10-year period, the PUD incidence was ∼10–12 times higher in CKD patients than in those without CKD. Its incidence in elderly CKD patients increased rapidly over time. For CKD patients, most PUD events (>95%) were managed during hospitalization. Peptic ulcer risk, adjusted for all potential confounders, was much higher in CKD patients undergoing hemodialysis (adjusted OR, 9.74; 95% CI, 7.11–13.31). Maintenance hemodialysis patients were 2 times more likely to have gastric ulcers than duodenal ulcers, while CKD patients not on dialysis had similar risks for both. There were no significant interactions between medications and CKD status on the peptic ulcer risk. Unlike CKD patients on nonsteroidal anti-inflammatory drugs and clopidogrel, those on aspirin did not have a higher peptic ulcer risk (adjusted OR, 0.88; 95% CI, 0.44–1.77). Conclusions CKD patients have a substantially increased PUD risk, and the majority of CKD patients with PUD require hospital management. Further, peptic ulcer risk is affected by hemodialysis therapy, patient status (inpatient vs. outpatient), and ulcerogenic medications. PMID:24498412

The Marihuana Dilemma: Challenge to Commanders.

Science.gov (United States)

The marihuana dilemma poses a major challenge to commanders in the US Army today. The problem was analyzed as to the characteristics of the drug...available to commanders to meet the challenge. The essay concludes that marihuana should not be legalized; drug users or former drug users should not be

The B.A.P. PACOCHA (SS-48) Collision: The Escape and Medical Recompression Treatment of Survivors

Science.gov (United States)

1989-03-30

Navy double-lock chamber which, for simplicity, will be referred to as chamber one. Commander Sierralta and Lieutenant Commander Villela supervised... Sierralta and Commander Murata were trained in Argentina in 1987. Inside tenders were divers with Peruvian Navy nursing training, similar to the U.S...ENT specialist, Member of rescue team aboard B.A.P. IQUIQUE Commander Fernando Sierralta Gutierrez, Medical Officer. Trained in submarine medicine in

Issues and Solutions for Command Post Simulations

National Research Council Canada - National Science Library

Stytz, Martin R; Banks, Sheila B

2006-01-01

.... Unfortunately, the modeling of joint command post teams is still very much in its infancy and this lack of foundational research hinders our ability to assess the performance of command post teams...

76 FR 19893 - Unified Command Plan 2011

Science.gov (United States)

2011-04-08

... Plan 2011 Memorandum for the Secretary of Defense Pursuant to my authority as Commander in Chief, I hereby approve and direct the implementation of the revised Unified Command Plan. Consistent with title...

Incidence of cutaneous adverse drug reactions among medical inpatients of Sultanah Aminah Hospital Johor Bahru.

Science.gov (United States)

Latha, S; Choon, S E

2017-06-01

Cutaneous adverse drug reactions (cADRs) are common. There are only few studies on the incidence of cADRs in Malaysia. To determine the incidence, clinical features and risk factors of cADRs among hospitalized patients. A prospective study was conducted among medical inpatients from July to December 2014. A total of 43 cADRs were seen among 11 017 inpatients, yielding an incidence rate of 0.4%. cADR accounted for hospitalization in 26 patients. Previous history of cADR was present in 14 patients, with 50% exposed to the same drug taken previously. Potentially lifethreatening severe cutaneous adverse reactions (SCAR), namely drug reaction with eosinophilia and systemic symptoms (DRESS: 14 cases) and Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN: 6 cases) comprise almost 50% of cADRs. The commonest culprit drug group was antibiotics (37.2%), followed by anticonvulsants (18.6%). Cotrimoxazole, phenytoin and rifampicin were the main causative drugs for DRESS. Anticonvulsants were most frequently implicated in SJS/TEN (66.7%). Most cases had "probable" causality relationship with suspected drug (69.8%). The majority of cases were of moderate severity (65.1%), while 18.6% had severe reaction with 1 death recorded. Most cases were not preventable (76.7%). Older age (> 60 years) and mucosal involvement were significantly associated with a more severe reaction. The incidence of cADRs was 0.4%, with most cases classified as moderate severity and not preventable. The commonest reaction pattern was DRESS, while the main culprit drug group was antibiotics. Older age and mucosal membrane involvement predicts a severe drug reaction.

Downtime after Critical Incidents in Emergency Medical Technicians/Paramedics

Directory of Open Access Journals (Sweden)

Janice Halpern

2014-01-01

Full Text Available Effective workplace-based interventions after critical incidents (CIs are needed for emergency medical technicians (EMT/paramedics. The evidence for a period out of service post-CI (downtime is sparse; however it may prevent posttraumatic stress disorder (PTSD and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores. Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between 1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.

Command and motivation

DEFF Research Database (Denmark)

Jacobsen, Christian Bøtcher; Hvidtved, Johan; Andersen, Lotte Bøgh

2014-01-01

Motivated employees are crucial to organizations, but external interventions such as command systems and financial incentives may decrease motivation. If these external interventions are perceived to be controlling, they are expected to crowd out intrinsic motivation, and this may also apply...... to other types of autonomous motivation such as public service motivation. The perception of external interventions is thus expected to be vital. This article investigates how the perception of a specific command system (obligatory student plans) is associated with intrinsic motivation and public service...... motivation. Using a dataset with 3,230 school teachers in Denmark, a structural equation model shows that the perception of obligatory student plans as controlling is negatively associated with all of the investigated types of employee motivation, supporting that motivation crowding can occur....

Leadership challenges in multinational medical peacekeeping operations: Lessons from UNIFIL Hospital.

Science.gov (United States)

Datta, Rakesh; Khanna, Sangeeta

2017-10-01

Commanding a military multinational and multilingual healthcare facility can be a formidable task with very little margin for error. The authors were in leadership positions of UNIFIL Hospital, unique in its diversity of both staff and clientele. Experience about the challenges faced and methods adopted to overcome them will be shared. Troops from diverse backgrounds differ in their competency, and also in their attitudinal approach to situations. It is imperative for the medical commanders to identify these differences, and work towards harnessing individual strengths to form a cohesive unit. Frequent rotation of team members and thereby difficulty in adapting to new environment makes the tasks more challenging. Challenges can be broadly categorized in those dealing with functional roles (providing medical support) and command and control issues. Linguistic challenges especially in situations where professionals have to work as a coordinated unit remains a major challenge. The threat of medical errors arising out of misunderstandings is very real. Gender sensitization is essential to avoid potential unpleasant situations. Interpersonal conflict can easily go out of hand. The leadership has to be more direct and deliberate relying less on hierarchy and more on direct communication. A strict enforcement of UN standards for equipment and competence, frequent joint medical drills help to overcome interoperability issues and develop mutual confidence. Leadership in multinational UN hospitals is a demanding task with its peculiar set of challenges. A systematic and deliberate approach focused on mutual respect, flexibility and direct leadership can help medical commanders in such situations.

32 CFR 700.1056 - Command of a ship.

Science.gov (United States)

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Command of a ship. 700.1056 Section 700.1056 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS Precedence, Authority and Command Detail to Duty § 700.1056 Command of a...

The Linux command line a complete introduction

CERN Document Server

Shotts, William E

2012-01-01

You've experienced the shiny, point-and-click surface of your Linux computer—now dive below and explore its depths with the power of the command line. The Linux Command Line takes you from your very first terminal keystrokes to writing full programs in Bash, the most popular Linux shell. Along the way you'll learn the timeless skills handed down by generations of gray-bearded, mouse-shunning gurus: file navigation, environment configuration, command chaining, pattern matching with regular expressions, and more.

Three astronauts inside Command Module Simulator during Apollo Simulation

Science.gov (United States)

1968-01-01

Three astronauts inside the Command Module Simulator in bldg 5 during an Apollo Simulation. Left to right are Astronauts Thomas P. Stafford, commander; John W. Young, command module pilot; and Eugene A. Cernan, lunar module pilot.

Operational Maneuver from the Sea and Amphibious Command Relationships: Is It time for a Joint Force Amphibious Component Commander?

National Research Council Canada - National Science Library

Bennett, Michael

2004-01-01

.... In a joint community that is becoming increasingly dependant on the use of functional component commanders in the execution of major operations, the need for a Joint Force Amphibious Component Commander (JFAMCC...

Unit Testing for Command and Control Systems

Science.gov (United States)

Alexander, Joshua

2018-01-01

Unit tests were created to evaluate the functionality of a Data Generation and Publication tool for a command and control system. These unit tests are developed to constantly evaluate the tool and ensure it functions properly as the command and control system grows in size and scope. Unit tests are a crucial part of testing any software project and are especially instrumental in the development of a command and control system. They save resources, time and costs associated with testing, and catch issues before they become increasingly difficult and costly. The unit tests produced for the Data Generation and Publication tool to be used in a command and control system assure the users and stakeholders of its functionality and offer assurances which are vital in the launching of spacecraft safely.

Command Disaggregation Attack and Mitigation in Industrial Internet of Things

Directory of Open Access Journals (Sweden)

Peng Xun

2017-10-01

Full Text Available A cyber-physical attack in the industrial Internet of Things can cause severe damage to physical system. In this paper, we focus on the command disaggregation attack, wherein attackers modify disaggregated commands by intruding command aggregators like programmable logic controllers, and then maliciously manipulate the physical process. It is necessary to investigate these attacks, analyze their impact on the physical process, and seek effective detection mechanisms. We depict two different types of command disaggregation attack modes: (1 the command sequence is disordered and (2 disaggregated sub-commands are allocated to wrong actuators. We describe three attack models to implement these modes with going undetected by existing detection methods. A novel and effective framework is provided to detect command disaggregation attacks. The framework utilizes the correlations among two-tier command sequences, including commands from the output of central controller and sub-commands from the input of actuators, to detect attacks before disruptions occur. We have designed components of the framework and explain how to mine and use these correlations to detect attacks. We present two case studies to validate different levels of impact from various attack models and the effectiveness of the detection framework. Finally, we discuss how to enhance the detection framework.

Command Disaggregation Attack and Mitigation in Industrial Internet of Things.

Science.gov (United States)

Xun, Peng; Zhu, Pei-Dong; Hu, Yi-Fan; Cui, Peng-Shuai; Zhang, Yan

2017-10-21

A cyber-physical attack in the industrial Internet of Things can cause severe damage to physical system. In this paper, we focus on the command disaggregation attack, wherein attackers modify disaggregated commands by intruding command aggregators like programmable logic controllers, and then maliciously manipulate the physical process. It is necessary to investigate these attacks, analyze their impact on the physical process, and seek effective detection mechanisms. We depict two different types of command disaggregation attack modes: (1) the command sequence is disordered and (2) disaggregated sub-commands are allocated to wrong actuators. We describe three attack models to implement these modes with going undetected by existing detection methods. A novel and effective framework is provided to detect command disaggregation attacks. The framework utilizes the correlations among two-tier command sequences, including commands from the output of central controller and sub-commands from the input of actuators, to detect attacks before disruptions occur. We have designed components of the framework and explain how to mine and use these correlations to detect attacks. We present two case studies to validate different levels of impact from various attack models and the effectiveness of the detection framework. Finally, we discuss how to enhance the detection framework.

Medical Information Technology in Support of the Operational Commander

National Research Council Canada - National Science Library

Mitchell, James

1999-01-01

.... DoD is aggressively pursuing a unified force health protection strategy to protect service members from medical hazards associated with their military service from accession through retirement...

Ready...Set... Command! Rethinking Training for Squadron Commanders

Science.gov (United States)

2016-02-16

commander faces many difficult challenges. When discussing the Air Force’s troubling trend in suicide rates, Airmen “blame being overworked ...Air Forces total suicides despite making up only 16 percent of the service.3 Three years later the Air Force Times reveals continued challenges in...23 challenges. They must address complex issues facing the Air Force, such as troubling suicide rates, manning shortfalls, decreasing resources

Prevalence and incidence of mental health problems among Dutch medical students and the study-related and personal risk factors: a longitudinal study.

Science.gov (United States)

Borst, Jorien M; Frings-Dresen, Monique H W; Sluiter, Judith K

2016-11-01

A high prevalence of mental health problems (i.e. depression and/or anxiety) has been found in medical students in comparison with the general population. Therefore, the objective was first to study the prevalence and 1-year incidence of symptoms of depression, anxiety and any mental health problems among Dutch medical students and, second, to study which study-related and personal factors present a risk of these mental health problems. A 1-year prospective longitudinal study was performed among medical students of two medical faculties in the Netherlands (n=951). Health problems and study-related and personal factors were measured with an online questionnaire. Mental health problems were assessed by depression and/or anxiety symptoms (BSI-DEP and BSI-ANG). Univariate and multivariate hierarchical logistic regression analyses were performed to examine which of the study-related and personal factors predict mental health problems. At follow-up, 36%, 28% and 48% of the medical students reported symptoms of depression, anxiety and mental health problems, respectively. The incidence between 2010 and 2011 for depression was 20%, 17% for anxiety and 25% for mental health problems. Students who are worried about their own health during medical education are at an increased risk of future mental health problems (OR 2.0 [1.3-2.9], p=0.00). Excessive drinking behavior is a protective factor in this study (OR 0.7 [0.5-0.9], p=0.02). This study shows that only two out of nine factors are significantly associated with mental health problems among Dutch medical students, one risk factor and one protective factor.

Engagement Skills Trainer: The Commander’s Perspective

Science.gov (United States)

2017-06-09

CBRN Chemical Biological Radiological and Nuclear CGSOC Command and General Staff Officers Course DMG Digital Master Gunner EST Engagement Skills...commanders always emphasized SHARP ( Sexual Harassment and Response Program) training, the battery commander may vividly recall those events but not the range...soldiers in the EST generally do worse at weapons safety and orientation .26 Indicators from research show that EST results predict live fire results. The

XTCE. XML Telemetry and Command Exchange Tutorial

Science.gov (United States)

Rice, Kevin; Kizzort, Brad; Simon, Jerry

2010-01-01

An XML Telemetry Command Exchange (XTCE) tutoral oriented towards packets or minor frames is shown. The contents include: 1) The Basics; 2) Describing Telemetry; 3) Describing the Telemetry Format; 4) Commanding; 5) Forgotten Elements; 6) Implementing XTCE; and 7) GovSat.

Doublet III neutral beam multi-stream command language system

International Nuclear Information System (INIS)

Campbell, L.; Garcia, J.R.

1983-01-01

A multi-stream command language system was developed to provide control of the dual source neutral beam injectors on the Doublet III experiment at GA Technologies Inc. The Neutral Beam command language system consists of three parts: compiler, sequencer, and interactive task. The command language, which was derived from the Doublet III tokamak command language, POPS, is compiled, using a recursive descent compiler, into reverse polish notation instructions which then can be executed by the sequencer task. The interactive task accepts operator commands via a keyboard. The interactive task directs the operation of three input streams, creating commands which are then executed by the sequencer. The streams correspond to the two sources within a Doublet III neutral beam, plus an interactive stream. The sequencer multiplexes the execution of instructions from these three streams. The instructions include reads and writes to an operator terminal, arithmetic computations, intrinsic functions such as CAMAC input and output, and logical instructions. The neutral beam command language system was implemented using Modular Computer Systems (ModComp) Pascal and consists of two tasks running on a ModComp Classic IV computer. The two tasks, the interactive and the sequencer, run independently and communicate using shared memory regions. The compiler runs as an overlay to the interactive task when so directed by operator commands. The system is succesfully being used to operate the three neutral beams on Doublet III

Doublet III neutral beam multi-stream command language system

International Nuclear Information System (INIS)

Campbell, L.; Garcia, J.R.

1983-12-01

A multi-stream command language system was developed to provide control of the dual source neutral beam injectors on the Doublet III experiment at GA Technologies Inc. The Neutral Beam command language system consists of three parts: compiler, sequencer, and interactive task. The command language, which was derived from the Doublet III tokamak command language, POPS, is compiled, using a recursive descent compiler, into reverse polish notation instructions which then can be executed by the sequencer task. The interactive task accepts operator commands via a keyboard. The interactive task directs the operation of three input streams, creating commands which are then executed by the sequencer. The streams correspond to the two sources within a Doublet III neutral beam, plus an interactive stream. The sequencer multiplexes the execution of instructions from these three streams. The instructions include reads and writes to an operator terminal, arithmetic computations, intrinsic functions such as CAMAC input and output, and logical instructions. The neutral beam command language system was implemented using Modular Computer Systems (ModComp) Pascal and consists of two tasks running on a ModComp Classic IV computer

Turn-based gaming for convoy commander training

NARCIS (Netherlands)

Boonekamp, R.C.; Muller, T.J.; Vrijer, J.C. de

2015-01-01

With the increasing complexity of current-day military operations, effective education and training of military commanders is of vital importance. Commanders need to perform within a broader range of conflicts; unpredictable threats and civil-military interaction place a great demand on their

Incidence of academic failure and its underlying factors in Lorestan university of medical sciences

Directory of Open Access Journals (Sweden)

Farzad Ebrahimzadeh

2016-02-01

Full Text Available Background: Academic failure, conceived of as lack of success in one’s education, is of paramount importance for students of medical sciences and it might lead to more acute problems. The present study set out to investigate the prevalence and underlying reasons of academic failure in Lorestan University of medical sciences.  Materials and Methods: In this cohort study, academic records of all students of Lorestan University of Medical Sciences during the academic years of 2006-2011 were collected from education and student affair center and also, demographic and educational records were entered into a checklist. Inappropriate grade point average, being a provisional student, prolonged graduation, expulsion and dropout were taken into account as academic failure. To model the related effective factors, logistic regression was adopted and significance level was set at 0.05. Results: The cumulative incidence of academic failure was about 25.1%. Factors such as department, being self-funded or government-funded student, academic grade students are pursuing, the elapsed time between academic grades, gender and location of residence were related to academic failure (P<0.05. It is worth mentioning that no relationship was observed between the academic failure and being accepted based on quota system. Conclusion: The most important at risk groups were students of department of medicine and health, associate or medical doctoral students, self-funded students, students with a considerable time elapsed between their academic grades, male students and students living in dormitory. It is suggested that these students refer to consulting centers of university or educational supervisors and receive particular attention.

Preparedness for and response to a radiological or nuclear incident

International Nuclear Information System (INIS)

Norman Coleman, C.

2014-01-01

Public health and medical planning for a nuclear or radiological incident requires a complex, multi-faceted systematic approach involving federal, state and local governments, private sector organizations, academia, industry, international partners and individual experts and volunteers. The approach developed by the U.S. Department of Health and Human Services in collaboration with other U.S. Departments is the result of efforts from government and non-government experts that connect the available capabilities, resources, guidance tools, underlying concepts and science into the Nuclear Incident Medical Enterprise (NlME). It is a systems approach that can be used to support planning for, response to, and recovery from the effects of a nuclear incident. Experience is gained in exercises specific to radiation but also from other mass casualty incidents as there are many principles and components in common. Resilience and the ability to mitigate the consequences of a nuclear incident are enhanced by effective planning, preparation and training, timely response, clear communication, and continuous improvements based on new science, technology, experience and ideas. Recognizing that preparation for a radiological or nuclear incident will be a lower priority for healthcare workers and responders due to other demands, the Radiation Emergency Medical Management website has been developed with the National Library of Medicine. This includes tools for education and training, just-in-time medical management and triage among others. Most of the components of NIME are published in the peer review medical and disaster medicine literature to help ensure high quality and accessibility. While NIME is a continuous work-in-progress, the current status of the public health and medical preparedness and response for a nuclear incident is presented. (author)

Apollo 16 astronauts in Apollo Command Module Mission Simulator

Science.gov (United States)

1972-01-01

Astronaut Thomas K. Mattingly II, command module pilot of the Apollo 16 lunar landing mission, participates in extravehicular activity (EVA) training in bldg 5 at the Manned Spacecraft Center (MSC). In the right background is Astronaut Charles M. Duke Jr., lunar module pilot. They are inside the Apollo Command Module Mission Simulator (31046); Mattingly (right foreground) and Duke (right backgroung) in the Apollo Command Module Mission Simulator for EVA simulation and training. Astronaut John W. Young, commander, can be seen in the left background (31047).

Linux Command Line and Shell Scripting Bible

CERN Document Server

Blum, Richard

2011-01-01

The authoritative guide to Linux command line and shell scripting?completely updated and revised [it's not a guide to Linux as a whole ? just to scripting] The Linux command line allows you to type specific Linux commands directly to the system so that you can easily manipulate files and query system resources, thereby permitting you to automate commonly used functions and even schedule those programs to run automatically. This new edition is packed with new and revised content, reflecting the many changes to new Linux versions, including coverage of alternative shells to the default bash shel

Toward Unity of Command for Multinational Air Forces

National Research Council Canada - National Science Library

Asjes, David

1998-01-01

To assure unity of command in future multinational air operations, combatant commanders must embrace the necessity of multinational air forces, maximize the integration of allied officers within air...

Defense or Diplomacy Geographic Combatant Commands

Science.gov (United States)

2011-06-01

originally ruled by 1 Priest, Dana , The Mission: Waging War and Keeping Peace with America’s Military...events. US Central Command. Dana Priest describes General Zinni‟s experience as a GCC commander, wherein General Zinni found that in many ways...ignored altogether. Dr. James Forsyth and Lt Col Chance Saltzman make this argument in their Air and Space Power Journal article “Stay Out —Why

Unity of Command in Afghanistan: A Forsaken Principle of War

National Research Council Canada - National Science Library

Hope, Ian

2008-01-01

... in the evolution of military command for Afghanistan. It examines how there was an unprecedented departure from the principle of unity of command in Afghanistan in 2006, when Combined Forces Command-Afghanistan (CFC...

Spacecraft command and control using expert systems

Science.gov (United States)

Norcross, Scott; Grieser, William H.

1994-01-01

This paper describes a product called the Intelligent Mission Toolkit (IMT), which was created to meet the changing demands of the spacecraft command and control market. IMT is a command and control system built upon an expert system. Its primary functions are to send commands to the spacecraft and process telemetry data received from the spacecraft. It also controls the ground equipment used to support the system, such as encryption gear, and telemetry front-end equipment. Add-on modules allow IMT to control antennas and antenna interface equipment. The design philosophy for IMT is to utilize available commercial products wherever possible. IMT utilizes Gensym's G2 Real-time Expert System as the core of the system. G2 is responsible for overall system control, spacecraft commanding control, and spacecraft telemetry analysis and display. Other commercial products incorporated into IMT include the SYBASE relational database management system and Loral Test and Integration Systems' System 500 for telemetry front-end processing.

Workplace interpersonal conflicts among the healthcare workers: Retrospective exploration from the institutional incident reporting system of a university-affiliated medical center.

Directory of Open Access Journals (Sweden)

Jih-Shuin Jerng

Full Text Available There have been concerns about the workplace interpersonal conflict (WIC among healthcare workers. As healthcare organizations have applied the incident reporting system (IRS widely for safety-related incidents, we proposed that this system might provide a channel to explore the WICs.We retrospectively reviewed the reports to the IRS from July 2010 to June 2013 in a medical center. We identified the WICs and typed these conflicts according to the two foci (task content/process and interpersonal relationship and the three properties (disagreement, interference, and negative emotion, and analyzed relevant data.Of the 147 incidents with WIC, the most common related processes were patient transfer (20%, laboratory tests (17%, surgery (16% and medical imaging (16%. All of the 147 incidents with WIC focused on task content or task process, but 41 (27.9% also focused on the interpersonal relationship. We found disagreement, interference, and negative emotion in 91.2%, 88.4%, and 55.8% of the cases, respectively. Nurses (57% were most often the reporting workers, while the most common encounter was the nurse-doctor interaction (33%, and the majority (67% of the conflicts were experienced concurrently with the incidents. There was a significant difference in the distribution of worker job types between cases focused on the interpersonal relationship and those without (p = 0.0064. The doctors were more frequently as the reporter when the conflicts focused on the interpersonal relationship (34.1% than not on it (17.0%. The distributions of worker job types were similar between those with and without negative emotion (p = 0.125.The institutional IRS is a useful place to report the workplace interpersonal conflicts actively. The healthcare systems need to improve the channels to communicate, manage and resolve these conflicts.

Workplace interpersonal conflicts among the healthcare workers: Retrospective exploration from the institutional incident reporting system of a university-affiliated medical center.

Science.gov (United States)

Jerng, Jih-Shuin; Huang, Szu-Fen; Liang, Huey-Wen; Chen, Li-Chin; Lin, Chia-Kuei; Huang, Hsiao-Fang; Hsieh, Ming-Yuan; Sun, Jui-Sheng

2017-01-01

There have been concerns about the workplace interpersonal conflict (WIC) among healthcare workers. As healthcare organizations have applied the incident reporting system (IRS) widely for safety-related incidents, we proposed that this system might provide a channel to explore the WICs. We retrospectively reviewed the reports to the IRS from July 2010 to June 2013 in a medical center. We identified the WICs and typed these conflicts according to the two foci (task content/process and interpersonal relationship) and the three properties (disagreement, interference, and negative emotion), and analyzed relevant data. Of the 147 incidents with WIC, the most common related processes were patient transfer (20%), laboratory tests (17%), surgery (16%) and medical imaging (16%). All of the 147 incidents with WIC focused on task content or task process, but 41 (27.9%) also focused on the interpersonal relationship. We found disagreement, interference, and negative emotion in 91.2%, 88.4%, and 55.8% of the cases, respectively. Nurses (57%) were most often the reporting workers, while the most common encounter was the nurse-doctor interaction (33%), and the majority (67%) of the conflicts were experienced concurrently with the incidents. There was a significant difference in the distribution of worker job types between cases focused on the interpersonal relationship and those without (p = 0.0064). The doctors were more frequently as the reporter when the conflicts focused on the interpersonal relationship (34.1%) than not on it (17.0%). The distributions of worker job types were similar between those with and without negative emotion (p = 0.125). The institutional IRS is a useful place to report the workplace interpersonal conflicts actively. The healthcare systems need to improve the channels to communicate, manage and resolve these conflicts.

[Medication errors in Spanish intensive care units].

Science.gov (United States)

Merino, P; Martín, M C; Alonso, A; Gutiérrez, I; Alvarez, J; Becerril, F

2013-01-01

To estimate the incidence of medication errors in Spanish intensive care units. Post hoc study of the SYREC trial. A longitudinal observational study carried out during 24 hours in patients admitted to the ICU. Spanish intensive care units. Patients admitted to the intensive care unit participating in the SYREC during the period of study. Risk, individual risk, and rate of medication errors. The final study sample consisted of 1017 patients from 79 intensive care units; 591 (58%) were affected by one or more incidents. Of these, 253 (43%) had at least one medication-related incident. The total number of incidents reported was 1424, of which 350 (25%) were medication errors. The risk of suffering at least one incident was 22% (IQR: 8-50%) while the individual risk was 21% (IQR: 8-42%). The medication error rate was 1.13 medication errors per 100 patient-days of stay. Most incidents occurred in the prescription (34%) and administration (28%) phases, 16% resulted in patient harm, and 82% were considered "totally avoidable". Medication errors are among the most frequent types of incidents in critically ill patients, and are more common in the prescription and administration stages. Although most such incidents have no clinical consequences, a significant percentage prove harmful for the patient, and a large proportion are avoidable. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

ASC Addresses Unit Commanders' Concerns through LBE and Reset Programs

National Research Council Canada - National Science Library

Young, Mark E

2008-01-01

.... Army Sustainment Command (ASC), part of the U.S. Army Materiel Command (AMC) team, is available to assist, identify, and resolve equipment and maintenance problems as well as materiel readiness issues for combatant commanders...

Maritime Coalitions: When is Unity of Command Required

National Research Council Canada - National Science Library

Gahlinger, Gregory J

2007-01-01

.... The concepts of Unity of Command, Unity of Effort and Parallel, Lead Nation, or Integrated coalition command structures are viable across a broad spectrum of maritime coalition operations but do have...

Unity of Command in Afghanistan: A Forsaken Principle of War

National Research Council Canada - National Science Library

Hope, Ian

2008-01-01

... of military command for Afghanistan. It examines the unprecedented departure from the principle of unity of command in Afghanistan in 2006, when Combined Forces Command-Afghanistan passed control of the ground fight to the International...

The Joint Military Medical Executive Skills initiative: an impressive response to changing human resource management rules of engagement.

Science.gov (United States)

Kerr, Bernard J

2007-01-01

Confronted with a sudden and substantial change in the rules regarding who could command a military medical treatment facility (MTF), the Military Health System (MHS) responded to the challenge with an impressive human resource management solution-the Joint Medical Executive Skills Program. The history, emergence, and continuing role of this initiative exemplifies the MHS's capacity to fulfill the spirit and intent of an arduous Congressional mandate while enhancing professional development and sustaining the career opportunities of medical officers. The MHS response to the Congressional requirement that candidates for MTF command demonstrate professional administrative skills was decisive, creative, and consistent with the basic principles of human resource management. The Joint Medical Executive Skills Program is a management success story that demonstrates how strategic planning, well-defined skills requirements, and structured training can assure a ready supply of qualified commanders for the military's MTFs.

An Advanced Commanding and Telemetry System

Science.gov (United States)

Hill, Maxwell G. G.

The Loral Instrumentation System 500 configured as an Advanced Commanding and Telemetry System (ACTS) supports the acquisition of multiple telemetry downlink streams, and simultaneously supports multiple uplink command streams for today's satellite vehicles. By using industry and federal standards, the system is able to support, without relying on a host computer, a true distributed dataflow architecture that is complemented by state-of-the-art RISC-based workstations and file servers.

Astronaut John Young in Command Module Simulator during Apollo Simulation

Science.gov (United States)

1968-01-01

Astronaut John W. Young, command module pilot, inside the Command Module Simulator in bldg 5 during an Apollo Simulation. Astronauts Thomas P. Stafford, commander and Eugene A. Cernan, lunar module pilot are out of the view.

Command Home Page

Science.gov (United States)

Inclusion And Diversity Navy Standard Integrated Personnel System (NSIPS) My Navy Portal Board of One Source USA.gov U.S. Office of Special Counsel Social Media Directory and Policy US Navy App Locker Navy Personnel Command (NPC) Navy SAPR Navy EEO Inclusion And Diversity Navy Standard Integrated

Utilizing Lean Six Sigma Methodology to Improve the Authored Works Command Approval Process at Naval Medical Center San Diego.

Science.gov (United States)

Valdez, Michelle M; Liwanag, Maureen; Mount, Charles; Rodriguez, Rechell; Avalos-Reyes, Elisea; Smith, Andrew; Collette, David; Starsiak, Michael; Green, Richard

2018-03-14

Inefficiencies in the command approval process for publications and/or presentations negatively impact DoD Graduate Medical Education (GME) residency programs' ability to meet ACGME scholarly activity requirements. A preliminary review of the authored works approval process at Naval Medical Center San Diego (NMCSD) disclosed significant inefficiency, variation in process, and a low level of customer satisfaction. In order to facilitate and encourage scholarly activity at NMCSD, and meet ACGME requirements, the Executive Steering Council (ESC) chartered an interprofessional team to lead a Lean Six Sigma (LSS) Rapid Improvement Event (RIE) project. Two major outcome metrics were identified: (1) the number of authored works submissions containing all required signatures and (2) customer satisfaction with the authored works process. Primary metric baseline data were gathered utilizing a Clinical Investigations database tracking publications and presentations. Secondary metric baseline data were collected via a customer satisfaction survey to GME faculty and residents. The project team analyzed pre-survey data and utilized LSS tools and methodology including a "gemba" (environment) walk, cause and effect diagram, critical to quality tree, voice of the customer, "muda" (waste) chart, and a pre- and post-event value stream map. The team selected an electronic submission system as the intervention most likely to positively impact the RIE project outcome measures. The number of authored works compliant with all required signatures improved from 52% to 100%. Customer satisfaction rated as "completely or mostly satisfied" improved from 24% to 97%. For both outcomes, signature compliance and customer satisfaction, statistical significance was achieved with a p methodology and tools to improve signature compliance and increase customer satisfaction with the authored works approval process, leading to 100% signature compliance, a comprehensive longitudinal repository of all

Comparison between a classical command law and a new advanced recovery command law in a MCB-ARS boost

Science.gov (United States)

Petit, Pierre; Saint-Eve, Frédéric; Sawicki, Jean-Paul; Aillerie, Michel

2017-02-01

This paper focuses on an original performed command on DC-DC boosts developed for applications in the LMOPS lab for the photovoltaic energy conversion and more specifically the Photovoltaic panels connected to HVDC smart grids. This boost, commonly named MCB-ARS (Magnetically Coupled Boost with Active Recovery Switch) presents great advantages concerning the simplicity of the command on the single constitutive switch, the global efficiency and the voltage conversion ratio. A fine analysis of the losses all over the entire converter shows that losses are not distributed uniformly in the constituting components. So a previous modification described in a previous paper consisting in the conducting assistance on the power flowing intermediate diode, performed advantageously the global efficiency. The present analysis takes into account the fact that the new configuration obtained after this important improvement looks like a classical half-bridge push-pull stage and may be controlled by a twice complementary command. In that way, a comparison has been done between a natural commutation recovery diode and an assisted switch commutation driven in a push-pull mode. As attempted, the switching command laws in charge to assume the energy transfer has been compared to the classical previous system described in anterior papers, and we demonstrate in this publication that a commutation based on a push-pull command mode within the two switches of the MCB-ARS converter is possible and increases the power transfer.

Reticulospinal Systems for Tuning Motor Commands

Directory of Open Access Journals (Sweden)

Robert M. Brownstone

2018-04-01

Full Text Available The pontomedullary reticular formation (RF is a key site responsible for integrating descending instructions to execute particular movements. The indiscrete nature of this region has led not only to some inconsistencies in nomenclature, but also to difficulties in understanding its role in the control of movement. In this review article, we first discuss nomenclature of the RF, and then examine the reticulospinal motor command system through evolution. These command neurons have direct monosynaptic connections with spinal interneurons and motoneurons. We next review their roles in postural adjustments, walking and sleep atonia, discussing their roles in movement activation or inhibition. We propose that knowledge of the internal organization of the RF is necessary to understand how the nervous system tunes motor commands, and that this knowledge will underlie strategies for motor functional recovery following neurological injuries or diseases.

Design of a hybrid command and control mobile botnet: Presentation

CSIR Research Space (South Africa)

Pieterse, H

2013-03-01

Full Text Available smartphones controlled by a botmaster through a command and control network to serve a malicious purpose. This study presents the design of a hybrid command and control mobile botnet. It describes the propagation vectors, command and control channels...

Incorrect Responses to Locative Commands: A Case Study.

Science.gov (United States)

Duchan, Judith; Siegel, Leo

1979-01-01

A six-year-old with a language problem responded consistently to 100 locative commands by putting objects in containers and on flat surfaces regardless of the preposition or order of the nouns in the commands. (Author/CL)

The command to love the neighbour in Paul and the Synoptics

Directory of Open Access Journals (Sweden)

Heinz A. Hiestermann

2016-03-01

Full Text Available When sayings of Jesus are compared between the Pauline letters and the Synoptic Gospels in an attempt to locate parallels, Galatians 5:14 and Romans 13:8�10 have frequently been put forward as possible parallels to the Synoptic renditions of the great commandment of Mark 12:28�34 (Mt 22:34�40; Lk 10:25�28. These Pauline and Synoptic texts all contain the command to love the neighbour, but the Synoptic texts have added the command to love God to the command to love the neighbour. Paul never quoted the great commandment. Consequently, a relationship between the verses is normally rejected. However, not all possibilities have been explored. In the search for parallels between Pauline and Synoptic Jesus traditions it has been overlooked that Paul and Matthew render the command to love the neighbour more than once. Matthew delivers the command to love the neighbour three times. Only once he has connected it to the command to love God. Matthew renders the single command to love the neighbour twice, resembling the Pauline use of the command. Using the criteria for validating parallels between Pauline and Synoptic Jesus traditions, including verbal agreement and the unique use of the command to love the neighbour by Paul and Matthew, it is argued that a connection between Romans 13:9 and Matthew 19:18�19 is likely.Intradisciplinary and/or interdisciplinary implications: The research explores the use of Leviticus 19:18b by the New Testament authors. It is argued that the command to love the neighbour was given high prominence in the early church, as it was used by the Synoptic authors and by Paul to summarise Jesus� ethical teachings.

Israeli hospital preparedness for terrorism-related multiple casualty incidents: can the surge capacity and injury severity distribution be better predicted?

Science.gov (United States)

Kosashvili, Yona; Aharonson-Daniel, L; Daniel, Limor A; Peleg, Kobi; Horowitz, Ariel; Laor, Danny; Blumenfeld, Amir

2009-07-01

The incidence of large-scale urban attacks on civilian populations has significantly increased across the globe over the past decade. These incidents often result in Hospital Multiple Casualty Incidents (HMCI), which are very challenging to hospital teams. 15 years ago the Emergency and Disaster Medicine Division in the Israeli Ministry of Health defined a key of 20 percent of each hospital's bed capacity as its readiness for multiple casualties. Half of those casualties are expected to require immediate medical treatment. This study was performed to evaluate the efficacy of the current readiness guidelines based on the epidemiology of encountered HMCIs. A retrospective study of HMCIs was recorded in the Israeli Defense Force (IDF) home front command and the Israeli National Trauma Registry (ITR) between November 2000 and June 2003. An HMCI is defined by the Emergency and Disaster Medicine Division in the Israeli Ministry of Health as >or=10 casualties or >or=4 suffering from injuries with an ISS>or=16 arriving to a single hospital. The study includes a total of 32 attacks, resulting in 62 HMCIs and 1292 casualties. The mean number of arriving casualties to a single hospital was 20.8+/-13.3 (range 4-56, median 16.5). In 95% of the HMCIs the casualty load was concept may improve the utilisation of national emergency health resources both in the preparation phase and on real time.

Identification and medical utilization of incident cases of alcohol dependence: A population-based case-control study.

Science.gov (United States)

Pan, Chun-Hung; Li, Min-Shan; Yang, Tien-Wey; Huang, Ming-Chyi; Su, Sheng-Shiang; Hung, Yen-Ni; Chen, Chiao-Chicy; Kuo, Chian-Jue

2018-05-05

Patients with alcohol dependence (AD) often seek help from medical professionals due to alcohol-related diseases, but the overall distribution of medical specialties identifying new AD cases is unclear. We investigated how such cases were identified and how medical resources were utilized before the identification of AD in a nationwide cohort. We enrolled a population-based cohort (N = 1,000,000) using the National Health Insurance Research Database of Taiwan; 8181 cases with incident AD were retrieved between January 1, 2000, and December 31, 2010. For this nested case-control study, four controls were matched for age and sex with each case based on risk-set sampling. We measured various dimensions of medical utilization before AD was diagnosed, including department visited, physical comorbidity, and medication used. Conditional logistic regression was used for estimating the variables associated with AD. Patients living in less urbanized areas who were unemployed were more likely to develop AD. The highest proportions (34.2%) of AD cases were identified in the internal medicine department, followed by the emergency (22.3%) and psychiatry (18.7%) departments. AD patients had a higher risk of comorbid chronic hepatic disease (adjusted RR = 2.72, p identification of AD than controls. AD patients also had greater numbers of hospital admissions than controls, including non-psychiatric and psychiatric hospitalizations. Outpatient visit numbers were similar for AD patients and controls. The findings indicate that clinicians providing care in diverse medical settings should be prepared to screen for unhealthy alcohol use and to mitigate its detrimental effects. Copyright © 2018 Elsevier B.V. All rights reserved.

COMMAND-AND-CONTROL AND MANAGEMENT DECISION MAKING,

Science.gov (United States)

Reports that the development of command-and-con trol systems in support of decision making and action taking has been accomplished by military...methods applicable to management systems. Concludes that the command-and-control type system for top management decision making is a man-machine system having as its core an on going, dynamic operation. (Author)

THE PARTICULARITIES OF THE COST CALCULATION METHOD ON COMMANDS IN FURNITURE INDUSTRY

Directory of Open Access Journals (Sweden)

Felicia Sabou

2014-10-01

Full Text Available The paper present the importance of the method on commands in cost calculation and the particularities of the cost calculation method on commands in the furniture industry. This paper presents a hypotetical study on the method on commands, considering the observations made during 2013-2014, on how it is organized and managed accounts management using method on commands.By presenting this hypothetical model about the accounting in management accounting using the method on commands, the paper contributes to the correct application of this method in practice, specifically in management accounting in companies from the furniture industry. In my opinion the method on commands is an appropriate method for achieving management accounting for companies that have as main activity the production of furniture. When applying the method on commands in cost calculation and in management accounting, the companies must to consider the particularities of the cost calculation, in the furniture industry, like: technical and economic factors from this sector, the technical details of each command, the codification of the commands, planning materials and labor costs for each command, monitoring and recording production costs, registration of the direct costs, distribution of the indirect costs on commands, registration of the indirect costs and registration in management accounting.

SOA approach to battle command: simulation interoperability

Science.gov (United States)

Mayott, Gregory; Self, Mid; Miller, Gordon J.; McDonnell, Joseph S.

2010-04-01

NVESD is developing a Sensor Data and Management Services (SDMS) Service Oriented Architecture (SOA) that provides an innovative approach to achieve seamless application functionality across simulation and battle command systems. In 2010, CERDEC will conduct a SDMS Battle Command demonstration that will highlight the SDMS SOA capability to couple simulation applications to existing Battle Command systems. The demonstration will leverage RDECOM MATREX simulation tools and TRADOC Maneuver Support Battle Laboratory Virtual Base Defense Operations Center facilities. The battle command systems are those specific to the operation of a base defense operations center in support of force protection missions. The SDMS SOA consists of four components that will be discussed. An Asset Management Service (AMS) will automatically discover the existence, state, and interface definition required to interact with a named asset (sensor or a sensor platform, a process such as level-1 fusion, or an interface to a sensor or other network endpoint). A Streaming Video Service (SVS) will automatically discover the existence, state, and interfaces required to interact with a named video stream, and abstract the consumers of the video stream from the originating device. A Task Manager Service (TMS) will be used to automatically discover the existence of a named mission task, and will interpret, translate and transmit a mission command for the blue force unit(s) described in a mission order. JC3IEDM data objects, and software development kit (SDK), will be utilized as the basic data object definition for implemented web services.

ITOUGH2 command reference. Version 3.1

International Nuclear Information System (INIS)

Finsterle, S.

1997-04-01

This report contains a detailed description of all ITOUGH2 commands. It complements the ITOUGH2 User's Guide and the collection of ITOUGH2 sample problems. ITOUGH2 is a program for parameter estimation, sensitivity analysis, and uncertainty propagation analysis. It is based on the TOUGH2 simulator for non-isothermal multiphase flow in fractured and porous media. Extensive experience in using TOUGH2 is a prerequisite for using ITOUGH2. The preparation of an input file for TOUGH2 or its derivatives is described in separate manuals and is not part of this report. The ITOUGH2 user's guide summarizes the inverse modeling theory pertaining to ITOUGH2, and describes the program output. Furthermore, information about code architecture and installation are given. In Chapter 2 of this report, a brief summary of inverse modeling theory is given to restate the main concepts implemented in ITOUGH2 and to introduce certain definitions. Chapter 3 introduces the basic concepts of the ITHOUGH2 input language and the main structure of an ITOUGH2 input file. Chapter 4, the main part of this report, provides detailed descriptions of each ITOUGH2 command in alphabetical order. It is complemented by a command index in Appendix B in which the commands are given in logical order. The content of Chapter 4 is also available on-line using command it2help. Chapter 5 describes the usage of the UNIX script files for executing, checking, and terminating ITOUGH2 simulations

Addressing the gap between public health emergency planning and incident response

OpenAIRE

Freedman, Ariela M; Mindlin, Michele; Morley, Christopher; Griffin, Meghan; Wooten, Wilma; Miner, Kathleen

2013-01-01

Objectives: Since 9/11, Incident Command System (ICS) and Emergency Operations Center (EOC) are relatively new concepts to public health, which typically operates using less hierarchical and more collaborative approaches to organizing staff. This paper describes the 2009 H1N1 influenza outbreak in San Diego County to explore the use of ICS and EOC in public health emergency response. Methods:?This study was conducted using critical case study methodology consisting of document review and 18 k...

Incidence of Diabetes mellitus at the Federal Medical Centre Katsina ...

African Journals Online (AJOL)

A six-year (2002 – 2007) retrospective study of hospital records (in-patients) was carried out to investigate the incidence of Diabetes Mellitus in Katsina. The records showed that a total of 754 cases were attended within the study period. The study showed yearly increase in the incidence of the disease with the highest ...

Intelligent Tutoring System for Teaching Battlefield Command Reasoning Skills

National Research Council Canada - National Science Library

Domeshek, Eric

2002-01-01

.... Achieving expert levels of proficiency in high-level command reasoning skills-whether for battlefield commanders or for executives in industry-requires extensive practice, coaching, and feedback...

The Mac'OS X command line Unix under the hood

CERN Document Server

McElhearn, Kirk

2006-01-01

The Mac command line offers a faster, easier way to accomplish many tasks. It''s also the medium for many commands that aren''t accessible using the GUI. The Mac OS X Command Line is a clear, concise, tutorial-style introduction to all the major functionality provided by the command line. It''s also packed with information the experienced users need, including little-known shortcuts and several chapters devoted to advanced topics. This is a book to get you started, but also a book you won't soon outgrow.

Command Structure for Theater Warfare: The Quest for Unity of Command

Science.gov (United States)

1984-09-01

that trryfari tail forth thr htst from iti—Btturki Major General« Pern M Smith. USAF. and Hark) A Hughe«. USAF. contributed more to the rndertaking...an air. ground, and sea component. These arc generic commands which control all combat operations in the media of the air. ground, and sea. There

Prevalence and incidence of mental health problems among Dutch medical students and the study-related and personal risk factors: a longitudinal study

NARCIS (Netherlands)

Borst, Jorien M.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

2016-01-01

A high prevalence of mental health problems (i.e. depression and/or anxiety) has been found in medical students in comparison with the general population. Therefore, the objective was first to study the prevalence and 1-year incidence of symptoms of depression, anxiety and any mental health problems

32 CFR 809a.10 - Military commanders' responsibilities.

Science.gov (United States)

2010-07-01

... authorities as soon as possible. (c) Military forces will ordinarily exercise police powers previously... 32 National Defense 6 2010-07-01 2010-07-01 false Military commanders' responsibilities. 809a.10... Disturbance Intervention and Disaster Assistance § 809a.10 Military commanders' responsibilities. (a...

106-17 Telemetry Standards Recorder and Reproducer Command and Control Chapter 6

Science.gov (United States)

2017-07-01

block identifiers (any ASCII text , one identifier per line) from the drive. A .BBLIST command is only valid following a declassify command. The type ... Processor Device Using IEEE 1394b ..... 6-49 6.5.6 Additional Mandatory Commands When Using Ethernet ........................... 6-54 6.5.7 Additional Non...state or magnetic disk). Not all commands (CLI or discrete) may be applicable to all types of R/R implementations. Commands are used to a) control the

Communication for command and control systems

CERN Document Server

Morris, D J

1983-01-01

Communication for Command and Control Systems provides a thorough exposition of the basic theoretical and practical features involved in the design of communication networks for command and control systems. This book focuses primarily on the practical side of computer-controlled communication. This text concentrates on the communication sides of the subject by surveying the means of transferring data between the various processing points and by appraising their potential advantages and possible defects in implementation. In this respect, this book should prove useful for the practicing enginee

Development and Validation of Nigerian Army Commanding Officers ...

African Journals Online (AJOL)

The research adopted an ex-post-facto design based on a qualitative and quantitative analysis of data. Focus Group Discussions (FGDs) and In-Depth Interviews (IDIs) were conducted with commanding officers. The FGDs were conducted with officers purposively drawn from incumbent commanding officers in the Nigerian ...

Scale-free Enterprise Command & Control

National Research Council Canada - National Science Library

Bayne, Jay; Paul, Raymond

2005-01-01

...) services that provide allied teams of commanders, planners and operations personnel with collaborative, grid-based and realtime situation assessment, plan generation, and plan execution services...

Incidence of Norovirus-Associated Medical Encounters among Active Duty United States Military Personnel and Their Dependents.

Directory of Open Access Journals (Sweden)

Brian Rha

Full Text Available Norovirus is a leading cause of gastroenteritis episodes and outbreaks in US military deployments, but estimates of endemic disease burden among military personnel in garrison are lacking.Diagnostic codes from gastroenteritis-associated medical encounters of active duty military personnel and their beneficiaries from July 1998-June 2011 were obtained from the Armed Forces Health Surveillance Center. Using time-series regression models, cause-unspecified encounters were modeled as a function of encounters for specific enteropathogens. Model residuals (representing unexplained encounters were used to estimate norovirus-attributable medical encounters. Incidence rates were calculated using population data for both active duty and beneficiary populations.The estimated annual mean rate of norovirus-associated medically-attended visits among active duty personnel and their beneficiaries was 292 (95% CI: 258 to 326 and 93 (95% CI: 80 to 105 encounters per 10,000 persons, respectively. Rates were highest among beneficiaries <5 years of age with a median annual rate of 435 (range: 318 to 646 encounters per 10,000 children. Norovirus was estimated to cause 31% and 27% of all-cause gastroenteritis encounters in the active duty and beneficiary populations, respectively, with over 60% occurring between November and April. There was no evidence of any lag effect where norovirus disease occurred in one population before the other, or in one beneficiary age group before the others.Norovirus is a major cause of medically-attended gastroenteritis among non-deployed US military active duty members as well as in their beneficiaries.

U.S. Africa Command: Shaping Africa for the Future

National Research Council Canada - National Science Library

Sholley, Hans

2006-01-01

.... It is argued the current Unified Command Plan is ill designed to address the complexities of the continent of Africa and that a proposed United States Africa Command would be better positioned...

14 CFR 417.303 - Command control system requirements.

Science.gov (United States)

2010-01-01

... system must transmit a command signal that has the radio frequency characteristics and power needed for.... (c) Reliability prediction. A command control system must have a predicted reliability of 0.999 at... for each launch. Any demonstration of the system's predicted reliability must satisfy § 417.309(b). (d...

(How) do medical students regulate their emotions?

Science.gov (United States)

Doulougeri, Karolina; Panagopoulou, Efharis; Montgomery, Anthony

2016-12-12

Medical training can be a challenging and emotionally intense period for medical students. However the emotions experienced by medical students in the face of challenging situations and the emotion regulation strategies they use remains relatively unexplored. The aim of the present study was to explore the emotions elicited by memorable incidents reported by medical students and the associated emotion regulation strategies. Peer interviewing was used to collect medical students' memorable incidents. Medical students at both preclinical and clinical stage of medical school were eligible to participate. In total 104 medical students provided memorable incidents. Only 54 narratives included references to emotions and emotion regulation and thus were further analyzed. The narratives of 47 clinical and 7 preclinical students were further analyzed for their references to emotions and emotion regulation strategies. Forty seven out of 54 incidents described a negative incident associated with negative emotions. The most frequently mentioned emotion was shock and surprise followed by feelings of embarrassment, sadness, anger and tension or anxiety. The most frequent reaction was inaction often associated with emotion regulation strategies such as distraction, focusing on a task, suppression of emotions and reappraisal. When students witnessed mistreatment or disrespect exhibited towards patients, the regulation strategy used involved focusing and comforting the patient. The present study sheds light on the strategies medical students use to deal with intense negative emotions. The vast majority reported inaction in the face of a challenging situation and the use of more subtle strategies to deal with the emotional impact of the incident.

Command vector memory systems: high performance at low cost

OpenAIRE

Corbal San Adrián, Jesús; Espasa Sans, Roger; Valero Cortés, Mateo

1998-01-01

The focus of this paper is on designing both a low cost and high performance, high bandwidth vector memory system that takes advantage of modern commodity SDRAM memory chips. To successfully extract the full bandwidth from SDRAM parts, we propose a new memory system organization based on sending commands to the memory system as opposed to sending individual addresses. A command specifies, in a few bytes, a request for multiple independent memory words. A command is similar to a burst found in...

Indonesian Automatic Speech Recognition For Command Speech Controller Multimedia Player

Directory of Open Access Journals (Sweden)

Vivien Arief Wardhany

2014-12-01

Full Text Available The purpose of multimedia devices development is controlling through voice. Nowdays voice that can be recognized only in English. To overcome the issue, then recognition using Indonesian language model and accousticc model and dictionary. Automatic Speech Recognizier is build using engine CMU Sphinx with modified english language to Indonesian Language database and XBMC used as the multimedia player. The experiment is using 10 volunteers testing items based on 7 commands. The volunteers is classifiedd by the genders, 5 Male & 5 female. 10 samples is taken in each command, continue with each volunteer perform 10 testing command. Each volunteer also have to try all 7 command that already provided. Based on percentage clarification table, the word “Kanan” had the most recognize with percentage 83% while “pilih” is the lowest one. The word which had the most wrong clarification is “kembali” with percentagee 67%, while the word “kanan” is the lowest one. From the result of Recognition Rate by male there are several command such as “Kembali”, “Utama”, “Atas “ and “Bawah” has the low Recognition Rate. Especially for “kembali” cannot be recognized as the command in the female voices but in male voice that command has 4% of RR this is because the command doesn’t have similar word in english near to “kembali” so the system unrecognize the command. Also for the command “Pilih” using the female voice has 80% of RR but for the male voice has only 4% of RR. This problem is mostly because of the different voice characteristic between adult male and female which male has lower voice frequencies (from 85 to 180 Hz than woman (165 to 255 Hz.The result of the experiment showed that each man had different number of recognition rate caused by the difference tone, pronunciation, and speed of speech. For further work needs to be done in order to improving the accouracy of the Indonesian Automatic Speech Recognition system

Irrigation and crop management in Gandak Canal command of India

International Nuclear Information System (INIS)

Singh, S.S.; Khan, A.R.

2002-05-01

The Gandak Project is one of the biggest irrigation projects in India, covering a culturable command area (CCA) of 4.44 lakh ha in U.P., 9.6 lakh ha CCA in Bihar and 0.44 lakh ha in Nepal (Singh and Khan, 2002). The total culturable command areas are 14.44 lakh hectares. The command area is located in between latitude 25 deg 40' to 27 deg 25' and longitude between 83 deg 15' to 85 deg 15'. It is a diversion project through construction of a barrage on the river Gandak. This project area covers up to five districts in the Command of Tirhut Main Canal (TMC) and 3 districts in the Saran Main Canal (SMC) command. The length of main canal is usually long (990 and 650 R.D.'s in eastern and western side, respectively) and the channels are unlined and seepage loss is quite high. (author)

Combatant Commanders Informational Series: USPACOM

National Research Council Canada - National Science Library

Comnick, Michael

1996-01-01

...) introducing potential joint staff officers to their specific command. Inbound staff officers, prepared by reviewing this product, arrive on station ready to receive specialized training without needing background indoctrination...

The Incidence of Ankle Sprains in Orienteering.

Science.gov (United States)

Ekstrand, Jan; And Others

1990-01-01

Investigates relationship between ankle sprains and participation time in competitive orienteering. Examined 15,474 competitors in races in the Swedish O-ringen 5-day event in 1987. Injuries requiring medical attention were analyzed, showing 137 (23.9 percent) ankle sprains. Injury incidence was 8.4/10,000 hours. Incidence of ankle sprains was…

Radiological Cs-137 accidents/incidents in Estonia

International Nuclear Information System (INIS)

Sinisso, Mark

1997-01-01

Two radiological accidents/incidents in Estonia are reported. The first -21 October 1994, three brothers entered the Tammiku repository and stole a radioactive Cs-137 source and received dangerous doses of radiation. The other incident (early 1995) involved an abandoned source - a discarded metal cylinder containing Cs-137. Chronologies and factual data are considered for both events. Concise descriptions of the incidents, a medical overview of the fate of injured people and lessons learned are presented

Radiological Cs-137 accidents/incidents in Estonia

Energy Technology Data Exchange (ETDEWEB)

Sinisso, Mark [Ministry of Foreign Affairs, Tallin (Estonia)

1997-12-31

Two radiological accidents/incidents in Estonia are reported. The first -21 October 1994, three brothers entered the Tammiku repository and stole a radioactive Cs-137 source and received dangerous doses of radiation. The other incident (early 1995) involved an abandoned source - a discarded metal cylinder containing Cs-137. Chronologies and factual data are considered for both events. Concise descriptions of the incidents, a medical overview of the fate of injured people and lessons learned are presented

[Mass casualty incidents - current concepts and developments].

Science.gov (United States)

Savinsky, Godo; Stuhr, Markus; Kappus, Stefan; Trümpler, Stefan; Wenderoth, Stephan; Wohlers, Jan-Hauke; Paschen, Hans-Richard; Kerner, Thoralf

2014-12-01

Medical concepts and strategies are permanently changing. Due to the emergency response in a mass casualty incident everyone who is involved has to work together with different organisations and public authorities, which are not part of the regular emergency medical service. Within the last 25 years throughout the whole country of Germany the role of a "chief emergency physician" has been implemented and in preparation for the FIFA World Cup 2006 mobile treatment units were set up. In 2007, special units of the "Medical Task Force" - funded by the german state - were introduced and have been established by now. They will be a permanent part of regional plannings for mass casualty incidents. This article highlights current concepts and developments in different parts of Germany. © Georg Thieme Verlag Stuttgart · New York.

Commander manipulator scoops prestigious mulit-million pound BNFL contract

International Nuclear Information System (INIS)

Bailey, Andrew.

1997-01-01

Twenty-one Commander robotic arms are on order from INBIS (formerly Ricardo Hitec) and BNFL Engineering Limited (''BEL'', the engineering arm of parent company BNFL). The multi-million pound contract was won amid fierce competition from other well-known names in robotic engineering. The specially designed Commander manipulators will be engaged in remotely handling Intermediate Level Waste (ILW) in a suite of four BNFL ILW plants, which are currently either under construction or planned at Sellafield. The first Commander will delivered to BNFL's Sellafield Silo Emptying Project in January 1998. (Author)

Design of a hybrid command and control mobile botnet

CSIR Research Space (South Africa)

Pieterse, H

2013-05-01

Full Text Available and control mobile botnet. The hybrid design explores the efficiency of multiple command and control channels against the following objectives: no single point of failure within the topology, low cost for command dissemination, limited network activities...

Warfighter Associate: Decision Aiding and Metrics for Mission Command

Science.gov (United States)

2012-01-23

Distributions: highlights the Pareto Principle -- the top 20% of the mission-command staff is heavily involved in collaborations. • Our...developing “Command Web”, a web service to support thin- client functionality (Intelligent Presentation Services enables this) Thank you

The Influence of Future Command, Control, Communications, and Computers (C4) on Doctrine and the Operational Commander's Decision-Making Process

Science.gov (United States)

Mayer, Michael G.

1996-01-01

Future C4 systems will alter the traditional balance between force and information, having a profound influence on doctrine and the operational commander's decision making process. The Joint Staff's future vision of C4 is conceptualized in 'C4I for the Warrior' which envisions a joint C4I architecture providing timely sensor to shoot information direct to the warfighter. C4 system must manage and filter an overwhelming amount of information; deal with interoperability issues; overcome technological limitations; meet emerging security requirements; and protect against 'Information Warfare.' Severe budget constraints necessitate unified control of C4 systems under singular leadership for the common good of all the services. In addition, acquisition policy and procedures must be revamped to allow new technologies to be fielded quickly; and the commercial marketplace will become the preferred starting point for modernization. Flatter command structures are recommended in this environment where information is available instantaneously. New responsibilities for decision making at lower levels are created. Commanders will have to strike a balance between exerting greater control and allowing subordinates enough flexibility to maintain initiative. Clearly, the commander's intent remains the most important tool in striking this balance.

U.S. Pacific Command > Leadership

Science.gov (United States)

USPACOM U.S. Pacific Command Search USPACOM: Search Search Search USPACOM: Search Home Leadership Directory Media Inquiries Home : Leadership Admiral Harry B. Harris, Jr., U.S. Navy Read the full biography

XTCE: XML Telemetry and Command Exchange Tutorial, XTCE Version 1

Science.gov (United States)

Rice, Kevin; Kizzort, Brad

2008-01-01

These presentation slides are a tutorial on XML Telemetry and Command Exchange (XTCE). The goal of XTCE is to provide an industry standard mechanism for describing telemetry and command streams (particularly from satellites.) it wiill lower cost and increase validation over traditional formats, and support exchange or native format.XCTE is designed to describe bit streams, that are typical of telemetry and command in the historic space domain.

Army Aviation and the Mission Command Warfighting Function

Science.gov (United States)

2017-06-09

information systems , processes and procedures, optimize facilities and equipment, and build understanding of the networks that link the headquarters...however further publication or sale of copyrighted images is not permissible. ii REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188...Command System , Mission Command Information Systems , Training, Mission Training Complex 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT

The R Commander: A Basic-Statistics Graphical User Interface to R

Directory of Open Access Journals (Sweden)

John Fox

2005-08-01

Full Text Available Unlike S-PLUS, R does not incorporate a statistical graphical user interface (GUI, but it does include tools for building GUIs. Based on the tcltk package (which furnishes an interface to the Tcl/Tk GUI toolkit, the Rcmdr package provides a basic-statistics graphical user interface to R called the "R Commander." The design objectives of the R Commander were as follows: to support, through an easy-to-use, extensible, cross-platform GUI, the statistical functionality required for a basic-statistics course (though its current functionality has grown to include support for linear and generalized-linear models, and other more advanced features; to make it relatively difficult to do unreasonable things; and to render visible the relationship between choices made in the GUI and the R commands that they generate. The R Commander uses a simple and familiar menu/dialog-box interface. Top-level menus include File, Edit, Data, Statistics, Graphs, Models, Distributions, Tools, and Help, with the complete menu tree given in the paper. Each dialog box includes a Help button, which leads to a relevant help page. Menu and dialog-box selections generate R commands, which are recorded in a script window and are echoed, along with output, to an output window. The script window also provides the ability to edit, enter, and re-execute commands. Error messages, warnings, and some other information appear in a separate messages window. Data sets in the R Commander are simply R data frames, and can be read from attached packages or imported from files. Although several data frames may reside in memory, only one is "active" at any given time. There may also be an active statistical model (e.g., an R lm or glm ob ject. The purpose of this paper is to introduce and describe the use of the R Commander GUI; to describe the design and development of the R Commander; and to explain how the R Commander GUI can be extended. The second part of the paper (following a brief

Distributed computing environment for Mine Warfare Command

OpenAIRE

Pritchard, Lane L.

1993-01-01

Approved for public release; distribution is unlimited. The Mine Warfare Command in Charleston, South Carolina has been converting its information systems architecture from a centralized mainframe based system to a decentralized network of personal computers over the past several years. This thesis analyzes the progress Of the evolution as of May of 1992. The building blocks of a distributed architecture are discussed in relation to the choices the Mine Warfare Command has made to date. Ar...

Control of automated system with voice commands

OpenAIRE

Švara, Denis

2012-01-01

In smart houses contemporary achievements in the fields of automation, communications, security and artificial intelligence, increase comfort and improve the quality of user's lifes. For the purpose of this thesis we developed a system for managing a smart house with voice commands via smart phone. We focused at voice commands most. We want move from communication with fingers - touches, to a more natural, human relationship - speech. We developed the entire chain of communication, by which t...

Command in the Objective Force

National Research Council Canada - National Science Library

Wilbeck, Christopher

2003-01-01

This paper seeks to answer what type of command will best serve the Army's Objective Force in gaining the initiative, building momentum, and exploiting success to achieve land dominance in the future...

Community pharmacy incident reporting: a new tool for community pharmacies in Canada.

Science.gov (United States)

Ho, Certina; Hung, Patricia; Lee, Gary; Kadija, Medina

2010-01-01

Incident reporting offers insight into a variety of intricate processes in healthcare. However, it has been found that medication incidents are under reported in the community pharmacy setting. The Community Pharmacy Incident Reporting (CPhIR) program was created by the Institute for Safe Medication Practices Canada specifically for incident reporting in the community pharmacy setting in Canada. The initial development of key elements for CPhIR included several focus-group teleconferences with pharmacists from Ontario and Nova Scotia. Throughout the development and release of the CPhIR pilot, feedback from pharmacists and pharmacy technicians was constantly incorporated into the reporting program. After several rounds of iterative feedback, testing and consultation with community pharmacy practitioners, a final version of the CPhIR program, together with self-directed training materials, is now ready to launch. The CPhIR program provides users with a one-stop platform to report and record medication incidents, export data for customized analysis and view comparisons of individual and aggregate data. These unique functions allow for a detailed analysis of underlying contributing factors in medication incidents. A communication piece for pharmacies to share their experiences is in the process of development. To ensure the success of the CPhIR program, a patient safety culture must be established. By gaining a deeper understanding of possible causes of medication incidents, community pharmacies can implement system-based strategies for quality improvement and to prevent potential errors from occurring again in the future. This article highlights key features of the CPhIR program that will assist community pharmacies to improve their drug distribution system and, ultimately, enhance patient safety.

Normalized Index of Synergy for Evaluating the Coordination of Motor Commands

Science.gov (United States)

Togo, Shunta; Imamizu, Hiroshi

2015-01-01

Humans perform various motor tasks by coordinating the redundant motor elements in their bodies. The coordination of motor outputs is produced by motor commands, as well properties of the musculoskeletal system. The aim of this study was to dissociate the coordination of motor commands from motor outputs. First, we conducted simulation experiments where the total elbow torque was generated by a model of a simple human right and left elbow with redundant muscles. The results demonstrated that muscle tension with signal-dependent noise formed a coordinated structure of trial-to-trial variability of muscle tension. Therefore, the removal of signal-dependent noise effects was required to evaluate the coordination of motor commands. We proposed a method to evaluate the coordination of motor commands, which removed signal-dependent noise from the measured variability of muscle tension. We used uncontrolled manifold analysis to calculate a normalized index of synergy. Simulation experiments confirmed that the proposed method could appropriately represent the coordinated structure of the variability of motor commands. We also conducted experiments in which subjects performed the same task as in the simulation experiments. The normalized index of synergy revealed that the subjects coordinated their motor commands to achieve the task. Finally, the normalized index of synergy was applied to a motor learning task to determine the utility of the proposed method. We hypothesized that a large part of the change in the coordination of motor outputs through learning was because of changes in motor commands. In a motor learning task, subjects tracked a target trajectory of the total torque. The change in the coordination of muscle tension through learning was dominated by that of motor commands, which supported the hypothesis. We conclude that the normalized index of synergy can be used to evaluate the coordination of motor commands independently from the properties of the

Integrating an incident management system within a continuity of operations programme: case study of the Bank of Canada.

Science.gov (United States)

Loop, Carole

2013-01-01

Carrying out critical business functions without interruption requires a resilient and robust business continuity framework. By embedding an industry-standard incident management system within its business continuity structure, the Bank of Canada strengthened its response plan by enabling timely response to incidents while maintaining a strong focus on business continuity. A total programme approach, integrating the two disciplines, provided for enhanced recovery capabilities. While the value of an effective and efficient response organisation is clear, as demonstrated by emergency events around the world, incident response structures based on normal operating hierarchy can experience unique challenges. The internationally-recognised Incident Command System (ICS) model addresses these issues and reflects the five primary incident management functions, each contributing to the overall strength and effectiveness of the response organisation. The paper focuses on the Bank of Canada's successful implementation of the ICS model as its incident management and continuity of operations programmes evolved to reflect current best practices.

Command Leadership DEOCS 4.1 Construct Validity Summary

Science.gov (United States)

2017-08-01

Command Leadership DEOCS 4.1 Construct Validity Summary DEFENSE EQUAL OPPORTUNITY MANAGEMENT INSTITUTE...Report #15-18 1 Command Leadership DEOCS 4.1 Construct Validity Summary Background In 2014, DEOMI released DEOCS 4.0 for Department of Defense...individual items on the DEOCS. The following paper details the work conducted to modify the factor of Leadership Cohesion so that it focuses more

Rapid Response Command and Control (R2C2): a systems engineering analysis of scaleable communications for Regional Combatant Commanders

OpenAIRE

Sullivan, Lisa; Cannon, Lennard; Reyes, Ronel; Bae, Kitan; Colgary, James; Minerowicz, Nick; Leong, Chris; Lim, Harry; Lim, Hang Sheng; Ng, Chin Chin; Neo, Tiong Tien; Tan, Guan Chye; Ng, Yu Loon; Wong, Eric; Wong, Heng Yue

2006-01-01

Includes supplementary material. Disaster relief operations, such as the 2005 Tsunami and Hurricane Katrina, and wartime operations, such as Operation Enduring Freedom and Operation Iraqi Freedom, have identified the need for a standardized command and control system interoperable among Joint, Coalition, and Interagency entities. The Systems Engineering Analysis Cohort 9 (SEA-9) Rapid Response Command and Control (R2C2) integrated project team completed a systems engineering (SE) ...

GPS and the Joint Force Commander: Critical Asset, Critical Vulnerability

National Research Council Canada - National Science Library

McPherson, Michael

2001-01-01

Joint Force Commanders (JFCs) have become over reliant on military and commercial satellite systems for intelligence gathering and dissemination, weather, command, control, communications, and navigation/guidance functions, to name a few...

Robot Task Commander with Extensible Programming Environment

Science.gov (United States)

Hart, Stephen W (Inventor); Yamokoski, John D. (Inventor); Wightman, Brian J (Inventor); Dinh, Duy Paul (Inventor); Gooding, Dustin R (Inventor)

2014-01-01

A system for developing distributed robot application-level software includes a robot having an associated control module which controls motion of the robot in response to a commanded task, and a robot task commander (RTC) in networked communication with the control module over a network transport layer (NTL). The RTC includes a script engine(s) and a GUI, with a processor and a centralized library of library blocks constructed from an interpretive computer programming code and having input and output connections. The GUI provides access to a Visual Programming Language (VPL) environment and a text editor. In executing a method, the VPL is opened, a task for the robot is built from the code library blocks, and data is assigned to input and output connections identifying input and output data for each block. A task sequence(s) is sent to the control module(s) over the NTL to command execution of the task.

Leaders in space: Mission commanders and crew on the International Space Station

Science.gov (United States)

Brcic, Jelena

Understanding the relationship between leaders and their subordinates is important for building better interpersonal connections, improving group cohesion and cooperation, and increasing task success. This relationship has been examined in many types of groups but not a great amount of analysis has been applied to spaceflight crews. We specifically investigated differences between mission commanders and flight commanders during missions to the International Space Station (ISS). Astronauts and cosmonauts on the ISS participate in long-duration missions (2 to 6 months in length) in which they live and work in close proximity with their 2 or 3 member crews. The leaders are physically distant from their command centres which may result in delay of instructions or important advice. Therefore, the leaders must be able to make quick, sound decisions with unwavering certainty. Potential complications include that the leaders may not be able to exercise their power fully, since material reward or punishment of any one member affects the whole group, and that the leader's actions (or lack thereof) in this isolated, confined environment could create stress in members. To be effective, the mission commander must be able to prevent or alleviate any group conflict and be able to relate to members on an emotional level. Mission commanders and crew are equal in the competencies of spaceflight; therefore, what are the unique characteristics that enable the commanders to fulfill their role? To highlight the differences between commander and crew, astronaut journals, diaries, pre- flight interviews, NASA oral histories, and letters written to family from space were scored and analyzed for values and coping styles. During pre-flight, mission commanders scored higher than other crew members on the values of Stimulation, Security, Universalism, Conformity, Spirituality, and Benevolence, and more often used Self-Control as a coping style. During the long-duration mission on ISS, mission

Incident users of antipsychotics

DEFF Research Database (Denmark)

Baandrup, Lone; Kruse, Marie

2016-01-01

PURPOSE: In Denmark, as well as in many other countries, consumption of antipsychotics is on the rise, partly due to increasing off-label use. The aim of this study was to analyze and quantify the extent of off-label use and polypharmacy in incident users of antipsychotic medication, and to examine...

Fit for Command: Military Leadership Attributes for Small Wars

Science.gov (United States)

2013-04-18

Corps Command and StaffCollege Marine Corps University 2076 outh Street Marine Corps Combat Development Command Quantico, Virgin ia?? 134-5068...by the local imam to join him in the celebration of a religious Shi’a holiday .79 Just before departure to the mosque his translator informed him

The Warfighting Capacity of Air Combat Command's Numbered Air Forces

National Research Council Canada - National Science Library

Hanser, Lawrence

2000-01-01

...) of the Air Combat Command (ACC), General Richard E. Hawley, the ACC Commander, asked if RAND could offer an analysis of the number of NAFs that were needed by ACC to meet warfighting requirements...

Modular code supervisor. Automatic generation of command language

International Nuclear Information System (INIS)

Dumas, M.; Thomas, J.B.

1988-01-01

It is shown how, starting from a problem formulated by the user, to generate the adequate calculation procedure in the command code, and acquire the data necessary for the calculation while verifying their validity. Modular codes are used, because of their flexibility and wide utilisation. Modules are written in Fortran, and calculations are done in batches according to an algorithm written in the GIBIANE command language. The action plans are based on the STRIPS and WARPLAN families. Elementary representation of a module and special instructions are illustrated. Dynamic construction macro-actions, and acquisition of the specification (which allows users to express the goal of a program without indicating which algorithm is used to reach the goal) are illustrated. The final phase consists in translating the algorithm into the command language [fr

Command History for 1990

Science.gov (United States)

1991-05-01

Marine Corps Tiaining Systems (CBESS) memorization training Inteligence Center, Dam Neck Threat memorization training Commander Tactical Wings, Atlantic...News Shipbuilding Technical training AEGIS Training Center, Dare Artificial Intelligence (Al) Tools Computerized firm-end analysis tools NETSCPAC...Technology Department and provides computational and electronic mail support for research in areas of artificial intelligence, computer-assisted instruction

Short Text Messages (SMS) as an Additional Tool for Notifying Medical Staff in Case of a Hospital Mass Casualty Incident.

Science.gov (United States)

Timler, Dariusz; Bogusiak, Katarzyna; Kasielska-Trojan, Anna; Neskoromna-Jędrzejczak, Aneta; Gałązkowski, Robert; Szarpak, Łukasz

2016-02-01

The aim of the study was to verify the effectiveness of short text messages (short message service, or SMS) as an additional notification tool in case of fire or a mass casualty incident in a hospital. A total of 2242 SMS text messages were sent to 59 hospital workers divided into 3 groups (n=21, n=19, n=19). Messages were sent from a Samsung GT-S8500 Wave cell phone and Orange Poland was chosen as the telecommunication provider. During a 3-month trial period, messages were sent between 3:35 PM and midnight with no regular pattern. Employees were asked to respond by telling how much time it would take them to reach the hospital in case of a mass casualty incident. The mean reaction time (SMS reply) was 36.41 minutes. The mean declared time of arrival to the hospital was 100.5 minutes. After excluding 10% of extreme values for declared arrival time, the mean arrival time was estimated as 38.35 minutes. Short text messages (SMS) can be considered an additional tool for notifying medical staff in case of a mass casualty incident.

Mission Command and JC41: Managing Chaos in a Dynamic World

Science.gov (United States)

2018-04-20

doubly so, but perhaps not solely for the reasons expected. History has seen the progression of technology enable commanders and staffs to extend their...highlights the degree to which each Service embraces and codifies the mission command concept. Chapter 3 covers the history of the technologies ...Abstract Executing effective mission command has always been a challenge and in today’s technologically saturated joint operating environment is

Radiation incidents in dentistry

International Nuclear Information System (INIS)

Lovelock, D.J.

1996-01-01

Most dental practitioners act as their own radiographer and radiologist, unlike their medical colleagues. Virtually all dental surgeons have a dental X-ray machine for intraoral radiography available to them and 40% of dental practices have equipment for dental panoramic tomography. Because of the low energy of X-ray equipment used in dentistry, radiation incidents tend to be less serious than those associated with other aspects of patient care. Details of 47 known incidents are given. The advent of the 1985 and 1988 Ionising Radiation Regulations has made dental surgeons more aware of the hazards of radiation. These regulations, and general health and safety legislation, have led to a few dental surgeons facing legal action. Because of the publicity associated with these court cases, it is expected that there will be a decrease in radiation incidents arising from the practice of dentistry. (author)

Commands for financial data management and portfolio optimization

OpenAIRE

C. Alberto Dorantes

2013-01-01

Several econometric software offer portfolio management tools for practitioners and researchers. For example, MatLab and R offer a great variety of tools for the simulation, optimization, and analysis of financial time series. Stata, together with Mata, offers powerful programming tools for the simulation, optimization, and analysis of financial data. However, related user commands are scarce. In this presentation, commands for online market data collection, data manipulation, and financial a...

Linux command line and shell scripting bible

CERN Document Server

Blum, Richard

2014-01-01

Talk directly to your system for a faster workflow with automation capability Linux Command Line and Shell Scripting Bible is your essential Linux guide. With detailed instruction and abundant examples, this book teaches you how to bypass the graphical interface and communicate directly with your computer, saving time and expanding capability. This third edition incorporates thirty pages of new functional examples that are fully updated to align with the latest Linux features. Beginning with command line fundamentals, the book moves into shell scripting and shows you the practical application

'The Danger of Divided Command': British civil and military disputes ...

African Journals Online (AJOL)

Commander-in-Chief of the Indian Army, Lord Kitchener, which culminated in Curzon's ... and the officers commanding forces would have no doubt as to their .... but assuming financial responsibility for its own defence would have been ...

Incidence of constipation in an intensive care unit

OpenAIRE

Guerra, Tatiana Lopes de Souza; Mendonça, Simone Sotero; Guimarães Marshall, Norma

2013-01-01

Objectives To evaluate the incidence of constipation in critical patients on enteral nutrition in a hospital intensive care unit and to correlate this incidence with the variables found for critical patients. Methods The present investigation was a retrospective analytical study conducted in the intensive care unit of Hospital Regional da Asa Norte (DF) via the analysis of medical records of patients admitted during the period from January to December 2011. Data on the incidence of constipati...

Major Incident Hospital: Development of a Permanent Facility for Management of Incident Casualties.

Science.gov (United States)

Marres, Geertruid; Bemelman, Michael; van der Eijk, John; Leenen, Luke

2009-06-01

Preparation is essential to cope with the challenge of providing optimal care when there is a sudden, unexpected surge of casualties due to a disaster or major incident. By definition, the requirements of such cases exceed the standard care facilities of hospitals in qualitative or quantitative respects and interfere with the care of regular patients. To meet the growing demands to be prepared for disasters, a permanent facility to provide structured, prepared relief in such situations was developed. A permanent but reserved Major Incident Hospital (MIH) has been developed through cooperation between a large academic medical institution, a trauma center, a military hospital, and the National Poison Information Centre (NVIC). The infrastructure, organization, support systems, training and systematic working methods of the MIH are designed to create order in a chaotic, unexpected situation and to optimize care and logistics in any possible scenario. Focus points are: patient flow and triage, registration, communication, evaluation and training. Research and the literature are used to identify characteristic pitfalls due to the chaos associated with and the unexpected nature of disasters, and to adapt our organization. At the MIH, the exceptional has become the core business, and preparation for disaster and large-scale emergency care is a daily occupation. An Emergency Response Protocol enables admittance to the normally dormant hospital of up to 100 (in exceptional cases even 300) patients after a start-up time of only 15 min. The Patient Barcode Registration System (PBR) with EAN codes guarantees quick and adequate registration of patient data in order to facilitate good medical coordination and follow-up during a major incident. The fact that the hospital is strictly reserved for this type of care guarantees availability and minimizes impact on normal care. When it is not being used during a major incident, there is time to address training and research

Incidence of Carpal Tunnel Syndrome in the US Military Population

OpenAIRE

Wolf, Jennifer Moriatis; Mountcastle, Sally; Owens, Brett D.

2009-01-01

Carpal tunnel syndrome (CTS) is a common disease. Its epidemiology has been evaluated previously, mostly in regional populations or in working groups, with an incidence between 1.5 and 3.5 per 1,000 person-years. We studied this diagnosis in the US military population, with the hypothesis that this young population would have a lower incidence of CTS than previously reported in general populations. The Defense Medical Epidemiology Database notes all medical encounters for all US military pers...

Workload differences across command levels and emergency response organizations during a major joint training exercise.

Science.gov (United States)

Prytz, Erik G; Rybing, Jonas; Jonson, Carl-Oscar

2016-01-01

This study reports on an initial test using a validated workload measurement method, the NASA Task Load Index (TLX), as an indicator of joint emergency exercise effectiveness. Prior research on emergency exercises indicates that exercises must be challenging, ie, result in high workload, to be effective. However, this is often problematic with some participants being underloaded and some overloaded. The NASA TLX was used to test for differences in workload between commanders and subordinates and among three different emergency response organizations during a joint emergency exercise. Questionnaire-based evaluation with professional emergency responders. The study was performed in conjunction with a large-scale interorganizational joint emergency exercise in Sweden. A total of 20 participants from the rescue services, 12 from the emergency medical services, and 12 from the police participated in the study (N=44). Ten participants had a command-level role during the exercise and the remaining 34 were subordinates. The main outcome measures were the workload subscales of the NASA TLX: mental demands, physical demands, temporal demands, performance, effort, and frustration. The results showed that the organizations experienced different levels of workload, that the commanders experienced a higher workload than the subordinates, and that two out of three organizations fell below the twenty-fifth percentile of average workload scores compiled from 237 prior studies. The results support the notion that the NASA TLX could be a useful complementary tool to evaluate exercise designs and outcomes. This should be further explored and verified in additional studies.

[Analysis of an incident notification system and register in a critical care unit].

Science.gov (United States)

Murillo-Pérez, M A; García-Iglesias, M; Palomino-Sánchez, I; Cano Ruiz, G; Cuenca Solanas, M; Alted López, E

2016-01-01

To analyse the incident communicated through a notification system and register in a critical care unit. A cross-sectional descriptive study was conducted by performing an analysis of the records of incidents communicated anonymously and voluntarily from January 2007 to December 2013 in a critical care unit of adult patients with severe trauma. incident type and class, professional reports, and suggestions for improvement measures. A descriptive analysis was performed on the variables. Out of a total of 275 incidents reported, 58.5% of them were adverse events. Incident distributed by classes: medication, 33.7%; vascular access-drainage-catheter-sensor, 19.6%; devices-equipment, 13.3%, procedures, 11.5%; airway tract and mechanical ventilation, 10%; nursing care, 4.1%; inter-professional communication, 3%; diagnostic test, 3%; patient identification, 1.1%, and transfusion 0.7%. In the medication group, administrative errors accounted for a total of 62%; in vascular access-drainage-catheter-sensor group, central venous lines, a total of 27%; in devices and equipment group, respirators, a total of 46.9%; in airway self-extubations, a total of 32.1%. As regards to medication errors, 62% were incidents without damage. Incident notification by profession: doctors, 43%, residents, 5.6%, nurses, 51%, and technical assistants, 0.4%. Adverse events are the most communicated incidents. The events related to medication administration are the most frequent, although most of them were without damage. Nurses and doctors communicate the incidents with the same frequency. In order to highlight the low incident notification despite it being an anonymous and volunteer system, therefore, it is suggested to study measurements to increase the level of communication. Copyright © 2016 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

STS-93 Commander Collins suits up for launch

Science.gov (United States)

1999-01-01

During the third launch preparations in the Operations and Checkout Building, STS-93 Commander Eileen M. Collins waves while having her launch and entry suit checked. After Space Shuttle Columbia's July 20 and 22 launch attempts were scrubbed, the launch was again rescheduled for Friday, July 23, at 12:24 a.m. EDT. STS-93 is a five-day mission primarily to release the Chandra X-ray Observatory, which will allow scientists from around the world to study some of the most distant, powerful and dynamic objects in the universe. The STS-93 crew numbers five: Commander Collins, Pilot Jeffrey S. Ashby, and Mission Specialists Stephen A. Hawley (Ph.D.), Catherine G. Coleman (Ph.D.) and Michel Tognini of France, with the Centre National d'Etudes Spatiales (CNES). Collins is the first woman to serve as commander of a shuttle mission.

Education Requirements of Command Positions in the U.S. Border Patrol

Science.gov (United States)

2015-06-12

commander. Degrees in Culinary Arts , Fashion Design, or Film Studies are thus considered as relevant and valuable for command as degrees in Border...Command and General Staff College in partial fulfillment of the requirements for the degree MASTER OF MILITARY ART AND SCIENCE Homeland Security...Z39.18 iii MASTER OF MILITARY ART AND SCIENCE THESIS APPROVAL PAGE Name of Candidate: Julio C. Peña Thesis Title: Education Requirements of

Class VIII Medical Materiel Controls in the U.S. European Command

National Research Council Canada - National Science Library

1991-01-01

.... Class VIII medical materiel inventories are maintained as part of the U.S. war reserve stocks to ensure military readiness and to provide needed health care during wartime or contingencies. The U.S...

Command-And-Control or Taxation?

DEFF Research Database (Denmark)

Oh, Christina; Svendsen, Gert Tinggaard

2015-01-01

an ineffective command-and-control (CAC) tool, whereas Denmark has chosen the effective tool of taxation. One main explanation for this variation in policy choice is the variation in institutional setups, namely the corporatist route in Denmark versus the pluralistic route in California....

Tools virtualization for command and control systems

Science.gov (United States)

Piszczek, Marek; Maciejewski, Marcin; Pomianek, Mateusz; Szustakowski, Mieczysław

2017-10-01

Information management is an inseparable part of the command process. The result is that the person making decisions at the command post interacts with data providing devices in various ways. Tools virtualization process can introduce a number of significant modifications in the design of solutions for management and command. The general idea involves replacing physical devices user interface with their digital representation (so-called Virtual instruments). A more advanced level of the systems "digitalization" is to use the mixed reality environments. In solutions using Augmented reality (AR) customized HMI is displayed to the operator when he approaches to each device. Identification of device is done by image recognition of photo codes. Visualization is achieved by (optical) see-through head mounted display (HMD). Control can be done for example by means of a handheld touch panel. Using the immersive virtual environment, the command center can be digitally reconstructed. Workstation requires only VR system (HMD) and access to information network. Operator can interact with devices in such a way as it would perform in real world (for example with the virtual hands). Because of their procedures (an analysis of central vision, eye tracking) MR systems offers another useful feature of reducing requirements for system data throughput. Due to the fact that at the moment we focus on the single device. Experiments carried out using Moverio BT-200 and SteamVR systems and the results of experimental application testing clearly indicate the ability to create a fully functional information system with the use of mixed reality technology.

Command History, 1993.

Science.gov (United States)

1994-04-01

his space capsule. The ()CUILAR COtJNTI:,RROI,.L I)FVICI" was built by the Naval Air Rework Facility, NAS Pensacola. tfor NAMRI, in the early 1960s...Dunwoody, GA Kevin G. Singleton, ENS USNR Naval Aviation Schools Command Kyle W M. Taylor, ENS USNR U.S. Naval Academy Jason A. Temple, ENS USNR Auburn...Pensacola, 13-15 Oct 93. Pokorski, T.L., LICDR MSC USN, attended Aircrew Modified IEquipment for Ladies in Aviation (AMELIA) Fri -service Long-range Planning

Increasing Classroom Compliance: Using a High-Probability Command Sequence with Noncompliant Students

Science.gov (United States)

Axelrod, Michael I.; Zank, Amber J.

2012-01-01

Noncompliance is one of the most problematic behaviors within the school setting. One strategy to increase compliance of noncompliant students is a high-probability command sequence (HPCS; i.e., a set of simple commands in which an individual is likely to comply immediately prior to the delivery of a command that has a lower probability of…

ASTP crewmen in Apollo Command Module Trainer during training session at JSC

Science.gov (United States)

1975-01-01

The three members of the American ASTP prime crew are photographed inside the Apollo Command Module (CM) trainer in a water tank in bldg 260 during water egress training at JSC. They are, left to right, Astronauts Thomas P. Stafford, commander; Vance D. Brand, command module pilot; and Donald K. Slayton, docking module pilot (23430); Slayton attaches his life preserver as he egresses an Apollo Command Module trainer in a water tank in bldg 260 during water egresss training at JSC. Astronauts Brand (on left) and Stafford have already egressed the trainer and are seated in a three-man life raft.

A retrospective audit of the extent and nature of domestic violence cases identified over a three year period in the two district command units of the police service of Northern Ireland.

Science.gov (United States)

Stevenson, T R; Goodall, E A; Moore, C B T

2008-10-01

The work load of forensic medical officers (FMOs) who provide medical cover for the Coleraine and Limavady district command units (DCU) of the police service of Northern Ireland (PSNI) in dealing with domestic violence was investigated over a three year period from 1st April 2003 to 31st March 2006. A total of 128 cases involving domestic violence were identified during this three year period. There was a significant increase from 4% (32/791) in the first year to 6.6% (56/851, p<0.01) in the number of cases of identified domestic violence in the second year which dropped to 4.2% (40/956) in the third year. Victims were identified in 38% of these domestic violence cases with 62% being identified as assailants. It was noted that there was a significant difference in the proportion of male assailants (96.2%) from female assailants (3.8%). Fifty-four percent of victims were noted to have injuries in accordance with the more serious injury categories of assault of actual bodily harm (AOABH) and grievous bodily harm (GBH). Domestic incidents occurred at the home in 91% of cases, with the FMO being the primary contact in 97% of cases. Alcohol was implicated in 56% of all domestic violence cases recorded.

Ubuntu Linux Toolbox 1000 + Commands for Ubuntu and Debian Power Users

CERN Document Server

Negus, Christopher

2008-01-01

In this handy, compact guide, you'll explore a ton of powerful Ubuntu Linux commands while you learn to use Ubuntu Linux as the experts do: from the command line. Try out more than 1,000 commands to find and get software, monitor system health and security, and access network resources. Then, apply the skills you learn from this book to use and administer desktops and servers running Ubuntu, Debian, and KNOPPIX or any other Linux distribution.

Research into command, control, and communications in space construction

Science.gov (United States)

Davis, Randal

1990-01-01

Coordinating and controlling large numbers of autonomous or semi-autonomous robot elements in a space construction activity will present problems that are very different from most command and control problems encountered in the space business. As part of our research into the feasibility of robot constructors in space, the CSC Operations Group is examining a variety of command, control, and communications (C3) issues. Two major questions being asked are: can we apply C3 techniques and technologies already developed for use in space; and are there suitable terrestrial solutions for extraterrestrial C3 problems? An overview of the control architectures, command strategies, and communications technologies that we are examining is provided and plans for simulations and demonstrations of our concepts are described.

A Proposal for the Merger of the U.S. Army Recruiting Command (USAREC) and the U.S. Army Cadet Command: One Recruiting Organization - "More Than a Partnership"

National Research Council Canada - National Science Library

Kleppinger, Tim

2001-01-01

...) and the United States Army Cadet Command into one accessions organization. For the past five years both USAREC and Cadet Command have found greater difficulty in achieving their annual missions...

Medical device integration: CIOs must bridge the digital divide between devices and electronic medical records.

Science.gov (United States)

Raths, David

2009-02-01

To get funding approved for medical device integration, ClOs suggest focusing on specific patient safety or staff efficiency pain points. Organizations that make clinical engineering part of their IT team report fewer chain-of-command issues. It also helps IT people understand the clinical goals because the engineering people have been working closely with clinicians for years. A new organization has formed to work on collaboration between clinical engineers and IT professionals. For more information, go to www.ceitcollaboration.org. ECRI Institute has written a guide to handling the convergence of medical technology and hospital networks. Its "Medical Technology for the IT Professional: An Essential Guide for Working in Today's Healthcare Setting" also details how IT professionals can assist hospital technology planning and acquisition, and provide ongoing support for IT-based medical technologies. For more information, visit www.ecri.org/ITresource.

Is There a Need For a Joint Reserve Components Command?

Science.gov (United States)

2013-03-01

Bravo Zulu ”. If these words were heard by a Soldier, it might be interpreted as poor performance. By having one organization as a single source for...Commander, Joint Reserve Components Command. Creation of the JRCC would, in time, strengthen partnerships between the reserve components of each

Patient Safety Incidents and Nursing Workload

Directory of Open Access Journals (Sweden)

Katya Cuadros Carlesi

Full Text Available ABSTRACT Objective: to identify the relationship between the workload of the nursing team and the occurrence of patient safety incidents linked to nursing care in a public hospital in Chile. Method: quantitative, analytical, cross-sectional research through review of medical records. The estimation of workload in Intensive Care Units (ICUs was performed using the Therapeutic Interventions Scoring System (TISS-28 and for the other services, we used the nurse/patient and nursing assistant/patient ratios. Descriptive univariate and multivariate analysis were performed. For the multivariate analysis we used principal component analysis and Pearson correlation. Results: 879 post-discharge clinical records and the workload of 85 nurses and 157 nursing assistants were analyzed. The overall incident rate was 71.1%. It was found a high positive correlation between variables workload (r = 0.9611 to r = 0.9919 and rate of falls (r = 0.8770. The medication error rates, mechanical containment incidents and self-removal of invasive devices were not correlated with the workload. Conclusions: the workload was high in all units except the intermediate care unit. Only the rate of falls was associated with the workload.

Global Missile Defense: The Case for a New Operational Command Structure

National Research Council Canada - National Science Library

Galazin, Jared J

2005-01-01

...), violates the principle of unity of command. Placing components of the BMDS under the control of different combatant commanders creates unnecessary friction in a process where speed of execution is measured in seconds...

Network, system, and status software enhancements for the autonomously managed electrical power system breadboard. Volume 3: Commands specification

Science.gov (United States)

Mckee, James W.

1990-01-01

This volume (3 of 4) contains the specification for the command language for the AMPS system. The volume contains a requirements specification for the operating system and commands and a design specification for the operating system and command. The operating system and commands sits on top of the protocol. The commands are an extension of the present set of AMPS commands in that the commands are more compact, allow multiple sub-commands to be bundled into one command, and have provisions for identifying the sender and the intended receiver. The commands make no change to the actual software that implement the commands.

Modeling and simulating command and control for organizations under extreme situations

CERN Document Server

Moon, Il-Chul; Kim, Tag Gon

2013-01-01

Commanding and controlling organizations in extreme situations is a challenging task in military, intelligence, and disaster management. Such command and control must be quick, effective, and considerate when dealing with the changing, complex, and risky conditions of the situation. To enable optimal command and control under extremes, robust structures and efficient operations are required of organizations. This work discusses how to design and conduct virtual experiments on resilient organizational structures and operational practices using modeling and simulation. The work illustrates key a

Apollo 10 astronauts in space suits in front of Command Module

Science.gov (United States)

1968-01-01

Three astronauts named as the prime crew of the Apollo 10 space mission. Left to right, are Eugene A. Cernan, lunar module pilot; John W. Young, command module pilot; and Thomas P. Stafford, commander.

Man/terminal interaction evaluation of computer operating system command and control service concepts. [in Spacelab

Science.gov (United States)

Dodson, D. W.; Shields, N. L., Jr.

1978-01-01

The Experiment Computer Operating System (ECOS) of the Spacelab will allow the onboard Payload Specialist to command experiment devices and display information relative to the performance of experiments. Three candidate ECOS command and control service concepts were reviewed and laboratory data on operator performance was taken for each concept. The command and control service concepts evaluated included a dedicated operator's menu display from which all command inputs were issued, a dedicated command key concept with which command inputs could be issued from any display, and a multi-display concept in which command inputs were issued from several dedicated function displays. Advantages and disadvantages are discussed in terms of training, operational errors, task performance time, and subjective comments of system operators.

The use of augmented reality in command and control situation ...

African Journals Online (AJOL)

This study identifies possible uses of augmented reality in command and control applications with specific attention to situation awareness in the South African context. Applications across the different command and control functions, as well as at the different levels of military operations are considered. The article concludes ...

Comparative Research of Navy Voluntary Education at Operational Commands

Science.gov (United States)

2017-03-01

into a national and international market. This is especially effects land-grant institutions who can educate the citizens within their state by...RESEARCH OF NAVY VOLUNTARY EDUCATION AT OPERATIONAL COMMANDS by Christopher B. Veenhuis March 2017 Thesis Co-Advisors: William Hatch Chad...COVERED Master’s thesis 4. TITLE AND SUBTITLE COMPARATIVE RESEARCH OF NAVY VOLUNTARY EDUCATION AT OPERATIONAL COMMANDS 5. FUNDING NUMBERS 6. AUTHOR(S

A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates

Science.gov (United States)

2011-01-01

Background Tuberculosis (TB) in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. Methods Descriptive study of immigration TB screening programs Results 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. Conclusions In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas outlined in this study should

United States Southern Command * Home

Science.gov (United States)

or concerns please email or call us at 305-437-2287. Testing The USAG- Miami Joint Education Testing the Air Force | The Air University | US Air Force Academy Army: Army Continued Education System | Army Marine Corps Institute | US Marine Corps Training and Education Command | US Marine Corps University Navy

Predicting compliance with command hallucinations: anger, impulsivity and appraisals of voices' power and intent.

Science.gov (United States)

Bucci, Sandra; Birchwood, Max; Twist, Laura; Tarrier, Nicholas; Emsley, Richard; Haddock, Gillian

2013-06-01

Command hallucinations are experienced by 33-74% of people who experience voices, with varying levels of compliance reported. Compliance with command hallucinations can result in acts of aggression, violence, suicide and self-harm; the typical response however is non-compliance or appeasement. Two factors associated with such dangerous behaviours are anger and impulsivity, however few studies have examined their relationship with compliance to command hallucinations. The current study aimed to examine the roles of anger and impulsivity on compliance with command hallucinations in people diagnosed with a psychotic disorder. The study was a cross-sectional design and included individuals who reported auditory hallucinations in the past month. Subjects completed a variety of self-report questionnaire measures. Thirty-two people experiencing command hallucinations, from both in-patient and community settings, were included. The tendency to appraise the voice as powerful, to be impulsive, to experience anger and to regulate anger were significantly associated with compliance with command hallucinations to do harm. Two factors emerged as significant independent predictors of compliance with command hallucinations; omnipotence and impulsivity. An interaction between omnipotence and compliance with commands, via a link with impulsivity, is considered and important clinical factors in the assessment of risk when working with clients experiencing command hallucinations are recommended. The data is highly suggestive and warrants further investigation with a larger sample. Copyright © 2013 Elsevier B.V. All rights reserved.

Secure Authentication for Remote Patient Monitoring with Wireless Medical Sensor Networks.

Science.gov (United States)

Hayajneh, Thaier; Mohd, Bassam J; Imran, Muhammad; Almashaqbeh, Ghada; Vasilakos, Athanasios V

2016-03-24

There is broad consensus that remote health monitoring will benefit all stakeholders in the healthcare system and that it has the potential to save billions of dollars. Among the major concerns that are preventing the patients from widely adopting this technology are data privacy and security. Wireless Medical Sensor Networks (MSNs) are the building blocks for remote health monitoring systems. This paper helps to identify the most challenging security issues in the existing authentication protocols for remote patient monitoring and presents a lightweight public-key-based authentication protocol for MSNs. In MSNs, the nodes are classified into sensors that report measurements about the human body and actuators that receive commands from the medical staff and perform actions. Authenticating these commands is a critical security issue, as any alteration may lead to serious consequences. The proposed protocol is based on the Rabin authentication algorithm, which is modified in this paper to improve its signature signing process, making it suitable for delay-sensitive MSN applications. To prove the efficiency of the Rabin algorithm, we implemented the algorithm with different hardware settings using Tmote Sky motes and also programmed the algorithm on an FPGA to evaluate its design and performance. Furthermore, the proposed protocol is implemented and tested using the MIRACL (Multiprecision Integer and Rational Arithmetic C/C++) library. The results show that secure, direct, instant and authenticated commands can be delivered from the medical staff to the MSN nodes.

New Global Missions for Strategic Command

National Research Council Canada - National Science Library

Graham, David

2002-01-01

.... The focus of this White Paper is on the external decisions that will be needed to provide the Command with a clear mission, and the authority, resources and organizational support necessary to perform the mission...

AMO EXPRESS: A Command and Control Experiment for Crew Autonomy

Science.gov (United States)

Stetson, Howard K.; Frank, Jeremy; Cornelius, Randy; Haddock, Angie; Wang, Lui; Garner, Larry

2015-01-01

NASA is investigating a range of future human spaceflight missions, including both Mars-distance and Near Earth Object (NEO) targets. Of significant importance for these missions is the balance between crew autonomy and vehicle automation. As distance from Earth results in increasing communication delays, future crews need both the capability and authority to independently make decisions. However, small crews cannot take on all functions performed by ground today, and so vehicles must be more automated to reduce the crew workload for such missions. NASA's Advanced Exploration Systems Program funded Autonomous Mission Operations (AMO) project conducted an autonomous command and control demonstration of intelligent procedures to automatically initialize a rack onboard the International Space Station (ISS) with power and thermal interfaces, and involving core and payload command and telemetry processing, without support from ground controllers. This autonomous operations capability is enabling in scenarios such as a crew medical emergency, and representative of other spacecraft autonomy challenges. The experiment was conducted using the Expedite the Processing of Experiments for Space Station (EXPRESS) rack 7, which was located in the Port 2 location within the U.S Laboratory onboard the International Space Station (ISS). Activation and deactivation of this facility is time consuming and operationally intensive, requiring coordination of three flight control positions, 47 nominal steps, 57 commands, 276 telemetry checks, and coordination of multiple ISS systems (both core and payload). The autonomous operations concept includes a reduction of the amount of data a crew operator is required to verify during activation or de-activation, as well as integration of procedure execution status and relevant data in a single integrated display. During execution, the auto-procedures provide a step-by-step messaging paradigm and a high level status upon termination. This

10 commandments of smile esthetics

Science.gov (United States)

Machado, Andre Wilson

2014-01-01

The search for esthetic treatment has persisted in the routine of dental professionals. Following this trend, dental patients have sought treatment with the primary aim of improving smile esthetics. The aim of this article is to present a protocol to assess patient's smile: The 10 Commandments of smile esthetics. PMID:25279532

Terrain Commander: Unattended Ground-Based Surveillance System

National Research Council Canada - National Science Library

Steadman, Bob

2000-01-01

.... Terrain Commander OASIS provides next generation target detection, classification, and tracking through smart sensor fusion of beamforming acoustic, seismic, passive infrared, and magnetic sensors...

Hybrid EEG-fNIRS-Based Eight-Command Decoding for BCI: Application to Quadcopter Control.

Science.gov (United States)

Khan, Muhammad Jawad; Hong, Keum-Shik

2017-01-01

In this paper, a hybrid electroencephalography-functional near-infrared spectroscopy (EEG-fNIRS) scheme to decode eight active brain commands from the frontal brain region for brain-computer interface is presented. A total of eight commands are decoded by fNIRS, as positioned on the prefrontal cortex, and by EEG, around the frontal, parietal, and visual cortices. Mental arithmetic, mental counting, mental rotation, and word formation tasks are decoded with fNIRS, in which the selected features for classification and command generation are the peak, minimum, and mean ΔHbO values within a 2-s moving window. In the case of EEG, two eyeblinks, three eyeblinks, and eye movement in the up/down and left/right directions are used for four-command generation. The features in this case are the number of peaks and the mean of the EEG signal during 1 s window. We tested the generated commands on a quadcopter in an open space. An average accuracy of 75.6% was achieved with fNIRS for four-command decoding and 86% with EEG for another four-command decoding. The testing results show the possibility of controlling a quadcopter online and in real-time using eight commands from the prefrontal and frontal cortices via the proposed hybrid EEG-fNIRS interface.

CCL: console command language, RSX11M V4. 0, V7. OC tutorial

Energy Technology Data Exchange (ETDEWEB)

Downward, J. G.

1981-01-01

The normal user interface to an RSX11M operating system is via MCR (Monitor Console Routine). If terminal input is not specifically requested by a task, all data or commands typed in at a user's terminal, are sent by the terminal driver to MCR for decoding. The MCR task (and its child ...SYS) decode user commands (ACT, ABORT,RUN, DEV, ETC.). Tasks installed with special names of the form ...XYZ are treated as an external MCR command. Hence if a user types, XYZ COMMANDLINE, the commandline in its entirety (or at least up to 79 characters) is sent as input to the task ...XYZ. This is the conventional way of supplying most system commands and controlling the operation of the RSX11M utility program. The limitations of this method are: (1) each task must be installed to get MCR command lines; (2) each installed task uses valuable POOL space; (3) only privileged users can INSTALL and REMOVE tasks; and (4) non-privileged users are restricted to RUNning non-installed tasks. To solve this problem, a user tailorable Console Command Language (CCL) has been implemented which allows each user to have a private task control language to pass command lines to tasks that are not installed in th system as external MCR commands.

Oracle Enterprise Manager 12c command-line interface

CERN Document Server

Pot'Vin, Kellyn; Smith, Ray

2014-01-01

Oracle Enterprise Manager 12c Command-Line Interface shows how to use Enterprise Manager's powerful scripting language to automate your database administration work and save time by scripting routine tasks, and then executing those scripts across collections of databases and instances in your environment. This book is chock full of ready-made scripting examples contributed by the authors and leading members of the community. For example, you'll find scripts and examples of commands to: Remove an Enterprise Manager agent and its related targetsQuickly create administrator accounts that are ful

1 Commande multivariable du moteur asynchrone triphasé à cage ...

African Journals Online (AJOL)

AKA BOKO

Correspondance, courriel : rabenarivo.michel@yahoo.fr. Résumé. La commande du moteur asynchrone triphasé à ... synthèse du système à l'aide du logiciel MATLAB. Mots-clés : commande, système multivariable, variation de ... of the system by MATLAB software. Keywords : control, MIMO system, frequency variation, ...

Command and Control of the U.S. Tenth Army During the Battle of Okinawa

Science.gov (United States)

2009-06-12

Army‘s XXIV Corps, commanded by Major General John R . Hodge, and the U.S. Marine Corps‘ III Amphibious Corps, commanded by Major General Roy S. Geiger...Watanabe, was activated in April 1944. Ushijima assumed command in August 1944, after Watanabe was bedridden and sent back to Japan due to chronic...great success and combat experience during the war in the Pacific. Army Major General John R . Hodge commanded the XXIV Corps. Hodge was commissioned

STS-93 Commander Eileen Collins suits up for launch

Science.gov (United States)

1999-01-01

For the third time, in the Operations and Checkout Building, STS- 93 Commander Eileen M. Collins tries on her helmet with her launch and entry suit. After Space Shuttle Columbia's July 20 and 22 launch attempts were scrubbed, the launch was again rescheduled for Friday, July 23, at 12:24 a.m. EDT. STS-93 is a five-day mission primarily to release the Chandra X-ray Observatory, which will allow scientists from around the world to study some of the most distant, powerful and dynamic objects in the universe. The STS-93 crew numbers five: Commander Collins, Pilot Jeffrey S. Ashby, and Mission Specialists Stephen A. Hawley (Ph.D.), Catherine G. Coleman (Ph.D.) and Michel Tognini of France, with the Centre National d'Etudes Spatiales (CNES). Collins is the first woman to serve as commander of a shuttle mission.

Focused Logistics: Time for Functional Command

National Research Council Canada - National Science Library

Mintzlaff, Jeffrey G

2005-01-01

.... Military's distribution system -- the parts of the Department of Defense (DoD) that manage and execute the storage and movement of supplies to military customers -- consists of multiple entities and agencies made up of separate Services and commands...

Hip fracture incidence is decreasing in the high incidence area of Oslo, Norway.

Science.gov (United States)

Støen, R O; Nordsletten, L; Meyer, H E; Frihagen, J F; Falch, J A; Lofthus, C M

2012-10-01

This study reports a significant decrease in age-adjusted incidence rates of hip fracture for women in Oslo, Norway, even compared with data from 1978/1979. Use of bisphosphonate may explain up to one third of the decline in the incidence. The aims of the present study were to report the current incidence of hip fractures in Oslo and to estimate the influence of bisphosphonates on the current incidence. Using the electronic diagnosis registers and lists from the operating theaters of the hospitals of Oslo, all patients with ICD-10 codes S72.0 and S72.1 (hip fracture) in 2007 were identified. Medical records of all identified patients were reviewed to verify the diagnosis. Age- and gender-specific annual incidence rates were calculated using the population of Oslo on January 1, 2007 as the population at risk. Data on the use of bisphosphonates were obtained from official registers. A total number of 1,005 hip fractures, 712 (71%) in women, were included. The age-adjusted fracture rates per 10,000 for the age group >50 years were 82.0 for women and 39.1 for men in 2007, compared with 110.8 and 41.4 in 1996/1997, 116.5 and 42.9 in 1988/1989, and 97.5 and 34.5 in 1978/1979, respectively. It was estimated that the use of bisphosphonates may explain up to 13% of the decline in incidence in women aged 60-69 years and up to 34% in women aged 70-79 years. The incidence of hip fractures in women in Oslo has decreased significantly during the last decade and is now at a lower level than in 1978/1979. This reduction was not evident in men. The incidence of hip fractures in Oslo is, however, still the highest in the world.

An analysis of Navy Recruiting Command's officer goaling models

OpenAIRE

Senter, Robert R.

1990-01-01

Approved for public release; distribution unlimited. This study examines the goaling models used by the Navy Recruiting Command for the Nurse Corps and Nuclear Propulsion Officer Candidate (NUPOC) programs. These two programs serve as representative samples for the numerous officer recruitment programs administered by the Navy Recruiting Command. The intent of the study is to analyze and validate the accuracy of the current goaling models, to ascertain factors which could improve the accur...

Mature data transport and command management services for the Space Station

Science.gov (United States)

Carper, R. D.

1986-01-01

The duplex space/ground/space data services for the Space Station are described. The need to separate the uplink data service functions from the command functions is discussed. Command management is a process shared by an operation control center and a command management system and consists of four functions: (1) uplink data communications, (2) management of the on-board computer, (3) flight resource allocation and management, and (4) real command management. The new data service capabilities provided by microprocessors, ground and flight nodes, and closed loop and open loop capabilities are studied. The need for and functions of a flight resource allocation management service are examined. The system is designed so only users can access the system; the problems encountered with open loop uplink access are analyzed. The procedures for delivery of operational, verification, computer, and surveillance and monitoring data directly to users are reviewed.

Collection and sharing of medical information and medical intelligence (M2I) in NATO: a transversal survey.

Science.gov (United States)

Bedubourg, Gabriel; Wiik, H; Queyriaux, B; Lausund, P; Meynard, J-B

2018-04-06

There is a requirement for adequate medical expertise to be available throughout the range of potential future operations involving members of the North Atlantic Treaty Organization (NATO). The aim of this study was to assess the collection and sharing of medical intelligence and medical information (M2I) by NATO Nations, Partner Nations and NATO Command Structure and NATO Force Structure Headquarters (NCS/NFS HQs). A transversal survey was conducted between December 2014 and March 2015 using a survey form on M2I sent to NATO Nations and Partnership for Peace (PfP) Nations as well as NCS/NFS HQs. Correctly completed responses were received from 15/40 (37.5%) of the possible NATO and PfP Nations (37.5%) and 7/8 (87.5%) of the NCS/NFS HQs (100.0%). Deficiencies in the collection of M2I data were found due to lack of specific doctrines, networks, tools, structures and organisation. The survey provided an indication even though the participation rate was low for Nations. Part of the problem is thought to be that medical information and medical intelligence often lie in different chains of command. Future directions for this research could include studying the possibilities of a new specific information technology (IT) system to collect and to share M2I. Collection and sharing of M2I within the NATO/PfP community requires facilitation in order to strengthen the basis for decision-making and force health protection. The development of a dedicated NATO IT system may be a precondition for the implementation of an efficient M2I network. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Blossom Point Satellite Tracking and Command Station

Data.gov (United States)

Federal Laboratory Consortium — FUNCTION: The Blossom Point Satellite Command and Tracking Facility (BP) provides engineering and operational support to several complex space systems for the Navy...

Joint Mission Command Implementation

Science.gov (United States)

2016-01-22

choose. The paper finds that trust is strongly influenced by the subconscious brain and treating it like a tool ignores biology and results in... bias for action and empowerment.14 Since then, the services have evaluated their own concepts of command assessing them against Dempsey’s vision. Lt...understanding, intent, and trust, only trust is strongly influenced by the subconscious brain. Treating trust like it can be taught, or a behavior that

Command and Control of Space Assets Through Internet-Based Technologies Demonstrated

Science.gov (United States)

Foltz, David A.

2002-01-01

The NASA Glenn Research Center successfully demonstrated a transmission-control-protocol/ Internet-protocol- (TCP/IP) based approach to the command and control of onorbit assets over a secure network. This is a significant accomplishment because future NASA missions will benefit by using Internet-standards-based protocols. Benefits of this Internet-based space command and control system architecture include reduced mission costs and increased mission efficiency. The demonstration proved that this communications architecture is viable for future NASA missions. This demonstration was a significant feat involving multiple NASA organizations and industry. Phillip Paulsen, from Glenn's Project Development and Integration Office, served as the overall project lead, and David Foltz, from Glenn's Satellite Networks and Architectures Branch, provided the hybrid networking support for the required Internet connections. The goal was to build a network that would emulate a connection between a space experiment on the International Space Station and a researcher accessing the experiment from anywhere on the Internet, as shown. The experiment was interfaced to a wireless 802.11 network inside the demonstration area. The wireless link provided connectivity to the Tracking and Data Relay Satellite System (TDRSS) Internet Link Terminal (TILT) satellite uplink terminal located 300 ft away in a parking lot on top of a panel van. TILT provided a crucial link in this demonstration. Leslie Ambrose, NASA Goddard Space Flight Center, provided the TILT/TDRSS support. The TILT unit transmitted the signal to TDRS 6 and was received at the White Sands Second TDRSS Ground Station. This station provided the gateway to the Internet. Coordination also took place at the White Sands station to install a Veridian Firewall and automated security incident measurement (ASIM) system to the Second TDRSS Ground Station Internet gateway. The firewall provides a trusted network for the simulated space

STS-93 Commander Collins suits up before launch

Science.gov (United States)

1999-01-01

In the Operations and Checkout Building, STS-93 Commander Eileen M. Collins gets help donning her launch and entry suit. After Space Shuttle Columbia's July 20 launch attempt was scrubbed at the T-7 second mark in the countdown, the launch was rescheduled for Thursday, July 22, at 12:28 a.m. EDT. The target landing date is July 26, 1999, at 11:24 p.m. EDT. STS-93 is a five-day mission primarily to release the Chandra X-ray Observatory, which will allow scientists from around the world to study some of the most distant, powerful and dynamic objects in the universe. The new telescope is 20 to 50 times more sensitive than any previous X- ray telescope and is expected unlock the secrets of supernovae, quasars and black holes. The STS-93 crew numbers five: Commander Collins, Pilot Jeffrey S. Ashby, and Mission Specialists Stephen A. Hawley (Ph.D.), Catherine G. Coleman (Ph.D.) and Michel Tognini of France, with the Centre National d'Etudes Spatiales (CNES). Collins is the first woman to serve as commander of a shuttle mission.

Incidence and cost of rotavirus hospitalizations in Denmark

DEFF Research Database (Denmark)

Fischer, Thea Kølsen; Nielsen, Nete Munk; Wohlfahrt, Jan

2007-01-01

In anticipation of licensure and introduction of rotavirus vaccine into the western market, we used modeling of national hospital registry data to determine the incidence and direct medical costs of annual rotavirus-associated admissions over >11 years in Denmark. Diarrhea-associated hospitalizat......In anticipation of licensure and introduction of rotavirus vaccine into the western market, we used modeling of national hospital registry data to determine the incidence and direct medical costs of annual rotavirus-associated admissions over >11 years in Denmark. Diarrhea......-associated hospitalizations coded as nonspecified viral or presumed infectious have demonstrated a marked winter peak similar to that of rotavirus-associated hospitalizations, which suggests that the registered rotavirus-coded admissions are grossly underestimated. We therefore obtained more realistic estimates by 2...... different models, which indicated 2.4 and 2.5 (for children rotavirus-associated admissions per 1,000 children per year, respectively. These admissions amount to associated direct medical costs of US $1.7-1.8 million per year. Using 2 simple...

Incidence and prevalence of nutritional and hereditary rickets in southern Denmark

DEFF Research Database (Denmark)

Beck-Nielsen, Signe; Jacobsen, Bendt; Gram, Jeppe

2009-01-01

Objective To estimate the incidence of nutritional rickets and the incidence and prevalence of hereditary rickets. Design Population-based retrospective cohort study based on a review of medical records. Methods Patients aged 0-14.9 years referred to or discharged from hospitals in Southern Denmark...... from 1985 to 2005 with a diagnosis of rickets were identified by register search and their medical records were retrieved. Patients fulfilling the diagnostic criteria of primary rickets were included. Results We identified 112 patients with nutritional rickets of whom 74% were immigrants. From 1995......-2005 the average incidence of nutritional rickets in children aged 0-14.9 years and 0-2.9 years was 2.9 and 5.8 per 100,000 per year, respectively. Among immigrant children born in Denmark the average incidence was 60 (0-14.9 years) per 100,000 per year. Ethnic Danish children were only diagnosed in early...

Hybrid EEG–fNIRS-Based Eight-Command Decoding for BCI: Application to Quadcopter Control

Science.gov (United States)

Khan, Muhammad Jawad; Hong, Keum-Shik

2017-01-01

In this paper, a hybrid electroencephalography–functional near-infrared spectroscopy (EEG–fNIRS) scheme to decode eight active brain commands from the frontal brain region for brain–computer interface is presented. A total of eight commands are decoded by fNIRS, as positioned on the prefrontal cortex, and by EEG, around the frontal, parietal, and visual cortices. Mental arithmetic, mental counting, mental rotation, and word formation tasks are decoded with fNIRS, in which the selected features for classification and command generation are the peak, minimum, and mean ΔHbO values within a 2-s moving window. In the case of EEG, two eyeblinks, three eyeblinks, and eye movement in the up/down and left/right directions are used for four-command generation. The features in this case are the number of peaks and the mean of the EEG signal during 1 s window. We tested the generated commands on a quadcopter in an open space. An average accuracy of 75.6% was achieved with fNIRS for four-command decoding and 86% with EEG for another four-command decoding. The testing results show the possibility of controlling a quadcopter online and in real-time using eight commands from the prefrontal and frontal cortices via the proposed hybrid EEG–fNIRS interface. PMID:28261084

Variation in interpretation and counselling of blood exposure incidents by different medical practitioners.

NARCIS (Netherlands)

Wijk, P.T.L. van; Pelk-Jongen, M; Wijkmans, C.J.; Voss, A.; Timen, A.; Schneeberger, P.M.

2008-01-01

BACKGROUND: Blood exposure incidents pose a risk for transmission of bloodborne pathogens for both health care workers and public health. Despite several national and international guidelines, counsellors have often different opinions about the risks caused by these incidents. Little is known about

Legacy in the Sand: The United States Army Armament, Munitions and Chemical Command in Operations Desert Shield and Desert Storm

Science.gov (United States)

1992-12-21

States Army Medical Department, over 1.5 million British-designed Small Box Respirator ( SBR ) masks, utilizing activated coconut charcoal as a filter, had...conflicts this nation will tfce-short in rjuration but of high intensity. In such a war, relance must bpp oaced upon the established stockpile and the...Supply System SAW squad automatic weapon SBA Small Business Administration SBR small box respirator SCR senior command representati’e SCRAM self-contained

U.S. Pacific Command > Organization > Organization Chart

Science.gov (United States)

Responsibility USPACOM Previous Commanders Organization Organization Chart Media News Flickr Photos Video Directory Media Inquiries Home : Organization : Organization Chart About DoD DoD Careers Join the Military

Mission Command: Elasticity, Equilibrium, Culture, and Intent

National Research Council Canada - National Science Library

Stewart, Keith G

2006-01-01

.... It is enabled by decentralization of authority and responsibility that allows subordinate commanders the latitude to plan and conduct operations based upon their understanding of the local situation...

Epidemiology of biological-exposure incidents among Spanish healthcare workers.

Science.gov (United States)

Monge, V; Mato, G; Mariano, A; Fernández, C; Fereres, J

2001-12-01

To determine the frequency and the epidemiological characteristics of biological-exposure incidents occurring among healthcare personnel. Prospective surveillance study. Participating Spanish primary-care and specialty centers from January 1994 to December 1997. 70 centers in 1994, 87 in 1995, 97 in 1996, and 104 in 1997. Absolute and relative frequencies were calculated for several variables (position held, area of care, type of injuring object, activity, etc) and for the different categories of each variable. There were 20,235 registered incidents. Annual incidence rates were as follows: 1994, 51 per 1,000; 1995, 58 per 1,000, 1996, 54 per 1,000; and 1997, 59 per 1,000. Mean age of accident victims was as follows: 1994, 35.68 (standard deviation [SD], 16.26); 1995, 33.6 (SD, 11.9); 1996,38.2 (SD, 17.27); and 1997, 36.7 (SD, 16.33) years. Of the 20,235 incidents, 15,860 (80.7%) occurred to women; 50% (9,833) accidents were among nursing staff. The type of incident most frequently reported was percutaneous injury (81.1%). The highest frequency of accidents was seen in medical and surgical areas (28% and 25.6%, respectively). Blood and blood products were the most commonly involved material (87.6%). Administration of intramuscular or intravenous medication was the activity associated with the highest accident rate (20.3%). The most frequent immediate action in response was rinsing and disinfecting (65.6%). The incident registry was highly stable in terms of incidence rates over the observation period and served to highlight the large number of incidents recorded each year. The potential implications of the results are the need to explore reasons for increased exposures in certain areas, with the aim of focusing prevention efforts, and, similarly, to establish the factors associated with diminished incidence rates to model successful measures.

Apollo 11 Command Service Module

Science.gov (United States)

1969-01-01

A close-up view of the Apollo 11 command service module ready to be mated with the spacecraft LEM adapter of the third stage. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

STS-93 Commander Eileen Collins waves to her family

Science.gov (United States)

1999-01-01

STS-93 Commander Eileen M. Collins waves to her family nearby, a last meeting before launch of mission STS-93 on July 20. Liftoff is scheduled for 12:36 a.m. EDT. The primary mission of STS-93 is the release of the Chandra X-ray Observatory, which will allow scientists from around the world to study some of the most distant, powerful and dynamic objects in the universe. The new telescope is 20 to 50 times more sensitive than any previous X- ray telescope and is expected to unlock the secrets of supernovae, quasars and black holes. The STS-93 crew numbers five: Commander Collins, Pilot Jeffrey S. Ashby, and Mission Specialists Steven A. Hawley (Ph.D.), Catherine G. Coleman (Ph.D.) and Michel Tognini of France, with the Centre National d'Etudes Spatiales (CNES). Collins is the first woman to serve as commander of a shuttle mission.

Centralized Command and Control of Theater Missile Defense: The Joint Force Missile Defense Component Coordinator

National Research Council Canada - National Science Library

Bucey, William H

2006-01-01

.... The numerous commands, decentralized command and control, and limited and expensive resources involved in TMD require changes to the joint doctrine in order to provide unity of command and economy of force...

Should the Department of Defense Establish a Unified U.S. Logistics Command?

National Research Council Canada - National Science Library

Wenzel, Frank

2008-01-01

This monograph asserts that DoD should establish a Unified Combatant Command (COCOM)-level U.S. Logistics Command (USLOGCOM). DoD should begin a deliberate 10-20 year process to establish a USLOGCOM...

Human Factors and Medical Devices

International Nuclear Information System (INIS)

Dick Sawyer

1998-01-01

Medical device hardware- and software-driven user interfaces should be designed to minimize the likelihood of use-related errors and their consequences. The role of design-induced errors in medical device incidents is attracting widespread attention. The U.S. Food and Drug Administration (FDA) is fully cognizant that human factors engineering is critical to the design of safe medical devices, and user interface design is receiving substantial attention by the agency. Companies are paying more attention to the impact of device design, including user instructions, upon the performance of those health professionals and lay users who operate medical devices. Concurrently, the FDA is monitoring human factors issues in its site inspections, premarket device approvals, and postmarket incident evaluations. Overall, the outlook for improved designs and safer device operation is bright

Basic interrupt and command structures and applications

International Nuclear Information System (INIS)

Davies, R.C.

1974-01-01

Interrupt and command structures of a real-time system are described through specific examples. References to applications of a real-time system and programing development references are supplied. (auth)

Proposal of Non-Contact Type Interface of Command Input Using Lip Motion Features

Science.gov (United States)

Sato, Yoshiyuki; Kageyama, Yoichi; Nishida, Makoto

Lip motion features are of practical use in identifying individuals. It is therefore important to develop non-contact type interface. For the interface using lip motion features, individual differences such as accents and dialects in commands should be accepted. In this paper, we propose a method to identify commands by analyzing three kinds of lip motion features. They are lip width, lip length, and ratio of width and length. The analysis is made on the basis of these features' relative values obtained from the primary and object frame. The proposed method has three steps. First, we extracted the lip motion features on the basis of both positions and shapes of lip in each frame of facial images. Second, standard patterns were created from features of six utterances per command. The standard pattern is able to reduce the relative difference in the lip motion features. Third, similarities among commands were computed by Dynamic-Programming (DP) matching. And then, the command with the largest similarity was selected as the target one. Our experimental results suggest that proposed method is useful to construct the non-contact type interface of command input using lip motion features.

Unwarranted Variation in the Medical Management of Injured Civilian Workers in the U.S. Army Medical Command

National Research Council Canada - National Science Library

Rice, William A

2005-01-01

... submitted from each Army medical treatment facility (MTF). Using hierarchical multiple linear regression, these variables were tested as potential predictors of the average total cost per case of an injured civilian employee in each MTF...

Patient Safety Incidents and Nursing Workload 1

Science.gov (United States)

Carlesi, Katya Cuadros; Padilha, Kátia Grillo; Toffoletto, Maria Cecília; Henriquez-Roldán, Carlos; Juan, Monica Andrea Canales

2017-01-01

ABSTRACT Objective: to identify the relationship between the workload of the nursing team and the occurrence of patient safety incidents linked to nursing care in a public hospital in Chile. Method: quantitative, analytical, cross-sectional research through review of medical records. The estimation of workload in Intensive Care Units (ICUs) was performed using the Therapeutic Interventions Scoring System (TISS-28) and for the other services, we used the nurse/patient and nursing assistant/patient ratios. Descriptive univariate and multivariate analysis were performed. For the multivariate analysis we used principal component analysis and Pearson correlation. Results: 879 post-discharge clinical records and the workload of 85 nurses and 157 nursing assistants were analyzed. The overall incident rate was 71.1%. It was found a high positive correlation between variables workload (r = 0.9611 to r = 0.9919) and rate of falls (r = 0.8770). The medication error rates, mechanical containment incidents and self-removal of invasive devices were not correlated with the workload. Conclusions: the workload was high in all units except the intermediate care unit. Only the rate of falls was associated with the workload. PMID:28403334

Study and realisation of cabled interfaces for the control and command of the Saturne cyclotron

International Nuclear Information System (INIS)

Devailly, Jean

1975-01-01

This research thesis addressed the assessment of needs, design and realisation of some hardware used by the Saturne cyclotron to solve problems of command and control while using connections developed for the Saturne's computer. After some generalities (description of Saturne, requirements and constraints, general statements about acquisitions and commands, selection of the acquisition and command system, codes), the author presents the different hardware for analog acquisitions, digital acquisitions, analog commands, digital commands, all-or-none control, simulators, amplifiers and memories. He reports some examples: magnetic measurements, control of ejection currents, programs. He finally presents the developed hardware

Grazing incidence angle based sensing approach integrated with fiber-optic Fourier transform infrared (FO-FTIR) spectroscopy for remote and label-free detection of medical device contaminations

Energy Technology Data Exchange (ETDEWEB)

Hassan, Moinuddin, E-mail: moinuddin.hassan@fda.hhs.gov; Ilev, Ilko [Optical Therapeutics and Medical Nanophotonics Laboratory, Division of Biomedical Physics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Maryland 20993 (United States)

2014-10-15

Contamination of medical devices has become a critical and prevalent public health safety concern since medical devices are being increasingly used in clinical practices for diagnostics, therapeutics and medical implants. The development of effective sensing methods for real-time detection of pathogenic contamination is needed to prevent and reduce the spread of infections to patients and the healthcare community. In this study, a hollow-core fiber-optic Fourier transform infrared spectroscopy methodology employing a grazing incidence angle based sensing approach (FO-FTIR-GIA) was developed for detection of various biochemical contaminants on medical device surfaces. We demonstrated the sensitivity of FO-FTIR-GIA sensing approach for non-contact and label-free detection of contaminants such as lipopolysaccharide from various surface materials relevant to medical device. The proposed sensing system can detect at a minimum loading concentration of approximately 0.7 μg/cm{sup 2}. The FO-FTIR-GIA has the potential for the detection of unwanted pathogen in real time.

The medical management of breast cancer

International Nuclear Information System (INIS)

Williams, C.J.; Buchanan, R.

1988-01-01

The text is brief and directed primarily to the breast cancer specialist. Topics include epidemiology, screening, prognostic factors, pre- and postoperative assessment, surgery, radiotherapy adjuvant endocrine therapy, and management of advanced disease. Brief chapters also address nonspecific symptoms of advanced disease, male breast cancer, and psychological considerations. Emphasis is on clinical management and review of many published controlled trials. Chapters conclude with short lists of recommendations and long alphabetic lists of reference material from the world literature. Since breast cancer continues to increase gradually in incidence and is most common in the United States, it commands attention

Incidence of complicated acute appendicitis: a single-centre retrospective study

Directory of Open Access Journals (Sweden)

Aneta Piotrowska

2017-12-01

Full Text Available Introduction : Abdominal pain has been one of the most common reasons patients seek medical care for centuries. Nowadays, together with laboratory diagnostics and imaging, we are able to make an early diagnosis. This leads to the introduction of early adequate treatment. Aim of the research : To analyse the incidence and causes of complicated acute appendicitis in one medical centre in between 2004 and 2016. Material and methods : A retrospective study covered the period from December 23, 2004 to November 07, 2016. It included 2048 cases of children between 0 and 18 years of age undergoing surgery for suspected acute appendicitis.
 Demographic and clinical characteristics as well as length of hospitalisation, antibiotics schemes, and intraoperative diagnosis were reviewed. Complicated acute appendicitis cases were distinguished and compared with the incidence in world literature. Results : The percentage of complicated acute appendicitis ranged from 39% to 60%. Complicated acute appendicitis occurs much more often in children under 5 years of age. Conclusions : The delay and failure in diagnosis of acute appendicitis results in higher incidence of complicated acute appendicitis; consequently, there are higher costs of treatment. Improving the awareness of parents and primary care physicians may allow faster diagnosis and treatment of acute appendicitis. It was noted that the reform of the National Emergency Medical Services in Poland contributed to a reduction in the incidence of complicated appendicitis.

Risk factors for sexual violence in the military: an analysis of sexual assault and sexual harassment incidents and reporting

OpenAIRE

Souder, William C., III

2017-01-01

Approved for public release; distribution is unlimited Using the 2014 RAND Military Workplace Study, this thesis studies the effects of demographics, prior victimization, deployment status, and workplace characteristics—specifically, command climate, leadership and training quality—on both incidence and reporting of sexual assault and sexual harassment. Sexual assault consists of a nonconsensual sexual act coupled with a use of force or threat thereof that is likely to cause physical harm ...

Effectively utilising a 3rd party 3D visualization component in a discrete event simulation environment for Joint Command and Control (JC2)

CSIR Research Space (South Africa)

Ramadeen, P

2009-09-01

Full Text Available Roux [1]. Figure 13 shows the how the systems were connected during the respective exercises and operations. The computer icon represents a node. 7.2 Confederation Cup The Confederation Cup is a football tournament hosted by FIFA (The Fédération... Internationale de Football Association). It was held in South Africa in June 2009. Joint Command and Control is vital in events of this nature. JC2 includes include airspace control. The system was used as an Incident Management Tool to track and log...

Strategies for Improved Hospital Response to Mass Casualty Incidents.

Science.gov (United States)

TariVerdi, Mersedeh; Miller-Hooks, Elise; Kirsch, Thomas

2018-03-19

Mass casualty incidents are a concern in many urban areas. A community's ability to cope with such events depends on the capacities and capabilities of its hospitals for handling a sudden surge in demand of patients with resource-intensive and specialized medical needs. This paper uses a whole-hospital simulation model to replicate medical staff, resources, and space for the purpose of investigating hospital responsiveness to mass casualty incidents. It provides details of probable demand patterns of different mass casualty incident types in terms of patient categories and arrival patterns, and accounts for related transient system behavior over the response period. Using the layout of a typical urban hospital, it investigates a hospital's capacity and capability to handle mass casualty incidents of various sizes with various characteristics, and assesses the effectiveness of designed demand management and capacity-expansion strategies. Average performance improvements gained through capacity-expansion strategies are quantified and best response actions are identified. Capacity-expansion strategies were found to have superadditive benefits when combined. In fact, an acceptable service level could be achieved by implementing only 2 to 3 of the 9 studied enhancement strategies. (Disaster Med Public Health Preparedness. 2018;page 1 of 13).

Lundby revisited: first incidence of mental disorders 1947-1997

DEFF Research Database (Denmark)

Bogren, Mats; Mattisson, Cecilia; Horstmann, Vibeke

2007-01-01

OBJECTIVE: To investigate how first incidence of various mental disorders changed between the periods of 1947-1972 to 1972-1997 in the Lundby cohort. METHOD: First-incidence rates of mental disorders were calculated for two 25 year periods and ten 5 year periods. RESULTS: From 1947-1972 to 1972......-1997 a decrease in almost all age- and sex-specific incidences of neurotic and organic brain disorders was observed, whereas incidence rates of psychotic disorders increased consistently in male subjects but decreased in most age intervals in female subjects. For both sexes the age-standardized 5 year period...... incidences of neurotic disorders decreased after 1972, fluctuated for psychotic disorders 1947-1997 and decreased steadily for organic disorders 1947-1997. CONCLUSIONS: The reduction in neurotic and organic brain disorder incidences may be linked to structural changes in society and medical advances...

Transportation of medical isotopes

International Nuclear Information System (INIS)

Nielsen, D.L.

1997-01-01

A Draft Technical Information Document (HNF-1855) is being prepared to evaluate proposed interim tritium and medical isotope production at the Fast Flux Test Facility (FFTF). This assessment examines the potential health and safety impacts of transportation operations associated with the production of medical isotopes. Incident-free and accidental impacts are assessed using bounding source terms for the shipment of nonradiological target materials to the Hanford Site, the shipment of irradiated targets from the FFTF to the 325 Building, and the shipment of medical isotope products from the 325 Building to medical distributors. The health and safety consequences to workers and the public from the incident-free transportation of targets and isotope products would be within acceptable levels. For transportation accidents, risks to works and the public also would be within acceptable levels. This assessment is based on best information available at this time. As the medical isotope program matures, this analysis will be revised, if necessary, to support development of a final revision to the Technical Information Document

Transportation of medical isotopes

Energy Technology Data Exchange (ETDEWEB)

Nielsen, D.L.

1997-11-19

A Draft Technical Information Document (HNF-1855) is being prepared to evaluate proposed interim tritium and medical isotope production at the Fast Flux Test Facility (FFTF). This assessment examines the potential health and safety impacts of transportation operations associated with the production of medical isotopes. Incident-free and accidental impacts are assessed using bounding source terms for the shipment of nonradiological target materials to the Hanford Site, the shipment of irradiated targets from the FFTF to the 325 Building, and the shipment of medical isotope products from the 325 Building to medical distributors. The health and safety consequences to workers and the public from the incident-free transportation of targets and isotope products would be within acceptable levels. For transportation accidents, risks to works and the public also would be within acceptable levels. This assessment is based on best information available at this time. As the medical isotope program matures, this analysis will be revised, if necessary, to support development of a final revision to the Technical Information Document.

Incidence of pelvic organ prolapse in Nigerian women.

Science.gov (United States)

Okonkwo, J. E. N.; Obiechina, N. J. A.; Obionu, C. N.

2003-01-01

OBJECTIVE: To establish the incidence and types of utero-vaginal prolapse. METHODS: Retrospective medical records analyses of women who were subjected to reconstructive pelvic surgery for various types of pelvic relaxation at the Nnamdi Azikiwe University Teaching Hospital, Nnewi and the University Of Nigeria Teaching Hospital, Enugu, Nigeria was carried out. The study was conducted from January 1996 to December 1999 during which there were 7515 surgical admissions. The inclusion criteria were those women who complained of feeling a mass in the vagina with demonAstrable descent of the anterior and/or posterior and/or apical vaginal walls and/or perineal descent. Excluded were patients who had other symptoms other than utero-vaginal prolapse and those whose grades and sites of prolapse were not determinable from the clinical or surgical notes. Also excluded were patients with nerve injury or disease, connective tissue disorders and neuromuscular diseases. The subjects were divided into two groups. Group I consisted of 54 women (age or = 40 years). The findings between those two groups were compared with reference to sites, types and degree of prolapse. Also, coexistence of pelvic relaxation and underlying medical conditions were evaluated. RESULTS: A total of 159 subjects out of 492 charts studied met the inclusion criteria for the study. In group I, mean age was 32.839 with a standard deviation (SD) of +/- 6.012 years; and in group II the mean age was 56.543 with a SD of 8.094. Hypertrophic (elongated) cervix was determined in 15 (6.3%) subjects in group I for an incidence of 1.58% per year, cystocele (vaginal anterior wall descent) was present in 21 (8.9%) women for an incidence of 2.2% per year; rectocele (posterior vaginal wall descent) was identified in 15 (6.3%) women for an incidence of 1.58% per year; vaginal cough prolapse (apical descent) was present 21 (8.9%) women for an incidence of 2.2% per year. Perineal descent was absent in this group. In group II

Incidence of pelvic organ prolapse in Nigerian women.

Science.gov (United States)

Okonkwo, J E N; Obiechina, N J A; Obionu, C N

2003-02-01

To establish the incidence and types of utero-vaginal prolapse. Retrospective medical records analyses of women who were subjected to reconstructive pelvic surgery for various types of pelvic relaxation at the Nnamdi Azikiwe University Teaching Hospital, Nnewi and the University Of Nigeria Teaching Hospital, Enugu, Nigeria was carried out. The study was conducted from January 1996 to December 1999 during which there were 7515 surgical admissions. The inclusion criteria were those women who complained of feeling a mass in the vagina with demonAstrable descent of the anterior and/or posterior and/or apical vaginal walls and/or perineal descent. Excluded were patients who had other symptoms other than utero-vaginal prolapse and those whose grades and sites of prolapse were not determinable from the clinical or surgical notes. Also excluded were patients with nerve injury or disease, connective tissue disorders and neuromuscular diseases. The subjects were divided into two groups. Group I consisted of 54 women (age or = 40 years). The findings between those two groups were compared with reference to sites, types and degree of prolapse. Also, coexistence of pelvic relaxation and underlying medical conditions were evaluated. A total of 159 subjects out of 492 charts studied met the inclusion criteria for the study. In group I, mean age was 32.839 with a standard deviation (SD) of +/- 6.012 years; and in group II the mean age was 56.543 with a SD of 8.094. Hypertrophic (elongated) cervix was determined in 15 (6.3%) subjects in group I for an incidence of 1.58% per year, cystocele (vaginal anterior wall descent) was present in 21 (8.9%) women for an incidence of 2.2% per year; rectocele (posterior vaginal wall descent) was identified in 15 (6.3%) women for an incidence of 1.58% per year; vaginal cough prolapse (apical descent) was present 21 (8.9%) women for an incidence of 2.2% per year. Perineal descent was absent in this group. In group II, there was no hypertrophic

EMS helicopter incidents reported to the NASA Aviation Safety Reporting System

Science.gov (United States)

Connell, Linda J.; Reynard, William D.

1993-01-01

The objectives of this evaluation were to: Identify the types of safety-related incidents reported to the Aviation Safety Reporting System (ASRS) in Emergency Medical Service (EMS) helicopter operations; Describe the operational conditions surrounding these incidents, such as weather, airspace, flight phase, time of day; and Assess the contribution to these incidents of selected human factors considerations, such as communication, distraction, time pressure, workload, and flight/duty impact.

A Commander in Chief's Network-Centric Odyssey

National Research Council Canada - National Science Library

Copley, E

2002-01-01

.... Each Armed Service has begun training and equipping its force using the tenets of Network-Centric Operations, but those forces come together for the first time under the combatant Commander-in-Chief...

Analysis of a radiation incident with intraoral dental radiological equipment

International Nuclear Information System (INIS)

Malone, J.F.

1996-01-01

A case is described involving a serious incident with dental radiological equipment, containing many lessons that may be applied to the preparation of other cases. The description includes an account of the incident, the circumstances surrounding it, the dosimetry, risk estimates and the medical consequences of the incident. In addition, some aspects of the associated legal proceedings are reviewed and assessed. As a result of the incident described, a number of conclusions are drawn with respect to important practices in ensuring the safety of installations and the value of evidence brought forward by expert witnesses. (author)

Incidence Rate of Canonical vs. Derived Medical Terminology in Natural Language.

Science.gov (United States)

Topac, Vasile; Jurcau, Daniel-Alexandru; Stoicu-Tivadar, Vasile

2015-01-01

Medical terminology appears in the natural language in multiple forms: canonical, derived or inflected form. This research presents an analysis of the form in which medical terminology appears in Romanian and English language. The sources of medical language used for the study are web pages presenting medical information for patients and other lay users. The results show that, in English, medical terminology tends to appear more in canonical form while, in the case of Romanian, it is the opposite. This paper also presents the service that was created to perform this analysis. This tool is available for the general public, and it is designed to be easily extensible, allowing the addition of other languages.

Public health incident management: logistical and operational aspects of the 2009 initial outbreak of H1N1 influenza in Mexico.

Science.gov (United States)

Cruz, Miguel A; Hawk, Nicole M; Poulet, Christopher; Rovira, Jose; Rouse, Edward N

2015-01-01

Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.

Rising incidence of Merkel cell carcinoma

DEFF Research Database (Denmark)

Lyhne, Dorte; Lock-Andersen, Jørgen; Dahlstrøm, Karin

2011-01-01

Abstract Merkel cell carcinoma (MCC) is a rare, aggressive, skin cancer of obscure histogenesis, the incidence of which is rising. There is no consensus on the optimal treatment. Our aim was to evaluate the staging, investigation, treatment, and follow-up of MCC in eastern Denmark, and to investi......Abstract Merkel cell carcinoma (MCC) is a rare, aggressive, skin cancer of obscure histogenesis, the incidence of which is rising. There is no consensus on the optimal treatment. Our aim was to evaluate the staging, investigation, treatment, and follow-up of MCC in eastern Denmark......, and to investigate the incidence. We suggest guidelines for treatment. First we reviewed the medical records of 51 patients diagnosed with MCC from 1995 until 2006 in eastern Denmark. The nation-wide incidence of MCC was extracted from the Danish Cancer Registry for the calculations for the period 1986-2003. We...... reviwed published papers about MCC based on a MEDLINE search. Fourteen of the 51 patients developed recurrence, and 37 (73%) died during the study period. Mean follow-up was 13 months (range 1-122). A total of 153 patients were identified in the Danish Cancer Registry, and showed that incidence rates had...

Military Medical Revolution: Military Trauma System

Science.gov (United States)

2012-01-01

receive state-of-the-art physical therapy and occupational therapy , in- cluding demanding and challenging sports equipment and virtual reality systems...Knudson MM. Into the theater: perspectives from a civilian trauma sur- geon’s visit to the combat support hospital in Balad, Iraq. Bull Am Coll Surg...following type III open tibia fracture . J Orthop Trauma. 2012;26:43 47. 52. U.S Army Medical Research and Materiel Command. Armed Forces In- stitute of

Command injection attacks, continuations, and the Lambek calculus

Directory of Open Access Journals (Sweden)

Hayo Thielecke

2016-06-01

Full Text Available This paper shows connections between command injection attacks, continuations, and the Lambek calculus: certain command injections, such as the tautology attack on SQL, are shown to be a form of control effect that can be typed using the Lambek calculus, generalizing the double-negation typing of continuations. Lambek's syntactic calculus is a logic with two implicational connectives taking their arguments from the left and right, respectively. These connectives describe how strings interact with their left and right contexts when building up syntactic structures. The calculus is a form of propositional logic without structural rules, and so a forerunner of substructural logics like Linear Logic and Separation Logic.

The Role of the NCO Inside the BCT Command Post

Science.gov (United States)

2016-11-22

formation. Doctrine 2015 introduced the importance of mission command doctrine into operations at all levels of leadership, and in the last five...utilizing tents is crucial to support the combined arms maneuver of the brigade. Physical layout of the command post can promote or hinder the ability to...equipment when a printer starting printing or a coffee maker was turned on? Understanding how PDISE configurations distribute loads in order to maintain

An Operational Commander's Guide to the Media

National Research Council Canada - National Science Library

McCartney, Michael

2005-01-01

... of the embedded reporter . The Operational Commander is wise to review media relations and the successes and pitfalls of past conflicts, and to examine closely the results of Operation Iraqi Freedom so as to...

Africa Command: U.S. Strategic Interests and the Role of the U.S. Military in Africa

National Research Council Canada - National Science Library

ploch, Lauren

2007-01-01

.... national security objectives in Africa and in its surrounding waters. U.S. military involvement on the continent is currently divided among three commands: European Command (EUCOM), Central Command (CENTCOM...

U.S. Strategic Command Chief Talks Deterrence, Partnerships During Latest SGL

OpenAIRE

Ochoa, Victoria

2017-01-01

Today@NPS The Naval Postgraduate School (NPS) welcomed U.S. Air Force Gen. John E. Hyten, Commander, U.S. Strategic Command (USSTRATCOM), for its latest Secretary of the Navy Guest Lecture (SGL), May 18 in King Auditorium. Hyten spoke about the importance of maintaining strategic deterrence and NPS' inclusion into the USSTRATCOM's Academic Alliance.

Command and Control in Littoral Operations

Science.gov (United States)

2016-05-13

at the graphics on the wall displaying the position of the various forces under his command. Only a few of his 14 ships were in formation with him...Mainz, 2d MEB Lead Planner (November 11, 2014). Moskowitz, Michael, and Nolan Noble. Dawn Blitz 2015- Observations and Analysis. Exercise

SU-E-P-07: Retrospective Analysis of Incident Reports at a Radiology Department: Feedback From Incident Reporting System

Energy Technology Data Exchange (ETDEWEB)

Kakinohana, Y; Toita, T; Heianna, J; Murayama, S [School of medicine, University of the Ryukyus, Nishihara-cho, Okinawa (Japan)

2015-06-15

Purpose: To provide an overview of reported incidents that occurred in a radiology department and to describe the most common causal source of incidents. Methods: Incident reports from the radiology department at the University of the Ryukyus Hospital between 2008 and 2013 were collected and analyzed retrospectively. The incident report form contains the following items, causal factors of the incident and desirable corrective actions to prevent recurrence of similar incidents. These items allow the institution to investigate/analyze root causes of the incidents and suggest measures to be taken to prevent further, similar incidents. The ‘causal factors of the incident’ item comprises multiple selections from among 24 selections and includes some synonymous selections. In this study, this item was re-categorized into four causal source types: (i) carelessness, (ii) lack of skill or knowledge, (iii) deficiencies in communication, and (iv) external factors. Results: There were a total of 7490 incident reports over the study period and 276 (3.7%) were identified as originating from the radiology department. The most frequent causal source type was carelessness (62%). The other three types showed similar frequencies (10–14%). The staff members involved in incidents indicate three predominant desirable corrective actions to prevent or decrease the recurrence of similar incidents. These are ‘improvement in communication’ (24%), ‘staff training/education’ (19%), and ‘daily medical procedures’ (22%), and the most frequent was ‘improvement in communication’. Even though the most frequent causal factor was related to carelessness, the most desirable corrective action indicated by the staff members was related to communication. Conclusion: Our finding suggests that the most immediate causes are strongly related to carelessness. However, the most likely underlying causes of incidents would be related to deficiencies in effective communication. At our

[Self-medication with antibiotics in Poland

NARCIS (Netherlands)

Olczak, A.; Grzesiowski, P.; Hryniewicz, W.; Haaijer-Ruskamp, F.M.

2006-01-01

Antibiotic resistance, the important public health threat, depends on antibiotic overuse/misuse. Self-medication with antibiotics is of serious medical concern. The aim of the study, as a part of SAR project (Self-medication with antibiotic in Europe) was to survey the incidence of this phenomenon.

Burn Incidence and Treatment in the U.S.

Science.gov (United States)

... News and Activities Media Contact Us Disaster Response Burn Incidence Fact Sheet Home / Who We Are / Media / ... hospitals with specialized services provided by “burn centers.” Burn Injuries Receiving Medical Treatment: 486,000 This general ...

American Joint Helicopter Command: Addressing a Lack of Operational Control of Rotary Assets

National Research Council Canada - National Science Library

Marsowicz, Brandon

2007-01-01

... to achieve unity of effort. Based on the tenets of operational command and control by Milan Vego, across all services, the United States helicopter forces fare lacking operational command and control...

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service.

NARCIS (Netherlands)

Gerritse, B.M.; Schalkwijk, A.; Pelzer, B.J.; Scheffer, G.J.; Draaisma, J.M.T.

2010-01-01

BACKGROUND: To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures

Incident reporting to BfArM - regulatory framework, results and challenges.

Science.gov (United States)

Seidel, Robin; Stößlein, Ekkehard; Lauer, Wolfgang

2016-04-01

Medical devices are manifold and one of the most innovative fields of technology. As technologies advance, former limits cease to exist and complex devices become reality. Medical devices represent a very dynamic field with high economic relevance. The manufacturer of a medical device is obliged to minimize product-related risks as well as to demonstrate compliance with the so-called "essential requirements" regarding safety and performance before placing the device on the market. Any critical incident in relation to the application of a medical device has to be reported to the competent authority for risk assessment, which in Germany is either the Federal Institute for Drugs and Medical Devices (BfArM) or the Paul Ehrlich Institute (PEI) depending on the type of device. In this article, the German regulatory framework for medical devices and the resulting tasks for BfArM are described as well as the topics of its recently installed research and development group on prospective risk identification and application safety for medical devices. Results of failure mode and root cause analyses of incident data are presented as well as further data on cases with the result "root-cause analysis not possible". Finally an outlook is given on future challenges regarding risk assessment for medical devices.

Recommendations on Future Operational Environments Command Control and Cyber Security

OpenAIRE

Goztepe, Kerim

2015-01-01

It is a well-known fact that today a nation's telecommunication networks, critical infrastructure, and information systems are vulnerable to growing number of attacks in cyberspace. Cyber space contains very different problems involving various sets of threats, targets and costs. Cyber security is not only problem of banking, communication or transportation. It also threatens core systems of army as command control. Some significant recommendations on command control (C2) and cyber security h...

Incidence of carpal tunnel syndrome in the US military population.

Science.gov (United States)

Wolf, Jennifer Moriatis; Mountcastle, Sally; Owens, Brett D

2009-09-01

Carpal tunnel syndrome (CTS) is a common disease. Its epidemiology has been evaluated previously, mostly in regional populations or in working groups, with an incidence between 1.5 and 3.5 per 1,000 person-years. We studied this diagnosis in the US military population, with the hypothesis that this young population would have a lower incidence of CTS than previously reported in general populations. The Defense Medical Epidemiology Database notes all medical encounters for all US military personnel and maintains the number of all personnel on active duty each year. We queried the database using the International Classification of Diseases, ninth revision, code 354.0 (CTS) and analyzed the personnel presenting for initial visits for the years 1998-2006. Multivariate Poisson analysis was performed, controlling for rank, gender, age, and race. The raw incidence of CTS in the US military was 3.98 per 1,000 person-years, in a population of 12,298,088 person-years. Females had a significantly higher incidence of CTS than males, with an adjusted incidence rate ratio of 3.29. CTS incidence increased by age, with the age group > or = 40 years having a significantly higher incidence. Additionally, military rank was found to be an independent risk factor for CTS, with rates higher in senior officer and enlisted groups. This suggests that occupational requirements have an effect on CTS within the military. We showed a comparable incidence of CTS between the US military and general population, with a significantly higher female cohort with a diagnosis of CTS. Increased age and advanced rank were risk factors for CTS.

Melanoma in Organ Transplant Recipients: Incidence, Outcomes and Management Considerations

Directory of Open Access Journals (Sweden)

Faisal R. Ali

2012-01-01

Full Text Available The incidence of melanoma continues to increase year on year. With better surgical techniques and medical management, greater numbers of organ transplants are being performed annually with much longer graft survival. The authors review our current understanding of the incidence of melanoma amongst organ transplant recipients, outcomes compared to the immunocompetent population, and management strategies in this burgeoning group.

Incidence of ascariasis in gastric carcinoma

Energy Technology Data Exchange (ETDEWEB)

Kim, Jong Woo; Rhee, Hak Song; Bahk, Yong Whee [St Mary' s Hospital Catholic Medical College, Seoul (Korea, Republic of)

1972-09-15

Prompted by the finding that the radiological incidence of small bowel ascariasis in the patient with gastric carcinoma was unexpectedly lower than the incidence in the normal population, a clinical study was performed to investigate possible relationship between gastric carcinoma and intestinal ascariasis. As a preliminary survey, we reviewed the radiological incidence of ascariasis in a total of 2,446 cases of upper GI series performed at the Department of Radiology, St Mary's Hospital Catholic Medical College. These included 1,573 normal subjects, 146 gastric carcinoma patients, 100 benign gastric ulcer and 249 duodenal ulcer patients and 378 other upper GI diseases. Following the preliminary study, a more accurate parasitologic study was conducted in another 578 normal subjects and 51 gastric carcinoma patients. The radiological incidences of ascaiasis in normal subjects and gastric carcinoma patients were 15.1% and 28.1%, respectively. The incidence of overall helminthiasis including ascaris lumbricoides, trichocephalus trichiurus and trichostrongyloides orientalis in normal subjects of the present series was 73.5%. This figure is virtually the same with 69.1% of the general population incidence reported by Kim, et al. (1971), but the incidence in gastric carcinoma patients was 94.1%. The high incidence pattern of overall helminthiasis in gastric carcinoma patients is, however, reversed as for as ascariasis is concerned. Thus, the incidence of ascariasis of gastric carcinoma patients was much lower than that of normal subjects (9.8% vs 19.4%). From the present observation, it is postulated that there can be some possible antagonistic relationship between evolution of gastric carcinoma and small bowel infestation of ascaris lumbricoides.

Incidence of ascariasis in gastric carcinoma

International Nuclear Information System (INIS)

Kim, Jong Woo; Rhee, Hak Song; Bahk, Yong Whee

1972-01-01

Prompted by the finding that the radiological incidence of small bowel ascariasis in the patient with gastric carcinoma was unexpectedly lower than the incidence in the normal population, a clinical study was performed to investigate possible relationship between gastric carcinoma and intestinal ascariasis. As a preliminary survey, we reviewed the radiological incidence of ascariasis in a total of 2,446 cases of upper GI series performed at the Department of Radiology, St Mary's Hospital Catholic Medical College. These included 1,573 normal subjects, 146 gastric carcinoma patients, 100 benign gastric ulcer and 249 duodenal ulcer patients and 378 other upper GI diseases. Following the preliminary study, a more accurate parasitologic study was conducted in another 578 normal subjects and 51 gastric carcinoma patients. The radiological incidences of ascaiasis in normal subjects and gastric carcinoma patients were 15.1% and 28.1%, respectively. The incidence of overall helminthiasis including ascaris lumbricoides, trichocephalus trichiurus and trichostrongyloides orientalis in normal subjects of the present series was 73.5%. This figure is virtually the same with 69.1% of the general population incidence reported by Kim, et al. (1971), but the incidence in gastric carcinoma patients was 94.1%. The high incidence pattern of overall helminthiasis in gastric carcinoma patients is, however, reversed as for as ascariasis is concerned. Thus, the incidence of ascariasis of gastric carcinoma patients was much lower than that of normal subjects (9.8% vs 19.4%). From the present observation, it is postulated that there can be some possible antagonistic relationship between evolution of gastric carcinoma and small bowel infestation of ascaris lumbricoides

A study of personality of leader and style of his co-operation in sporting command

Directory of Open Access Journals (Sweden)

Smolar I.I.

2012-12-01

Full Text Available The personality features of leader of sporting command and style of his co-operation are considered. The problems of adjusting and optimization of co-operation of leader and other players of command are selected in achievement of the set team purpose. 37 skilled sportsmen-handballers took part in research. An informal structure is exposed in commands, leaders and followers are certain. The quantitative indexes of personality features of leader, follower of sporting command are certain. Style of co-operation of leader and follower (prevailing and goodwill and quality is exposed personalities which will be realized by them in a sporting command. It is set that in interpersonality co-operation a leader will realize dominant style, and follower equal will realize dominant and benevolent styles.

PEACEKEEPING OPERATIONS MANAGEMENT. AN ANALYSIS OF CHALLENGES, CHANGES IN COMMAND ACTION AND TRAINING NEEDS

Directory of Open Access Journals (Sweden)

Ünsal SIĞRI

2015-10-01

Full Text Available The aim of this paper is to uncover emerging challenges of peacekeeping operations, determine the changes in command actions and its effects on the professional preparation of commanders by analyzing experiences of military officers. To that end the research data were collected by means of structured face-to- face interviews with voluntary participation of fourteen officers, who took charge in various peacekeeping operations. The collected data were analyzed based on the content analysis method. Findings indicate that peacekeeping operations pose specific challenges for peacekeepers, necessitate changes in command action in terms of flexibility and new precautions in terms of preparation of commanders.

Bandwidth Efficient Overlapped FSK Coded Secure Command Transmission for Medical Implant Communication Systems

Directory of Open Access Journals (Sweden)

Selman KULAÇ

2018-06-01

Full Text Available Nowadays, wireless communication systems are exploited in most health care systems. Implantable Medical Systems (IMS also have wireless communication capability. However, it is very important that secure wireless communication should be provided in terms of both patient rights and patient health. Therefore, wireless transmission systems of IMS should also be robust against to eavesdroppers and adversaries. In this study, a specific overlapped and coded frequency shift keying (FSK modulation technique is developed and security containing with low complexity is provided by this proposed technique. The developed method is suitable for wireless implantable medical systems since it provides low complexity and security as well as bandwidth efficiency.

Three dimensional visualization to support command and control

International Nuclear Information System (INIS)

Van Slambrook, G.A.

1997-04-01

Virtual reality concepts are changing the way one thinks about and with computers. The concepts have already proven their potential usefulness in a broad range of applications. This research was concerned with exploring and demonstrating the utility of virtual reality in robotics and satellite command and control applications. The robotics work addressed the need to quickly build accurate graphical models of physical environments by allowing a user to interactively build a model of a remote environment by superimposing stereo graphics onto live stereo video. The satellite work addressed the fusion of multiple data sets or models into one synergistic display for more effective training, design, and command and control of satellite systems

75 FR 67695 - U.S. Strategic Command Strategic Advisory Group Closed Meeting

Science.gov (United States)

2010-11-03

..., intelligence, and policy-related issues to the Commander, U.S. Strategic Command, during the development of the... Stockpile Assessment, Weapons of Mass Destruction, Intelligence Operations, Cyber Operations, Global Strike... these statements must be submitted no later than five business days prior to the meeting in question...

Two Approaches to Developing a Multi-Agent System for Battle Command Simulation

NARCIS (Netherlands)

Løvlid, R.A.; Alstad, A.; Mevassvik, O.M.; Reus, N.M. de; Henderson, H.C.; Vecht, B.van der; Luik, T.T.

2013-01-01

In the military, Command and Control Information Systems (C2ISs) are used for issuing commands to subordinate units. In training or decision support, simulations are used instead of live military forces. The Coalition Battle Management Language (C-BML) is currently being developed as an interface

Commande floue adaptative directe stable étendue appliquée à la ...

African Journals Online (AJOL)

Administrateur

... Machine asynchrone- Systèmes flous- Commande par logique floue- Commande adaptative- lois adaptative floue- analyse de stabilité- fonction de Lyapunov. Abstract. Today, as a result of significant progress in thearea of control of electrical machines, new techniques and approaches have emerged. In order nonlinear ...

Resources planning for radiological incidents management

Science.gov (United States)

Hamid, Amy Hamijah binti Ab.; Rozan, Mohd Zaidi Abd; Ibrahim, Roliana; Deris, Safaai; Yunus, Muhd. Noor Muhd.

2017-01-01

Disastrous radiation and nuclear meltdown require an intricate scale of emergency health and social care capacity planning framework. In Malaysia, multiple agencies are responsible for implementing radiological and nuclear safety and security. This research project focused on the Radiological Trauma Triage (RTT) System. This system applies patient's classification based on their injury and level of radiation sickness. This classification prioritizes on the diagnostic and treatment of the casualties which include resources estimation of the medical delivery system supply and demand. Also, this system consists of the leading rescue agency organization and disaster coordinator, as well as the technical support and radiological medical response teams. This research implemented and developed the resources planning simulator for radiological incidents management. The objective of the simulator is to assist the authorities in planning their resources while managing the radiological incidents within the Internal Treatment Area (ITA), Reception Area Treatment (RAT) and Hospital Care Treatment (HCT) phases. The majority (75%) of the stakeholders and experts, who had been interviewed, witnessed and accepted that the simulator would be effective to resolve various types of disaster and resources management issues.

Incidence of concussions in youth ice hockey players

OpenAIRE

Linzmeier, Kathleen A.; LaBella, Cynthia R.

2016-01-01

Investigators from the University of Pittsburg, University of Arkansas, Lake Erie College of Osteopathic Medicine, and Boston Children’s Hospital/Harvard Medical College researched the incidence of concussions in youth hockey in relation to age and activity setting.

Automated constraint checking of spacecraft command sequences

Science.gov (United States)

Horvath, Joan C.; Alkalaj, Leon J.; Schneider, Karl M.; Spitale, Joseph M.; Le, Dang

1995-01-01

Robotic spacecraft are controlled by onboard sets of commands called "sequences." Determining that sequences will have the desired effect on the spacecraft can be expensive in terms of both labor and computer coding time, with different particular costs for different types of spacecraft. Specification languages and appropriate user interface to the languages can be used to make the most effective use of engineering validation time. This paper describes one specification and verification environment ("SAVE") designed for validating that command sequences have not violated any flight rules. This SAVE system was subsequently adapted for flight use on the TOPEX/Poseidon spacecraft. The relationship of this work to rule-based artificial intelligence and to other specification techniques is discussed, as well as the issues that arise in the transfer of technology from a research prototype to a full flight system.

On Preparing for Squadron Command

Science.gov (United States)

1988-04-01

Gortler, Majur Gordon D. "Management Development---Could the Air Force Be Doing More?" Resear,;h Study, Air Command and Staff College. 1 07:3. 20...ABSTRACT (Continue on reverse If necessary and identify by block number) -This study addresses the broad issue of preparing Air Force officers for...are obsolete. SECURITY CLASSIFICATION OF THIS PAGE UNCLASSIFIED - - PREFACE This study addresses the broad Issue of preparing Air Force officers to

Environmental Licensing: an Instrument of Command and Control by Exception?

OpenAIRE

Sleman Chams, Juliette; Gestión Ambiental de la Corporación Autónoma Regional del Atlántico-CRA, autoridad ambiental del Departamento del Atlántico,; Velásquez Muñoz, Carlos Javier; Universidad del Norte (Barranquilla)

2016-01-01

This article analyzes the situation of the most important instrument of command and control existing in the Colombian environmental legislation: the environmental license. Since its first formal regulation, on behalf of Decree 1753 of August 3, 1994, has received several modifications which, apparently, have made, in spite of its importance, in an instrument of command and control by exception. The article revises on the scope of each of the modifications and the justifications put forward by...

The Road to a New Unified Command

Science.gov (United States)

2008-01-01

The Directorate of Command, Control, Communications, and Computers (C4) Systems is chartered with information architecture (including in Africa...Friday afternoon cinema presentations where a documentary or feature film covering an African historic event was played, followed by dialogue

Adjusting for the Incidence of Measurement Errors in Multilevel ...

African Journals Online (AJOL)

the incidence of measurement errors using these techniques generally revealed coefficient estimates of ... physical, biological, social and medical science, measurement errors are found. The errors are ... (M) and Science and Technology (ST).

Incidence of endocrine disorders in Indian adult male population

Directory of Open Access Journals (Sweden)

K. V. S. Hari Kumar

2017-01-01

Full Text Available Background: The comprehensive epidemiology of endocrine disorders is lacking from our country. Most of the available data pertain to the prevalence of diabetes and thyroid disorders only. We studied the incidence of endocrine disorders in a cohort of service personnel followed for a long duration. Materials and Methods: The data for this descriptive epidemiologic study were derived from the electronic medical records of the male service personnel enrolled between 1990 and 2015. They were recruited between the ages of 17 and 20 years in good health, and their morbidity data were derived from the medical records. We calculated the incidence rates as per person-years (py using appropriate statistical methods. Results: Our analysis includes 51,217 participants (median: age 33 years, range: 17–54 with a mean follow-up of 12.5 years. Yearly evaluation of the data gave a cumulative follow-up duration of 613,925 py. The incidence of diabetes, obesity, and dyslipidemia was 0.41, 0.23, and 0.12 per 1000 py, respectively. The incidence of thyroid, parathyroid, pituitary, adrenal, and metabolic bone disorders was 3.9, 8.6, 1.6, 0.81, and 0.97 per 100,000 py, respectively. Conclusion: Our cohort had lower incidence rates of endocrine disorders when compared with the Western population. Long-term epidemiological studies are essential to identify the demographic trends of the endocrine disorders in India.

Development of the Macro Command Editing Executive System for Factory Workers-Oriented Programless Visual Inspection System

Science.gov (United States)

Anezaki, Takashi; Wakitani, Kouichi; Nakamura, Masatoshi; Kubo, Hiroyasu

Because visual inspection systems are difficult to tune, they create many problems for the kaizen process. This results in increased development costs and time to assure that the inspection systems function properly. In order to improve inspection system development, we designed an easy-tuning system called a “Program-less” visual inspection system. The ROI macro command which consisted of eight kinds of shape recognition macro commands and decision, operation, control commands was built. Furthermore, the macro command editing executive system was developed by the operation of only the GUI without editing source program. The validity of the ROI macro command was proved by the application of 488 places.

Critical incidents during prehospital cardiopulmonary resuscitation: what are the problems nobody wants to talk about?

Science.gov (United States)

Hohenstein, Christian; Rupp, Peter; Fleischmann, Thomas

2011-02-01

We wanted to identify incidents that led or could have led to patient harm during prehospital cardiopulmonary resuscitation. A nationwide anonymous and Internet-based critical incident reporting system gave the data. During a 4-year period we received 548 reports of which 74 occurred during cardiopulmonary resuscitation. Human error was responsible for 85% of the incidents, whereas equipment failure contributed to 15% of the reports. Equipment failure was considered to be preventable in 61% of all the cases, whereas incidents because of human error could have been prevented in almost all the cases. In most cases, prevention can be accomplished by simple strategies with the Poka-Yoke technique. Insufficient training of emergency medical service physicians in Germany requires special attention. The critical incident reports raise concerns regarding the level of expertize provided by emergency medical service doctors.

Considerations on command and response language features for a network of heterogeneous autonomous computers

Science.gov (United States)

Engelberg, N.; Shaw, C., III

1984-01-01

The design of a uniform command language to be used in a local area network of heterogeneous, autonomous nodes is considered. After examining the major characteristics of such a network, and after considering the profile of a scientist using the computers on the net as an investigative aid, a set of reasonable requirements for the command language are derived. Taking into account the possible inefficiencies in implementing a guest-layered network operating system and command language on a heterogeneous net, the authors examine command language naming, process/procedure invocation, parameter acquisition, help and response facilities, and other features found in single-node command languages, and conclude that some features may extend simply to the network case, others extend after some restrictions are imposed, and still others require modifications. In addition, it is noted that some requirements considered reasonable (user accounting reports, for example) demand further study before they can be efficiently implemented on a network of the sort described.

The Prevalence of Painful Incidents among Young Recreational Gymnasts

OpenAIRE

Coates, Chrystal; McMurtry, C Meghan; Lingley-Pottie, Patricia; McGrath, Patrick J

2010-01-01

BACKGROUND: Although children experience pain during their daily life, research has generally focused on medical pain. Sport-related pain has not been widely studied in children and research has not examined the occurrence of painful incidents in gymnastics. The prevalence of painful incidents among children in recreational gymnastics classes and accompanying coach responses were recorded.METHODS: Sixty-one children between five and 10 years of age were observed at a gymnastics club. A checkl...

Teaching Bibliometric Analysis and MS/DOS Commands.

Science.gov (United States)

Dou, Henri; And Others

1988-01-01

Outlines the steps involved in bibliometric studies, and demonstrates the ability to execute simple studies on microcomputers by downloading files using only the capability of MS/DOS. Detailed illustrations of the MS/DOS commands used are provided. (eight references) (CLB)

[Network Design of the Spaceport Command and Control System

Science.gov (United States)

Teijeiro, Antonio

2017-01-01

I helped the Launch Control System (LCS) hardware team sustain the network design of the Spaceport Command and Control System. I wrote the procedure that will be used to satisfy an official hardware test for the hardware carrying data from the Launch Vehicle. I installed hardware and updated design documents in support of the ongoing development of the Spaceport Command and Control System and applied firewall experience I gained during my spring 2017 semester to inspect and create firewall security policies as requested. Finally, I completed several online courses concerning networking fundamentals and Unix operating systems.

Commande adaptive d'une machine asynchrone

Science.gov (United States)

Slama-Belkhodja, I.; de Fornel, B.

1996-06-01

The paper deals with an indirect self-tuning speed control for an induction motor supplied by a chopper-filter-inverter system. Input/Output models are identified with the recursive least squares algorithm and the controller adaptation is based on a pole assignement strategy. Emphasis is put on the evaluation of the parameter identification in order to avoid instabilities because of disturbances or insufficient excitations. This is especially of importance when the adaptive control is carried out in closed loop systems and without additional test signals. Simulation results show the improvement of the dynamic responses and the robustness against load variations or parameters variations (rotor resistance, inertia). Cat article décrit une stratégie de commande adaptive indirecte à Placement de Pôles (PP), appliquée à la commande en vitesse d'une machine asynchrone alimentée par un ensemble hacheur-filtre-onduleur de tension. L'algorithme des Moindres Carrés Récursifs (MCR) est utilisé pour l'identification des modèles de comportement type entrées/sorties. Un intérêt particulier est porté à la mise en oeuvre de cet algorithme et à la discussion de ses résultats, tenant compte des erreurs de modélisation et de la nature peu riche en excitations des entrées du processus. Différents régimes transitoires ont été simulés pour apprécier l'apport de cette association (MCR-PP) : démarrages et inversion des sens de rotation, à vide et en charges, applications d'échelons de couple résistant, variations paramétriques. Les résultats permettent d'illustrer, tant au niveau des performances que de la robustesse, l'apport d'une telle commande adaptive pour des entraînements électriques avec une machine asynchrone.

US Navy Transfers Research Vessel to Philippine Navy > U.S. Pacific Command

Science.gov (United States)

, 2016 EMAIL PRINT Photos 1 of 1 SAN DIEGO (April 27, 2016) - Vice Adm. Nora Tyson, left, commander of Philippines oceanographic research and study capabilities. SAN DIEGO (April 27, 2016) - Vice Adm. Nora Tyson part in that relationship," said Vice Adm. Nora Tyson, commander, U.S. 3rd Fleet. "Today, we

Scenario design : adaptive architecture for command and control experiment eight

OpenAIRE

Clark, Frankie J.

2002-01-01

Approved for public release; distribution is unlimited. The Adaptive Architectures for Command and Control (A2C2) project is an ongoing research effort sponsored by the Office of Naval Research to explore adaptation in joint command and control. The objective of the project's eighth experiment is to study the adjustments that organizations make when they are confronted with a scenario for which their organizational is ill-suited. To accomplish this, teams will each be in one of two fundame...

Incidence of hypothyroidism occurring long after iodine-131 therapy for hyperthyroidism

International Nuclear Information System (INIS)

Holm, L.E.; Lundell, G.; Israelsson, A.; Dahlgvist, I.

1982-01-01

We have studied the long-term incidence of hypothyroidism in 4,473 formerly hyperthyroid patients given I-131 therapy between 1951 and 1975. The mean age at the first I-131 treatment was 56 yr. Six percent developed hypothyroidism within one year of therapy, and 72% within 26 yr. Prior antithyroid medication did not affect the incidence of hypothyroidism. Patients cured with one dose of I-131 had a lower cumulative long-term incidence of hypothyroidism than those requiring more than one dose

CMS penalizes 758 hospitals for safety incidents

Directory of Open Access Journals (Sweden)

Robbins RA

2015-12-01

Full Text Available No abstract available. Article truncated after 150 words. The Centers for Medicare and Medicaid Services (CMS is penalizing 758 hospitals with higher rates of patient safety incidents, and more than half of those were also fined last year, as reported by Kaiser Health News (1. Among the hospitals being financially punished are some well-known institutions, including Yale New Haven Hospital, Medstar Washington Hospital Center in DC, Grady Memorial Hospital, Northwestern Memorial Hospital in Chicago, Indiana University Health, Brigham and Womens Hospital, Tufts Medical Center, University of North Carolina Hospital, the Cleveland Clinic, Hospital of the University of Pennsylvania, Parkland Health and Hospital, and the University of Virginia Medical Center (Complete List of Hospitals Penalized 2016. In the Southwest the list includes Banner University Medical Center in Tucson, Ronald Reagan UCLA Medical Center, Stanford Health Care, Denver Health Medical Center and the University of New Mexico Medical Center (for list of Southwest hospitals see Appendix 1. In total, CMS ...

SciBox, an end-to-end automated science planning and commanding system

Science.gov (United States)

Choo, Teck H.; Murchie, Scott L.; Bedini, Peter D.; Steele, R. Josh; Skura, Joseph P.; Nguyen, Lillian; Nair, Hari; Lucks, Michael; Berman, Alice F.; McGovern, James A.; Turner, F. Scott

2014-01-01

SciBox is a new technology for planning and commanding science operations for Earth-orbital and planetary space missions. It has been incrementally developed since 2001 and demonstrated on several spaceflight projects. The technology has matured to the point that it is now being used to plan and command all orbital science operations for the MErcury Surface, Space ENvironment, GEochemistry, and Ranging (MESSENGER) mission to Mercury. SciBox encompasses the derivation of observing sequences from science objectives, the scheduling of those sequences, the generation of spacecraft and instrument commands, and the validation of those commands prior to uploading to the spacecraft. Although the process is automated, science and observing requirements are incorporated at each step by a series of rules and parameters to optimize observing opportunities, which are tested and validated through simulation and review. Except for limited special operations and tests, there is no manual scheduling of observations or construction of command sequences. SciBox reduces the lead time for operations planning by shortening the time-consuming coordination process, reduces cost by automating the labor-intensive processes of human-in-the-loop adjudication of observing priorities, reduces operations risk by systematically checking constraints, and maximizes science return by fully evaluating the trade space of observing opportunities to meet MESSENGER science priorities within spacecraft recorder, downlink, scheduling, and orbital-geometry constraints.

Principles of Emergency Department facility design for optimal management of mass-casualty incidents.

Science.gov (United States)

Halpern, Pinchas; Goldberg, Scott A; Keng, Jimmy G; Koenig, Kristi L

2012-04-01

The Emergency Department (ED) is the triage, stabilization and disposition unit of the hospital during a mass-casualty incident (MCI). With most EDs already functioning at or over capacity, efficient management of an MCI requires optimization of all ED components. While the operational aspects of MCI management have been well described, the architectural/structural principles have not. Further, there are limited reports of the testing of ED design components in actual MCI events. The objective of this study is to outline the important infrastructural design components for optimization of ED response to an MCI, as developed, implemented, and repeatedly tested in one urban medical center. In the authors' experience, the most important aspects of ED design for MCI have included external infrastructure and promoting rapid lockdown of the facility for security purposes; an ambulance bay permitting efficient vehicle flow and casualty discharge; strategic placement of the triage location; patient tracking techniques; planning adequate surge capacity for both patients and staff; sufficient command, control, communications, computers, and information; well-positioned and functional decontamination facilities; adequate, well-located and easily distributed medical supplies; and appropriately built and functioning essential services. Designing the ED to cope well with a large casualty surge during a disaster is not easy, and it may not be feasible for all EDs to implement all the necessary components. However, many of the components of an appropriate infrastructural design add minimal cost to the normal expenditures of building an ED. This study highlights the role of design and infrastructure in MCI preparedness in order to assist planners in improving their ED capabilities. Structural optimization calls for a paradigm shift in the concept of structural and operational ED design, but may be necessary in order to maximize surge capacity, department resilience, and patient and

31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false In-kind donations of medicine... Licensing Policy § 597.511 In-kind donations of medicine, medical devices, and medical services. (a... incident to the provision by nongovernmental organizations that are U.S. persons of in-kind donations of...

Command History. 1968. Volume 1. Sanitized.

Science.gov (United States)

1968-01-01

battalions. Additionally, a diary captured on 19 December, Z1 kilometers southwest of Song Cau, revealed that on 19 November the author. a cadre member...the 306th and 312th ( AYA 308th) Bns. This reorga- nization was an apparent attempt by the headquarters of MR 3 to tighten its command and con- trol. (C

The incidence of child abuse in the contemporary society: a fact or ...

African Journals Online (AJOL)

The study investigated the incidence of child abuse in the contemporary society. It examined the dimension of the incidence whether it is a fact or a farce. 300 participants, from school of Nursing, Mid-wifery and Medical Laboratory of Bishop Shanahan Hospital Nsukka. 285 females and 15 males freely participated.

Multidisciplinary Treatments, Patient Characteristics, Context of Care, and Adverse Incidents in Older, Hospitalized Adults

Directory of Open Access Journals (Sweden)

Leah L. Shever

2012-01-01

Full Text Available The purpose of this study was to examine factors that contribute to adverse incidents by creating a model that included patient characteristics, clinical conditions, nursing unit context of care variables, medical treatments, pharmaceutical treatments, and nursing treatments. Data were abstracted from electronic, administrative, and clinical data repositories. The sample included older adults hospitalized during a four-year period at one, academic medical facility in the Midwestern United States who were at risk for falling. Relational databases were built and a multistep, statistical model building analytic process was used. Total registered nurse (RN hours per patient day (HPPD and HPPDs dropping below the nursing unit average were significant explanatory variables for experiencing an adverse incident. The number of medical and pharmaceutical treatments that a patient received during hospitalization as well as many specific nursing treatments (e.g., restraint use, neurological monitoring were also contributors to experiencing an adverse incident.

A Descriptive Analysis of Incidents Reported by Community Aged Care Workers.

Science.gov (United States)

Tariq, Amina; Douglas, Heather E; Smith, Cheryl; Georgiou, Andrew; Osmond, Tracey; Armour, Pauline; Westbrook, Johanna I

2015-07-01

Little is known about the types of incidents that occur to aged care clients in the community. This limits the development of effective strategies to improve client safety. The objective of the study was to present a profile of incidents reported in Australian community aged care settings. All incident reports made by community care workers employed by one of the largest community aged care provider organizations in Australia during the period November 1, 2012, to August 8, 2013, were analyzed. A total of 356 reports were analyzed, corresponding to a 7.5% incidence rate per client year. Falls and medication incidents were the most prevalent incident types. Clients receiving high-level care and those who attended day therapy centers had the highest rate of incidents with 14% to 20% of these clients having a reported incident. The incident profile indicates that clients on higher levels of care had higher incident rates. Incident data represent an opportunity to improve client safety in community aged care. © The Author(s) 2014.

Future command and control systems should combine decision support and personalization interface features

NARCIS (Netherlands)

Streefkerk, J.W.; Smets, N.; Varkevisser, M.; Hiemstra-Van Mastrigt, S.

2014-01-01

On future battlefields, increasingly more sensor information will become available for military commanders to support mission execution. To improve (shared) situational awareness, decision-making and communication in face of this increased amount of information, the design of command and control

Patients' Perceptions of Nurses' Behaviour That Influence Patient Participation in Nursing Care: A Critical Incident Study

Directory of Open Access Journals (Sweden)

Inga E. Larsson

2011-01-01

Full Text Available Patient participation is an important basis for nursing care and medical treatment and is a legal right in many Western countries. Studies have established that patients consider participation to be both obvious and important, but there are also findings showing the opposite and patients often prefer a passive recipient role. Knowledge of what may influence patients' participation is thus of great importance. The aim was to identify incidents and nurses' behaviours that influence patients' participation in nursing care based on patients' experiences from inpatient somatic care. The Critical Incident Technique (CIT was employed. Interviews were performed with patients (=17, recruited from somatic inpatient care at an internal medical clinic in West Sweden. This study provided a picture of incidents, nurses' behaviours that stimulate or inhibit patients' participation, and patient reactions on nurses' behaviours. Incidents took place during medical ward round, nursing ward round, information session, nursing documentation, drug administration, and meal.

Software and commands on VAX CERN. User's guide

International Nuclear Information System (INIS)

Balashov, V.K.; Trofimov, V.V.

1990-01-01

This guide describes a structure of applications software, which is available at VAX-type computers in JINR. The software includes program libraries, scientific programs and commands developed at CERN. 20 refs

Religious Expression or Religious Coercion: Commanders Caught in the Cross-Fire

Science.gov (United States)

2010-02-17

ministers as chaplains with a rank of captain and a salary of $20 per month. With this action , the American government officially established the military...leadership and chaplains resulting in Airmen’s insidious harm or ruin? Are they being unconstitutionally raped of religious rights? Are groups like...military’s hierarchal command structure bears careful scrutiny of any potential coercive action created by a commander sharing his or her faith. Military

Circuit of synchronous logic for the transmission of safety commands

International Nuclear Information System (INIS)

Uberschlag, J.

1969-01-01

The author reports the development of a control-command circuit for the transmission of binary commands related to the safety of nuclear reactors. He presents the main design criteria (operation safety, provided safety level, flexibility, technical adaptation), the definition of the operation principle (inputs, logical outputs), the properties of a logic system. He evokes redundancy issues, and presents the system structure, proposes a possible sketch of the logic circuit. He describes the possible options for intermediate circuits and logic outputs, and tests to be performed

Decontamination of persons and other medical measures

International Nuclear Information System (INIS)

Ohlenschlaeger, L.

1982-01-01

Medical measures in case of radiation damages are discussed on the basis of five potential categories of radiation incidents or accidents, namely contaminations, incorporations, external local and general radiation over-exposures, contaminated wounds, and combinations of radiation damages and conventional injuries. Considerations are made for diagnostic and therapeutic initial measures especially in case of minor and moderate radiation accidents. The medical emergency planning is reviewed by means of definitions used in the practical handling of radiation incidents or accidents. The parameters are: extent of the incident or accident, number of persons involved, severity of the radiation damage. Based on guiding symptoms the criteria for the classification into minor, moderate or severe radiation accidents are discussed. (orig./RW)

Trust: The Key to the Success of Mission Command in the Joint Force

Science.gov (United States)

2015-05-18

Malaysia , Kuala Lumpur: International Conference on ISO9000. Schmidt, Todd A. “Design, Mission Command and the Network: Enabling Organization...trust.pdf. Steele , Dennis. “Setting the Azimuth for Joint Force 2020: Globally Integrated Operations and Mission Command.” Army Magazine, November

NET: an inter-computer file transfer command

International Nuclear Information System (INIS)

Burris, R.D.

1978-05-01

The NET command was defined and supported in order to facilitate file transfer between computers. Among the goals of the implementation were greatest possible ease of use, maximum power (i.e., support of a diversity of equipment and operations), and protection of the operating system

APOLLO 11 COMMANDER NEIL ARMSTRONG IN SIMULATOR

Science.gov (United States)

1969-01-01

Apollo 11 commander Neil Armstrong is going through flight training in the lunar module simulator situated in the flight crew training building at KSC. Armstrong will pilot the lunar module to a moon landing on July 20, following launch from KSC on July 16.

Implementation of the Asthma Practice Guideline in the Army Medical Department: Evaluation of Process and Effects

National Research Council Canada - National Science Library

Farley, Donna O; Cretin, Shan; Vernez, Georges; Pieklik, Suzanne; Quiter, Elaine; Ashwood, J. S; Tu, Wenli

2005-01-01

.... The Quality Management Directorate of the Army Medical Command (MEDCOM) contracted with RAND to work as a partner in the development and testing of guideline implementation methods for ultimate application to an Army-wide guideline program...

Receiver Operator Characteristic Tools Graphic User Interface Extension for R Commander

Directory of Open Access Journals (Sweden)

Daniel Corneliu LEUCUŢA

2015-12-01

Full Text Available Background: Receiver Operator Characteristic (ROC curve, is a graphical plot which presents the performance of a binary classifier when the discrimination cutoff is varied. The aim of this work was to create an extension for R Commander that offers a graphical user interface for Receiver Operator Characteristic tools provided by several existing command line accessible packages like pROC and ROCR. Material and Methods: The extension was built and tested with R version 3.2.0 and R Commander 2.1-7. Results: We built an extension called RcmdrPlugin.ROC that we uploaded on the CRAN servers. The extension adds a new menu called ROC, along with two submenus pROC and ROCR that broadly corresponds to commands available to access the functions of these packages. The pROC menu offers several commands: to plot a ROC curve for a dataset or for a logistic regression model, to compare paired and unpaired ROC curves, each providing the following tabs: General (to select the variables for the analysis, and options for switching cases with controls; Smoothing (allowing the user to select different types of smoothing – binominal, density, distributions like normal, lognormal, ...; AUC (to specify the partial area under the curve (AUC options, CI (to select the options of confidence intervals (CI – the level, computing method: DeLong, bootstrap, ...; Plot (for the plotting options. The ROCR dialogue window offers more options in choosing the performance measures for the plot. Conclusion: The RcmdrPlugin.ROC extension helps less advanced users of R accessing ROC tools in a friendly graphical user interface.

Commande floue adaptative directe stable étendue appliquée à la ...

African Journals Online (AJOL)

Administrateur

Commande floue adaptative directe stable étendue appliquée à la machine asynchrone. Stable direct adaptive fuzzy control extended applied to the asynchronous machine. Malika Fodil. 1. , Said Barkat. 1 et Djamel Boukhetala. 2. 1Université de M'sila, BP 166, rue Ichbillia, M'sila, Algérie. 2Laboratoire de Commande des ...

Post Cold War transformation of the medical function in support of the deployed soldier.

Science.gov (United States)

Vekerdi, Zoltan

2013-12-01

This article summarises the changes that resulted in, and still act towards, final implementation of a separate medical function in operational medical support. This article is not intended to represent an historical account, but to provide concise supplemental material for decision makers to position medical under the commander, which enables medical staff to support and care for the troops and which can be used in the best possible way as an image forming factor for the force. The aim of this article is to clearly articulate the necessity for independence of the medical and logistic functions, while recognising the need for continued close coordination.

[Obstetric hysterectomy. Incidence, indications and complications].

Science.gov (United States)

Vázquez, Juan A Reveles; Rivera, Geannyne Villegas; Higareda, Salvador Hernández; Páez, Fernando Grover; Vega, Carmen C Hernández; Segura, Agustin Patiño

2008-03-01

Obstetric hysterectomy is indicated when patient's life is at risk, and it is a procedure that requires a highly experienced and skilled medical team to solve any complication. To identify incidence, indications, and complications of obstetric hysterectomy within a high-risk population. Transversal, retrospective study from July 1st 2004 to June 30 2006 at Unidad Medica de Alta Especialidad, Hospital de Ginecoobstetricia, Centro Medico Nacional de Occidente, IMSS. There were reviewed 103 patient' files with obstetric hysterectomy. Incidence was calculated, and clinical and socio-demographic characteristics, indications, and complications of obstetric hysterectomy identified and expressed in frequency, percentages, and central tendency measurements. Incidence of obstetric hysterectomy was 8 cases within every 1,000 obstetric consultation. Age average was 31.1 +/- 5.1 years. 72.8% had cesarean surgery history. Main indication was placenta previa associated with placenta accreta (33%), followed by uterine hypotony (22.3%). Complications were hypovolemic shock (56.3%), and vesical injuries (5.8%). There were no maternal deaths. Cesarean history induces higher obstetric hysterectomy incidence in women with high-risk pregnancy, due to its relation to placentation disorders, as placenta previa that increases hemorrhage possibility, and thus, maternal morbidity and mortality.

Gesture Commanding of a Robot with EVA Gloves

Data.gov (United States)

National Aeronautics and Space Administration — Gestures commands allow a human operator to directly interact with a robot without the use of intermediary hand controllers. There are two main types of hand gesture...

Cognitive Systems Modeling and Analysis of Command and Control Systems

Science.gov (United States)

Norlander, Arne

2012-01-01

Military operations, counter-terrorism operations and emergency response often oblige operators and commanders to operate within distributed organizations and systems for safe and effective mission accomplishment. Tactical commanders and operators frequently encounter violent threats and critical demands on cognitive capacity and reaction time. In the future they will make decisions in situations where operational and system characteristics are highly dynamic and non-linear, i.e. minor events, decisions or actions may have serious and irreversible consequences for the entire mission. Commanders and other decision makers must manage true real time properties at all levels; individual operators, stand-alone technical systems, higher-order integrated human-machine systems and joint operations forces alike. Coping with these conditions in performance assessment, system development and operational testing is a challenge for both practitioners and researchers. This paper reports on research from which the results led to a breakthrough: An integrated approach to information-centered systems analysis to support future command and control systems research development. This approach integrates several areas of research into a coherent framework, Action Control Theory (ACT). It comprises measurement techniques and methodological advances that facilitate a more accurate and deeper understanding of the operational environment, its agents, actors and effectors, generating new and updated models. This in turn generates theoretical advances. Some good examples of successful approaches are found in the research areas of cognitive systems engineering, systems theory, and psychophysiology, and in the fields of dynamic, distributed decision making and naturalistic decision making.

APOLLO 16 COMMANDER JOHN YOUNG ENTERS ALTITUDE CHAMBER FOR TESTS

Science.gov (United States)

1971-01-01

Apollo 16 commander John W. Young prepares to enter the lunar module in an altitude chamber in the Manned Spacecraft Operations Building at the spaceport prior to an altitude run. During the altitude run, in which Apollo 16 lunar module pilot Charles M. Duke also participated, the chamber was pumped down to simulate pressure at an altitude in excess of 200,000 feet. Young, Duke and command module pilot Thomas K. Mattingly II, are training at the Kennedy Space Center for the Apollo 16 mission. Launch is scheduled from Pad 39A, March 17, 1972.

A database application for the Naval Command Physical Readiness Testing Program

OpenAIRE

Quinones, Frances M.

1998-01-01

Approved for public release; distribution is unlimited 1T21 envisions a Navy with tandardized, state-of-art computer systems. Based on this vision, Naval database management systems will also need to become standardized among Naval commands. Today most commercial off the shelf (COTS) database management systems provide a graphical user interface. Among the many Naval database systems currently in use, the Navy's Physical Readiness Program database has continued to exist at the command leve...

A Joint Force Medical Command is Required to Fix Combat Casualty Care

Science.gov (United States)

2017-10-05

DISTRIBUTION STATEMENT: A Approved for Public Release Distribution is Unlimited The views expressed herein are those of the author(s) and do not...MHS) is required to provide medical operational forces for military and contingency operations while also providing services that maintain a healthy...provide timely support of joint forcible entry or other contingencies requiring rapid response. Further, the complexity and cost of the beneficiary

Analysis of Recruit Attrition from the Navy's Delayed Entry Program and Recruit Training Command

National Research Council Canada - National Science Library

Neuhalfen, Jon K

2007-01-01

.... The analysis uses the PRIDE database, provided by Commander, Navy Recruiting Command. Trend analyses are used to identify significant changes in enlistment and attrition behavior for recruits who joined from fiscal years 1998 through 2005...

Charles Bernard Puestow (1902-1973): American surgeon and commander of the 27th Evacuation Hospital during the Second World War.

Science.gov (United States)

Bosmia, Anand N; Christein, John D

2017-08-01

Dr. Charles Bernard Puestow (1902-1973) was an American surgeon who is well known for developing the longitudinal pancreaticojejunostomy, which is known as the "Puestow procedure" in his honor. Puestow served in the American military during the Second World War and commanded the 27th Evacuation Hospital, which provided medical and surgical services to wounded individuals in Europe and North Africa. In 1946, he founded the surgical residency training program at the Hines Veterans Hospital, which was the first such program in the United States based at a veterans hospital.

Pediatric melanoma: incidence, treatment, and prognosis

Directory of Open Access Journals (Sweden)

Saiyed FK

2017-04-01

Full Text Available Faiez K Saiyed,1 Emma C Hamilton,1 Mary T Austin,1,2 1Department of Pediatric Surgery, McGovern Medical School, 2Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: The purpose of this review is to outline recent advancements in diagnosis, treatment, and prevention of pediatric melanoma. Despite the recent decline in incidence, it continues to be the deadliest form of skin cancer in children and adolescents. Pediatric melanoma presents differently from adult melanoma; thus, the traditional asymmetry, border irregularity, color variegation, diameter >6 mm, and evolution (ABCDE criteria have been modified to include features unique to pediatric melanoma (amelanotic, bleeding/bump, color uniformity, de novo/any diameter, evolution of mole. Surgical and medical management of pediatric melanoma continues to derive guidelines from adult melanoma treatment. However, more drug trials are being conducted to determine the specific impact of drug combinations on pediatric patients. Alongside medical and surgical treatment, prevention is a central component of battling the incidence, as ultraviolet (UV-related mutations play a central role in the vast majority of pediatric melanoma cases. Aggressive prevention measures targeting sun safety and tanning bed usage have shown positive sun-safety behavior trends, as well as the potential to decrease melanomas that manifest later in life. As research into the field of pediatric melanoma continues to expand, a prevention paradigm needs to continue on a community-wide level. Keywords: melanoma, pediatric, adolescent, childhood

Thyroid cancer incidence in Corsica. 1998 - 2006

International Nuclear Information System (INIS)

Pascal, Laurence; Lasalle, Jean-Luc

2012-07-01

In France, Corsica appears to be one of the most exposed regions to the fallout from the Chernobyl accident. Taking into account the scientific knowledge at that time, it was decided to focus studies on thyroid cancers. A study was carried out in order to estimate thyroid cancer incidence in Corsica for the periods 1998-2001 and 2002-2006. The study identified incident thyroid cancer cases between 1998 and 2006 among residents in Corsica. Data were collected using information from the hospitals (PMSI) and the local health insurance funds (ALD). Cases were validated through medical records before inclusion in the study. Over the period of study, 342 cases of thyroid cancer, rather women and relatively young patients, were identified in Corsica. Incidence rate of the thyroid cancer was high, but stable among men, and with a slight increase among women, particularly between 2002 and 2006. However, incidence rate and clinical characteristics of thyroid cancer in Corsica are not exceptional and are similar to those in other French districts. (authors)

Monte Carlo Investigation of Photon Beam Characteristics and its Variation with Incident Electron Beam Parameters for Indigenous Medical Linear Accelerator.

Science.gov (United States)

Mishra, Subhalaxmi; Dixit, P K; Selvam, T Palani; Yavalkar, Sanket S; Deshpande, D D

2018-01-01

A Monte Carlo model of a 6 MV medical linear accelerator (linac) unit built indigenously was developed using the BEAMnrc user code of the EGSnrc code system. The model was benchmarked against the measurements. Monte Carlo simulations were carried out for different incident electron beam parameters in the study. Simulation of indigenously developed linac unit has been carried out using the Monte Carlo based BEAMnrc user-code of the EGSnrc code system. Using the model, percentage depth dose (PDD), and lateral dose profiles were studied using the DOSXYZnrc user code. To identify appropriate electron parameters, three different distributions of electron beam intensity were investigated. For each case, the kinetic energy of the incident electron was varied from 6 to 6.5 MeV (0.1 MeV increment). The calculated dose data were compared against the measurements using the PTW, Germany make RFA dosimetric system (water tank MP3-M and 0.125 cm 3 ion chamber). The best fit of incident electron beam parameter was found for the combination of beam energy of 6.2 MeV and circular Gaussian distributed source in X and Y with FWHM of 1.0 mm. PDD and beam profiles (along both X and Y directions) were calculated for the field sizes from 5 cm × 5 cm to 25 cm × 25 cm. The dose difference between the calculated and measured PDD and profile values were under 1%, except for the penumbra region where the maximum deviation was found to be around 2%. A Monte Carlo model of indigenous linac (6 MV) has been developed and benchmarked against the measured data.

Determinants of medication incident reporting, recovery, and learning in community pharmacies: a conceptual model.

Science.gov (United States)

Boyle, Todd A; Mahaffey, Thomas; Mackinnon, Neil J; Deal, Heidi; Hallstrom, Lars K; Morgan, Holly

2011-03-01

Evidence suggests that the underreporting of medication errors and near misses, collectively referred to as medication incidents (MIs), in the community pharmacy setting, is high. Despite the obvious negative implications, MIs present opportunities for pharmacy staff and regulatory authorities to learn from these mistakes and take steps to reduce the likelihood that they reoccur. However, these activities can only take place if such errors are reported and openly discussed. This research proposes a model of factors influencing the reporting, service recovery, and organizational learning resulting from MIs within Canadian community pharmacies. The conceptual model is based on a synthesis of the literature and findings from a pilot study conducted among pharmacy management, pharmacists, and pharmacy technicians from 13 community pharmacies in Nova Scotia, Canada. The purpose of the pilot study was to identify various actions that should be taken to improve MI reporting and included staff perceptions of the strengths and weaknesses of their current MI-reporting process, desired characteristics of a new process, and broader external and internal activities that would likely improve reporting. Out of the 109 surveys sent, 72 usable surveys were returned (66.1% response rate). Multivariate analysis of variance found no significant differences among staff type in their perceptions of the current or new desired system but were found for broader initiatives to improve MI reporting. These findings were used for a proposed structural equation model (SEM). The SEM proposes that individual-perceived self-efficacy, MI process capability, MI process support, organizational culture, management support, and regulatory authority all influence the completeness of MI reporting, which, in turn, influences MI service recovery and learning. This model may eventually be used to enable pharmacy managers to make better decisions. By identifying risk factors that contribute to low MI

Full Spectrum Operations: An Analysis of Course Content at the Command and General Staff College

National Research Council Canada - National Science Library

Turner, II, Frank L

2008-01-01

.... This monograph examined the Intermediate Level Education, the Advanced Military Studies Program, and the Tactical Commanders Development Program curricula at the Command and General Staff College...

Command and Control : faster decisions

CSIR Research Space (South Africa)

Venter, C

2012-10-01

Full Text Available Decisions 4th Biennial Conference Presented by Cobus Venter 10 October 2012 ? CSIR 2012 Slide 2 Command and Control Planning TaskingControl Assessment Si tu at io n DPSS Objective Ends Increase the Defence Capability of South Africa Ways... Supported by SAAB THALES Global CommsDPSS DDSI ERGOTECH Cooperation to make it work Example 1: Future SA Army Strategy and Joint Operations Support Campus Experiment Example 1: Future SA Army Strategy and Joint Operations Support Campus Experiment...

Economics of paternalism: the hidden costs of self-commanding strategies

Directory of Open Access Journals (Sweden)

Christophe Salvat

2015-11-01

Full Text Available The paper proposes an economic assessment of paternalism by comparing different alternative responses to dynamically inconsistent behaviors consecutive to hyperbolic discounting. Two main types of action are possible, self-commanding strategies and paternalism The first category includes personal rules and pre-commitment The second can be subcategorized between coercive and non-coercive forms of paternalism, which are respectively associated (although it is debatable with legal paternalism and with ‘nudges’. Despite being self-inflicted, self-commanding strategies are actually not cost free and can result in a dramatic cutback of people’s freedom of choice. Likewise, legal paternalism can, on occasion, be less harmful than personal rules or pre-commitment; similarly, nudges can be more invasive and less effective than their proponents want us to believe. The aim of this paper is not to propose any standardized form of response to irrational behavior (whatever that may mean but to argue, on the contrary, that every case should be individually appraised. Individual situations can be remedied by self-commanding strategies or by paternalistic policies, either in isolation or in combination.

Tactical Command and Control in the Combined Arms Battalion Task Force,

Science.gov (United States)

1988-03-08

described as [ •follows. -.. Acquire information in the basic categories of mission, enemy, terrain, and troops available on a * continual basis through a...became the basic unit." 55 A study by Dr. Gabel describes a wide range of organizational and -*"" control structures which were ultimately used to...FreLelonolSystell each orce evel Commander * Procedures/acioa otrlS a / eCommunication $ 0’ Automation/// _. Other Notion’$ Command *e Facilities ’/ a nd Control

Incidence and prevalence of hospital-acquired infections in a cohort of patients admitted to medical departments

DEFF Research Database (Denmark)

Petersen, Martin Haubro; Holm, Morten Olskjær; Pedersen, Svend Stenvang

2010-01-01

INTRODUCTION: Hospital-acquired infections (HAI) are a significant cause of morbidity and mortality. Only point prevalence analyses of HAI have been recorded in Denmark. The aim of this study was to investigate the incidence and prevalence of HAI in patients admitted to departments of internal.......7-10.6). Exposure to bladder catheter was associated with an increased risk of urinary tract infection, incidence rate ratio 4.9; (95% CI 1.8-11.5). For the initial 14 days of hospitalization, the incidence of HAI was independent, while the prevalence increased linearly with duration of admittance. CONCLUSION......: The incidence of HAI was relatively constant during the initial 14-day-period of hospitalization, suggesting that shortening the period will have no major impact on the incidence of HAI. The prevalence was 9.7%, which is in line with results from prior studies....

A self-learning rule base for command following in dynamical systems

Science.gov (United States)

Tsai, Wei K.; Lee, Hon-Mun; Parlos, Alexander

1992-01-01

In this paper, a self-learning Rule Base for command following in dynamical systems is presented. The learning is accomplished though reinforcement learning using an associative memory called SAM. The main advantage of SAM is that it is a function approximator with explicit storage of training samples. A learning algorithm patterned after the dynamic programming is proposed. Two artificially created, unstable dynamical systems are used for testing, and the Rule Base was used to generate a feedback control to improve the command following ability of the otherwise uncontrolled systems. The numerical results are very encouraging. The controlled systems exhibit a more stable behavior and a better capability to follow reference commands. The rules resulting from the reinforcement learning are explicitly stored and they can be modified or augmented by human experts. Due to overlapping storage scheme of SAM, the stored rules are similar to fuzzy rules.

Smartphone apps for cardiopulmonary resuscitation training and real incident support: a mixed-methods evaluation study.

Science.gov (United States)

Kalz, Marco; Lenssen, Niklas; Felzen, Marc; Rossaint, Rolf; Tabuenca, Bernardo; Specht, Marcus; Skorning, Max

2014-03-19

No systematic evaluation of smartphone/mobile apps for resuscitation training and real incident support is available to date. To provide medical, usability, and additional quality criteria for the development of apps, we conducted a mixed-methods sequential evaluation combining the perspective of medical experts and end-users. The study aims to assess the quality of current mobile apps for cardiopulmonary resuscitation (CPR) training and real incident support from expert as well as end-user perspective. Two independent medical experts evaluated the medical content of CPR apps from the Google Play store and the Apple App store. The evaluation was based on pre-defined minimum medical content requirements according to current Basic Life Support (BLS) guidelines. In a second phase, non-medical end-users tested usability and appeal of the apps that had at least met the minimum requirements. Usability was assessed with the System Usability Scale (SUS); appeal was measured with the self-developed ReactionDeck toolkit. Out of 61 apps, 46 were included in the experts' evaluation. A consolidated list of 13 apps resulted for the following layperson evaluation. The interrater reliability was substantial (kappa=.61). Layperson end-users (n=14) had a high interrater reliability (intraclass correlation 1 [ICC1]=.83, Ptraining and real incident support are available, very few are designed according to current BLS guidelines and offer an acceptable level of usability and hedonic quality for laypersons. The results of this study are intended to optimize the development of CPR mobile apps. The app ranking supports the informed selection of mobile apps for training situations and CPR campaigns as well as for real incident support.

Command and Control for Distributed Lethality

Science.gov (United States)

2017-06-01

extended communications between the AFP CDR and the CCDR are required. As shown in Figure 20, the principle command relationships are between...frequency (RF) communications are limited by maximum antenna height of each surface platform without an airborne relay. LOS is estimated with an online ...documents the interconnections and relationship of information flow and the system requirements for maintaining the interconnection links during a

Advances in Discrete-Event Simulation for MSL Command Validation

Science.gov (United States)

Patrikalakis, Alexander; O'Reilly, Taifun

2013-01-01

In the last five years, the discrete event simulator, SEQuence GENerator (SEQGEN), developed at the Jet Propulsion Laboratory to plan deep-space missions, has greatly increased uplink operations capacity to deal with increasingly complicated missions. In this paper, we describe how the Mars Science Laboratory (MSL) project makes full use of an interpreted environment to simulate change in more than fifty thousand flight software parameters and conditional command sequences to predict the result of executing a conditional branch in a command sequence, and enable the ability to warn users whenever one or more simulated spacecraft states change in an unexpected manner. Using these new SEQGEN features, operators plan more activities in one sol than ever before.

Incidence and Speciation of Candida Species among Non-gravid ...

African Journals Online (AJOL)

This study investigated the incidence and speciation of Candida species among non-gravid young females, using commercially available chromogenic Candida speciation media (CHROM agar) for the identification/speciation of medically important yeast and yeastlike organisms in a routine clinical mycology laboratory.

U.S. Special Operations Command Training and Education Program

National Research Council Canada - National Science Library

Gimble, Thomas

1996-01-01

.... Special Operations Command (USCINCSOC), to train assigned forces to meet special operations mission taskings and to ensure interoperability with conventional forces and other special operations forces (SOF...

Incidence of Gastric Cancer in Marrakech and Casablanca, Morocco

International Nuclear Information System (INIS)

Smith, B. L.; Watkins, K.; Soliman, A. S.

2015-01-01

Gastric cancer is the fifth most common cancer globally with over 70% of new cases occurring in developing countries. In Morocco, oncologists in Marrakech suspected higher frequency of gastric cancer compared to Casablanca, a city 150 kilometers away. This study calculated age-specific, sex-specific, and total incidence rates of gastric cancer in Marrakech and was compared to the Casablanca population-based cancer registry. Using medical records from Center Hospital University Mohammad VI and reports from 4 main private pathology laboratories in Marrakech, we identified 774 patients for the period 2008-2012. Comparison of rates showed higher age-specific incidence in Marrakech in nearly all age groups for both genders. A higher total incidence in Marrakech than in Casablanca was found with rates of 5.50 and 3.23 per 100,000, respectively. Incidence was significantly higher among males in Marrakech than males in Casablanca (7.19 and 3.91 per 100,000, resp.) and females in Marrakech compared to females in Casablanca (3.87 and 2.58 per 100,000, resp.). Future studies should address possible underestimation of gastric cancer in Marrakech, estimate incidence in other regions of Morocco, and investigate possible risk factors to explain the difference in rates.Gastric cancer is the fifth most common cancer globally with over 70% of new cases occurring in developing countries. In Morocco, oncologists in Marrakech suspected higher frequency of gastric cancer compared to Casablanca, a city 150 kilometers away. This study calculated age-specific, sex-specific, and total incidence rates of gastric cancer in Marrakech and was compared to the Casablanca population-based cancer registry. Using medical records from Center Hospital University Mohammad VI and reports from 4 main private pathology laboratories in Marrakech, we identified 774 patients for the period 2008-2012. Comparison of rates showed higher age-specific incidence in Marrakech in nearly all age groups for both

Implementing UPDM to develop command and control systems

CSIR Research Space (South Africa)

Oosthuizen, R

2016-09-01

Full Text Available Systems engineering is an established approach to develop systems, including complex sociotechnical systems such as Command and Control (C2) Systems. These systems often occur through introduction of a new technology into an existing system...

[Second victim : Critical incident stress management in clinical medicine].

Science.gov (United States)

Schiechtl, B; Hunger, M S; Schwappach, D L; Schmidt, C E; Padosch, S A

2013-09-01

Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.

Geostatistics: a common link between medical geography, mathematical geology, and medical geology.

Science.gov (United States)

Goovaerts, P

2014-08-01

Since its development in the mining industry, geostatistics has emerged as the primary tool for spatial data analysis in various fields, ranging from earth and atmospheric sciences to agriculture, soil science, remote sensing, and more recently environmental exposure assessment. In the last few years, these tools have been tailored to the field of medical geography or spatial epidemiology, which is concerned with the study of spatial patterns of disease incidence and mortality and the identification of potential 'causes' of disease, such as environmental exposure, diet and unhealthy behaviours, economic or socio-demographic factors. On the other hand, medical geology is an emerging interdisciplinary scientific field studying the relationship between natural geological factors and their effects on human and animal health. This paper provides an introduction to the field of medical geology with an overview of geostatistical methods available for the analysis of geological and health data. Key concepts are illustrated using the mapping of groundwater arsenic concentration across eleven Michigan counties and the exploration of its relationship to the incidence of prostate cancer at the township level.

Ethnicity and incidence of Hodgkin lymphoma in Canadian population

Directory of Open Access Journals (Sweden)

Spinelli John J

2009-05-01

Full Text Available Abstract Background Research has shown that ethnicity is a significant predictor of Hodgkin lymphoma (HL. Variations in cancer incidence among ethnic groups in the same country can lead to important information in the search for etiological factors. Other risk factors important in the etiology of HL are medical history and exposure to pesticides. In this report we investigated the association between ethnicity and HL in the presence of medical history, and exposure to pesticides. Methods The data resulting from a matched population-based case-control study conducted in six provinces of Canada (Ontario, Quebec, Manitoba, Saskatchewan, Alberta, and British Columbia was analyzed to determine whether or not there was any association between ethnicity and incidence of HL when adjusted for personal medical history and pesticide exposure. Information on ethnicity, personal medical history, and pesticide exposure was collected by questionnaires via mail on 316 men diagnosed with HL; and on 1506 controls. A conditional logistic regression was utilized and results were presented as odds ratios and 95% confidence intervals. Results In our study population, the distribution of ethnic groups was: 38.5% North American, 15% British, 8.4% Western European, 8.2% Eastern European, 1.7% Asian, 1.4% Scandinavian and 27% of other ethnic origin. Compared to North Americans (i the risk of HL was greater among the Eastern European descendents (Odds Ratio (ORadj: 1.82; 95% confidence interval (CI: 1.02, 3.25 and Western European (ORadj: 1.62; 95% CI: 0.95–2.76 descent population (borderline significance at 5% level; and (ii the risk of HL was lower in Asian descents. Diagnosis with measles (ORadj: 0.72, 95% C.I.: 0.53–0.98 and/or positive history of allergy desensitization shots (ORadj: 0.55, 95% C.I.: 0.30–0.99 were negatively associated with the incidence of HL, while diagnosis with acne (ORadj: 2.12, 95% C.I.: 1.19–3.78, shingles (ORadj: 2.41, 95% C.I.: 1.38�

Artificial Intelligence Applied to the Command, Control, Communications, and Intelligence of the U.S. Central Command.

Science.gov (United States)

1983-06-06

these components will be presented. 4.17 °°,. CHAPTER III FOOTNOTES 1. Arron Barr and Edward A. Feigenbaum, eds., Te Handbook gf Artificial Inteligence ol...RD-R137 205 ARTIFICIAL INTELLIGENCE APPLIED TO THE COMIMAND CONTROL i/i COMMUNICATIONS RND..(U) ARMY WAR COLL CARLISLE BARRACKS U PA J N ENVART 06...appropriate mlitary servic or *swesmment aency. ARTIFICIAL INTELLIGENCE APPLIED TO THE COMMAND, CONTROL, COMMUNICATIONS, AND INTELLIGENCE OF THE U.S. CENTRAL

32 CFR 700.880 - Duties of the prospective commanding officer of a ship.

Science.gov (United States)

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Duties of the prospective commanding officer of a ship. 700.880 Section 700.880 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS The Commanding Officer Special...

When Contractors Deploy: A Guide for the Operational Commander

National Research Council Canada - National Science Library

Buhler, Carl

2000-01-01

.... Furthermore, this paper also lists four recommendations for operational commanders and the military on how to better integrate contractors into the military effort, especially during hostile combat situations...

Incidences and variations of hospital acquired venous thromboembolism in Australian hospitals: a population-based study.

Science.gov (United States)

Assareh, Hassan; Chen, Jack; Ou, Lixin; Hillman, Ken; Flabouris, Arthas

2016-09-22

Data on hospital-acquired venous thromboembolism (HA-VTE) incidence, case fatality rate and variation amongst patient groups and health providers is lacking. We aim to explore HA-VTE incidences, associated mortality, trends and variations across all acute hospitals in New South Wales (NSW)-Australia. A population-based study using all admitted patients (aged 18-90 with a length of stay of at least two days and not transferred to another acute care facility) in 104 NSW acute public and private hospitals during 2002-2009. Poisson mixed models were used to derive adjusted rate ratios (IRR) in presence of patient and hospital characteristics. Amongst, 3,331,677 patients, the incidence of HA-VTE was 11.45 per 1000 patients and one in ten who developed HA-VTE died in hospital. HA-VTE incidence, initially rose, but subsequently declined, whereas case fatality rate consistently declined by 22 % over the study period. Surgical patients were 128 % (IRR = 2.28, 95 % CI: 2.19-2.38) more likely to develop HA-VTE, but had similar case fatality rates compared to medical patients. Private hospitals, in comparison to public hospitals had a higher incidence of HA-VTE (IRR = 1.76; 95 % CI: 1.42-2.18) for medical patients. However, they had a similar incidence (IRR = 0.91; 95 % CI: 0.75-1.11), but a lower mortality (IRR = 0.59; 95 % CI: 0.47-0.75) amongst surgical patients. Smaller public hospitals had a lower HA-VTE incidence rate compared to larger hospitals (IRR  1.71). Hospitals with a lower reported HA-VTE incidence tended to have a higher HA-VTE case fatality rate. Despite the decline in HA-VTE incidence and case fatality, there were large variations in incidents between medical and surgical patients, public and private hospitals, and different hospital groups. The causes of such differences warrant further investigation and may provide potential for targeted interventions and quality improvement initiatives.

Sexual harassment during clinical clerkships in Dutch medical schools.

Science.gov (United States)

Rademakers, Jany J D J M; van den Muijsenbergh, Maria E T C; Slappendel, Geerte; Lagro-Janssen, Antoine L M; Borleffs, Jan C C

2008-05-01

Sexual harassment of medical students has been the focus of many international studies. Prevalence rates from 18% to over 60% have been reported. However, a Dutch study at Nijmegen Medical School found the prevalence rate to be lower (13.3% in the total group; 20% among female students only). We aimed to identify whether Nijmegen constitutes a positive sample of Dutch medical schools or whether incidents of sexual harassment are less prevalent in the Netherlands than elsewhere, and to establish if and how these experiences impact the professional lives of students. Students received a semi-structured questionnaire containing questions about their experiences of sexual harassment during clerkships. The questions referred to students' reactions to any incidents, the possible consequences for their wellbeing or professional functioning and the way cases of sexual harassment were handled. The prevalence of sexual harassment was significantly higher in Utrecht than in Nijmegen. In both studies rates were relatively low compared with international data. Nevertheless, 1 in 3-5 Dutch female medical students had experienced unwelcome sexual attention from patients, colleagues or supervisors. Three of 10 students who had experienced such an incident stated that it had a negative impact on their functioning afterwards. Prevalence rates of sexual harassment in medical schools in the Netherlands are low compared with international rates. However, the number of women students who experience sexual harassment is still 1 in 3-5. The occurrence of and ways to deal with these incidents should be important topics in the training of medical students and supervisors.

Military Assistance Command, Vietnam: The Imperative of Pol-Mil Unity. ACSC Quick-Look 05-12

National Research Council Canada - National Science Library

Weaver, Michael

2005-01-01

...), when General William Westmoreland assumed command. The MAAG continued to assist the development of the South Vietnamese Armed Forces, but the command change fragmented its operational efforts among the MACV staff...

[New possibilities in emergency medical transportation and emergency services of Polish Medical Air Rescue].

Science.gov (United States)

Gałazkowski, Robert

2010-01-01

In Poland, two types of medical services are accomplished by the Medical Air Rescue (MAR) operating all over the country: emergency transport from the incident scene to hospital and inter-hospital transport. Helicopters or planes are used for this purpose. In 2009, helicopters performed 4359 flights to incidents and 1537 inter-hospital transports whereas planes performed 589 inter-hospital ambulance and 196 rescue flights. MAR operates from 17 bases of the Helicopter Emergency Medical Service (HEMS) and one airbase. Helicopters are mainly used when medical transport is emergent, within the operational region of a given base whereas planes when the distance between the present and target airports exceeds 250 km. In 2008, new modern aircraft were introduced to HEMS-helicopters EC 135. They fulfil all requirements of air transport regulations and are adjusted to visual (VFR) and instrumental (IFR) flights rules, at day and night. The medical cabin of EC 135 is ergonomic and functional considering the majority of rescue activities under life-saving circumstances. It is equipped with ventilator, defibrillator, infusion pumps etc. Defibrillators have 12-lead ECG, E(T)CO2, SpO2, NIBP, and IBP modules. Transport ventilators can work in a variety of ventilation modes including CMV, SIMV, SVV, BILEVEL, PCV, ASB, PPV and CPAP. The purchase of helicopters with modern avionic and medical configuration ensures high quality services of MAR for many years to come.

Command and Control Planning and Teamwork: Exploring the Future

National Research Council Canada - National Science Library

Sterling, Bruce S; Lickteig, Carl W

2000-01-01

.... This paper examines how participant ratings of command and control planning and observer assessments of teamwork were related in a series of futuristic missions conducted by the Mounted Maneuver...

From Sensory Space to Motor Commands: Lessons from Saccades

National Research Council Canada - National Science Library

Optican, L

2001-01-01

.... We conclude that intrinsic brain signals might represent non-physical signals, such as desired sensory states, approximate motor drives, and distributed motor commands, rather than physical signals (e.g...

Command and Control (C2) in Joint Operations: Separate Functions, their Purpose, and Application to Battle Command in the 2lst Century

National Research Council Canada - National Science Library

Hampton, David

1998-01-01

The command and control function at the operational level is the most important operations function because it ties together the other functions at all levels of war across the range of military operations...

AMO EXPRESS: A Command and Control Experiment for Crew Autonomy Onboard the International Space Station

Science.gov (United States)

Stetson, Howard K.; Haddock, Angie T.; Frank, Jeremy; Cornelius, Randy; Wang, Lui; Garner, Larry

2015-01-01

NASA is investigating a range of future human spaceflight missions, including both Mars-distance and Near Earth Object (NEO) targets. Of significant importance for these missions is the balance between crew autonomy and vehicle automation. As distance from Earth results in increasing communication delays, future crews need both the capability and authority to independently make decisions. However, small crews cannot take on all functions performed by ground today, and so vehicles must be more automated to reduce the crew workload for such missions. NASA's Advanced Exploration Systems Program funded Autonomous Mission Operations (AMO) project conducted an autonomous command and control experiment on-board the International Space Station that demonstrated single action intelligent procedures for crew command and control. The target problem was to enable crew initialization of a facility class rack with power and thermal interfaces, and involving core and payload command and telemetry processing, without support from ground controllers. This autonomous operations capability is enabling in scenarios such as initialization of a medical facility to respond to a crew medical emergency, and representative of other spacecraft autonomy challenges. The experiment was conducted using the Expedite the Processing of Experiments for Space Station (EXPRESS) rack 7, which was located in the Port 2 location within the U.S Laboratory onboard the International Space Station (ISS). Activation and deactivation of this facility is time consuming and operationally intensive, requiring coordination of three flight control positions, 47 nominal steps, 57 commands, 276 telemetry checks, and coordination of multiple ISS systems (both core and payload). Utilization of Draper Laboratory's Timeliner software, deployed on-board the ISS within the Command and Control (C&C) computers and the Payload computers, allowed development of the automated procedures specific to ISS without having to certify

Design and Implementation of the Automatic Assessment System for the Command and Control Specialty in Ships

Directory of Open Access Journals (Sweden)

Zhang Hao

2017-01-01

Full Text Available On the basis of analyzing the actual demand of automated assessment system for the command and control specialty in ships, the thought of the overall design of automated assessment system for the command and control specialty in ships is given, and the concrete realization methods of the user login module, test paper operation module and system maintenance module are studied and demonstrated. The proposed design idea and implementation method of automated assessment system for the command and control specialty in ships is scientific, efficient and practical, and provides reference for the exploitation of automated assessment system for the command and control specialty in ships.

STS-26 Commander Hauck in fixed based (FB) shuttle mission simulator (SMS)

Science.gov (United States)

1988-01-01

STS-26 Discovery, Orbiter Vehicle (OV) 103, Commander Frederick H. Hauck, wearing comunications kit assembly headset and seated in the commanders seat on forward flight deck, looks over his shoulder toward the aft flight deck. A flight data file (FDF) notebook rests on his lap. The STS-26 crew is training in the fixed base (FB) shuttle mission simulator (SMS) located in JSC Mission Simulation and Training Facility Bldg 5.

Social Factors Determine the Emergency Medical Admission Workload

Directory of Open Access Journals (Sweden)

Seán Cournane

2017-06-01

Full Text Available We related social factors with the annual rate of emergency medical admissions using census small area statistics. All emergency medical admissions (70,543 episodes in 33,343 patients within the catchment area of St. James’s Hospital, Dublin, were examined between 2002 and 2016. Deprivation Index, Single-Parent status, Educational level and Unemployment rates were regressed against admission rates. High deprivation areas had an approximately fourfold (Incidence Rate Ratio (IRR 4.0 (3.96, 4.12 increase in annual admission rate incidence/1000 population from Quintile 1(Q1, from 9.2/1000 (95% Confidence Interval (CI: 9.0, 9.4 to Q5 37.3 (37.0, 37.5. Single-Parent families comprised 40.6% of households (95% CI: 32.4, 49.7; small areas with more Single Parents had a higher admission rate-IRR (Q1 vs. for Q5 of 2.92 (95% CI: 2.83, 3.01. The admission incidence rate was higher for Single-Parent status (IRR 1.50 (95% CI: 1.46, 1.52 where the educational completion level was limited to primary level (Incidence Rate Ratio 1.45 (95% CI: 1.43, 1.47. Small areas with higher educational quintiles predicted lower Admission Rates (IRR 0.85 (95% CI: 0.84, 0.86. Social factors strongly predict the annual incidence rate of emergency medical admissions.

Commanding Generation Y: How Generation X Military Leaders Can Better Utilize Generational Tendencies

Science.gov (United States)

2013-03-21

generation ( Baby Boomers ). Although the profession of arms is a time-honored tradition steeped in discipline...senior leadership generational tendencies. Command; Leadership; Generation ; Baby Boomer ; Generation X; Generation Y Unclass Unclass Unclass UU 32 USMC...enable commanders to better lead Generation Y within the U.S. military. Discussion: Baby Boomers , Generation X, and Generation Y are

THE ANALYSIS OF CANCER INCIDENCE AND MORTALITY AMONG THE POPULATION OF THE MOSCOW REGION IN 2014

Directory of Open Access Journals (Sweden)

A. N. Gurov

2015-01-01

Full Text Available Rationale: Analysis of the cancer incidence and mortality in the population is of major importance for planning of measures aimed at improvement of organization of medical care to cancer patients, ensuring high quality and availability of this type of medical care.Aim: To evaluate cancer-related incidence and mortality rates and structure among the population of the Moscow Region depending on patient gender and tumor localization.Materials and methods: The estimation and analysis of incidence and mortality rates was performed based on the Reporting Form of the Federal Statistic Surveillance #7 “Information on disorders related to malignant tumors” in the Moscow Region in 2014. For mortality analysis, including that among pediatric patients, we used data from the State Statistics Service of the Moscow Region.Results: In 2014, there were 25 600 new cases of malignancies diagnosed in the Moscow Region, that corresponded to the incidence rate of 363.2 per 100,000 of the population. The leading types of newly diagnosed tumors in men were prostate cancer, as well as tracheal, bronchial and lung cancers (54.2 and 47.0 per 100,000 of male population, respectively. In women, the highest incidence rates were found for breast and skin cancers (86.0 and 58.9 per 100,000 of female population, respectively. According to the data from Rosstat, in 2014, the overall cancer mortality rate in the Moscow Region was 228.1 per 100,000 of the population. Among the causes of cancer mortality in men, the leading one was tracheal, bronchial and lung cancer (22.2%, followed by stomach cancer (13.3% and prostate cancer (8.1%. In women, the leading cause of cancer mortality was breast cancer (16.6%, followed by ovarian, uterine and cervical cancers (14.1% and stomach cancer (11.4%.Conclusion: Based on the results of medical and statistical analysis of cancer incidence and mortality rates, the main direction of improvement of medical care to cancer patients and the ways

Plant Habitat Telemetry / Command Interface and E-MIST

Science.gov (United States)

Walker, Uriae M.

2013-01-01

Plant Habitat (PH) is an experiment to be taken to the International Space Station (ISS) in 2016. It is critical that ground support computers have the ability to uplink commands to control PH, and that ISS computers have the ability to downlink PH telemetry data to ground support. This necessitates communication software that can send, receive, and process, PH specific commands and telemetry. The objective of the Plant Habitat Telemetry/ Command Interface is to provide this communication software, and to couple it with an intuitive Graphical User Interface (GUI). Initial investigation of the project objective led to the decision that code be written in C++ because of its compatibility with existing source code infrastructures and robustness. Further investigation led to a determination that multiple Ethernet packet structures would need to be created to effectively transmit data. Setting a standard for packet structures would allow us to distinguish these packets that would range from command type packets to sub categories of telemetry packets. In order to handle this range of packet types, the conclusion was made to take an object-oriented programming approach which complemented our decision to use the C++ programming language. In addition, extensive utilization of port programming concepts was required to implement the core functionality of the communication software. Also, a concrete understanding of a packet processing software was required in order to put aU the components of ISS-to-Ground Support Equipment (GSE) communication together and complete the objective. A second project discussed in this paper is Exposing Microbes to the Stratosphere (EMIST). This project exposes microbes into the stratosphere to observe how they are impacted by atmospheric effects. This paper focuses on the electrical and software expectations of the project, specifically drafting the printed circuit board, and programming the on-board sensors. The Eagle Computer-Aided Drafting

Interfaces and Integration of Medical Image Analysis Frameworks: Challenges and Opportunities.

Science.gov (United States)

Covington, Kelsie; McCreedy, Evan S; Chen, Min; Carass, Aaron; Aucoin, Nicole; Landman, Bennett A

2010-05-25

Clinical research with medical imaging typically involves large-scale data analysis with interdependent software toolsets tied together in a processing workflow. Numerous, complementary platforms are available, but these are not readily compatible in terms of workflows or data formats. Both image scientists and clinical investigators could benefit from using the framework which is a most natural fit to the specific problem at hand, but pragmatic choices often dictate that a compromise platform is used for collaboration. Manual merging of platforms through carefully tuned scripts has been effective, but exceptionally time consuming and is not feasible for large-scale integration efforts. Hence, the benefits of innovation are constrained by platform dependence. Removing this constraint via integration of algorithms from one framework into another is the focus of this work. We propose and demonstrate a light-weight interface system to expose parameters across platforms and provide seamless integration. In this initial effort, we focus on four platforms Medical Image Analysis and Visualization (MIPAV), Java Image Science Toolkit (JIST), command line tools, and 3D Slicer. We explore three case studies: (1) providing a system for MIPAV to expose internal algorithms and utilize these algorithms within JIST, (2) exposing JIST modules through self-documenting command line interface for inclusion in scripting environments, and (3) detecting and using JIST modules in 3D Slicer. We review the challenges and opportunities for light-weight software integration both within development language (e.g., Java in MIPAV and JIST) and across languages (e.g., C/C++ in 3D Slicer and shell in command line tools).

Computer-assisted command and control for Chooz B

International Nuclear Information System (INIS)

Anon.

1995-01-01

A new type of command and control system has been installed at the Chooz B nuclear power plant. A key feature of the system is a man/machine interface designed to provide operators with on-screen assistance more quickly than ever. (Author)

Acquisition and Development of System Command (SYSCOM) Technical Manuals

National Research Council Canada - National Science Library

2003-01-01

... (NAVSEA) and Space and Naval Warfare Systems Command (SPAWAR). TMs are the primary information source for technical training, installation, operation, testing, maintenance, and repair associated with NAVSEA/SPAWAR systems or equipment...

FRONT COMMANDS IN WINTER OF 1917 IN COMBATING CRISIS OF FOOD SUPPLY TO FIELD FORCES

Directory of Open Access Journals (Sweden)

Максим Викторович Оськин

2015-12-01

Full Text Available This article considers the problem of food supply to the Eastern front in the winter of 1917 during World War I. In the conditions of the food supply crisis the military authorities managed to avoid the famine in the army. The Front Command and the Supreme Command took some measures to resolve this problem. Attracting extra workers for harvesting, clarity of the resources allocation, calculations of the government funds allocation- all these actions bolstered the army's efforts on the home front. A considerable role in this work was played by Emperor Nicholas II, who timely and positively reacted to the suggestions of the military commanders on the issue. Overall, the Russian military command coped with this problem in the conditions of the general crisis of supplies.

Implications of a Non-Unified Command System and the Need for a Unified Command System in Zambia

Science.gov (United States)

2015-06-12

aspects. It has been found that Zambia’s two attempts to unify its system happened during the one party participatory democracy era. Since the coming...and its Implication for Democracy ,” in Ourselves to Know: Civil Military Relations and Defence Transformation in Southern Africa, eds. Rocky Williams...adopted a multiparty system of government under the Movement for Multi-Party Democracy (MMD) which decided to revert to independent commands. As

First responder tracking and visualization for command and control toolkit

Science.gov (United States)

Woodley, Robert; Petrov, Plamen; Meisinger, Roger

2010-04-01

In order for First Responder Command and Control personnel to visualize incidents at urban building locations, DHS sponsored a small business research program to develop a tool to visualize 3D building interiors and movement of First Responders on site. 21st Century Systems, Inc. (21CSI), has developed a toolkit called Hierarchical Grid Referenced Normalized Display (HiGRND). HiGRND utilizes three components to provide a full spectrum of visualization tools to the First Responder. First, HiGRND visualizes the structure in 3D. Utilities in the 3D environment allow the user to switch between views (2D floor plans, 3D spatial, evacuation routes, etc.) and manually edit fast changing environments. HiGRND accepts CAD drawings and 3D digital objects and renders these in the 3D space. Second, HiGRND has a First Responder tracker that uses the transponder signals from First Responders to locate them in the virtual space. We use the movements of the First Responder to map the interior of structures. Finally, HiGRND can turn 2D blueprints into 3D objects. The 3D extruder extracts walls, symbols, and text from scanned blueprints to create the 3D mesh of the building. HiGRND increases the situational awareness of First Responders and allows them to make better, faster decisions in critical urban situations.

STS-93 Commander Collins waves after suiting up before launch

Science.gov (United States)

1999-01-01

During final launch preparations in the Operations and Checkout Building, STS-93 Commander Eileen M. Collins waves after donning her launch and entry suit. After Space Shuttle Columbia's July 20 launch attempt was scrubbed at the T-7 second mark in the countdown, the launch was rescheduled for Thursday, July 22, at 12:28 a.m. EDT. The target landing date is July 26, 1999, at 11:24 p.m. EDT. STS-93 is a five-day mission primarily to release the Chandra X-ray Observatory, which will allow scientists from around the world to study some of the most distant, powerful and dynamic objects in the universe. The new telescope is 20 to 50 times more sensitive than any previous X-ray telescope and is expected unlock the secrets of supernovae, quasars and black holes. The STS-93 crew numbers five: Commander Collins, Pilot Jeffrey S. Ashby, and Mission Specialists Stephen A. Hawley (Ph.D.), Catherine G. Coleman (Ph.D.) and Michel Tognini of France, with the Centre National d'Etudes Spatiales (CNES). Collins is the first woman to serve as commander of a shuttle mission.

From medical astrology to medical astronomy: sol-lunar and planetary theories of disease in British medicine, c. 1700-1850.

Science.gov (United States)

Harrison, M

2000-03-01

After 1700, astrology lost the respect it once commanded in medical circles. But the belief that the heavens influenced bodily health persisted - even in learned medicine - until well into the nineteenth century. The continuing vitality of these ideas owed much to the new empirical and mechanical outlook of their proponents. Taking their cue from the work of Robert Boyle and Richard Mead, a number of British practitioners amassed statistical evidence which purported to prove the influence of the Moon upon fevers and other diseases. Such ideas flourished in the colonies and in the medical services of the armed forces, but their exponents were not marginal men. Some, like James Lind, were widely respected and drew support for their views from such influential figures as Erasmus Darwin.

The Operations Intent and Effects Model: A Command and Control Methodology for Increased Automation

Science.gov (United States)

2013-06-01

Command and Control Process (Curts and Cambell , 2006), in that an order describes Actions that cause Effects. The Effects in turn change the Current...Interoperability Workshop. Orlando, FL, USA, IEEE CS Press. Curts, R. J., Dr. & Cambell , D. E., Dr. (2006) “Rethinking Command & Control”. Paper 005

Using Arm and Hand Gestures to Command Robots during Stealth Operations

Science.gov (United States)

Stoica, Adrian; Assad, Chris; Wolf, Michael; You, Ki Sung; Pavone, Marco; Huntsberger, Terry; Iwashita, Yumi

2012-01-01

Command of support robots by the warfighter requires intuitive interfaces to quickly communicate high degree-of-freedom (DOF) information while leaving the hands unencumbered. Stealth operations rule out voice commands and vision-based gesture interpretation techniques, as they often entail silent operations at night or in other low visibility conditions. Targeted at using bio-signal inputs to set navigation and manipulation goals for the robot (say, simply by pointing), we developed a system based on an electromyography (EMG) "BioSleeve", a high density sensor array for robust, practical signal collection from forearm muscles. The EMG sensor array data is fused with inertial measurement unit (IMU) data. This paper describes the BioSleeve system and presents initial results of decoding robot commands from the EMG and IMU data using a BioSleeve prototype with up to sixteen bipolar surface EMG sensors. The BioSleeve is demonstrated on the recognition of static hand positions (e.g. palm facing front, fingers upwards) and on dynamic gestures (e.g. hand wave). In preliminary experiments, over 90% correct recognition was achieved on five static and nine dynamic gestures. We use the BioSleeve to control a team of five LANdroid robots in individual and group/squad behaviors. We define a gesture composition mechanism that allows the specification of complex robot behaviors with only a small vocabulary of gestures/commands, and we illustrate it with a set of complex orders.